Persuasive Communication about Risks from and Responses to Zika – State, Local and Tribal Government Interviews

CDC/ATSDR Formative Research and Tool Development

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Document Name Document Type
Persuasive Communication about Risks from and Responses to Zika – State, Local and Tribal Government Interviews Form and Instruction
Interview Guide - Public Health Officials Attachment F - Interview Guide Public Health Officials.docx Form and Instruction
GenICRequestTemplate OPHPR Persuasive Communication Zika GenIC Interviews 4.13.17.pdf 0920-1154 GenIC Request Template - OPHPR IC Document
Attachment D - Interviews Recruitment Letter.docx Interview Recruitment Letter IC Document
Attachment E - 6979 HRPO Exemption Determination.docx Non-Research Determination IC Document
SSA-0920-1154-GenIC-OPHPR-Persuasive Communication Zika.docx Supporting Statement A IC Document

Information Collection (IC) Details

IC Title:	Persuasive Communication about Risks from and Responses to Zika – State, Local and Tribal Government Interviews	Agency IC Tracking Number:	17AGG

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	NA	Interview Guide - Public Health Officials	Attachment F - Interview Guide Public Health Officials.docx	NA	No		Paper Only

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0920-1154 GenIC Request Template - OPHPR	GenICRequestTemplate OPHPR Persuasive Communication Zika GenIC Interviews 4.13.17.pdf	04/20/2017
Interview Recruitment Letter	Attachment D - Interviews Recruitment Letter.docx	04/20/2017
Non-Research Determination	Attachment E - 6979 HRPO Exemption Determination.docx	04/20/2017
Supporting Statement A	SSA-0920-1154-GenIC-OPHPR-Persuasive Communication Zika.docx	04/20/2017

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