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[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities
[OS] CDC/ATSDR Formative Research and Tool Development
OMB: 0920-1154
IC ID: 275349
OMB.report
HHS/CDC
OMB 0920-1154
ICR 202507-0920-005
IC 275349
( )
Documents and Forms
Document Name
Document Type
[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities
Form and Instruction
DHQP Interview Screener
Attachment 1_DHQP_Screener_4.16.25.docx
Form and Instruction
Interview Guide: Resident and Family/Close Friend (Paired Interview)
Attachment 4_DHQP_Resident and Family Guide_3.25.25_Final.docx
Form and Instruction
Interview Guide: Family/Close Friend (Follow-Up Interview)
Attachment 5_DHQP_Family Follow-Up Guide_4.16.25.docx
Form and Instruction
Attachment 2_DHQP_Consent Form_Resident_4.16.25.docx
Consent Form Resident
IC Document
Attachment 3_DHQP_Consent Form_Family or Friend_4.16.25.docx
Consent Form Family or Friend
IC Document
Attachment 6_Human Subjects Determination Memo.pdf
Research Determination
IC Document
DHQP_Gen IC Request Form_4.16.25.docx
GenIC Request Template
IC Document
DHQP_OMB Supporting Statement A_4.16.25.docx
SSA
IC Document
DHQP_OMB Supporting Statement B_4.16.25.docx
SSB
IC Document
Information Collection (IC) Details
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