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Practice Facilitator Focus Groups
Supporting and Evaluation the Dissemination and Implementation of PCOR to Improve Non-Surgical Treatment of Urinary Incontinence Among Women in Primary Care
OMB: 0935-0264
IC ID: 258005
OMB.report
HHS/AHRQ
OMB 0935-0264
ICR 202301-0935-002
IC 258005
( )
Documents and Forms
Document Name
Document Type
Form 1
Practice Facilitator Focus Groups
Form and Instruction
1 Focus Group Protocol
A-MUI_Practice facilitator_Focus Group Protocol (Base Year)_20Oct22.pdf
Form and Instruction
1 Focus Group Protocol
A-MUI_Practice facilitator_Focus Group Protocol (Base Year)_20Oct22.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Practice Facilitator Focus Groups
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
1
Focus Group Protocol
A-MUI_Practice facilitator_Focus Group Protocol (Base Year)_20Oct22.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
45
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
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
45
0
45
0
0
0
Annual IC Time Burden (Hours)
45
0
45
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.