Information Collection Request

Evaluation of the Text4baby Program

ICR 201207-0915-001 · OMB 0915-0347 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Stakeholder 1 Stakeholder Interview Guide Form Modified Available
Form 1 Key Informant Interview Guide Form Modified Available
Form Focus Group-1 Focus Group Protocol Form Modified Available
Form Focus Group-3 Focus Group: Participant Information Form (Postpartum Women) Form Modified Available
Form Focus Group-2 Focus Group: Participant Information Form (Pregnant Women) Form Modified Available
Form 2 R2 HPP Survey Revised Jan 2012 Access Questions Form Modified Available
Form 1.0 Safety Net Consumer Survey - R1 Form Modified Available
Justification memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2012-07-02 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
200144 Prenatal Patient and Parent of Minor Consent Other-Explanation of burden associated with consent Modified
200143 Consent Training and Coordination Other-Explanation of Burden Modified
200142 Stakeholder Interviews Form ModifiedStakeholder Interview Guide
200141 Key Informant Interviews Form ModifiedKey Informant Interview Guide
200140 Consumer Focus Groups Form ModifiedFocus Group Protocol
200140 Consumer Focus Groups Form ModifiedFocus Group: Participant Information Form (Postpartum Women)
200140 Consumer Focus Groups Form ModifiedFocus Group: Participant Information Form (Pregnant Women)
200139 Safety Net Consumer Survey Round 2 Form ModifiedR2 HPP Survey Revised Jan 2012 Access Questions
200138 Safety Net Consumer Survey Round 1 Form ModifiedSafety Net Consumer Survey - R1

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2015 02/28/2015 02/28/2015
5,266 0 5,266
1,196 0 1,196
0 0 0





Reginfo record details
7
table that charts list of burden
IC Title Form No. Form Name
Consent Training and Coordination
Consumer Focus Groups Focus Group-2, Focus Group-3, Focus Group-1 ,   ,  
Key Informant Interviews 1
Prenatal Patient and Parent of Minor Consent
Safety Net Consumer Survey Round 1 1.0
Safety Net Consumer Survey Round 2 2
Stakeholder Interviews Stakeholder 1



Reginfo record details
  No