View Information Collection (IC)

View Information Collection (IC)

DASH Demo: Comprehensive Health Educator Core Knowledge and Skills Training (CHECKS) PD Pilot Study 0920-0840-20CQ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0840 Adolescent Growth and Development Survey Att 2_Adolescent Growth and Development survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 2a_Adolescent Growth and Development_screenshot.pdf No   Paper Only
Form 0920-0840 Assess and Adjust Survey Att 3_Assess and Adjust survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 3a_Assess and Adjust_screenshot.pdf No   Paper Only
Form 0920-0840 Basic Principles of Teaching Health Education Survey Att 4_Basic Principles of Teaching HE_elearning survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 4a_ Basic Principles of Teaching Health Education_screenshots.pdf No   Paper Only
Form 0920-0840 Culturally Responsive Health Education Classroom Survey Att 5_Culturally Responsive survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 5a_Culturally Responsive Health Education Classroom_screenshot.pdf No   Paper Only
Form 0920-0840 In-person Training Survey Att 6_In-person training survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 6a_In-Person Training Evaluation_screenshot.pdf No   Paper Only
Form 0920-0840 Micro Session Survey Att 7_Micro session survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 7a_CHECKS_Micro Session Survey_screenshot.pdf No   Paper Only
Form 0920-0840 Trauma Informed Approach Survey Att 8_TIA elearning module survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 8a_E-Learning Trauma Informed Approach_screenshot.pdf No   Paper Only
Form 0920-0840 Teacher Survey Att 9_Teacher Survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 9a_Teacher tool_screenshots.pdf No   Paper Only
Form 0920-0840 Student Survey Att 10_Student Survey.pdf Yes Yes Fillable Fileable
Other-Screenshots Att 10a_Student Tool_screenthots.pdf No   Paper Only

Health Illness Prevention

 

1,800 0
   
Individuals or Households
 
   100 %

  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 1,800 0 1,800 0 0 0
Annual IC Time Burden (Hours) 662 0 662 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Invitation Email Att 11_ CHECKS_Pilot_Invitation Email.pdf 02/23/2021
Reminder Email Att 11a_CHECKS PD_PIlot_Reminder Email.pdf 02/23/2021
Teacher Consent Att 12 CHECKS PD Pilot_Teacher Consent.pdf 02/23/2021
Student Assent Att 13_ CHECKS PD Pilot_Student Assent Form.pdf 02/23/2021
Parental Consent Att 14_CHECKS PD Pilot_Parental Consent Form.pdf 02/23/2021
IRB Approval Att 15_IRB Approval.pdf 02/23/2021
Respondent Universe Att 16_Respondent Universe.docx 02/23/2021
Consultants Att 17_CHECKS PD Pilot_Consultants.docx 02/23/2021
PIA Att 18_PIA_CHECKS_PD_Pilot.pdf 02/23/2021
SSA SSA-CHECKS-3_9_21_Clean.pdf 03/10/2021
SSB SSB-CHECKS_1_11_20.docx 02/25/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.