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Federal forms, ICRs, and supporting documents

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
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

[NCEZID] Public Health Communications Messages and Materials Testing Focused on Antimicrobial Resistance Among the U.S. General Population Pilot Data Collection Project 0920-1154-23HK
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Recruitment Screener Attachment A_ARX_Task1_Panel Provider Recruitment Screener_FINAL 7-28-2023.docx Yes No Fillable Fileable
Form and Instruction n/a Technology Pre-check Attachment D_ARX_Task1_Technology Check Email & Check List_FINAL 07-28-2023.docx Yes No Fillable Fileable
Form and Instruction n/a AR Formative Evaluation Interview Guide Attachment C_ARX_Task1_DiscussionGuide_Final_OMB 07-28-2023.docx Yes No Fillable Fileable

Health Public Health Monitoring

 

1,590 0
   
Individuals or Households
 
   5 %

  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

Title Document Date Uploaded
Informed Consent Attachment B_ARX_Task1_Informed Consent Form_FINAL Focus Grps 7-28-2023.docx 08/09/2023
Research Determination Attachment E_Kopf Protocol Exempt Determination Notice Feb2423.pdf 08/09/2023
Informed Consent (IDI) Attachment F_ARX_Task1_Informed Consent Form-IDI 7-28-2023.docx 08/09/2023
GenIC Request Template GenIC Request Template_ARX 07-28-2023_final.docx 08/09/2023
SSA Supporting Statement A (0920-1154) 07-28-2023_final.docx 08/09/2023
SSB Supporting Statement B (0920-1154) 07-28-2023.docx 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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