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
Instrument 10: Key Informant Interviews with BSC Faculty Members Affiliated with the States/Regions Discussion Guide
Unchanged
3
3
0
Other-Interview Protocol
Instrument 11: BSC Implementation Staff and Faculty Focus Group Discussion Guide
Modified
20
30
0
Other-Interview Protocol
Instrument 12: BSC Implementation Staff and Faculty Background Survey
Unchanged
10
2
0
Other-Survey
Instrument 13: Key Informant Interviews with BSC Center Administrators Discussion Guide
Modified
16
16
0
Other-Interview Protocol
Instrument 14: BSC Teachers and Support Staff Focus Group Discussion Guide
Modified
80
120
0
Other-Interview Protocol
Instrument 15: BSC Parent Focus Group Discussion Guide
Modified
16
24
0
Other-Interview Protocol
Instrument 16: Individual BSC Teams Focus Group Discussion Guide
Unchanged
112
168
0
Other-Interview Protocol
Instrument 17a: Administrator Surveys
Modified
24
12
0
Other-Survey
Instrument 17b: Teacher Surveys
Modified
240
120
0
Other-Survey
Instrument 17c. Other Center Staff Surveys
Modified
96
48
0
Other-Survey
Instrument 17di: Non-BSC Parent Surveys
Modified
1424
356
0
Other-Survey
Instrument 17dii: BSC Parent Surveys
Modified
24
12
0
Other-Survey
Instrument 18: Administrative Data Survey
Unchanged
32
8
0
Instruction
Instrument 1: BSC Selection Application Questionnaire
Unchanged
75
94
0
Other-Questionnaire
Instrument 2: Pre-Work Assignment: Data Collection Planning Worksheet
Unchanged
16
32
0
Other-Planning Worksheet
Instrument 3: Plan, Do, Study, Act (PDSA) Form & Tracker
Unchanged
1904
476
0
Other-Form & Tracker
Instrument 4: Monthly Metrics
Unchanged
128
192
0
Instruction
Instrument 5: Implementation Discussion Forum Prompts
Unchanged
1904
476
0
Other-Forum Guide
Instrument 6: Learning Session Feedback Form
Unchanged
224
56
0
Other-Feedback Form
Instrument 7: Action Planning Form
Unchanged
224
56
0
Other-Action Planning Form
Instrument 8: BSC Overall Feedback Form
Unchanged
56
14
0
Other-Feedback Form
Instrument 9: Organizational Self-Assessment
Modified
280
420
0
Other-Survey
Total burden requested under this ICR:
6908
2735
0
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