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Focus Group Participant Characteristics Form
Assessing the Use of Informal Contacts to Promote Caregivers’ Engagement and Satisfaction with Early Childhood Home Visiting Through Rapid Cycle Learning
OMB: 0906-0098
IC ID: 269570
OMB.report
HHS/HRSA
OMB 0906-0098
ICR 202412-0906-003
IC 269570
( )
Documents and Forms
Document Name
Document Type
Form 9
Focus Group Participant Characteristics Form
Form and Instruction
9 Focus Group Participant Characteristics Form
Instrument 9- MCHB- ADAPT HV Informal Contacts- 6.10.24.docx
Form and Instruction
9 Focus Group Participant Characteristics Form
Instrument 9- MCHB- ADAPT HV Informal Contacts- 6.10.24.docx
Form and Instruction
9 0906-0098 9_Focus Group Participant Characteristics Form
0906-0098 9_Focus Group Participant Characteristics Form-All Phases.docx
Form and Instruction
9 0906-0098 9_Focus Group Participant Characteristics Form
0906-0098 9_Focus Group Participant Characteristics Form-All Phases.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Focus Group Participant Characteristics Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
9
Focus Group Participant Characteristics Form
Instrument 9- MCHB- ADAPT HV Informal Contacts- 6.10.24.docx
Yes
Yes
Fillable Fileable
Form and Instruction
9
0906-0098 9_Focus Group Participant Characteristics Form-All Phases (Redline 07302024)
0906-0098 9_Focus Group Participant Characteristics Form-All Phases.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
120
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
120
0
0
0
0
120
Annual IC Time Burden (Hours)
100
0
0
0
0
100
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.