[NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases

[OS] CDC/ATSDR Formative Research and Tool Development

OMB: 0920-1154

IC ID: 261557

Documents and Forms
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Document Type
Form and Instruction
Form and Instruction
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Form and Instruction
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Information Collection (IC) Details

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[NCEZID] In-depth Interviews with Hispanic or Latina Women on the Topic of Climate Change and Infectious Diseases 0920-1154-23HR
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1154 RECRUITMENT SCREENER In-Depth Interviews with Hispanic or Latina Women Attachment 1 - Screener.docx Yes Yes Fillable Fileable
Form 0920-1154 CONSENT FORM In-Depth Interviews with Hispanic or Latina Women Attachment 2 - Consent Form.docx Yes Yes Fillable Fileable Signable
Form and Instruction 0920-1154 MODERATOR INTERVIEW GUIDE In-Depth Interviews with Hispanic or Latina Women Attachment 3 - Interview Guide.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

90 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 90 0 0 0 0 90
Annual IC Time Burden (Hours) 18 0 0 0 0 18
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for Approval under the “Generic Clearance (OMB Control Number: 0920-1154) GenIC Request Form - 081423.docx 08/14/2023
Human Subjects Determination Attachment 4 - Human Subjects Determination.pdf 08/14/2023
SSA Supporting Statement A - 8-10-23.docx 08/14/2023
SSB Supporting Statement B - 8-10-23.docx 08/14/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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