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Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)
CDC and ATSDR Health Message Testing System
OMB: 0920-0572
IC ID: 211907
OMB.report
HHS/CDC
OMB 0920-0572
ICR 201111-0920-003
IC 211907
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:
2024-10-18 - Revision of a currently approved collection
2021-08-31 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)
Form
Screener in English and Spanish
ATTACHMENT_D-Participant_Screening_Instrument.docx
Form
Dicussion Guide in English and Spanish
ATTACHMENT_C-Discussion_Guide.docx
Form
ATTACHMENT_E-Participant_Information_Sheet.docx
Participant Information Sheet
IC Document
ATTACHMENT_F-Breaking_News_Script.docx
News Script
IC Document
ATTACHMENT_G_Materials_for_Testing.pptx
Materials for Testing
IC Document
ATTACHMENT_B-Full_Protocol.docx
Full Protocol
IC Document
ATTACHMENT_A-Protocol_Summary.docx
Protocol Summary
IC Document
Anthrax Materials-HMTS Expedited Review Form_508 compliant-signed.pdf
Expedited Review Form
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)
Agency IC Tracking Number:
14AHO
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
none
Screener in English and Spanish
ATTACHMENT_D-Participant_Screening_Instrument.docx
No
Paper Only
Form
none
Dicussion Guide in English and Spanish
ATTACHMENT_C-Discussion_Guide.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Disaster Management
Subfunction:
Disaster Preparedness and Planning
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
450
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
450
0
450
0
0
0
Annual IC Time Burden (Hours)
351
0
351
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Participant Information Sheet
ATTACHMENT_E-Participant_Information_Sheet.docx
06/16/2014
News Script
ATTACHMENT_F-Breaking_News_Script.docx
06/16/2014
Materials for Testing
ATTACHMENT_G_Materials_for_Testing.pptx
06/16/2014
Full Protocol
ATTACHMENT_B-Full_Protocol.docx
06/16/2014
Protocol Summary
ATTACHMENT_A-Protocol_Summary.docx
06/16/2014
Expedited Review Form
Anthrax Materials-HMTS Expedited Review Form_508 compliant-signed.pdf
06/16/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.