Information Collection

Assessments of the Quality and Utility of National Public Health Improvement Initiative to Support STLT

IC 206096 under ICR 201110-0920-004 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Assessments of the Quality and Utility of National Public Health Improvement Initiative to Support STLT Form and Instruction
Focus Group Guide NPHII Att F Focus Group Guide.docx Form and Instruction
Att H - TA Satisfaction Screen Shots NPHII Att H TA Tool (screenshots).docx Form
NPHII Support Assessment- Supporting Statement A - v030413.docx Supporting Statement A IC Document
NPHII Support Assessment- Supporting Statement B - v030413.docx Supporting Statement B IC Document
NPHII Att A Original NPHII FOA.docx Att A - NPHII FOA IC Document
NPHII Att B FY2012 NPHII Awardees.docx Att B - NPHII Awardees IC Document
NPHII Att C Logic Model for NPHII.docx Att C - Logic Model IC Document
NPHII Att D. NPHII Assessment Strategy am2.docx Att D - Assessment Strategy IC Document
NPHII Att E Focus Group Protocol.docx Att E - Focus Group Protocol IC Document
NPHII Att G Focus Group Anonymity Statement am.docx Att G - Focus Group Anonymity Statement IC Document
NPHII Attt I TA Tool (word doc).docx Att I - TA Satisfaction Tool - word IC Document
NPHII Att J Invite to focus group (grantee) am.docx Att J - Invite to Focus Groups - grantees IC Document
NPHII Att K Invite to focus group (offsite) am.docx Att K - Invite to Focus Group - offsite IC Document
NPHII Att L Focus Group Confirmation (grantee) am.docx Att L - Focus Group Confirmation IC Document
NPHII Att M Focus Group Confirmation (offsite) am.docx Att M - Focus Group Confirmation - offsite IC Document
NPHII Att N TA Tool Notification_srd.docx Att N - TA Survey Notfication IC Document
NPHII Att O TA Satisfaction Reminders.docx Att O - TA Survey Reminder IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Assessments of the Quality and Utility of National Public Health Improvement Initiative to Support STLT	Agency IC Tracking Number:

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
Form and Instruction	none	Focus Group Guide	NPHII Att F Focus Group Guide.docx		No	No	Printable Only
Form	none	Att H - TA Satisfaction Screen Shots	NPHII Att H TA Tool (screenshots).docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 176	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 68 %

	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	176	0	0	0	0	0
Annual IC Time Burden (Hours)	142	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	NPHII Support Assessment- Supporting Statement A - v030413.docx	03/07/2013
Supporting Statement B	NPHII Support Assessment- Supporting Statement B - v030413.docx	03/07/2013
Att A - NPHII FOA	NPHII Att A Original NPHII FOA.docx	03/07/2013
Att B - NPHII Awardees	NPHII Att B FY2012 NPHII Awardees.docx	03/07/2013
Att C - Logic Model	NPHII Att C Logic Model for NPHII.docx	03/07/2013
Att D - Assessment Strategy	NPHII Att D. NPHII Assessment Strategy am2.docx	03/07/2013
Att E - Focus Group Protocol	NPHII Att E Focus Group Protocol.docx	03/07/2013
Att G - Focus Group Anonymity Statement	NPHII Att G Focus Group Anonymity Statement am.docx	03/07/2013
Att I - TA Satisfaction Tool - word	NPHII Attt I TA Tool (word doc).docx	03/07/2013
Att J - Invite to Focus Groups - grantees	NPHII Att J Invite to focus group (grantee) am.docx	03/07/2013
Att K - Invite to Focus Group - offsite	NPHII Att K Invite to focus group (offsite) am.docx	03/07/2013
Att L - Focus Group Confirmation	NPHII Att L Focus Group Confirmation (grantee) am.docx	03/07/2013
Att M - Focus Group Confirmation - offsite	NPHII Att M Focus Group Confirmation (offsite) am.docx	03/07/2013
Att N - TA Survey Notfication	NPHII Att N TA Tool Notification_srd.docx	03/07/2013
Att O - TA Survey Reminder	NPHII Att O TA Satisfaction Reminders.docx	03/07/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.