OMB control number

Evaluation of Medication- Assisted Treatment (MAT) for Opioid Use Disorders Study

OMB 0920-1218 · HHS/CDC.

OMB 0920-1218

Conduct an epidemiologic study to assess the real-world client outcomes of three types of Medication Assisted Treatment (MAT) and counseling without medication for individuals with Opioid Use Disorder (OUD). This study will also examine the contextual, provider, and individual factors that influence treatment implementation and client outcomes. This request for change is to add one MSA to the study with no change in burden.

The latest form for Evaluation of Medication- Assisted Treatment (MAT) for Opioid Use Disorders Study expires 2021-02-28 and is listed under ICR 201905-0920-006.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Client questionnaire - 18 month follow-up	Form
Client questionnaire - 12 month follow-up	Form
Client Questionnaire - baseline	Form
Client Check-in Questionnaire	Form
Client Screener	Form
Attachment 9 Power Calculations.docx	Supplementary Document
Non substantial change request Memo OMB 0920-1218 MAT 05-03-19.docx	Justification for No Material/Nonsubstantive Change
MAT Study PRA Change Request 11-30-18.docx	Justification for No Material/Nonsubstantive Change
Attachment 8_CoC for MAT Study.pdf	Supplementary Document
SSA_MAT_1218 (003) new_final.docx	Supporting Statement A
SSB_MAT_1218.docx	Supporting Statement B
Attachment 7 Informed Consent.docx	Supplementary Document
Attachment 6 IRB Doc.pdf	Supplementary Document
Attachment 5_ Privacy Impact Assessment MAT.pdf	Supplementary Document
Attachment 2 FRN 60 day_ 1218_MAT.pdf	Supplementary Document
Attachment 1 Authorizing Legislation.docx	Supplementary Document
Treatment Facility Staff Focus Groups	Other-Focus group guide
Client Focus Groups	Other-Focus group guide
Client questionnaire - 18 month follow-up	Form
Client questionnaire - 12 month follow-up	Form
Client Questionnaire - baseline	Form
Client Check-in Questionnaire	Form
Client Screener	Form

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202012-0920-014	Revision of a currently approved collection	2021-01-26	Approved without change
201905-0920-006	No material or nonsubstantive change to a currently approved collection	2019-05-15	Approved without change
201812-0920-002	No material or nonsubstantive change to a currently approved collection	2018-12-10	Approved without change
201711-0920-009	New collection (Request for a new OMB Control Number)	2017-12-07	Approved with change

OMB Details

Client Screener

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
Form	Name	Electronic access	Type
Form none	Client Screener	Fillable Fileable	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.