Information Collection

Touchpoints for Addressing Substance Use Issues in Home Visiting: Performance Measurement Pilot

IC 247483 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⚠️ Notice: This information collection may be referencing outdated material.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:

2026-01-30 - No material or nonsubstantive change to a currently approved collection
2025-03-28 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1_SUD1 and SUD2 Measures Reporting Tool.xlsx	Other-Reporting Tool
Instrument 1_SUD1 and SUD2 Measures Reporting Tool.xlsx	Other-Reporting Tool
Instrument 2_Interview Protocol_State Awardees.docx	Other-Interview Protocol
Instrument 2_Interview Protocol_State Awardees.docx	Other-Interview Protocol
Instrument 3_Interview Protocol_LIA Managers and Data Managers, Home Visiting Supervisors, and Home Visitors.docx	Other-Interview Protocol
Instrument 3_Interview Protocol_LIA Managers and Data Managers, Home Visiting Supervisors, and Home Visitors.docx	Other-Interview Protocol
Instrument 4_Interview Protocol_Home-Visiting-Model Representatives.docx	Other-Interview Protocol
Instrument 4_Interview Protocol_Home-Visiting-Model Representatives.docx	Other-Interview Protocol
Generic SSA_Touchpoints_Pretesting.docx Supporting Statement A - Touchpoints Pretesting GenIC	IC Document
Generic SSA_Touchpoints_Pretesting.docx Supporting Statement A - Touchpoints Pretesting GenIC	IC Document
Generic SSB_Touchpoints_Pretesting.docx Supporting Statement B - Touchpoints Pretesting GenIC	IC Document
Generic SSB_Touchpoints_Pretesting.docx Supporting Statement B - Touchpoints Pretesting GenIC	IC Document
Appendix A_Pilot Study FAQs.docx Appendix A_Pilot Study FAQs	IC Document
Appendix A_Pilot Study FAQs.docx Appendix A_Pilot Study FAQs	IC Document
Appendix B_Invitations to Participate in the Study.docx Appendix B_Invitations to Participate in the Study	IC Document
Appendix B_Invitations to Participate in the Study.docx Appendix B_Invitations to Participate in the Study	IC Document
Appendix C_Research Questions Addressed by Interview Protocols.docx Appendix C_Research Questions Addressed by Interview Protocols	IC Document
Appendix C_Research Questions Addressed by Interview Protocols.docx Appendix C_Research Questions Addressed by Interview Protocols	IC Document
NOA - Pretesting_Touchpoints GenIC_3.20.21.pdf NOA - Touchpoints Pretesting GenIC	IC Document
NOA - Pretesting_Touchpoints GenIC_3.20.21.pdf NOA - Touchpoints Pretesting GenIC	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Touchpoints for Addressing Substance Use Issues in Home Visiting: Performance Measurement Pilot

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Reporting Tool	Instrument 1_SUD1 and SUD2 Measures Reporting Tool.xlsx	Yes	Yes	Fillable Fileable
Other-Interview Protocol	Instrument 2_Interview Protocol_State Awardees.docx	No		Paper Only
Other-Interview Protocol	Instrument 3_Interview Protocol_LIA Managers and Data Managers, Home Visiting Supervisors, and Home Visitors.docx	No		Paper Only
Other-Interview Protocol	Instrument 4_Interview Protocol_Home-Visiting-Model Representatives.docx	No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

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
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	87	87
Annual IC Time Burden (Hours)	73	73
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A - Touchpoints Pretesting GenIC	Generic SSA_Touchpoints_Pretesting.docx	05/18/2021
Supporting Statement B - Touchpoints Pretesting GenIC	Generic SSB_Touchpoints_Pretesting.docx	05/18/2021
Appendix A_Pilot Study FAQs	Appendix A_Pilot Study FAQs.docx	05/18/2021
Appendix B_Invitations to Participate in the Study	Appendix B_Invitations to Participate in the Study.docx	05/18/2021
Appendix C_Research Questions Addressed by Interview Protocols	Appendix C_Research Questions Addressed by Interview Protocols.docx	05/18/2021
NOA - Touchpoints Pretesting GenIC	NOA - Pretesting_Touchpoints GenIC_3.20.21.pdf	05/18/2021

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