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