Att 10_List of Approved GenICs

NCHHSTP Generic Clearance

Formative Research and Tool Development

OMB No. 0920-0840

Attachment 10: List of Approved GenIC (02/2013 – 10/2015)

Number of Information Collection (IC) in this ICR: 17

IC Title	Form No.	Form Name
Informing the Development of Mobile Apps for HIV Prevention, Treatment & Care	none, none, none, none, none, none, form, none, none, none, none, none, none, none, none, none, none	Screener ,  Screener High Risk ,  Screener HIV Providers ,  PLWH Guide ,  PLWH Guide Spanish ,  High Risk Guide ,  High Risk Guide Spanish ,  HC Providers Guide ,  Focus Group Assessment ,  Focus Group Assessment Spanish ,  End User Survey ,  Consent PLWH & High Risk ,  Consent PLWH & High Risk Spanish ,  Assent PLWH & High Risk ,  Consent HC Providers ,  Usability Consent ,  Usability Assent
CBO Needs Assessment for Preparedness and Resources for Support of Biomedical HIV Prevention	null, None, none	,  Biomedical HIV Prevention Organizational Assessment Web-based Survey Screenshots ,  Consent Form
Injection Behaviors Among Young Persons in Rural/Suburban Settings	none, none, none	Formative Research Study ,  Screener ,  Consent
Evaluation of HIV Self-Testing Among MSM in High Prevalence Cities (eSTAMP)	none, none, none, none, none, null	Eligibility Screener ,  Registration ,  Baseline Survey ,  Reporting of Self-Test Results ,  Follow-up Survey
Development of a Motion Comic for HIV/STI Prevention Among Young People Ages 15-24 Phase 2	none, none, none, none, none	Motion Comic Pre Test Survey ,  Motion Comic Focus Group Guide 2 ,  Motion Comic Screener ,  Motion Comic Post Test Survey ,  Motion Comic Focus Group Guide 1
DSTP Assessment of STD Clinic Users	null, none	,  DSTDP Assessment of STD Clinic Users
Evaluating HIV/AIDS Focused Video Game for Young People	none, none, none, none	Enrollment Day Survey ,  Experimental Group Survey ,  30 Day Post Survey ,  Demographic Screener
Formative Research and Tool Development: Survey of HIV Medical Care Providers to Guide the Medical Monitoring Project	none, none	MMP Provider Survey ,  MMP Provider Survey Web-based Application Screenshots
Testing Brief Messages for Black and Latino MSM	none, none, none, none, none, none	Eligibility Screener -Spanish ,  Messages and Outcomes ,  Messages and Outcomes - Spanish ,  Assessment - English ,  Assessment - Spanish ,  Eligibility Screener - English
Understanding Barriers and Facilitators to HIV Prevention, Care, and Treatment	none, none, none, none, none, none, none, none, none, none, none, none, none, none, none, none, none, none, none	Provider Demographic Questionnaire ,  Provider interview guide ,  Study screener - English ,  Study screener - Spanish ,  Discordant partners screeners - English ,  Discordant partners screener - Spanish ,  Contact Information - English ,  Contact Information - Spanish ,  Discordant partners contact info - English ,  PLWH interview guide - English ,  PLWH interview guide - Spanish ,  Discordant partners interview guide - English ,  Discordant partners interview guide - Spanish ,  Provider info sheet and consent ,  PLWH consent ,  PLWH consent - Spanish ,  Discordant partner consent - English ,  Discordant partner consent - Spanish ,  Discordant partners contact info - Spanish
Feasibility of HIV Behavioral Surveillance for Young MSM	0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840, 0920-0840	Attachment 4_Recruitment Debriefing ,  Attachment 5_Eligibility Screener ,  Attachment 6_Behavioral Assessment ,  Attachment 7_Key informant interview ,  Attachment 8_Focus Group Interview ,  Attachment 9_Enumeration Interview ,  Attachment 10_Landing Page and Banner Ad
Local Effectiveness Assessment Project (LEAP): A Case Study of a Local Jurisdiction Providing HIV Services to MSM	None, None, None, None	Interview Guide - Community Leaders ,  Interview Guide - Individual/Network ,  Key Participant Information Sheet and Consent Form ,  Interview Guide - Public Policy Stakeholders
Testing Solutions for Sampling Challenges for MMP	none, none	2a - Interview questionnaire - English ,  2b - interview questionnaire - Spanish
Formative Research to Develop Social Marketing Campaigns: Prevention Is Care (PIC)	None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None	Paper and Pencil Survey ,  Informed Consent Form ,  Provider Screening Instrument ,  Review Material-Envelope ,  Review Material Patient Baseline Screen ,  Review Material Adherence Wall Poster ,  Review Material Risk Reduction MD Brochure ,  Review Material Patient Action Plan ,  Review Material Patient Risk Reduction Brochure ,  Review Material Patient Record Form ,  Review Material Retention Brochure Patient ,  CME Promotion Card ,  Review Material Brouchure and Folding Instructions ,  Review Material Risk Reduction Poster Option ,  Provider Screening Instrument ,  Review Material Patient Adherence Brochure ,  Review Material Retention Brochure MD ,  Review Material Retention Poster ,  Review Material Gardner Study Reprint ,  Review Material Adherence Brochure MD ,  Review Material Folder
Testing Messages for Black and Latino MSM	none, none, none, none	Eligibility Screener ,  Eligibility Screener - Spanish Version ,  Focus Group/Interview Guide ,  Focus Group/Interview Guide - Spanish Version
Development of CDC's Act Against AIDS Social Marketing Campaigns Targeting Consumers	null, null, null, null, null, null, null, null, null, null, null, null, null, null, null, null, null, null, null, null
Pilot Test Study for the HIV Risk Reduction Educational Tool (HRRET)	None, null, None, None	Pilot Test HRRET POSTTEST Web-based Survey ,  Pilot Study HRRET Screener Survey ,  Pilot Test HRRET PRETEST Web-based Survey

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