Information Collection Request

Mother and Infant Home Visiting Program Evaluation (MIHOPE)

ICR 201203-0970-005 · OMB 0970-0402 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
05_MIHOPE Consent for All Respondent Activities 7 10 12.docx Supplementary Document Uploaded 2012-07-11 Available
27_MIHOPE Messages to Home Visiting Staff.docx Supplementary Document Uploaded 2012-07-11 Available
26_MIHOPE Birthday Cards.docx Supplementary Document Uploaded 2012-07-11 Available
25_MIHOPE Family Tracking Postcard and Contact Script.docx Supplementary Document Uploaded 2012-07-11 Available
MIHOPE 2nd Package Supporting Statement B_July 10 2012.docx Supporting Statement B Uploaded 2012-07-11 Available
05_MIHOPE Consent for All Respondent Activities.docx Supplementary Document Uploaded 2012-03-20 Available
28_MIHOPE Messages to Home Visiting Staff - Copy.docx Supplementary Document Uploaded 2012-03-20 Available
27_MIHOPE Birthday Cards - Copy.docx Supplementary Document Uploaded 2012-03-20 Repair queued
26_MIHOPE Family Tracking Postcard and Contact Script - Copy.docx Supplementary Document Uploaded 2012-03-20 Available
29_Response to FRN Comments.docx Supplementary Document Uploaded 2012-03-20 Available
MIHOPE 2nd Package Supporting Statement A_July 10 2012.docx Supporting Statement A Uploaded 2012-07-11 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
203185 Family Screening and Consent Other-Screener New
201664 Home Visitor Individual Interview 12 Month Other-Interview New
201663 Home Visitor Group Interview 12 Month Other-Interview New
201662 Supervisor Group Interview 12 Month Other-Interview New
201661 Program Manager Group Interview 12 Month Other-Interview New
201660 Home Visitor Logs Other-Logs New
201659 Supervisor Logs Other-Logs New
201658 Other Home Visiting Programs Survey Other-Survey New
201657 Community Service Provider Survey Other-Survey New
201656 Home Visitor Survey 12 Month Other-Survey New
201655 Home Visitor Survey Baseline Other-Survey New
201654 Supervisor Survey 12 Month Other-Survey New
201653 Supervisor Survey Baseline Other-Survey New
201652 Program Manager Survey 12 Month Other-Survey New
201651 Program Manager Survey_Part 3 Baseline Other-Survey New
201650 Program Manager Survey_Part 2 Baseline Other-Survey New
201649 Program Manager Survey_Part 1 Baseline Other-Survey New
201648 State Administrator Interview 12 Month Other-Interview New
201647 State Administrator Interview Baseline Other-Interview New
201646 Family Baseline Survey Other-Survey New
200745 Visits and Calls with Local Program Directors Other-Visits and Calls Modified
200744 Second Round Visits with State Administrators Other-Site Visits Modified
200743 First Round Visits with State Administrators Other-Site Visits Modified
200742 Telephone contact with state administrators Other-Telephone Contact Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2015 36 Months From Approved 07/31/2012
17,397 0 202
5,876 0 459
0 0 13,159





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 17,397 202 0 17,195 0 0
Annual Time Burden (Hours) 5,876 459 0 5,417 0 0
Annual Cost Burden (Dollars) 0 13,159 0 -13,159 0 0


Reginfo record details
  No