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Qualitative Interviews
National HIV Behavioral Surveillance: Brief HIV Bio-behavioral Assessment (NHBS-BHBA)
OMB: 0920-1398
IC ID: 255848
OMB.report
HHS/CDC
OMB 0920-1398
ICR 202209-0920-004
IC 255848
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1398 can be found here:
2023-06-01 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Qualitative Interviews
Form and Instruction
Qualitative Interviews (English)
Att 3f_Model Qualitative Data Collection Instrument_Eng.docx
Form and Instruction
Qualitative Interviews (English)
Att 3f_Model Qualitative Data Collection Instrument_Eng.docx
Form and Instruction
Qualitative Interviews (Spanish)
Att 4f_Model Qualitative Data Collection Instrument_Spa.docx
Form and Instruction
Qualitative Interviews (Spanish)
Att 4f_Model Qualitative Data Collection Instrument_Spa.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Qualitative Interviews
Agency IC Tracking Number:
Is this a Common Form?
No
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
Form and Instruction
None
Qualitative Interviews (English)
Att 3f_Model Qualitative Data Collection Instrument_Eng.docx
Yes
Yes
Fillable Fileable
Form and Instruction
None
Qualitative Interviews (Spanish)
Att 4f_Model Qualitative Data Collection Instrument_Spa.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC
FR Citation:
76 FR 4458
Number of Respondents:
80
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
80
0
80
0
0
0
Annual IC Time Burden (Hours)
120
0
120
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.