Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Outcomes and impacts data - Standardized instruments: Data entry for comparison study sites (16 grantees) (Appendix G) Modified 1600 1000 0 Other-Data Elements
Enrollment and services data: Case closure (Appendix F) Modified 1782 30 0 Other-Data Elements
Enrollment and services data: Case closure – prenatal (Appendix F) Modified 180 3 0 Other-Data Elements
Enrollment and services data: Case enrollment data (Appendix F) Modified 1782 446 0 Other-Data Elements
Enrollment and services data: Semiannual progress reports (Appendix E) Modified 36 594 0 Other-Progress Report
Enrollment and services data: Service log entries (Appendix F) Modified 168480 5560 0 Other-Data Elements
Outcomes and impacts data - Administrative data: Obtain access to administrative data (Appendix H) Modified 18 738 0 Other-Admin Data
Outcomes and impacts data - Administrative data: Report administrative data (Appendix H) Modified 36 5184 0 Other-Admin Data
Outcomes and impacts data - Standardized instruments: Data entry for comparison study sites (Appendix F) Removed 0 0 0 Other-Data Elements
Outcomes and impacts data - Standardized instruments: Enter data into local database (Appendix G) Modified 1800 1125 0 Other-Data Elements
Outcomes and impacts data - Standardized instruments: Review records and submit (Appendix G) Modified 36 900 0 Other-Data Elements
Site visit and key informant data collection: Frontline staff interviews (Appendix B) Modified 5 5 0 Other-Interview
Site visit and key informant data collection: PD/PM phone interview (Appendix B) Removed 0 0 0 Other-Interview
Site visit and key informant data collection: Partner representative interviews (Appendix B) Modified 8 8 0 Other-Interview
Site visit and key informant data collection: Partner survey (Appendix C) Modified 14 6 0 Other-Survey
Site visit and key informant data collection: Program director individual interview (Appendix B) Modified 3 5 0 Other-Interview Guide
Site visit and key informant data collection: Program manager/supervisor individual interviews (Appendix B) Modified 3 3 0 Other-Interview
Site visit and key informant data collection: Sustainability survey (Appendix D) New 53 18 0 Other-Survey
Total burden requested under this ICR: 175836 15625 0  
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