Information Collection

Family Partners for Research Study

IC 269109 under ICR 202504-0970-028 · OMB 0970-0356.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1 - Parent Pre-Screener and Screening Call_revised_6.27.24_Clean.docx	Other-Screener
Instrument 1 - Parent Pre-Screener and Screening Call_revised_6.27.24_Clean.docx	Other-Screener
Instrument 2 - Remote Child Well-Being Assessment by Parent Report_revised_6.27.24_Clean.docx	Other-Child Assessment Parent Report
Instrument 2 - Remote Child Well-Being Assessment by Parent Report_revised_6.27.24_Clean.docx	Other-Child Assessment Parent Report
Instrument 3 - Online Parent Feedback Questionnaire 6.19.24_CLEAN.docx	Other-Questionnaire
Instrument 3 - Online Parent Feedback Questionnaire 6.19.24_CLEAN.docx	Other-Questionnaire
Instrument 4 - Parent In-Person Interviewer-Administered Child WellBeing Assessment 6_27_24_Clean.docx	Other-Child Assessment - Interviewer
Instrument 4 - Parent In-Person Interviewer-Administered Child WellBeing Assessment 6_27_24_Clean.docx	Other-Child Assessment - Interviewer
Instrument 5 - Child - In-Person Interviewer-Administered Play Session 6.19.24_CLEAN.docx	Other-Play Session
Instrument 5 - Child - In-Person Interviewer-Administered Play Session 6.19.24_CLEAN.docx	Other-Play Session
Instrument 6 - In-Person Parent Feedback Interview 6.19.24_CLEAN.docx	Other-Interview
Instrument 6 - In-Person Parent Feedback Interview 6.19.24_CLEAN.docx	Other-Interview
Reimagining NSCAW Multi-Mode SSA 6.19.24_CLEAN.docx SSA - Formative Research GenIC: Family Partners for Research Study	IC Document
Reimagining NSCAW Multi-Mode SSA 6.19.24_CLEAN.docx SSA - Formative Research GenIC: Family Partners for Research Study	IC Document
Reimagining NSCAW Multi-Mode SSB 6.25.24_CLEAN.docx SSB - Formative Research GenIC: Family Partners for Research Study	IC Document
Reimagining NSCAW Multi-Mode SSB 6.25.24_CLEAN.docx SSB - Formative Research GenIC: Family Partners for Research Study	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Family Partners for Research Study

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screener	Yes	Yes	Fillable Fileable
Other-Child Assessment Parent Report	Yes	Yes	Fillable Fileable
Other-Questionnaire	Yes	Yes	Fillable Fileable
Other-Child Assessment - Interviewer Administered	Yes	Yes	Fillable Fileable
Other-Play Session	Yes	Yes	Fillable Fileable
Other-Interview	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: 140

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	700	700
Annual IC Time Burden (Hours)	197	197
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Formative Research GenIC: Family Partners for Research Study		07/01/2024
SSB - Formative Research GenIC: Family Partners for Research Study		07/01/2024

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].