Jackson Heart Study Participant Recruitment Survey

ICR 199911-0925-003

OMB: 0925-0464

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
37824
Migrated
ICR Details
0925-0464 199911-0925-003
Historical Active 199904-0925-001
HHS/NIH
Jackson Heart Study Participant Recruitment Survey
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/04/1999
Retrieve Notice of Action (NOA) 11/04/1999
  Inventory as of this Action Requested Previously Approved
04/30/2002 04/30/2002 04/30/2002
1 0 1
249 0 239,766
0 0 0

A telephone survey will be administered to 400 African-American men and women, as well as in-depth qualitative interviews administered to 60 men and women, in order to examine facilitators and barriers to long-term participation in the upcoming observational Jackson Heart Study. Two random samples without replacement will be selected from drop-outs (n=50) and current participants (n=50) of a prior study (ARIC) begun in Jackson, MS, 12 years ago. A third sample of 300 African-American non-ARIC community residents of Jackson, MS, ages 35-84, will be randomly selected.

None
None


No

1
IC Title Form No. Form Name
Jackson Heart Study Participant Recruitment Survey

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1 1 0 0 0 0
Annual Time Burden (Hours) 249 239,766 0 0 -239,517 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/04/1999


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