Computerized Adaptive Test (CAT) Screenshot

Attachment C: Computer Adaptive Test (CAT) Screenshot
This screenshot represents the initial entry that the participant will see when administered the survey
through YouGov’s website.
The actual survey instrument is not standardized and will vary depending on the participant’s responses to
previous questions. Future questions are determined by previous responses and thus the length of the
survey can vary from 5 to 15 minutes, depending on the how the participant responds. All questions will
come from the Item Banks, Attachments A and B. No other questions will be asked.

OMB No.: 0925-0589
Expiration Date: xx/xx/20xx
Public reporting burden for this collection of information is estimated to range from 5 to 15 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 208927974, ATTN: PRA (0925-0589). Do not return the completed form to this address.