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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Focus Group Guide Assessments of the Quality and Utility of National Public Health Improvement Initiative to Support STLT	Form and Instruction
Att H - TA Satisfaction Screen Shots Assessments of the Quality and Utility of National Public Health Improvement Initiative to Support STLT	Form
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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none				No	No	Printable Only
Form	none				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 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A		03/07/2013
Supporting Statement B		03/07/2013
Att A - NPHII FOA		03/07/2013
Att B - NPHII Awardees		03/07/2013
Att C - Logic Model		03/07/2013
Att D - Assessment Strategy		03/07/2013
Att E - Focus Group Protocol		03/07/2013
Att G - Focus Group Anonymity Statement		03/07/2013
Att I - TA Satisfaction Tool - word		03/07/2013
Att J - Invite to Focus Groups - grantees		03/07/2013
Att K - Invite to Focus Group - offsite		03/07/2013
Att L - Focus Group Confirmation		03/07/2013
Att M - Focus Group Confirmation - offsite		03/07/2013
Att N - TA Survey Notfication		03/07/2013
Att O - TA Survey Reminder		03/07/2013

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].