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Federal forms, ICRs, and supporting documents

Information Collection Request

"Physical Activity: The Arthritis Pain Reliever" Campaign Evaluation

ICR 200312-0920-007 · OMB 0920-0627 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
7094 "Physical Activity: The Arthritis Pain Reliever" Campaign Evaluation Migrated
ICR Details
0920-0627 200312-0920-007
Historical Active
HHS/CDC
"Physical Activity: The Arthritis Pain Reliever" Campaign Evaluation
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/26/2004
Retrieve Notice of Action (NOA) 12/09/2003
  Inventory as of this Action Requested Previously Approved
08/31/2005 08/31/2005
2,220 0 0
555 0 0
0 0 0
CDC plans to conduct a quantitative evaluation of a recently developed health communications campaign promoting physical activity among people with arthritis. Data from this evaluation will be used to shape recommendations to state health departments on the use of this campaign. Respondents will be African Americans or Caucasians who have a high school education or less.
None
None
No
1
IC Title Form No. Form Name
"Physical Activity: The Arthritis Pain Reliever" Campaign Evaluation
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,220 0 0 2,220 0 0
Annual Time Burden (Hours) 555 0 0 555 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/09/2003