Information Collection

Supporting and Strengthening the Home Visiting Workforce (SAS-HV): Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting

IC 264527 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⚠️ Notice: This information collection may be referencing outdated material.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_Participant and Contextual Characteristics Questionnaire CLEAN 3-5-24.docx	Other-
Instrument 1_Participant and Contextual Characteristics Questionnaire CLEAN 3-5-24.docx	Other-
Instrument 2_Focus Group Protocol for Relevance Across Racial and Ethnic Subgroups, 1-10-24, CLEAN.docx	Other-
Instrument 2_Focus Group Protocol for Relevance Across Racial and Ethnic Subgroups, 1-10-24, CLEAN.docx	Other-
Instrument 3_ Reflective Supervision Measure CLEAN 3-5-24.docx	Other-
Instrument 3_ Reflective Supervision Measure CLEAN 3-5-24.docx	Other-
Instrument 4_ Participant Perspectives on Reflective Supervision Measure CLEAN 3-5-24.docx	Other-
Instrument 4_ Participant Perspectives on Reflective Supervision Measure CLEAN 3-5-24.docx	Other-
Instrument 5_Measures to Examine Convergent and Concurrent Validity CLEAN 3-5-24.docx	Other-
Instrument 5_Measures to Examine Convergent and Concurrent Validity CLEAN 3-5-24.docx	Other-
Instrument 6_Supervisor Questionnaire for Repeated Measures CLEAN 3-5-24.docx	Other-
Instrument 6_Supervisor Questionnaire for Repeated Measures CLEAN 3-5-24.docx	Other-
Instrument 7_Supervisee Questionnaire for Repeated Measures Sample, 1-17-24, CLEAN.docx	Other-
Instrument 7_Supervisee Questionnaire for Repeated Measures Sample, 1-17-24, CLEAN.docx	Other-
Instrument 8_Focus Group Protocol for Repeated Measures Supervisor Subsample, 1-10-24, CLEAN.docx	Other-
Instrument 8_Focus Group Protocol for Repeated Measures Supervisor Subsample, 1-10-24, CLEAN.docx	Other-
SAS-HV OSC4 Draft SSA OMB 1-17-24, CLEAN.docx SSA - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting	IC Document
SAS-HV OSC4 Draft SSA OMB 1-17-24, CLEAN.docx SSA - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting	IC Document
SAS-HV OSC4 Draft SSB OMB 1-10-24 CLEAN.docx SSB : SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting	IC Document
SAS-HV OSC4 Draft SSB OMB 1-10-24 CLEAN.docx SSB : SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting	IC Document
Recruitment appendices SAS-HV OSC4a OMB package 1-10-24, CLEAN.docx Appendices: Recruitment Materials	IC Document
Recruitment appendices SAS-HV OSC4a OMB package 1-10-24, CLEAN.docx Appendices: Recruitment Materials	IC Document
Change Request SAS-HV 3-5-24 (002).docx NonSub Change - SAS-HV: Testing and Validation Instrument Updates	IC Document
Change Request SAS-HV 3-5-24 (002).docx NonSub Change - SAS-HV: Testing and Validation Instrument Updates	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Supporting and Strengthening the Home Visiting Workforce (SAS-HV): Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting

Agency IC Tracking Number:

OPRE

IC Status: Modified

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-	Instrument 1_Participant and Contextual Characteristics Questionnaire CLEAN 3-5-24.docx	Yes	Yes	Fillable Fileable
Other-	Instrument 2_Focus Group Protocol for Relevance Across Racial and Ethnic Subgroups, 1-10-24, CLEAN.docx	Yes	Yes	Printable Only
Other-	Instrument 3_ Reflective Supervision Measure CLEAN 3-5-24.docx	Yes	Yes	Fillable Fileable
Other-	Instrument 4_ Participant Perspectives on Reflective Supervision Measure CLEAN 3-5-24.docx	Yes	Yes	Printable Only
Other-	Instrument 5_Measures to Examine Convergent and Concurrent Validity CLEAN 3-5-24.docx	Yes	Yes	Fillable Fileable
Other-	Instrument 6_Supervisor Questionnaire for Repeated Measures CLEAN 3-5-24.docx	Yes	Yes	Fillable Fileable
Other-	Instrument 7_Supervisee Questionnaire for Repeated Measures Sample, 1-17-24, CLEAN.docx	Yes	Yes	Fillable Fileable
Other-	Instrument 8_Focus Group Protocol for Repeated Measures Supervisor Subsample, 1-10-24, CLEAN.docx	Yes	Yes	Printable Only

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: 785

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	1,570	1,570
Annual IC Time Burden (Hours)	810	810
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting	SAS-HV OSC4 Draft SSA OMB 1-17-24, CLEAN.docx	01/19/2024
SSB : SAS-HV: Testing and Validation of a Draft Measure of Reflective Supervision for Home Visiting	SAS-HV OSC4 Draft SSB OMB 1-10-24 CLEAN.docx	01/19/2024
Appendices: Recruitment Materials	Recruitment appendices SAS-HV OSC4a OMB package 1-10-24, CLEAN.docx	01/19/2024
NonSub Change - SAS-HV: Testing and Validation Instrument Updates	Change Request SAS-HV 3-5-24 (002).docx	03/05/2024

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