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Evaluation of an Education Intervention for Immigration Applicants with B1 or B2 Tuberculosis Classificati

IC 239665 under ICR 201803-0920-013 · OMB 0920-0932.

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Information Collection (IC) Details

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Evaluation of an Education Intervention for Immigration Applicants with B1 or B2 Tuberculosis Classificati 0920-0932-20EV
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none B1 Pretest Attachment 4-Data Collection Instrument B1 Pre-Test .docx No   Paper Only
Form none B1 Pretest - Spanish Anexo 4- Instrumento preliminar de recolección de datos B1.docx No   Paper Only
Form none B1 Post-test Attachment 5-Data Collection Instrument B1 Post-Test for Comparison and Program Groups.docx No   Paper Only
Form none B1 Post-test - Spanish Anexo 5- Instrumento de recolección de datos post- prueba para grupos de comparación y programas B1.docx No   Paper Only
Form none B2 Pretest Attachment 6- Data Collection Instrument B2 Pre-Test.docx No   Paper Only
Form none B2 Pretest - Spanish Anexo 6- Instrumento preliminar de recolección de datos B2.docx No   Paper Only
Form none B2 Post-test Attachment 7- Data Collection Instrument B2 Post-Test for Comparison and Program Groups.docx No   Paper Only
Form none B2 Post-test - Spanish Anexo 7- Instrumento de recolección de datos post- prueba para grupos de comparación y programas B2.docx No   Paper Only
Form none B1 Screener Attachment 9- B1 Applicant Screener.docx No   Paper Only
Form none B1 Screener - Spanish Anexo 9- Selección de aplicantes B1.docx No   Paper Only
Form none B2 Screener Attachment 11- B2 Applicant Screener.docx No   Paper Only
Form none B2 Screener Anexo 11- Selección de aplicantes B2.docx No   Paper Only

Health Public Health Monitoring

 

1,164 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,164 0 1,164 0 0 0
Annual IC Time Burden (Hours) 236 0 236 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A Statement A .docx 01/30/2020
Supporting Statement B Statement B.docx 01/30/2020
B1 Consent Attachment 1- B1 Applicant Consent Script.docx 01/30/2020
B1 Consent - Spanish Anexo 1- Consentimiento escrito para aplicantes B1.docx 01/30/2020
B2 Consent Attachment 2- B2 Applicant Consent Script.docx 01/30/2020
B2 Consent - Spanish Anexo 2- Consentimiento escrito para aplicantes B2.docx 01/30/2020
Non-research determination Attachment 3- Non-Research Determination.pdf 01/30/2020
B1 Recruitment Attachment 8- B1 Applicant Recruitment Script .docx 01/30/2020
B1 Recruitment - Spanish Anexo 8- Guion de reclutamiento para aplicantes B1.docx 01/30/2020
B2 Recruitment Attachment 10- B2 Applicant Recruitment Script.docx 01/30/2020
B2 Recruitment - Spanish Anexo 10- Guion de reclutamiento para Aplicantes B2.docx 01/30/2020
B1 Photo Novella Attachment 12- B1 Photo Novella.docx 01/30/2020
B1 Photo Novella - Spanish Attachment 12- B1 Photo Novella_Spanish.docx 01/30/2020
B2 Photo Novella Attachment 13- B2 Photo Novella.docx 01/30/2020
B2 Photo Novella - Spanish Attachment 13- B2 Photo Novella_Spanish.docx 01/30/2020
Educational video Attachment 14- B1B2 Educational Video.docx 01/30/2020
Educational video- Spanish Attachment 14- B1B2 Educational Video_Spanish.docx 01/30/2020
Directory Attachment 15- Directory.docx 01/30/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.