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Communities Putting Prevention to Work (CPPW) National Prevention Media Initiative Focus Group with Parents/Caregivers
CDC and ATSDR Health Message Testing System
OMB: 0920-0572
IC ID: 207551
OMB.report
HHS/CDC
OMB 0920-0572
ICR 201501-0920-003
IC 207551
( )
⚠️ Notice: This information collection may be referencing outdated material.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
2013.05.30_Attachment 2 - Eligibility Screener.doc
Other-WORD
2013 05 30_Attachment 3 - Moderators Guide.docx
Other-WORD
2013.05.30_Attachment 1 - Research Plan - Burden Table.doc
2013
IC Document
2013.05.30_Attachment 4 - Consent Form.docx
2013
IC Document
2013.05.30_Attachment 5 - Materials.docx
2013
IC Document
2013.05.30_HMTS_Expedited_Form_CPPW_Focus_Groups[1].docx
mini statement
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Communities Putting Prevention to Work (CPPW) National Prevention Media Initiative Focus Group with Parents/Caregivers
Agency IC Tracking Number:
IC Status:
Unchanged
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
Other-WORD
2013.05.30_Attachment 2 - Eligibility Screener.doc
No
No
Paper Only
Other-WORD
2013 05 30_Attachment 3 - Moderators Guide.docx
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
120
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
120
0
0
0
0
120
Annual IC Time Burden (Hours)
154
0
0
0
0
154
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
2013
2013.05.30_Attachment 1 - Research Plan - Burden Table.doc
06/24/2013
2013
2013.05.30_Attachment 4 - Consent Form.docx
06/24/2013
2013
2013.05.30_Attachment 5 - Materials.docx
06/24/2013
mini statement
2013.05.30_HMTS_Expedited_Form_CPPW_Focus_Groups[1].docx
07/03/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.