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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Instrument #10: Telephone interviews (with staff at referral organizations)
Modified
50
25
0
Other-Interview
Instrument #12: Focus Group Guide
Modified
600
900
0
Other-Guide
Instrument #13: Telephone interviews - Program participants (program dropouts)
Modified
150
38
0
Other-Interview
Instrument #14: Guide for in-person, in-depth interviews with study participants
Modified
96
192
0
Other-Interview Guide
Instrument #15: Check in Call Guide
Modified
128
21
0
Other-Guide
Instrument #16: Semi-structured interview topic guide - Hispanic Population Focus
Modified
42
63
0
Other-Topic Guide
Instrument #17: Focus Group Guide - Hispanic Population Focused
Modified
20
30
0
Other-Focus Group Guide
Instrument #18: Questionnaires for Participants in Focus Group with Hispanic Population Focus
Modified
20
7
0
Other-Questionaire
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
Other-Script
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
Modified
102000
3400
0
Other-MIS
Instrument #8: Semi-structured interview topic guide
Modified
500
517
0
Other-Topic Guide
Instrument #9: On-line Survey for Program Staff
Modified
500
250
0
Other-Survey
Instrument 11a: On-line Working Alliance Inventory - Program Staff
Modified
1000
167
0
Other-Inventory
Instrument 11b: On-line Working Alliance Inventory - Participants
Modified
1000
167
0
Other-Inventory
Instrument 4a: Introductory script - Program Staff Burden
Modified
2100
351
0
Other-Script
Instrument 4b: Introductory script - HM Program Applicants
Modified
4210
703
0
Other-Script
Instrument 5: Baseline survey - HM Study Participants
Modified
4000
2000
0
Other-Survey
NEW - Instrument #19: RF Follow-up survey - Study Participants
New
1600
1200
0
Other-Survey
NEW - Instrument #20: HM Follow-up survey - Study Participants
New
3200
2400
0
Other-Survey
Total burden requested under this ICR:
203467
16716
0
To view an IC, click on IC Title