Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Instrument #10: Telephone interviews (with staff at referral organizations) New 50 25 0 Other-Interview
Instrument #12: Focus Group Guide New 600 900 0 Other-Guide
Instrument #13: Telephone interviews - Program participants (program dropouts) New 150 38 0 Other-Interview
Instrument #14: Guide for in-person, in-depth interviews with study participants New 96 192 0 Other-Interview Guide
Instrument #15: Check in Call Guide New 128 21 0 Other-Guide
Instrument #16: Semi-structured interview topic guide - Hispanic Population Focus New 42 63 0 Other-Topic Guide
Instrument #17: Focus Group Guide - Hispanic Population Focused New 20 30 0 Other-Focus Group Guide
Instrument #18: Questionnaires for Participants in Focus Group with Hispanic Population Focus New 20 7 0 Other-Questionnaire
Instrument #1: PACT - Discussion Guide Modified 50 50 0 Other-Discussion Guide
Instrument #2a: Introductory Script - Grantee Staff Modified 2106 351 0 Other-Script
Instrument #2b: Introductory Script - Program Applicants Modified 2105 351 0 Instruction
Instrument #3 - Baseline Survey Modified 2000 1000 0 Other-Survey
Instrument #6 - RF Study MIS Modified 75990 2533 0 Other-MIS
Instrument #7: HM Study MIS New 102000 3400 0 Other-MIS
Instrument #8: Semi-structured interview topic guide New 500 517 0 Other-Topic Guide
Instrument #9: On-line Survey for Program Staff New 500 250 0 Other-Survey
Instrument 11a: On-line Working Alliance Inventory - Program Staff New 1000 167 0 Other-Inventory
Instrument 11b: On-line Working Alliance Inventory - Participants New 1000 167 0 Other-Inventory
Instrument 4a: Introductory script - Program Staff Burden New 2100 351 0 Other-Script
Instrument 4b: Introductory script - HM Program Applicants New 4210 703 0 Other-Script
Instrument 5: Baseline survey - HM Study Participants New 4000 2000 0 Other-Survey
Total burden requested under this ICR: 198667 13116 0  
To view an IC, click on IC Title