Information Collection

[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project

IC 261493 under ICR 202507-0920-001 · OMB 0920-1154.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project Form and Instruction
Recruitment Screener [NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project Form and Instruction
Technology Pre-check [NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project Form and Instruction
AR Formative Evaluation Interview Guide [NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project Form and Instruction
Recruitment Screener
Attachment A_ARX_Task1_Panel Provider Recruitment Screener_FINAL 7-28-2023.docx
Form and Instruction
Recruitment Screener
Attachment A_ARX_Task1_Panel Provider Recruitment Screener_FINAL 7-28-2023.docx
Form and Instruction
Technology Pre-check
Attachment D_ARX_Task1_Technology Check Email & Check List_FINAL 07-28-2023.docx
Form and Instruction
Technology Pre-check
Attachment D_ARX_Task1_Technology Check Email & Check List_FINAL 07-28-2023.docx
Form and Instruction
AR Formative Evaluation Interview Guide
Attachment C_ARX_Task1_DiscussionGuide_Final_OMB 07-28-2023.docx
Form and Instruction
AR Formative Evaluation Interview Guide
Attachment C_ARX_Task1_DiscussionGuide_Final_OMB 07-28-2023.docx
Form and Instruction
Attachment B_ARX_Task1_Informed Consent Form_FINAL Focus Grps 7-28-2023.docx
Informed Consent
IC Document
Attachment B_ARX_Task1_Informed Consent Form_FINAL Focus Grps 7-28-2023.docx
Informed Consent
IC Document
Attachment E_Kopf Protocol Exempt Determination Notice Feb2423.pdf
Research Determination
IC Document
Attachment E_Kopf Protocol Exempt Determination Notice Feb2423.pdf
Research Determination
IC Document
Attachment F_ARX_Task1_Informed Consent Form-IDI 7-28-2023.docx
Informed Consent (IDI)
IC Document
Attachment F_ARX_Task1_Informed Consent Form-IDI 7-28-2023.docx
Informed Consent (IDI)
IC Document
GenIC Request Template_ARX 07-28-2023_final.docx
GenIC Request Template
IC Document
GenIC Request Template_ARX 07-28-2023_final.docx
GenIC Request Template
IC Document
Supporting Statement A (0920-1154) 07-28-2023_final.docx
SSA
IC Document
Supporting Statement A (0920-1154) 07-28-2023_final.docx
SSA
IC Document
Supporting Statement B (0920-1154) 07-28-2023.docx
SSB
IC Document
Supporting Statement B (0920-1154) 07-28-2023.docx
SSB
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Yes No Fillable Fileable
Form and Instruction n/a Yes No Fillable Fileable
Form and Instruction n/a Yes No Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 1,590 0 0 0 0 1,590
Annual IC Time Burden (Hours) 306 0 0 0 0 306
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Informed Consent 08/09/2023
Research Determination 08/09/2023
Informed Consent (IDI) 08/09/2023
GenIC Request Template 08/09/2023
SSA 08/09/2023
SSB 08/09/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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