Information Collection Request

Assessing Strategies To Promote Children’s Engagement and Active Participation in Virtual Visits

ICR 202404-0906-010 · OMB 0906-0092 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0906-0092 can be found here:

2025-03-28 - No material or nonsubstantive change to a currently approved collection
2024-12-04 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Forms and supporting documents for this ICR
Document	Type	Status	Availability
Form 9 Focus Group Participant Characteristics Form – All Phases	Form and Instruction	New	Repair queued
Form 8 Program Staff Focus Group Protocol (Summary Phase)	Form and Instruction	New	Repair queued
Form 7 Family Post-Visit Form – Refinement Phase	Form and Instruction	New	Repair queued
Form 6 Home Visitor Learning Cycle Form – Installation & Refinement Phases	Form and Instruction	New	Missing upstream
Form 5 Program Staff Focus Group Protocol (Installation & Refinement Phases)	Form and Instruction	New	Repair queued
Form 4 Family Focus Group Protocol – Co-definition & Summary Phases	Form and Instruction	New	Repair queued
Form 3 Program Staff Focus Group Protocol 2 (Co-definition Phase)	Form and Instruction	New	Repair queued
Form 2 Program Staff Focus Group Protocol 1 (Co-definition Phase)	Form and Instruction	New	Repair queued
Form 1 Program Eligibility Protocol	Form and Instruction	New	Repair queued
Appendix D Active Engagement Consent Statements.docx	Supplementary Document	Uploaded 2024-04-26	Missing upstream
Appendix C Active Engagement Contact Scripts.docx	Supplementary Document	Uploaded 2024-04-26	Repair queued
Appendix B Active Engagement Recruitment.docx	Supplementary Document	Uploaded 2024-04-26	Repair queued
Appendix A - Active Engagement 60-day FRN.pdf	Supplementary Document	Uploaded 2024-04-26	Repair queued
Supporting Statement B_ADAPT HV Active Engagement.docx	Supporting Statement B	Uploaded 2024-04-26	Repair queued
Supporting Statement A_ADAPT HV Active Engagement_revised 4.19.24.docx	Supporting Statement A	Uploaded 2024-04-26	Repair queued

IC Document Collections

Information collection document groups
IC ID	Collection	Type	Status
267295	Focus Group Participant Characteristics Form – All Phases	Form and Instruction	New
267294	Program Staff Focus Group Protocol (Summary Phase)	Form and Instruction	New
267293	Family Post-Visit Form – Refinement Phase	Form and Instruction	New
267290	Home Visitor Learning Cycle Form – Installation & Refinement Phases	Form and Instruction	New
267288	Program Staff Focus Group Protocol (Installation & Refinement Phases)	Form and Instruction	New
267286	Family Focus Group Protocol – Co-definition & Summary Phases	Form and Instruction	New
267285	Program Staff Focus Group Protocol 2 (Co-definition Phase)	Form and Instruction	New
267284	Program Staff Focus Group Protocol 1 (Co-definition Phase)	Form and Instruction	New
267283	Program Eligibility Protocol	Form and Instruction	New

ICR Details

Record metadata
Status	Received in OIRA
Agency/Subagency	HHS/HRSA
OMB Control No	0906-0092
Type of Information Collection	New collection (Request for a new OMB Control Number)
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31