Information Collection Request

National Hypertension Control Initiative

ICR 202204-0990-005 · OMB 0990-0482 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 CBOs: Social Needs Platforms Readiness Assessment Form and Instruction New Missing upstream
Form 1 Individual Consumers: ETS health lesson learning questionnaires Form and Instruction New Repair queued
Form 1 CBO Qualtrics Survey Form and Instruction New Missing upstream
NHCI_Supporting Statement A_Final (4).docx Supporting Statement A Uploaded 2022-05-10 Repair queued
30-day 0990-Hypertension__05022022.pdf Supplementary Document Uploaded 2022-05-03 Repair queued
NHCI 60d FRN 2021-19975.pdf Supplementary Document Uploaded 2022-04-15 Repair queued
Appendix F_CHC Readiness Assessment.pdf Supplementary Document Uploaded 2022-04-15 Repair queued
Appendix E_CBO Readiness Assessment.pdf Supplementary Document Uploaded 2022-04-15 Repair queued
Appendix D2_ETS Salt and Cardiovascular Risk.pdf Supplementary Document Uploaded 2022-04-15 Repair queued
Appendix D2_ETS Salt and Cardiovascular Risk.pdf Supplementary Document Uploaded 2022-04-15 Repair queued
Appendix D1_ETS Control Your Blood Pressure.pdf Supplementary Document Uploaded 2022-04-15 Repair queued
Appendix C_Feasibility Assessments-CHCs and CBOs_Final.docx Supplementary Document Uploaded 2022-04-15 Repair queued
Appendix B_Qualtrics and DREaM CBO quarterly survey questions_Final.docx Supplementary Document Uploaded 2022-04-15 Missing upstream
Appendix A_Qualtrics and DREaM CHC quarterly survey questions_Final.docx Supplementary Document Uploaded 2022-04-15 Missing upstream
NHCI_Supporting Statement B Statistical Methods_Final.docx Supporting Statement B Uploaded 2022-04-15 Repair queued

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
20,069 0
8,141 0
0 0





table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 20,069 0 0 20,069 0 0
Annual Time Burden (Hours) 8,141 0 0 8,141 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No