[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)

[OS] CDC/ATSDR Formative Research and Tool Development

OMB: 0920-1154

IC ID: 264849

Documents and Forms

Document Name Document Type
Form 0920-1154 [NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP) Form
Form 0920-1154 [NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP) Form
Attachment #5 - Respondent Consent Form_FG.docx Other-Consent
Attachment #5 - Respondent Consent Form_FG.docx Other-Consent
0920-1154 Screening/Eligibility Form for Focus Groups Attachment #1 - Eligibility Screener.docx Form
0920-1154 Screening/Eligibility Form for Focus Groups Attachment #1 - Eligibility Screener.docx Form
0920-1154 Eligible Participant Screener for Focus Group (24CP) Attachment #3 - Eligible Participant Screener_FG_DA.docx Form
0920-1154 Eligible Participant Screener for Focus Group (24CP) Attachment #3 - Eligible Participant Screener_FG_DA.docx Form
0920-1154 Focus Group Moderator Guide (24CP) Attachment #8 - Focus Group Moderator Guide_.docx Form and Instruction
0920-1154 Focus Group Moderator Guide (24CP) Attachment #8 - Focus Group Moderator Guide_.docx Form and Instruction
Attachment #2 - Recruitment Materials_FG.docx Recruitment Materials (General and Post) IC Document
Attachment #2 - Recruitment Materials_FG.docx Recruitment Materials (General and Post) IC Document
Attachment #4 - Privacy Agreement.docx Project Staff Agreement of Privacy IC Document
Attachment #4 - Privacy Agreement.docx Project Staff Agreement of Privacy IC Document
Attachment #6 - Standard Invitation_FG.docx Invitation (Standard)_ Focus Group IC Document
Attachment #6 - Standard Invitation_FG.docx Invitation (Standard)_ Focus Group IC Document
Attachment #7 - Participant Confirmation Email_FG.docx Participant Confirmation Email IC Document
Attachment #7 - Participant Confirmation Email_FG.docx Participant Confirmation Email IC Document
Attachment #9- messages to be tested NWSS.docx Messages to be Tested IC Document
Attachment #9- messages to be tested NWSS.docx Messages to be Tested IC Document
Attachment #10- Human Subjects Determination.pdf Human Subjects Determination IC Document
Attachment #10- Human Subjects Determination.pdf Human Subjects Determination IC Document
GenIC Request_Wastewater.020524 (24CP).docx Request for Approval under the “Generic Clearance for the Collection of Formative Research and Tool Development” (OMB Control Nu IC Document
GenIC Request_Wastewater.020524 (24CP).docx Request for Approval under the “Generic Clearance for the Collection of Formative Research and Tool Development” (OMB Control Nu IC Document
SSA.020524_(24CP).docx SSA (24CP) IC Document
SSA.020524_(24CP).docx SSA (24CP) IC Document
SSB (24CP).docx SSB [0920-1154-24CP] IC Document
SSB (24CP).docx SSB [0920-1154-24CP] IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)	Agency IC Tracking Number:	0920-1154-24CP

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	0920-1154	Screening/Eligibility Form for Focus Groups	Attachment #1 - Eligibility Screener.docx	No	Fillable Fileable
Form	0920-1154	Eligible Participant Screener for Focus Group (24CP)	Attachment #3 - Eligible Participant Screener_FG_DA.docx	No	Fillable Fileable
Other-Consent			Attachment #5 - Respondent Consent Form_FG.docx	No	Printable Only
Form and Instruction	0920-1154	Focus Group Moderator Guide (24CP)	Attachment #8 - Focus Group Moderator Guide_.docx	No	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Previously Approved
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Recruitment Materials (General and Post)	Attachment #2 - Recruitment Materials_FG.docx	02/01/2024
Project Staff Agreement of Privacy	Attachment #4 - Privacy Agreement.docx	02/01/2024
Invitation (Standard)_ Focus Group	Attachment #6 - Standard Invitation_FG.docx	02/01/2024
Participant Confirmation Email	Attachment #7 - Participant Confirmation Email_FG.docx	02/01/2024
Messages to be Tested	Attachment #9- messages to be tested NWSS.docx	02/01/2024
Human Subjects Determination	Attachment #10- Human Subjects Determination.pdf	02/01/2024
Request for Approval under the “Generic Clearance for the Collection of Formative Research and Tool Development” (OMB Control Number: 0920-1154) 24CP	GenIC Request_Wastewater.020524 (24CP).docx	02/05/2024
SSA (24CP)	SSA.020524_(24CP).docx	02/05/2024
SSB [0920-1154-24CP]	SSB (24CP).docx	02/01/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.