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 Removed 0 0 0 Other-Interview
Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews Removed 0 0 0 Other-Interview
Instrument 12a: COVID-19 Cohort STS New 1875 1875 0 Other-Survey
Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study Modified 379 349 0 Other-Survey
Instrument 18a: Intermediate Follow-up Survey for the National Evaluation impact study - Critical Items Only Modified 42 14 0 Other-Survey
Instrument 5a: HPOG 2.0 National Evaluation Welcome to the Study Packet Modified 2500 250 0 Other-Welcome Packet
Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form Modified 5236 524 0 Other-Update Form
Other-Update Form - Phone Version
Instrument 6: HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews Removed 0 0 0 Other-Interview
Instrument 7: HPOG 2.0 Tribal Evaluation program implementation staff interviews Removed 0 0 0 Other-Interview
Instrument 8: HPOG 2.0 Tribal Evaluation employer interviews Removed 0 0 0 Other-Interview
Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups Removed 0 0 0 Other-Focus Group
PAGES Grantee- and Participant-Level Data Collection (all grantees) Modified 21 667 0 Other-Data collection System
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees) Modified 142 36 0 Other-Data collection System
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study) Modified 1620 810 0 Other-Data collection System
Total burden requested under this ICR: 11815 4525 0  
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