Information Collection Request

Mother and Infant Home Visiting Program Evaluation (MIHOPE)

ICR 201403-0970-002 · OMB 0970-0402 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
MIHOPE Changes to Follow Up Survey-Memo to OMB-Mar2014 .docx Justification for No Material/Nonsubstantive Change Uploaded 2014-03-12 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
205475 Measuring Height and Weight Other-Protocol - Child assessments Modified
205474 Direct Child Assessments Other-Protocol - Child assessments Modified
205473 Direct parent-child interaction Other-Protocol - parent-child interaction Modified
205472 Family follow-up survey Other-Survey Modified
205471 Home Visitor Logs - Past 15 months Other-Logs Modified
205470 Combined Home Visitor-Supervisor 12 Month Survey Other-Survey Modified
205469 Combined Home Visitor - Supervisor Baseline Survey Other-Survey Modified
203185 Family Screening and Consent Other-Screener Modified
201664 Home Visitor Individual Interview 12 Month Other-Interview Modified
201663 Home Visitor Group Interview 12 Month Other-Interview Modified
201662 Supervisor Group Interview 12 Month Other-Interview Modified
201661 Program Manager Group Interview 12 Month Other-Interview Modified
201660 Home Visitor Logs Other-Logs Modified
201659 Supervisor Logs Other-Logs Modified
201658 Other Home Visiting Programs Survey Other-Survey Modified
201657 Community Service Provider Survey Other-Survey Modified
201656 Home Visitor Survey 12 Month Other-Survey Modified
201655 Home Visitor Survey Baseline Other-Survey Modified
201654 Supervisor Survey 12 Month Other-Survey Modified
201653 Supervisor Survey Baseline Other-Survey Modified
201652 Program Manager Survey 12 Month Other-Survey Modified
201651 Program Manager Survey_Part 3 Baseline Other-Survey Modified
201650 Program Manager Survey_Part 2 Baseline Other-Survey Modified
201649 Program Manager Survey_Part 1 Baseline Other-Survey Modified
201648 State Administrator Interview 12 Month Other-Interview Modified
201647 State Administrator Interview Baseline Other-Interview Modified
201646 Family Baseline Survey Other-Survey Modified
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
06/30/2016 06/30/2016 06/30/2016
34,487 0 34,487
11,161 0 11,161
0 0 0





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 34,487 34,487 0 0 0 0
Annual Time Burden (Hours) 11,161 11,161 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No