Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Instrument 10: HPOG 2.0 Tribal Evaluation program participant completer interviews Modified 67 67 0 Other-Interview
Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews Modified 34 34 0 Other-Interview
Instrument 12: Short-Term Follow-up Survey for the HPOG 2.0 National Evaluation Impact Evaluation Modified 1981 1981 0 Other-Survey
Instrument 13: Screening tool for identifying respondents for second-round telephone interviews New 13 7 0 Other-Screener
Instrument 14: Second round telephone interview protocol for non-tribal HPOG grantee staff and partners New 63 79 0 Other-Interview Guide
Instrument 15: Program operator interview guide for the systems study New 5 6 0 Other-Interview Guide
Instrument 16: Partner interview guide for the systems study New 37 37 0 Other-Interview Guide
Instrument 17: Participant interview guide New 47 63 0 Other-Interview Guide
Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study New 1333 1333 0 Other-Survey
Instrument 19: Phone-based Skills Assessment Pilot Instrument New 100 75 0 Other-Phone-based Assessment
Instrument 20: Program cost survey New 13 91 0 Other-Survey
Instrument 4: HPOG 2.0 National Evaluation in-person implementation interviews Removed 0 0 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 Removed 0 0 0 Other-Welcome Packet
Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form Modified 11751 1175 0 Other-Update Form
Instrument 6: HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews Modified 24 24 0 Other-Interview
Instrument 7: HPOG 2.0 Tribal Evaluation program implementation staff interviews Modified 34 51 0 Other-Interview
Instrument 8: HPOG 2.0 Tribal Evaluation employer interviews Modified 20 15 0 Other-Interview
Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups Modified 90 135 0 Other-Focus Group
PAGES Grantee- and Participant-Level Data Collection (all grantees) Modified 64 2032 0 Other-Data collection System
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees) Modified 430 108 0 Other-Data collection System
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study) Modified 4934 2467 0 Other-Data collection System
Total burden requested under this ICR: 21040 9780 0  
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