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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Advancing COVID-19 Health Equity Research
Agency IC Tracking Number:
OC
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-AIM 1 focus group flyer
0497 AIM 1 Focus Group Flyer 7-14-22.pdf
Yes
No
Printable Only
Other-AIM 1 screener
0497 AIM 1 Screening 7-14-22.docx
Yes
Yes
Fillable Fileable
Other-AIM 1 focus group moderator guide
0497 Aim 1 Focus Group Moderator Guide 7-14-22.docx
Yes
Yes
Fillable Fileable
Other-AIM 2 community leaders focus group flyer
0497 AIM 2 Focus Group Flyer Community Leaders 7-14-22.pdf
Yes
No
Printable Only
Other-AIM 2 community leaders screener
0497 AIM 2 Community Leaders Screening 7-14-22.docx
Yes
Yes
Fillable Fileable
Other-AIM 2 community leader focus group moderator guide
0497 AIM 2 Focus Group Community Leader Moderator Guide 7-14-22.docx
Yes
Yes
Fillable Fileable
Other-AIM 2 healthcare professionals focus group flyer
0497 AIM 2 Focus Group Flyer Healthcare Profesionals 7-14-22.pdf
Yes
No
Printable Only
Other-AIM 2 healthcare professionals focus group screener
0497 AIM 2 Healthcare Professionals Screening 7-14-22.docx
Yes
Yes
Fillable Fileable
Other-AIM 2 healthcare professionals focus group moderator guide
0497 AIM 2 Healthcare Professionals Moderator Guide 7-14-22.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
144
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
144
0
144
0
0
0
Annual IC Time Burden (Hours)
230
0
230
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
0947 OMB Memo Advancing COVID-19 Health Equity Research
0497 OMB Memo Advancing COVID-19 Health Equity Research 7-14-22.docx
07/14/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.