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Qualitative Interview: Collaborative Process Evaluation (THRIVE Partners)
Comprehensive HIV Prevention and Care for Men Who Have Sex with Men of Color
OMB: 0920-1178
IC ID: 224630
OMB.report
HHS/CDC
OMB 0920-1178
ICR 201911-0920-006
IC 224630
( )
Documents and Forms
Document Name
Document Type
Att 5_Qualitative Interview Collaborative Process Evaluation.docx
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Qualitative Interview: Collaborative Process Evaluation (THRIVE Partners)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Instruction
Att 5_Qualitative Interview Collaborative Process Evaluation.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
80
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, 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
80
0
0
0
0
80
Annual IC Time Burden (Hours)
53
0
0
0
0
53
Annual IC Cost Burden (Dollars)
1,378
0
0
0
0
1,378
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.