PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
10 minute Meeting
Modified
180
30
0
Form and Instruction
na
C1 - 10 minute meeting
Changes in Behaviors After Training
Modified
60
2
0
Form and Instruction
na
C7 - Changes in Behavior Survey
Demographics and Work Experience Survey
Modified
60
2
0
Form and Instruction
na
C2 - Demographic and Work Experience Survey
Epworth Sleepiness Scale Survey
Modified
120
2
0
Form and Instruction
na
C4 - Epworth sleepiness scale survey
Feedback About the Training, Barriers, and Influeuntial People
Modified
60
5
0
Form and Instruction
na
C6 - Feedback Survey
Initial Meeting (Fit Actigraph)
Modified
60
15
0
Form and Instruction
na
C1 - Initial meeting
Knowledge Survey
Modified
120
10
0
Form and Instruction
na
C3 - Knowledge survey
Online Training
Modified
60
150
0
Instruction
Pittsburgh Sleep Quality Index
Modified
120
4
0
Form and Instruction
na
C5 - Pittsburgh Sleep Quality Survey
Recruitment
Modified
60
30
0
Instruction
Sleep Activity Diary
Modified
5040
84
0
Form and Instruction
na
C1 - Sleep diary
Total burden requested under this ICR:
5940
334
0
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