Educating and Training of Healthcare Violence Against Women

ICR 201502-0990-011

OMB: 0990-0422

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement B
2015-02-25
Supporting Statement A
2015-02-25
IC Document Collections
IC ID
Document
Title
Status
212286 Unchanged
212285 Unchanged
212226 Unchanged
ICR Details
0990-0422 201502-0990-011
Historical Active 201410-0990-001
HHS/HHSDM
Educating and Training of Healthcare Violence Against Women
Extension without change of a currently approved collection   No
Regular
Approved without change 05/18/2015
Retrieve Notice of Action (NOA) 02/26/2015
  Inventory as of this Action Requested Previously Approved
05/31/2018 36 Months From Approved 08/31/2015
4,800 0 4,800
2,001 0 2,001
0 0 0

The purpose of this data collection is to gather data from healthcare providers who have volunteered to participate in the pilot and evaluation of an e-learning course designed to educate and train healthcare providers on how to respond to intimate partner violence (IPV) against women. Information obtained from this data collection will be used to identify areas of improvement and measure the effectiveness of the e-learning course in educating healthcare providers about IPV, addressing attitudinal barriers to IPV screening, and increasing IPV screening in clinical practice.

PL: Pub.L. 111 - 148 2713 Name of Law: The Patient Protection and Affordable Care Act
  
None

Not associated with rulemaking

  79 FR 68883 11/19/2014
80 FR 9723 02/24/2015
No

3
IC Title Form No. Form Name
Pre-Assessment
Post-Assessment
3-Month Follow-up Assessment

  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 4,800 4,800 0 0 0 0
Annual Time Burden (Hours) 2,001 2,001 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$410,817
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Sherette Funn-Coleman

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/26/2015


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