Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
*NOT NEW* Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form New 14700 1470 0 Other-Update Form
Instrument 10: HPOG 2.0 Tribal Evaluation program participant completer interviews Unchanged 100 100 0 Other-Interview
Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews Unchanged 50 50 0 Other-Interview
Instrument 12: Short-Term Follow-up Survey for the HPOG 2.0 National Evaluation Impact Evaluation New 3467 3467 0 Other-Survey
Instrument 2: Screening Interview to identify respondents for the HPOG 2.0 National Evaluation first-round telephone interviews Removed 0 0 0 Other-Screening Interview
Instrument 3: HPOG 2.0 National Evaluation first-round telephone interviews with management, staff, partners, and staffstakeholders Removed 0 0 0 Other-Interview
Instrument 4: HPOG 2.0 National Evaluation in-person implementation interviews Unchanged 33 50 0 Other-Interview
Other-Interview
Other-Interview
Other-Interview
Other-Interview
Instrument 5a: HPOG 2.0 National Evaluation welcome packet, letter and participant contact update forms Modified 4550 455 0 Other-Welcome Packet
Instrument 6: HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews Unchanged 35 35 0 Other-Interview
Instrument 7: HPOG 2.0 Tribal Evaluation program implementation staff interviews Unchanged 50 75 0 Other-Interview
Instrument 8: HPOG 2.0 Tribal Evaluation employer interviews Unchanged 30 23 0 Other-Interview
Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups Unchanged 135 203 0 Other-Focus Group
PAGES Grantee- and Participant-Level Data Collection (all grantees) Modified 38 1207 0 Other-Data collection System
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees) Modified 693 173 0 Other-Data collection System
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study) Modified 7393 3697 0 Other-Data collection System
Total burden requested under this ICR: 31274 11005 0  
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