Information Collection

Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study

IC 270182 under ICR 202508-0607-002 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

2025-12-30 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 1 Demographic Questionnaire Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 2 Food-at-Home (FAH) Use Case for R2 Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 3 Food-at-Home (FAH) Use Case for R3a Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 4 Food-at-Home (FAH) Use Case for R3b Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 5 Food-away-from-Home (FAFH) Use Case Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 6 Quiz for Training Assessment for R2 Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 7 Quiz for Training Assessment for R3 Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 8 Debriefing Interview Questionnaire Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
Form 9 Scripts of Video Training Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study	Form and Instruction
1 Demographic Questionnaire Appendix H Demographic Questionnaire revision 20240712.docx	Form and Instruction
1 Demographic Questionnaire Appendix H Demographic Questionnaire revision 20240712.docx	Form and Instruction
2 Food-at-Home (FAH) Use Case for R2 Appendix K2 Food-at-Home (FAH) Use Case for R2.docx	Form and Instruction
2 Food-at-Home (FAH) Use Case for R2 Appendix K2 Food-at-Home (FAH) Use Case for R2.docx	Form and Instruction
3 Food-at-Home (FAH) Use Case for R3a Appendix K3a Food-at-Home (FAH) Use Case for R3a.docx	Form and Instruction
3 Food-at-Home (FAH) Use Case for R3a Appendix K3a Food-at-Home (FAH) Use Case for R3a.docx	Form and Instruction
4 Food-at-Home (FAH) Use Case for R3b Appendix K3b Food-at-Home (FAH) Use Case for R3b.docx	Form and Instruction
4 Food-at-Home (FAH) Use Case for R3b Appendix K3b Food-at-Home (FAH) Use Case for R3b.docx	Form and Instruction
5 Food-away-from-Home (FAFH) Use Case Appendix L Food-away-from-Home (FAFH) Use Case revision 20240712.docx	Form and Instruction
5 Food-away-from-Home (FAFH) Use Case Appendix L Food-away-from-Home (FAFH) Use Case revision 20240712.docx	Form and Instruction
6 Quiz for Training Assessment for R2 Appendix P2 Quiz for Training Assessment for R2_clean 0801.docx	Form and Instruction
6 Quiz for Training Assessment for R2 Appendix P2 Quiz for Training Assessment for R2_clean 0801.docx	Form and Instruction
7 Quiz for Training Assessment for R3 Appendix P3 Quiz for Training Assessment for R3.docx	Form and Instruction
7 Quiz for Training Assessment for R3 Appendix P3 Quiz for Training Assessment for R3.docx	Form and Instruction
8 Debriefing Interview Questionnaire Appendix T Debriefing Interview Questionnaire.docx	Form and Instruction
8 Debriefing Interview Questionnaire Appendix T Debriefing Interview Questionnaire.docx	Form and Instruction
9 Scripts of Video Training Appendix U Scripts of Video Training_clean 0801.docx	Form and Instruction
9 Scripts of Video Training Appendix U Scripts of Video Training_clean 0801.docx	Form and Instruction
Addendum to OMB request for FoodAPS-2 Pilot Test usability evaluation revision 20240802.docx OMB Memo	IC Document
Addendum to OMB request for FoodAPS-2 Pilot Test usability evaluation revision 20240802.docx OMB Memo	IC Document
Appendix D Screener Questionnaire for Participant Recruitment revision_clean 0801.docx Screener Instrument	IC Document
Appendix D Screener Questionnaire for Participant Recruitment revision_clean 0801.docx Screener Instrument	IC Document
Appendix O2a Round-2 Protocol Odd_clean 0801.docx Round-2 Protocol Odd	IC Document
Appendix O2a Round-2 Protocol Odd_clean 0801.docx Round-2 Protocol Odd	IC Document
Appendix O2b Round-2 Protocol Even_clean 0801.docx Round-2 Protocol Even	IC Document
Appendix O2b Round-2 Protocol Even_clean 0801.docx Round-2 Protocol Even	IC Document
Appendix O3 Round-3 Protocol_clean 0801.docx Round-3 Protocol	IC Document
Appendix O3 Round-3 Protocol_clean 0801.docx Round-3 Protocol	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Addendum to Usability and Cognitive Evaluation for the Data Collection Instrument of FoodAPS-2 Pilot Study

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Electronic Capability
Form and Instruction	1	No	Fillable Fileable
Form and Instruction	2	No	Fillable Fileable
Form and Instruction	3	No	Fillable Fileable
Form and Instruction	4	No	Fillable Fileable
Form and Instruction	5	No	Fillable Fileable
Form and Instruction	6	No	Fillable Fileable
Form and Instruction	7	No	Fillable Fileable
Form and Instruction	8	No	Fillable Fileable
Form and Instruction	9	No	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo		08/16/2024
Screener Instrument		08/16/2024
Round-2 Protocol Odd		08/16/2024
Round-2 Protocol Even		08/16/2024
Round-3 Protocol		08/16/2024

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

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