Information Collection

Qualitative, semi-structured interviews with AIM Team Leads

IC 237417 under ICR 202105-0935-001 · OMB 0935-0246.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form J3 Qualitative, semi-structured interviews with AIM Team Leads	Form and Instruction
J3 Attachment J1 Interview guide for qualitative interviews Appendix J1_revised_Interview Guide 3_4 mos_06042020-clean.docx	Form and Instruction
J3 Attachment J1 Interview guide for qualitative interviews Appendix J1_revised_Interview Guide 3_4 mos_06042020-clean.docx	Form and Instruction
J5 Attachment J5 Handout 2 listing Tier 1 online modules (n Appendix J5-Handout 1 List of Tier 2 Toolkit.docx	Form and Instruction
J5 Attachment J5 Handout 2 listing Tier 1 online modules (n Appendix J5-Handout 1 List of Tier 2 Toolkit.docx	Form and Instruction
J6 Attachment J6 Interview guide for FGDs with AIM Team Lea Appendix J6-Handout 2 Online Modules.docx	Form and Instruction
J6 Attachment J6 Interview guide for FGDs with AIM Team Lea Appendix J6-Handout 2 Online Modules.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	J3	Attachment J1 Interview guide for qualitative interviews with AIM Team Leads, 3-4mo (revised)	Appendix J1_revised_Interview Guide 3_4 mos_06042020-clean.docx	No	Paper Only
Form and Instruction	J5	Attachment J5 Handout 2 listing Tier 1 online modules (new)	Appendix J5-Handout 1 List of Tier 2 Toolkit.docx	No	Paper Only
Form and Instruction	J6	Attachment J6 Interview guide for FGDs with AIM Team Leads & frontline staff (summer/fall 2022, new)	Appendix J6-Handout 2 Online Modules.docx	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8	-22	30
Annual IC Time Burden (Hours)	8	-22	30
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.