Community Informants/Participants UCI

National Children's Study Formative Generic Clearance

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0590 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Community Informants/Participants UCI Form and Instruction
1 instrument 5. Appendix C - Anonymous Demographic Questionnaire.doc Form and Instruction
2 guide 7. Appendix E - Focus Group Moderator Guide.doc Form and Instruction
2. UCI Formative Research Cover Memo.rev.doc Revised UCI Formative Research Cover Memo IC Document
6. Appendix D - Study Information Sheet for Focus Groups.rev.doc Revised Appendix D - Study Information Sheet for Focus Groups IC Document
7. Appendix E - Focus Group Moderator Guide.rev.doc Revised Appendix E - Focus Group Moderator Guide IC Document
8. Appendix F - Study Information Sheet for Key Informant Interviews.rev.doc Revised Appendix F - Study Information Sheet for Key Informant Interviews IC Document
9. Appendix G - Recruitment Flyer for Focus Groups.rev.doc Revised Appendix G - Recruitment Flyer for Focus Groups IC Document
1. Submission of Information Collection - UCI.doc 1 IC Document
2. UCI Formative Research Cover Memo.doc 2 IC Document
3. Appendix A - University of California-Irvine IRB Approval Memo.doc 3 IC Document
4. Appendix B - Summary of Methods and Segments.doc 4 IC Document
6. Appendix D - Study Information Sheet for Focus Groups.doc 6 IC Document
8. Appendix F - Study Information Sheet for Key Informant Interviews.doc 8 IC Document

Information Collection (IC) Details

IC Title:	Community Informants/Participants UCI	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	instrument	5. Appendix C - Anonymous Demographic Questionnaire.doc		Yes	Yes	Paper Only
Form and Instruction	2	guide	7. Appendix E - Focus Group Moderator Guide.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	170	170
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
1	1. Submission of Information Collection - UCI.doc	01/05/2009
2	2. UCI Formative Research Cover Memo.doc	01/05/2009
3	3. Appendix A - University of California-Irvine IRB Approval Memo.doc	01/05/2009
4	4. Appendix B - Summary of Methods and Segments.doc	01/05/2009
6	6. Appendix D - Study Information Sheet for Focus Groups.doc	01/05/2009
8	8. Appendix F - Study Information Sheet for Key Informant Interviews.doc	01/05/2009
Revised UCI Formative Research Cover Memo	2. UCI Formative Research Cover Memo.rev.doc	03/31/2009
Revised Appendix D - Study Information Sheet for Focus Groups	6. Appendix D - Study Information Sheet for Focus Groups.rev.doc	03/31/2009
Revised Appendix E - Focus Group Moderator Guide	7. Appendix E - Focus Group Moderator Guide.rev.doc	03/31/2009
Revised Appendix F - Study Information Sheet for Key Informant Interviews	8. Appendix F - Study Information Sheet for Key Informant Interviews.rev.doc	03/31/2009
Revised Appendix G - Recruitment Flyer for Focus Groups	9. Appendix G - Recruitment Flyer for Focus Groups.rev.doc	03/31/2009

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