Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
AIM Team Lead self-administered baseline surveys Unchanged 258 85 0 Form E
Form and Instruction F
Clinical staff self-administered baseline surveys Unchanged 774 325 0 Form and Instruction G
Form and Instruction H
DUA for AIM data Unchanged 258 21 0 Form and Instruction R
Evaluation form for training of AIM Team Leads Unchanged 290 23 0 Instruction
Form and Instruction B
Facilitation sessions Unchanged 61920 15480 0 Instruction
Focus group discussions with AIM Team Leads and frontline staff New 40 40 0 Instruction
Frontline staff rosters developed by AIM Team Leads Unchanged 1548 124 0 Form A
Qualitative semi-structured interviews with frontline staff New 32 16 0 Form and Instruction J3
Instruction
Instruction
Qualitative, semi-structured interviews with AIM Team Leads Modified 8 8 0 Form and Instruction J3
Form and Instruction J5
Form and Instruction J6
Self-administered implementation surveys with clinical staff at 18 months Unchanged 774 387 0 Form and Instruction M
Form P
Self-administered implementation surveys with clinical staff at 30 months Unchanged 774 387 0 Form and Instruction N
Form Q
Self-administered implementation surveys with clinical staff at 6 months Unchanged 774 387 0 Form and Instruction L
Form O
Tracking attendance of facilitation sessions Unchanged 1032 1032 0 Form and Instruction I
Training of AIM Team Leads Unchanged 387 3096 0 Form and Instruction 1
Training of frontline clinical staff Unchanged 15480 30960 0 Instruction
c) Coaching calls Unchanged 2322 2322 0 Form D
Total burden requested under this ICR: 86671 54693 0  
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