View Information Collection (IC)

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DASH COVID-19 Demonstration: Mental Health Formative Evaluation and Pilot Study 0920-0840-22HZ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0840 School Administrators - Key Informant Interview Att 5 KeyInformantInterview (KII) Guide.docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-0840 District MTSS Team Members - Key Informant Interview Att 5 KeyInformantInterview (KII) Guide.docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-0840 Middle/High School Students - Student Focus Groups Att 7 Student Level Focus Group Guide.docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-0840 School MTS Team Members - School Implementation Checklist Att 8 School Implementation Chklst (Adapted SAM scales) .docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-0840 District MTSS Team Members - District Implementation Checklist Att 10 District Implementation Chklst (Adapted SAM scales).docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-0840 School MTSS Team Members - MTSS School Level Focus Group Att 11 School MTSS Team FG Guide.docx NA Yes Yes Fillable Fileable

Health Illness Prevention

 

174 0
   
State, Local, and Tribal Governments
 
   50 %

  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 1,044 0 1,044 0 0 0
Annual IC Time Burden (Hours) 152 0 152 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
IRB Determination Att 2 IRB Determination.docx 08/26/2022
Family Consent Form Att 3 Family Consent Form.docx 08/26/2022
Student Consent Form Att 4 Student Assent Form.docx 08/26/2022
Mental Health Study Information Sheet Att 6 MH Study Information Sheet.docx 08/26/2022
Reminder/Participation Emails Att 9 M&H AIR Follow Up Emails.docx 08/26/2022
Supporting Statement A SSA_Mental Health Project-Final.docx 08/26/2022
Supporting Statement B SSB_Mental Health Project.docx 08/26/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.