OMB control number

National Hypertension Control Initiative

OMB 0990-0482 · HHS/HHSDM.

OMB 0990-0482

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 CHCs Uniti Health Form and Instruction
Form 1 CHCs: JumpStart Modules Form and Instruction
Form 1 CHCs: Use of Azara/Population Health Tool Form and Instruction
Form Module 1 CHW Program Modules Form and Instruction
Form 2 CHW Assessment Form and Instruction
Form 1 CHW Application Form
Form 1 CBOs: Social Needs Platforms Readiness Assessment Form and Instruction
Form 1 Individual Consumers: ETS health lesson learning questionnaires Form and Instruction
Form 1 CBO Qualtrics Survey Form and Instruction
30-day FRN NHCI Submitted 3-15-2024.docx (document unavailable) Supplementary Document
NHCI_ Justification for non material_nonsubstantive change for CHC data collection_Final Clean 01.09.2023 (002).docx Justification for No Material/Nonsubstantive Change
NHCI TA Group 2 Evaluation Survey.docx (document unavailable) Supplementary Document
HRSA NHCI OMB Memo_Non-Substantive Change.docx Justification for No Material/Nonsubstantive Change
NHCI_Supporting Statement A_updated_3_28_24.docx Supporting Statement A
30-day 0990-Hypertension__05022022.pdf Supplementary Document
NHCI 60d FRN 2021-19975.pdf Supplementary Document
Appendix F_CHC Readiness Assessment.pdf Supplementary Document
Appendix E_CBO Readiness Assessment.pdf Supplementary Document
Appendix D2_ETS Salt and Cardiovascular Risk.pdf (document unavailable) Supplementary Document
Appendix D2_ETS Salt and Cardiovascular Risk.pdf (document unavailable) Supplementary Document
Appendix D1_ETS Control Your Blood Pressure.pdf (document unavailable) Supplementary Document
Appendix C_Feasibility Assessments-CHCs and CBOs_Final.docx (document unavailable) Supplementary Document
Appendix B_Qualtrics and DREaM CBO quarterly survey questions_Final.docx Supplementary Document
Appendix A_Qualtrics and DREaM CHC quarterly survey questions_Final.docx Supplementary Document
NHCI_Supporting Statement B Statistical Methods_Final.docx Supporting Statement B
CHCs Uniti Health Form and Instruction
CHCs: JumpStart Modules Form and Instruction
CHCs: Use of Azara/Population Health Tool Form and Instruction
CHW Program Modules Form and Instruction
CHW Assessment Form and Instruction
CHW Application Form
Blood Pressure Control Metrics via Electronic Health Records
Individual Consumers: Remote Patient Monitoring (RPM)
CBOs: Remote Patient Monitoring (RPM)
Management Occupation: Remote Patient Monitoring Provider data delivery
Individual Consumers: Social Needs Platform Participation
CBOs: Social Needs Platforms Readiness Assessment Form and Instruction
CHCs: Social Needs Platforms Readiness Assessment
Individual Consumers: ETS health lesson learning questionnaires Form and Instruction
CBOs: Feasibility assessment focus groups Other-Interview Questions
CHCs: Feasibility assessment focus groups Other-Interview Questions
CBOs: Training on data entry into DREaM
CHCs: Training on data entry into DREaM
CBO Qualtrics Survey Form and Instruction
CHC Qualtrics Survey Other-instruction and form

All Historical Document Collections

202403-0990-008 Approved without change	Revision of a currently approved collection	2024-04-10
202301-0990-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-01-19
202208-0990-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2022-08-16
202204-0990-005 Approved with change	New collection (Request for a new OMB Control Number)	2022-05-11