Information Collection Request

National Hypertension Control Initiative

ICR 202403-0990-008 · OMB 0990-0482 · Received in OIRA

Forms and Documents

Document	Type	Status	Availability
Form 1 CHCs Uniti Health	Form and Instruction	New	Repair queued
Form 1 CHCs: JumpStart Modules	Form and Instruction	New	Repair queued
Form 1 CHCs: Use of Azara/Population Health Tool	Form and Instruction	New	Missing upstream
Form Module 1 CHW Program Modules	Form and Instruction	New	Repair queued
Form 2 CHW Assessment	Form and Instruction	New	Repair queued
Form 1 CHW Application	Form	New	Missing upstream
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	Missing upstream
Form 1 CBO Qualtrics Survey	Form and Instruction	Unchanged	Repair queued
30-day FRN NHCI Submitted 3-15-2024.docx	Supplementary Document	Uploaded 2024-03-22	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	Missing upstream
NHCI TA Group 2 Evaluation Survey.docx	Supplementary Document	Uploaded 2022-08-16	Repair queued
HRSA NHCI OMB Memo_Non-Substantive Change.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-08-16	Missing upstream
NHCI_Supporting Statement A_updated_3_28_24.docx	Supporting Statement A	Uploaded 2024-04-10	Repair queued
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	Missing upstream
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	Repair queued
Appendix D2_ETS Salt and Cardiovascular Risk.pdf	Supplementary Document	Uploaded 2022-04-15	Repair queued
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	Repair queued
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	Repair queued
Appendix A_Qualtrics and DREaM CHC quarterly survey questions_Final.docx	Supplementary Document	Uploaded 2022-04-15	Missing upstream
NHCI_Supporting Statement B Statistical Methods_Final.docx	Supporting Statement B	Uploaded 2022-04-15	Repair queued

IC Document Collections

IC ID	Collection	Type	Status
266250	CHCs Uniti Health	Form and Instruction	New
266249	CHCs: JumpStart Modules	Form and Instruction	New
266248	CHCs: Use of Azara/Population Health Tool	Form and Instruction	New
266245	CHW Program Modules	Form and Instruction	New
266244	CHW Assessment	Form and Instruction	New
266239	CHW Application	Form	New
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
252922	CHCs: Social Needs Platforms Readiness Assessment		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
252914	CHC Qualtrics Survey	Other-instruction and form	Unchanged

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/HHSDM
OMB Control No	0990-0482
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202301-0990-002
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31