Information Collection

Mother and Infant Home Visiting Program Evaluation: Kindergarten Follow-Up (MIHOPE-K)

IC 247466 under ICR 202105-0970-011 · OMB 0970-0355.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1_MIHOPE-K_Pilot_Recruitment Script_5.3.21.docx	Other-Recruitment Screener
Instrument 1_MIHOPE-K_Pilot_Recruitment Script_5.3.21.docx	Other-Recruitment Screener
Instrument 2_MIHOPE-K_Pilot_Virtual Visit Specifications_Clean Copy_5.3.21.docx	Other-Virtual Visit
Instrument 2_MIHOPE-K_Pilot_Virtual Visit Specifications_Clean Copy_5.3.21.docx	Other-Virtual Visit
Generics SSA - Draft of Cohorts 3 and 4 pretesting generic_5.4.21.docx SSA - MIHOPE-K Pretesting GenIC	IC Document
Generics SSA - Draft of Cohorts 3 and 4 pretesting generic_5.4.21.docx SSA - MIHOPE-K Pretesting GenIC	IC Document
Generics SSB - Draft of Cohorts 3 and 4 pretesting generic_04.20.21.docx SSB - MIHOPE-K Pretesting GenIC	IC Document
Generics SSB - Draft of Cohorts 3 and 4 pretesting generic_04.20.21.docx SSB - MIHOPE-K Pretesting GenIC	IC Document
Appendix A_MIHOPE-K_Pilot_Caregiver Contact Materials_Clean Copy_5.3.21.docx Appendix A - MIHOPE-K_Pilot_Caregiver Contact Materials	IC Document
Appendix A_MIHOPE-K_Pilot_Caregiver Contact Materials_Clean Copy_5.3.21.docx Appendix A - MIHOPE-K_Pilot_Caregiver Contact Materials	IC Document
NOA - MIHOPE LT Gen IC_0970-0355_5.17.21.pdf NOA - MIHOPE LT Pretesting GenIC_5.17.21	IC Document
NOA - MIHOPE LT Gen IC_0970-0355_5.17.21.pdf NOA - MIHOPE LT Pretesting GenIC_5.17.21	IC Document

IC Title:

Mother and Infant Home Visiting Program Evaluation: Kindergarten Follow-Up (MIHOPE-K)

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
Other-Recruitment Screener			Instrument 1_MIHOPE-K_Pilot_Recruitment Script_5.3.21.docx		Yes	Yes	Fillable Fileable
Other-Virtual Visit			Instrument 2_MIHOPE-K_Pilot_Virtual Visit Specifications_Clean Copy_5.3.21.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 125

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	125	125
Annual IC Time Burden (Hours)	219	219
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - MIHOPE-K Pretesting GenIC	Generics SSA - Draft of Cohorts 3 and 4 pretesting generic_5.4.21.docx	05/18/2021
SSB - MIHOPE-K Pretesting GenIC	Generics SSB - Draft of Cohorts 3 and 4 pretesting generic_04.20.21.docx	05/18/2021
Appendix A - MIHOPE-K_Pilot_Caregiver Contact Materials	Appendix A_MIHOPE-K_Pilot_Caregiver Contact Materials_Clean Copy_5.3.21.docx	05/18/2021
NOA - MIHOPE LT Pretesting GenIC_5.17.21	NOA - MIHOPE LT Gen IC_0970-0355_5.17.21.pdf	05/18/2021

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