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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.