National DPP Lifestyle Coach Interview

National Evaluation of the DP18-1815 Cooperative Agreement Program: Category A, Diabetes Management and Type 2 Diabetes Prevention

Documents and Forms

Document Name Document Type
National DPP Lifestyle Coach Interview Form and Instruction
National DPP Site-Level Rapid Evaluation - Semi-Structur Att 4i. NDPP LC Interview_30Day_v2.docx Form and Instruction

Information Collection (IC) Details

IC Title:	National DPP Lifestyle Coach Interview	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
Form and Instruction	n/a	National DPP Site-Level Rapid Evaluation - Semi-Structured Interview Guide, Lifestyle Coach	Att 4i. NDPP LC Interview_30Day_v2.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 28	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	28	28
Annual IC Time Burden (Hours)	28	28
Annual IC Cost Burden (Dollars)	588	588

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.