African American STD Disparities Health Communication and Emergency Risk Communication Network Needs Assessment Projects

Health Marketing

OMB: 0920-0798

IC ID: 192323

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African American STD Disparities Health Communication and Emergency Risk Communication Network Needs Assessment Projects
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Emergency Risk Communication Network Needs Assessment Attachment A.doc Yes Yes Fillable Fileable
Form none AA STD Disparities -Phase I Interview Guide for Triads 0920-0798-Attachment 2- Phase I Guide used for Triad Discussions - 7-22.doc No No Paper Only
Form none AA STD Disparities - Phase I Interview Guide for Individuals 0920-0798-Attachment 3- Phase I Interview Guide used for Individual Interviews- 7-22.doc No No Paper Only
Form none AA STD Disparities - Phase II Interview Guide for Individuals 0920-0798-Attachment 6- Phase II- Individual Interview Guide 6-29.doc No No Paper Only
Form none AA STD Disparities - Demographic and Behavioral Questionnaire 0920-0798-Attachment 4- Participant Demographic and Behavioral Pencil Paper Questionaire- 2 18 10.doc No No Paper Only
Form none AA STD DIsparities - Participant Domain Assessment 0920-0798-Attachment 5- Particpant Domain Assesment Structured Data Collection- 2.18.10.doc No No Paper Only
Form none AA STD Disparities - Triad and Interview Screener 0920-0798-Attachment 9- Triad Interview Screener-2.18.10.doc No No Paper Only

Health Illness Prevention

 

1,048 0
   
Individuals or Households
 
   0 %

  Approved 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 1,048 0 0 0 0 0
Annual IC Time Burden (Hours) 365 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Emergency Risk Communication Network - Invitation to Participate RCom Letters of Request to Participate 2-22-10.doc 03/04/2010
Emergency Risk Communication Network - Supporting Statement RCOM ICR Package 11-16-09.doc 03/04/2010
Emergency Risk Communication Network - Pilot Protocol AttachmentB.doc 03/04/2010
AA STD Disparities - Supporting Statement Backup of 0920-0798-AA STD disparity project-Section A- 12-07-09.wbk 03/04/2010
AA STD Disparities - Consent Forms 0920-0798-Attachment 12- Consent Forms 2.18.10.doc 03/04/2010
AA STD Disparities - Reminders 0920-0798-Attachment 10- Reminder Letters E-Mails Phone Scripts- 2 18 10.doc 03/04/2010
AA STD Disparities - IRB Determination Attachment 7 IRB Determination.doc 03/04/2010
AA STD Disparities - Recruitment Materials 0920-0798-Attachment 8- Recruitment Materials.doc 03/04/2010
AA STD Dispariies - Confidentiality Agreement 0920-0798-Attachment 11- Confidentiality Agreement.doc 03/04/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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