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Key Informant interview-Community Health Workers
OS Think Cultural Health
OMB: 0990-0407
IC ID: 219188
OMB.report
HHS/HHSDM
OMB 0990-0407
ICR 201511-0990-001
IC 219188
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0407 can be found here:
2022-08-26 - Reinstatement without change of a previously approved collection
2019-04-30 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
0990-0407Appendix F - TCH Key Informant Interview Protocol (Community Health Workers)(12.2.15).pdf
Other-interview
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Key Informant interview-Community Health Workers
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-interview
0990-0407Appendix F - TCH Key Informant Interview Protocol (Community Health Workers)(12.2.15).pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
25
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
25
0
25
0
0
0
Annual IC Time Burden (Hours)
25
0
25
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.