Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual Interview (Quarters 4, 8, and 11) New 9000 4500 0 Other-Annual Interview Questions
Baseline Interview New 3000 2250 0 Other-Baseline Interview Questions
Competency and CIDI Screener New 3000 2000 0 Other-CIDI Screener
Other-Additional screener questions
Fidelity Assessment Family Member Interview New 360 360 0 Other-Fidelity Assessement Family Member Interview
Fidelity Assessment Participant Interview New 720 720 0 Other-Fidelity Assessment Interview
Key Informant Interview New 480 480 0 Other-Key Informant Interview
Participant Focus Groups New 1200 1200 0 Other-Participant Focus Group Questions
Person-Centered Interview New 720 720 0 Other-Person Centered Interview
Quarterly Interview (Quarters 1, 2, 3, 5, 6, 7, 9, 10, and 11) New 27000 9000 0 Other-Quarterly Interview Questions
Total burden requested under this ICR: 45480 21230 0  
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