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

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 can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
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All Historical Document Collections

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

OMB Details

Client Screener

Federal Enterprise Architecture: Health - Health Care Services

Form none

Client Screener

Fillable Fileable

Form

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