Information Collection

[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I)

IC 260016 under ICR 202507-0920-004 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Document Name Document Type
[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I) Form and Instruction
DSMES Provider Screener Script and Guidelines 1154 Att A FIRE Listening Sessions_DSMES Provider Screener_.docx Form and Instruction
DSMES Provider Screener Script and Guidelines 1154 Att A FIRE Listening Sessions_DSMES Provider Screener_.docx Form and Instruction
Listening Sessions Guide for Providers Who Support Peopl 1154 Att B FIRE Listening Session Guide PLD.docx Form and Instruction
Listening Sessions Guide for Providers Who Support Peopl 1154 Att B FIRE Listening Session Guide PLD.docx Form and Instruction
Listening Sessions Guide for Providers Who Support Minor 1154 Att C FIRE Listening Session Guide MW.docx Form and Instruction
Listening Sessions Guide for Providers Who Support Minor 1154 Att C FIRE Listening Session Guide MW.docx Form and Instruction
Listening Sessions Guide for Providers Who Support Peopl 1154 Att D FIRE Listening Session Guide PWMHD.docx Form and Instruction
Listening Sessions Guide for Providers Who Support Peopl 1154 Att D FIRE Listening Session Guide PWMHD.docx Form and Instruction
1154 SSA DDT_revised.docx Supporting Statement Part A IC Document
1154 SSA DDT_revised.docx Supporting Statement Part A IC Document
1154 SSB DDT.docx Supporting Statement Part B IC Document
1154 SSB DDT.docx Supporting Statement Part B IC Document
1154 Att E FIRE Recruitment Emails.docx Recruitment Emails IC Document
1154 Att E FIRE Recruitment Emails.docx Recruitment Emails IC Document
1154 Att F IRB Determination notice.pdf FHI360 Determination: IRB Approval is Not Required IC Document
1154 Att F IRB Determination notice.pdf FHI360 Determination: IRB Approval is Not Required IC Document

Information Collection (IC) Details

IC Title	[NCCDPHP] Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of Diabetes Self-Management in Disproportionately Affected Populations (DAPs) Provider Listening Sessions (Phase I)
IC Status	Unchanged
Obligation to Respond	Voluntary