Information Collection

Stopping Elderly Accidents, Deaths, and Injuries (STEADI) - Focus Groups

IC 221538 under ICR 201405-0920-002 · OMB 0920-1009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1009 can be found here:

Documents and Forms

Document Name Document Type
Stopping Elderly Accidents, Deaths, and Injuries (STEADI) - Focus Groups Form and Instruction
Recruitment Screening Phone Script Att C Recruitment Screening phone scripts.docx Form and Instruction
STEADI Focus Group Moderator Guide 18MAY2016 Att E Instrument STEADI Moderators Guide.docx Form and Instruction
STEADI Phone Interview Moderator Guide 18MAY2016 Att F Phone Instrument STEADI Moderators Guide.docx Form and Instruction
Att A Final SAFE.pdf SAFE Medication Review Framework IC Document
Att B Steadi Flyer.pdf Pharmacist Focus Group Flyer IC Document
Att D Confirmation call.docx Confirmatioin Call Script IC Document
GenIC_Request_STEADI_051816ICRO.docx GenIC Request IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Stopping Elderly Accidents, Deaths, and Injuries (STEADI) - Focus Groups	Agency IC Tracking Number:	16AKU

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form and Instruction	NA	Recruitment Screening Phone Script	Att C Recruitment Screening phone scripts.docx	NA	No	Fillable Printable
Form and Instruction	NA	STEADI Focus Group Moderator Guide 18MAY2016	Att E Instrument STEADI Moderators Guide.docx	NA	No	Fillable Printable
Form and Instruction	NA	STEADI Phone Interview Moderator Guide 18MAY2016	Att F Phone Instrument STEADI Moderators Guide.docx	NA	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 270	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	270	270
Annual IC Time Burden (Hours)	140	140
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SAFE Medication Review Framework	Att A Final SAFE.pdf	05/16/2016
Pharmacist Focus Group Flyer	Att B Steadi Flyer.pdf	05/16/2016
Confirmatioin Call Script	Att D Confirmation call.docx	05/16/2016
GenIC Request	GenIC_Request_STEADI_051816ICRO.docx	05/18/2016

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