Summary of Respondents and Conversion for Annualization

Att 3e. Cat B 1815 Summ of Annual Resp.docx

National Evaluation of the DP18-1815 Cooperative Agreement Program: Category B, Cardiovascular Disease Prevention and Management

Summary of Respondents and Conversion for Annualization

OMB: 0920-1311

Document [docx]
Download: docx | pdf

Attachment 3f: Crosswalk of Type and Number of Respondents (total and annualized), by Evaluation Component and Information Collection Instrument

DP18-1815PHHF18

Improving the Health of Americans through Prevention and Management of Diabetes and Heart Disease and Stroke

Category B: CARDIOVASCULAR DISEASE PREVENTION AND MANAGEMENT



This cell = 1 if the form will be completed 1 time during the 3-year clearance period

This cell = 2 if the form will be completed 2 times during the 3-year clearance period

This cell = 3 if the form will be completed 3 times (i.e., annually) during the 3-year clearance period

No. sampled x Total Times / 3 = This cell



Type of Respondents


(and Sampling Frame)

Form Name

No. in Respondent Universe

Total No. to be sampled

Total No. of Times the Form will be Completed over the 3-year clearance period

Annualized Number of Respondents


Category B Case Study – Site-Level Interview Guides


Partner site staff

(Physicians, Pharmacists, Nurses, and Medical and Health Services Manager)

CQM Partner Site-Level Interview Guide

Unknown

45

1

15

Partner site staff

(Physicians, Pharmacists, Nurses, and CHWs)

TBC Partner Site-Level Interview Guide1

Unknown

24

1

8

Partner site staff

(Physicians, Pharmacists)

MTM Partner Site-Level Interview Guide1

Unknown

21

1

7

Partner site staff

(Physicians, Nurses, and CHWs)

CCL Partner Site-Level Interview Guide

Unknown

45

1

15


Category B Case Study – HD-Level Interview Guides


HD recipient staff

(HD Recipient Staff)

CQM HD Recipient Interview Guide

Unknown

25

2

17

TBC HD Recipient Interview Guide1

Unknown

13

2

9

MTM HD Recipient Interview Guide1

Unknown

12

2

8

CCL HD Recipient Interview Guide

Unknown

25

2

17


Category B Case Study – HD-Level Discussion Guide


HD recipient staff

(HD Recipient Staff)

CQM HD Recipient Group Discussion Guide

Unknown

40

2

27

TBC HD Recipient Group Discussion Guide

Unknown

40

2

27

CCL HD Recipient Group Discussion Guide

Unknown

40

2

27


Category B Cost Study


HD recipient staff

(HD Recipient Staff)

HD Recipient Resource Use and Cost Inventory Tool (Category B)

51

25

1

8

Partner site staff

(Partner Site Staff)

Partner Site-Level Resource Use and Cost Inventory Tool (Category B)

Unknown

50

1

17


1815 Recipient-Led Evaluation Reporting Deliverables


HD recipient staff

(HD Recipient Staff)

Category B - DHDSP Recipient-led Evaluation Reporting Deliverable Template(s)

51

51

3

51

Total




446 respondents to be sampled


253 annualized number of respondents





1 TBC and MTM interviews will both be used to inform the same TBC Case Studies. Since this program area requires two distinct interview guides, the total estimated number of participants has been split across the two guides.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorGopez, Gizelle
File Modified0000-00-00
File Created2021-01-14

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