Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
AIM Team Lead self-administered baseline surveys New 258 85 0 Form E
Form and Instruction F
Clinical staff self-administered baseline surveys New 774 325 0 Form and Instruction G
Form and Instruction H
DUA for AIM data New 258 21 0 Form and Instruction R
Evaluation form for training of AIM Team Leads New 290 23 0 Instruction
Form and Instruction B
Facilitation sessions New 61920 15480 0 Instruction
Frontline staff rosters developed by AIM Team Leads New 1548 124 0 Form A
Qualitative, semi-structured interviews with AIM Team Leads New 25 25 0 Form and Instruction J
Form and Instruction K
Self-administered implementation surveys with clinical staff at 18 months New 774 387 0 Form and Instruction M
Form P
Self-administered implementation surveys with clinical staff at 30 months New 774 387 0 Form and Instruction N
Form Q
Self-administered implementation surveys with clinical staff at 6 months New 774 387 0 Form and Instruction L
Form O
Tracking attendance of facilitation sessions New 1032 1032 0 Form and Instruction I
Training of AIM Team Leads New 387 3096 0 Form and Instruction 1
Training of frontline clinical staff New 15480 30960 0 Instruction
c) Coaching calls New 2322 2322 0 Form D
Total burden requested under this ICR: 86616 54654 0  
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