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Integrating Comprehensive Family-Centered Care into Substance Use Treatment Programs for Pregnant and Postpartum Women to Prevent the Intergenerational Transmission of Adverse Childhood Experiences
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Demographic Survey Screener 04 Attachment A - Demographic Survey Screener - administrators and providers.docx Yes Yes Fillable Fileable Signable
Other-Demographic Survey Screener 05 Attachment B - Demographic Survey Screener - Pregnant and Postpartum Women.docx Yes Yes Fillable Fileable Signable

Health Public Health Monitoring

 

190 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 190 0 190 0 0 0
Annual IC Time Burden (Hours) 116 0 116 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A 02 Supporting Statement A ASPE-CDC Collaboration on Family Centered SUD Treatment.docx 07/05/2022
Supporting Statement B 03 Supporting Statement B ASPE-CDC Collaboration on Family Centered SUD Treatment.docx 07/05/2022
Attachment C - Participant Information Sheet 06 Attachment C - Participant Information Sheet.docx 07/05/2022
Attachment D - Discussion Guide for Administrators and Providers 07 Attachment D - Discussion Guide for Administrators and Providers.docx 07/05/2022
Attachment E - Discussion guide for interviews with pregnant and postpartum women 08 Attachment E - Discussion Guide for Interviews with Pregnant and Postpartum Women.docx 07/05/2022
Generic Memo 01 Generic Clearance Cover Memo - ASPE-CDC Collaboration on Family Centered SUD Treatment.docx 07/25/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.