Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Enrollment and services data: Case closure (Appendix E) Unchanged 4515 90 0 Other-Data Elements
Enrollment and services data: Case closure – prenatal (Appendix E) Unchanged 3465 70 0 Other-Data Elements
Enrollment and services data: Case enrollment data (Appendix E) Unchanged 4515 1129 0 Other-Data Elements
Enrollment and services data: Semiannual progress reports (Appendix D) Unchanged 70 1155 0 Other-Progress Report
Enrollment and services data: Service log entries (Appendix E) Unchanged 480480 14414 0 Other-Data Elements
Outcomes and impacts data - Administrative data: Obtain access to administrative data (Appendix G) Unchanged 35 1493 0 Other-Admin Data
Outcomes and impacts data - Administrative data: Report administrative data (Appendix G) Unchanged 70 10080 0 Other-Admin Data
Outcomes and impacts data - Standardized instruments: Data entry for comparison study sites (Appendix F) Unchanged 3640 4550 0 Other-Data Elements
Outcomes and impacts data - Standardized instruments: Data entry for standardized instruments (Appendix F) Unchanged 4550 5688 0 Other-Data Elements
Outcomes and impacts data - Standardized instruments: Review and adopt reporting templates (Appendix F) Unchanged 12 93 0 Other-Data Elements
Outcomes and impacts data - Standardized instruments: Review records and submit (Appendix F) Unchanged 70 1750 0 Other-Data Elements
Site visit and key informant data collection: Frontline staff interviews (Appendix B) Unchanged 18 18 0 Other-Interview
Site visit and key informant data collection: PD/PM phone interview (Appendix B) Unchanged 5 5 0 Other-Interview
Site visit and key informant data collection: Partner representative interviews (Appendix B) Unchanged 27 27 0 Other-Interview
Site visit and key informant data collection: Partner survey (Appendix C) Modified 58 24 0 Other-Survey
Site visit and key informant data collection: Program director individual interview (Appendix B) Unchanged 9 18 0 Other-Interview Guide
Site visit and key informant data collection: Program manager/supervisor individual interviews (Appendix B) Unchanged 9 9 0 Other-Interview
Total burden requested under this ICR: 501548 40613 0  
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