Information Collection

Supporting and Strengthening the Home Visiting Workforce (SAS-HV)

IC 255172 under ICR 202403-0970-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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_Screening questionnaire_Revision 3_7-25-22. clean.docx	Other-Screening questionnaire
Instrument 1_Screening questionnaire_Revision 3_7-25-22. clean.docx	Other-Screening questionnaire
Instrument 2_ Web based survey_Revision 3, 7-25-22. clean.docx	Other-Web-based survey
Instrument 2_ Web based survey_Revision 3, 7-25-22. clean.docx	Other-Web-based survey
Instrument 3_Group Interpretation Meeting Guide 7-20-22_Revision 3, 7-25-22. clean.docx	Other-Group interpretation meeting
Instrument 3_Group Interpretation Meeting Guide 7-20-22_Revision 3, 7-25-22. clean.docx	Other-Group interpretation meeting
SAS-HV_Pretesting Generic_0970-0355_SSA GenIC- OPRE Pilot Template_Revision 3 7-25-22_clean.docx SSA - SAS-HV Pretesting GenIC	IC Document
SAS-HV_Pretesting Generic_0970-0355_SSA GenIC- OPRE Pilot Template_Revision 3 7-25-22_clean.docx SSA - SAS-HV Pretesting GenIC	IC Document
SAS-HV Pretesting Generic_0970-0355_SSB GenIC- OPRE Pilot Template_Revision 3 7-25-22_clean.docx SSB - SAS-HV Pretesting GenIC	IC Document
SAS-HV Pretesting Generic_0970-0355_SSB GenIC- OPRE Pilot Template_Revision 3 7-25-22_clean.docx SSB - SAS-HV Pretesting GenIC	IC Document
Appendix 1_Home Visiting Applied Research Collaborative Recruitment Announcement_final 8.4.22.docx Appendix 1: Home Visiting Applied Research Collaborative Recruitment Announcement	IC Document
Appendix 1_Home Visiting Applied Research Collaborative Recruitment Announcement_final 8.4.22.docx Appendix 1: Home Visiting Applied Research Collaborative Recruitment Announcement	IC Document
Appendix 2_Recruitment Email for Researchers_final 8.4.22.docx Appendix 2: Recruitment Email for Researchers	IC Document
Appendix 2_Recruitment Email for Researchers_final 8.4.22.docx Appendix 2: Recruitment Email for Researchers	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Supporting and Strengthening the Home Visiting Workforce (SAS-HV)

Agency IC Tracking Number:

OPRE

IC Status: Unchanged

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-Screening questionnaire	Instrument 1_Screening questionnaire_Revision 3_7-25-22. clean.docx	Yes	Yes	Fillable Fileable
Other-Web-based survey	Instrument 2_ Web based survey_Revision 3, 7-25-22. clean.docx	Yes	Yes	Fillable Fileable
Other-Group interpretation meeting	Instrument 3_Group Interpretation Meeting Guide 7-20-22_Revision 3, 7-25-22. clean.docx	Yes	Yes	Fillable Fileable

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: 60

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	162	162
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - SAS-HV Pretesting GenIC	SAS-HV_Pretesting Generic_0970-0355_SSA GenIC- OPRE Pilot Template_Revision 3 7-25-22_clean.docx	08/04/2022
SSB - SAS-HV Pretesting GenIC	SAS-HV Pretesting Generic_0970-0355_SSB GenIC- OPRE Pilot Template_Revision 3 7-25-22_clean.docx	08/04/2022
Appendix 1: Home Visiting Applied Research Collaborative Recruitment Announcement	Appendix 1_Home Visiting Applied Research Collaborative Recruitment Announcement_final 8.4.22.docx	08/04/2022
Appendix 2: Recruitment Email for Researchers	Appendix 2_Recruitment Email for Researchers_final 8.4.22.docx	08/04/2022

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