Instruments for Wave 2 of the PATH Study

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0664 can be found here:

Documents and Forms

Document Name Document Type
Form 3-New Instruments for Wave 2 of the PATH Study Form and Instruction
1-Rev English Version 2_PATH_Study_Data_Collection_Instruments.pdf Form and Instruction
1 Spanish Version 2-PATH_Study_Data_Collection_Instruments-Spanish.pdf Form and Instruction
2 Follow up, Retention and Tracking Documents - English Ve 9_Follow-up_Retention_and_Tracking.pdf Form and Instruction
2 Follow up, Retention and Tracking Documents - Spanish Ve 9_Follow-up_Retention_and_Tracking_Spanish.pdf Form and Instruction
3-New PATH Verification Form 23_PATH Verification Form (new) 5-8-15.pdf Form and Instruction
3-New PATH Validation Form 24_PATH Validation Form (new) 5-8-15.pdf Form and Instruction
5 Summary of Changes to Instruments for W2 6-27-2014.pdf Summary of Changes to the Instrument IC Document
6_Additional_Information_on_Biospecimens.pdf Additional Biospecimen Informatiion IC Document
19_Field_Data_Collection_Materials.pdf Field Materials - English IC Document
19_Field_Data_Collection_Materials_Spanish.pdf Field Materials - Spanish IC Document
17_Procedures_for_Keeping_Data_Confidential.pdf Data Confidentially Procedures IC Document
18_ICPSR_Data_Use_Agreement.pdf Data Use Agreement IC Document
8_Key_Design_Features.pdf Key Survey Design Features IC Document

Information Collection (IC) Details

IC Title:	Instruments for Wave 2 of the PATH Study	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3-New	PATH Verification Form	23_PATH Verification Form (new) 5-8-15.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3-New	PATH Validation Form	24_PATH Validation Form (new) 5-8-15.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	1-Rev	English Version	2_PATH_Study_Data_Collection_Instruments.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	1	Spanish Version	2-PATH_Study_Data_Collection_Instruments-Spanish.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	Follow up, Retention and Tracking Documents - English Version	9_Follow-up_Retention_and_Tracking.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	Follow up, Retention and Tracking Documents - Spanish Version	9_Follow-up_Retention_and_Tracking_Spanish.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-25-0200 ooClinical, Basic and Population-basedR esearchS tudieso f the National Institutes of Health (NIH), HHSAIIH/OD	FR Citation: 67 FR 60741

Number of Respondents: 41,662	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	192,858	-385	193,243
Annual IC Time Burden (Hours)	58,340	1,401	56,939
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Summary of Changes to the Instrument	5 Summary of Changes to Instruments for W2 6-27-2014.pdf	07/31/2014
Additional Biospecimen Informatiion	6_Additional_Information_on_Biospecimens.pdf	07/31/2014
Field Materials - English	19_Field_Data_Collection_Materials.pdf	07/31/2014
Field Materials - Spanish	19_Field_Data_Collection_Materials_Spanish.pdf	07/31/2014
Data Confidentially Procedures	17_Procedures_for_Keeping_Data_Confidential.pdf	07/31/2014
Data Use Agreement	18_ICPSR_Data_Use_Agreement.pdf	07/31/2014
Key Survey Design Features	8_Key_Design_Features.pdf	07/31/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.