OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Formative Research to Inform an HIV Testing Social Marketing Campaign for African American Heterosexual Men

ICR 200710-0920-005 · OMB 0920-0762 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Section B - Supporting Statement.doc Supporting Statement B Uploaded 2007-09-11 Available
A8 Confidentiality Agreement.doc Supplementary Document Uploaded 2007-09-13 Repair queued
A5 CDC and RTI IRB Approvals.doc Supplementary Document Uploaded 2007-09-13 Repair queued
60 Day FRN .pdf Supplementary Document Uploaded 2007-09-13 Available
A1 Authorizing Legislation.doc Supplementary Document Uploaded 2007-09-13 Repair queued
A6 Consent Documents.doc Supplementary Document Uploaded 2007-09-13 Available
Section A - Supporting Statement.doc Supporting Statement A Uploaded 2007-10-01 Available
IC Document Collections
IC IDCollectionTypeStatusForm
182369 Data Collection Instrument for Focus Groups Other-Data Collection Instrument New
182368 Data Collection Instrument for Interviews Other-Data Collection Instrument New
182367 Paper and Pencil Questionnaire Other-Questionnaire New
182366 Study Screener Other-Study Screener New
ICR Details
0920-0762 200710-0920-005
Historical Active
HHS/CDC
Formative Research to Inform an HIV Testing Social Marketing Campaign for African American Heterosexual Men
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 01/24/2008
Retrieve Notice of Action (NOA) 10/16/2007
Approved consistent with the following terms of clearance: OMB approves the collection for purposes of formative research however results of the survey will not be generalizable to the populations surveyed and will not be reported as such.
  Inventory as of this Action Requested Previously Approved
01/31/2011 36 Months From Approved
297 0 0
146 0 0
0 0 0
The purpose of this study is to conduct formative research to inform the development of a CDC-sponsored social marketing campaign that will be aimed at increasing HIV testing rates among young, single, African American heterosexual men.
US Code: 42 USC 241 Name of Law: Public Health Svc. Act
  
None
Not associated with rulemaking
  71 FR 74541 12/12/2006
72 FR 52881 09/17/2007
No
  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 297 0 0 297 0 0
Annual Time Burden (Hours) 146 0 0 146 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection.
$197,514
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Carol Walker 4046394773
  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.
10/16/2007