Information Collection Request

CDC and ATSDR Health Message Testing System

ICR 201111-0920-003 · OMB 0920-0572 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0572 Audience Research on Self-Management Education, Phase III Form and Instruction New Available
Parents are the Key Teen Driving Safety Initiative Form and Instruction New Available
Testing Business-Case Videos for CDC's Division of Community Health Form New Available
Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO) Form New Available
Spanish Trench Safety CD-ROM Form New Available
Form 0920-0572 Agency for Toxic Substances and Disease Registry Task Order 15: Message Testing Form and Instruction New Available
Radiation Emergencies Infographics Focus Groups Form New Available
Audience Research on Self-Management Education Form and Instruction New Available
African American STD Disparities Health Communications Project and Community Health Media Center Educational Campaign Materials Testing Form New Available
Form 0920-0572 Planes,Trains and Auto-Mobility: Increase Walking in the Atl Hartsfield-Jackson Arprt And Testing of brand concepts, msgs and material CDC National Diabetes Prevntion Program Form and Instruction New Available
Form 0920-0572 Message Testing for CDCs Division of Community Health with the General Public, Engaged Public, and Community Leaders Form and Instruction New Available
Pandemic Influenza Nonpharmaceutical Intervention Message Testing Form and Instruction New Available
Act Against AIDS Campaign Form and Instruction New Available
SS-PartB-HMTS .docx Supporting Statement B Uploaded 2011-11-09 Available
Att 12 - Public Comment.docx Supplementary Document Uploaded 2011-11-09 Available
Att 11 - IRB Ruling 060308.doc Supplementary Document Uploaded 2011-11-09 Repair queued
Att 10 - Examples-Data Collection Instruments 060308.doc Supplementary Document Uploaded 2011-11-09 Repair queued
Att 9-FollowUpQuestions.docx Supplementary Document Uploaded 2011-11-09 Available
Att 8-ActivityTaskQuestions.docx Supplementary Document Uploaded 2011-11-09 Repair queued
Att 7-CoreQuestions.docx Supplementary Document Uploaded 2011-11-09 Available
Att 6-IntroductoryQuestions.docx Supplementary Document Uploaded 2011-11-09 Repair queued
Att 5-MarketResearchExpQuestions.docx Supplementary Document Uploaded 2011-11-09 Available
Att 4-DemographicQuestions.docx Supplementary Document Uploaded 2011-11-09 Repair queued
Att 3 - Hlth Msg Testing System Expedited Review Form.docx Supplementary Document Uploaded 2012-01-18 Available
Att 2_60d FRN.pdf Supplementary Document Uploaded 2011-11-09 Repair queued
Att 1-AuthLegislation.pdf Supplementary Document Uploaded 2011-11-09 Repair queued
SS-Part A HMTS .docx Supporting Statement A Uploaded 2011-11-09 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
214010 Storyboard Testing Focus Groups for "No Trespassing Means No Trespassing" Campaign Other-WORD New
213762 Audience Research on Self-Management Education, Phase III Form and Instruction New
212361 Parents are the Key Teen Driving Safety Initiative Form and Instruction New
212298 Testing Business-Case Videos for CDC's Division of Community Health Form New
211907 Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO) Form New
211317 Spanish Trench Safety CD-ROM Form New
210596 Agency for Toxic Substances and Disease Registry Task Order 15: Message Testing Form and Instruction New
209309 Testing Health Messages in STEADI Oder Adult Fall Pevention Materials Among Caregivers Instruction New
208865 Communities Putting Prevention to Work (CPPW) National Media Initiative -- Message Testing Other-Word New
208746 HMTS Radiation Focus Group and Emergencies Infographics Other-WORD New
208617 Radiation Emergencies Infographics Focus Groups Form New
207551 Communities Putting Prevention to Work (CPPW) National Prevention Media Initiative Focus Group with Parents/Caregivers Other-WORD New
207102 Audience Research on Self-Management Education Form and Instruction New
206414 African American STD Disparities Health Communications Project and Community Health Media Center Educational Campaign Materials Testing Form New
205934 Planes,Trains and Auto-Mobility: Increase Walking in the Atl Hartsfield-Jackson Arprt And Testing of brand concepts, msgs and material CDC National Diabetes Prevntion Program Form and Instruction New
205130 Msg Testing for (3) Expedited Reviews--Detonation of an Improv Nuc Devise (Span), AND Impact of a Truck Driver Pub Hth Prac Proj, AND Dissemination of Occup Safety & Hlth Materials thru Mex Consul Instruction New
204153 Message Testing for CDCs Division of Community Health with the General Public, Engaged Public, and Community Leaders Form and Instruction New
203482 Pandemic Influenza Nonpharmaceutical Intervention Message Testing Form and Instruction New
201132 Act Against AIDS Campaign Form and Instruction New
ICR Details
0920-0572 201111-0920-003
Historical Active 201104-0920-015
HHS/CDC
CDC and ATSDR Health Message Testing System
Revision of a currently approved collection   No
Regular
Approved with change 02/06/2012
Retrieve Notice of Action (NOA) 11/10/2011
Approved consistent with the following terms of clearance: For each information collection, a GenIC information collection request will be prepared and submitted to OMB for review and approval. Any changes to the ICR will also be submitted to OMB for review and approval.
  Inventory as of this Action Requested Previously Approved
02/28/2015 36 Months From Approved 02/29/2012
55,575 0 6,000
7,410 0 3,000
0 0 0

CDC must communicate about hazards, outbreaks and other emergencies that present an urgent health threat to the public. Untested messages can waste communication resources and opportunities because the messages can be perceived as unclear or irrelevant. NCHM is requesting continuing approval for an expedited review of items to be used in health messgae testing to ensure the public will understand health messages and take recommended actions.

US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  76 FR 68358 07/26/2011
76 FR 189 09/29/2011
No

19
IC Title Form No. Form Name
Agency for Toxic Substances and Disease Registry Task Order 15: Message Testing 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572 ATSDR-Message-Testing_Attachment-2_Screener-Consumers_Clean ,   ATSDR-Message-Testing_Attachment-5_Consumers ,   ATSDR-Message-Testing_Attachment-6_PublicHealthProfessionals ,   ATSDR-Message-Testing_Attachment-7_Communitymembers ,   ATSDR-Message-Testing_Attachment-8_Consent-Form
Spanish Trench Safety CD-ROM none, none Survey - Spanish ,   Recruitment Script
HMTS Radiation Focus Group and Emergencies Infographics
Act Against AIDS Campaign none, none, none, none, none, none Screener - MSM ,   Interview - MSM ,   Screener - HIV+ ,   Interview - HIV+ ,   Interview - General Population ,   Invitation - General Population
Radiation Emergencies Infographics Focus Groups None Screening Instrument-Radiation Emergencies Infographics
Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO) none, none Screener in English and Spanish ,   Dicussion Guide in English and Spanish
Communities Putting Prevention to Work (CPPW) National Prevention Media Initiative Focus Group with Parents/Caregivers
Testing Business-Case Videos for CDC's Division of Community Health none, none, none Interview Guide for Videos ,   Eligibility Screener for Business people ,   Survey for Video Testing
Communities Putting Prevention to Work (CPPW) National Media Initiative -- Message Testing
Pandemic Influenza Nonpharmaceutical Intervention Message Testing none, none Screener ,   Moderator's Guide
Parents are the Key Teen Driving Safety Initiative none, none, none, none, none, none Pediatrician Screener ,   Parent Message Testing Moderator's Guide ,   Parent Message Testing Moderator's Guide - Spanish ,   Pediatrician Message Testing Moderator's Guide ,   Parent Screener ,   Parent Screener - Spanish
Audience Research on Self-Management Education none, none Moderator's Guide ,   Screener
Audience Research on Self-Management Education, Phase III 0920-0572, 0920-0572 Attachment 4 Screener_10282014 ,   Attachment 3 Mod Guide_10282014
African American STD Disparities Health Communications Project and Community Health Media Center Educational Campaign Materials Testing none, none, none, none, none, none, none, none, none, none African American Screener ,   African American Survey ,   Community Health Wave 1 Screener ,   Community Health Wave 2 Screener ,   Community Health Wave 3 Screener ,   Community Health Wave 4 Screener ,   Community Health Wave 1 Survey Screenshots ,   Community Health Wave 2 Survey Screenshots ,   Community Health Wave 3 Survey Screenshots ,   Community Health Wave 4 Survey Screenshots
Message Testing for CDCs Division of Community Health with the General Public, Engaged Public, and Community Leaders 0920-0572, 0920-0572, 0920-0572 Moderators Guide- Community Leaders Triad ,   Moderators Guide- General Public FG ,   Moderators Guide- Engaged Public Triad
Testing Health Messages in STEADI Oder Adult Fall Pevention Materials Among Caregivers None Informed Consent
Planes,Trains and Auto-Mobility: Increase Walking in the Atl Hartsfield-Jackson Arprt And Testing of brand concepts, msgs and material CDC National Diabetes Prevntion Program 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572, 0920-0572 Planes, Trains and Autop Appendix B3 Response Form ,   Planes, Trains and Auto Appendix B Instructions for Interview ,   Plane, Trains and Auto Appendix B 1 Interview 1 ,   Planes, Trains and Autop Appendix B2 Interview Cards 1 ,   Planes, Trains Auto Appendix B4 Participant Inform ,   Plane, Trains and Auto Appendix 5 Question 1 Rationale ,   Plane, Train Auto Appendix C Handheld Screenshots ,   Testing of brand Appendix A1-Screener-Consumers 010 ,   Testing of brand concepts Appendix A2-Screener-HCP ,   Testing of brand concepts Appendix B1-Consent form ,   Testing of brand concepts Appendix B2-Consent form- ,   Testing of Brand Appendix C1-Moderators Guide- Consumers FG ,   Testing of brands Appendix C2-Moderators Guide- HCP triads ,   Testing of brand Appendix D2-NDPP Branding Message Testing Supplement
Msg Testing for (3) Expedited Reviews--Detonation of an Improv Nuc Devise (Span), AND Impact of a Truck Driver Pub Hth Prac Proj, AND Dissemination of Occup Safety & Hlth Materials thru Mex Consul none, none, none, none Screening Instrument ,   Truck Driver Opinion Survey ,   Exit Survey_Spanish ,   Exit Survey_English Translation
Storyboard Testing Focus Groups for "No Trespassing Means No Trespassing" Campaign

  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 55,575 6,000 0 49,575 0 0
Annual Time Burden (Hours) 7,410 3,000 0 4,410 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The currently approved ICR hosts an approved question bank, managed by program. However, in a conference call on June 8, 2011, OMB staff indicated that question banks will no longer be approved. Due to this decision, Program had to revise how genICs would be submitted under this request, which Program determine would decrease the estimate burden hours required.

$1,550,000
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Thelma Sims 4046394771

  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.
11/10/2011