Information Collection

Formative assessment to inform the redesign of the Research Tested Intervention Programs (RTIPS) website

IC 236878 under ICR 201605-0925-007 · OMB 0925-0046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Formative assessment to inform the redesign of the Research Tested Intervention Programs (RTIPS) website	Form and Instruction
1 Interview Guide Attachment 1. Interview guide FINAL (3).docx	Form and Instruction
Mini SSA_RTIPS_formative - FINAL.docx Mini SSA RTIPS	IC Document
Attachment 2. Consent form (1).docx Consent Form	IC Document
Attachment 3. Email invite - FINAL (1).docx Email Invitation	IC Document

IC Title:

Formative assessment to inform the redesign of the Research Tested Intervention Programs (RTIPS) website

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Interview Guide	Attachment 1. Interview guide FINAL (3).docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Mini SSA RTIPS	Mini SSA_RTIPS_formative - FINAL.docx	07/15/2019
Consent Form	Attachment 2. Consent form (1).docx	07/15/2019
Email Invitation	Attachment 3. Email invite - FINAL (1).docx	07/15/2019

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