Information Collection Request

National Hypertension Control Initiative

ICR 202301-0990-002 · OMB 0990-0482 · Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0990-0482 can be found here:

2024-04-10 - Revision of a currently approved collection

Forms and Documents

Forms and supporting documents for this ICR
Document	Type	Status	Availability
Form 1 CBOs: Social Needs Platforms Readiness Assessment	Form and Instruction	Unchanged	Available
Form 1 CBOs: Social Needs Platforms Readiness Assessment	Form and Instruction	Unchanged	Repair queued
Form 1 Individual Consumers: ETS health lesson learning questionnaires	Form and Instruction	Unchanged	Available
Form 1 Individual Consumers: ETS health lesson learning questionnaires	Form and Instruction	Unchanged	Repair queued
Form 1 CBO Qualtrics Survey	Form and Instruction	Unchanged	Available
Form 1 CBO Qualtrics Survey	Form and Instruction	Unchanged	Repair queued
NHCI_ Justification for non material_nonsubstantive change for CHC data collection_Final Clean 01.09.2023 (002).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-01-19	Available
NHCI_ Justification for non material_nonsubstantive change for CHC data collection_Final Clean 01.09.2023 (002).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-01-19	Repair queued
NHCI TA Group 2 Evaluation Survey.docx	Supplementary Document	Uploaded 2022-08-16	Available
NHCI TA Group 2 Evaluation Survey.docx	Supplementary Document	Uploaded 2022-08-16	Missing upstream
HRSA NHCI OMB Memo_Non-Substantive Change.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-08-16	Available
HRSA NHCI OMB Memo_Non-Substantive Change.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-08-16	Repair queued
NHCI_Supporting Statement A_Final (4).docx	Supporting Statement A	Uploaded 2022-05-10	Available
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	Available
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	Available
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	Available
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	Available
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	Available
Appendix D2_ETS Salt and Cardiovascular Risk.pdf	Supplementary Document	Uploaded 2022-04-15	Missing upstream
Appendix D2_ETS Salt and Cardiovascular Risk.pdf	Supplementary Document	Uploaded 2022-04-15	Available
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	Available
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	Available
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	Available
Appendix B_Qualtrics and DREaM CBO quarterly survey questions_Final.docx	Supplementary Document	Uploaded 2022-04-15	Repair queued
Appendix A_Qualtrics and DREaM CHC quarterly survey questions_Final.docx	Supplementary Document	Uploaded 2022-04-15	Available
Appendix A_Qualtrics and DREaM CHC quarterly survey questions_Final.docx	Supplementary Document	Uploaded 2022-04-15	Repair queued
NHCI_Supporting Statement B Statistical Methods_Final.docx	Supporting Statement B	Uploaded 2022-04-15	Available
NHCI_Supporting Statement B Statistical Methods_Final.docx	Supporting Statement B	Uploaded 2022-04-15	Repair queued

IC Document Collections

Information collection document groups
IC ID	Collection	Type	Status
252928	Blood Pressure Control Metrics via Electronic Health Records		Unchanged
252927	Individual Consumers: Remote Patient Monitoring (RPM)		Unchanged
252926	CBOs: Remote Patient Monitoring (RPM)		Unchanged
252925	Management Occupation: Remote Patient Monitoring Provider data delivery		Unchanged
252924	Individual Consumers: Social Needs Platform Participation		Unchanged
252923	CBOs: Social Needs Platforms Readiness Assessment	Form and Instruction	Unchanged
252923	CBOs: Social Needs Platforms Readiness Assessment	Form and Instruction	Unchanged
252922	CHCs: Social Needs Platforms Readiness Assessment		Unchanged
252921	Individual Consumers: ETS health lesson learning questionnaires	Form and Instruction	Unchanged
252921	Individual Consumers: ETS health lesson learning questionnaires	Form and Instruction	Unchanged
252920	CBOs: Feasibility assessment focus groups	Other-Interview Questions	Unchanged
252919	CHCs: Feasibility assessment focus groups	Other-Interview Questions	Unchanged
252918	CBOs: Training on data entry into DREaM		Unchanged
252917	CHCs: Training on data entry into DREaM		Unchanged
252916	CBO Qualtrics Survey	Form and Instruction	Unchanged
252916	CBO Qualtrics Survey	Form and Instruction	Unchanged
252914	CHC Qualtrics Survey	Other-instruction and form	Unchanged

ICR Details

Record metadata
Status	Active
Agency/Subagency	HHS/HHSDM
OMB Control No	0990-0482
Type of Information Collection	No material or nonsubstantive change to a currently approved collection
Previous ICR Reference No	202208-0990-005
Date Submitted to OIRA	2023-01-19
Requested Expiration Date	1969-12-31