OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Focus Group Study for Raising Public Awareness of Deep Vein Thrombosis/Pulmonary Embolism

ICR 201106-0920-014 · OMB 0920-0899 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Participant Re-screener Form New Repair queued
Participant Screener Form New Available
Focus Group PSA List.docx Supplementary Document Uploaded 2011-07-28 Available
DVT-Factsheet_Final.pdf Supplementary Document Uploaded 2011-07-28 Available
Supporting Statement Part B_DVTPE.docx Supporting Statement B Uploaded 2011-06-22 Available
Informed Consent form.docx Supplementary Document Uploaded 2011-06-15 Available
Attachment 10 IRB Findings and Approval.pdf Supplementary Document Uploaded 2011-06-15 Available
60 Day FRN_DVTPE (03162011).pdf Supplementary Document Uploaded 2011-06-15 Available
Attachment 1 Legal authority.doc Supplementary Document Uploaded 2011-06-15 Available
Section_A_Supporting_Statement_RDVT_Revised.doc Supporting Statement A Uploaded 2011-07-28 Available
IC Document Collections
IC IDCollectionTypeStatusForm
198207 Moderator's Guide: Formative Research Focus Groups Instruction New
198206 Participant Re-screener Form New
198205 Participant Screener Form New
ICR Details
0920-0899 201106-0920-014
Historical Active
HHS/CDC
Focus Group Study for Raising Public Awareness of Deep Vein Thrombosis/Pulmonary Embolism
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 09/02/2011
Retrieve Notice of Action (NOA) 06/23/2011
This collection is approved for one year, for the first phase of formative research only. Before conducting the second round of message testing, CDC will be required to submit a revised ICR with copies of the testing stimuli that will be used in the message testing focus groups.
  Inventory as of this Action Requested Previously Approved
09/30/2012 24 Months From Approved
252 0 0
125 0 0
0 0 0
The National Center for Birth Defects and Developmental Disabilities, Division of Blood Disorders, will conduct focus groups to develop messaging concepts to be used in a public awareness campaign to build knowledge and awareness of deep vein thrombosis/pulmonary embolism, increase recognition of symptoms and risk factors, and empower people to take action. We will conduct focus groups to explore consumer knowledge, attitudes, and behaviors and use these insights to develop message concepts. Second stage focus groups will test the message concepts and identify ways to present the messages.
US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  76 FR 14400 03/16/2011
76 FR 34705 06/14/2011
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 252 0 0 252 0 0
Annual Time Burden (Hours) 125 0 0 125 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.
$177,783
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Daniel Holcomb 770 488-4472 [email protected]
  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.
06/23/2011