National Hypertension Control Initiative

ICR 202301-0990-002

OMB: 0990-0482

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0990-0482 can be found here:

2024-04-10 - Revision of a currently approved collection

Forms and Documents

Document Name	Status
Form 1 CBOs: Social Needs Platforms Readiness Assessment Form and Instruction	Unchanged
Form 1 CBOs: Social Needs Platforms Readiness Assessment Form and Instruction	Unchanged
Form 1 Individual Consumers: ETS health lesson learning questionnaires Form and Instruction	Unchanged
Form 1 Individual Consumers: ETS health lesson learning questionnaires Form and Instruction	Unchanged
Form 1 CBO Qualtrics Survey Form and Instruction	Unchanged
Form 1 CBO Qualtrics Survey Form and Instruction	Unchanged
NHCI_ Justification for non material_nonsubstantive change for CHC data collection_Final Clean 01.09.2023 (002).docx Justification for No Material/Nonsubstantive Change	2023-01-19
NHCI_ Justification for non material_nonsubstantive change for CHC data collection_Final Clean 01.09.2023 (002).docx Justification for No Material/Nonsubstantive Change	2023-01-19
NHCI TA Group 2 Evaluation Survey.docx Supplementary Document	2022-08-16
NHCI TA Group 2 Evaluation Survey.docx Supplementary Document	2022-08-16
HRSA NHCI OMB Memo_Non-Substantive Change.docx Justification for No Material/Nonsubstantive Change	2022-08-16
HRSA NHCI OMB Memo_Non-Substantive Change.docx Justification for No Material/Nonsubstantive Change	2022-08-16
NHCI_Supporting Statement A_Final (4).docx Supporting Statement A	2022-05-10
NHCI_Supporting Statement A_Final (4).docx Supporting Statement A	2022-05-10
30-day 0990-Hypertension__05022022.pdf Supplementary Document	2022-05-03
30-day 0990-Hypertension__05022022.pdf Supplementary Document	2022-05-03
NHCI 60d FRN 2021-19975.pdf Supplementary Document	2022-04-15
NHCI 60d FRN 2021-19975.pdf Supplementary Document	2022-04-15
Appendix F_CHC Readiness Assessment.pdf Supplementary Document	2022-04-15
Appendix F_CHC Readiness Assessment.pdf Supplementary Document	2022-04-15
Appendix E_CBO Readiness Assessment.pdf Supplementary Document	2022-04-15
Appendix E_CBO Readiness Assessment.pdf Supplementary Document	2022-04-15
Appendix D2_ETS Salt and Cardiovascular Risk.pdf Supplementary Document	2022-04-15
Appendix D2_ETS Salt and Cardiovascular Risk.pdf Supplementary Document	2022-04-15
Appendix D2_ETS Salt and Cardiovascular Risk.pdf Supplementary Document	2022-04-15
Appendix D2_ETS Salt and Cardiovascular Risk.pdf Supplementary Document	2022-04-15
Appendix D1_ETS Control Your Blood Pressure.pdf Supplementary Document	2022-04-15
Appendix D1_ETS Control Your Blood Pressure.pdf Supplementary Document	2022-04-15
Appendix C_Feasibility Assessments-CHCs and CBOs_Final.docx Supplementary Document	2022-04-15
Appendix C_Feasibility Assessments-CHCs and CBOs_Final.docx Supplementary Document	2022-04-15
Appendix B_Qualtrics and DREaM CBO quarterly survey questions_Final.docx Supplementary Document	2022-04-15
Appendix B_Qualtrics and DREaM CBO quarterly survey questions_Final.docx Supplementary Document	2022-04-15
Appendix A_Qualtrics and DREaM CHC quarterly survey questions_Final.docx Supplementary Document	2022-04-15
Appendix A_Qualtrics and DREaM CHC quarterly survey questions_Final.docx Supplementary Document	2022-04-15
NHCI_Supporting Statement B Statistical Methods_Final.docx Supporting Statement B	2022-04-15
NHCI_Supporting Statement B Statistical Methods_Final.docx Supporting Statement B	2022-04-15

IC Document Collections

IC ID	Document Title	Status
252928	Blood Pressure Control Metrics via Electronic Health Records	Unchanged
252927	Individual Consumers: Remote Patient Monitoring (RPM)	Unchanged
252926	CBOs: Remote Patient Monitoring (RPM)	Unchanged
252925	Management Occupation: Remote Patient Monitoring Provider data delivery	Unchanged
252924	Individual Consumers: Social Needs Platform Participation	Unchanged
252923	CBOs: Social Needs Platforms Readiness Assessment Form and Instruction	Unchanged
252923	CBOs: Social Needs Platforms Readiness Assessment Form and Instruction	Unchanged
252922	CHCs: Social Needs Platforms Readiness Assessment	Unchanged
252921	Individual Consumers: ETS health lesson learning questionnaires Form and Instruction	Unchanged
252921	Individual Consumers: ETS health lesson learning questionnaires Form and Instruction	Unchanged
252920	CBOs: Feasibility assessment focus groups Other-Interview Questions	Unchanged
252919	CHCs: Feasibility assessment focus groups Other-Interview Questions	Unchanged
252918	CBOs: Training on data entry into DREaM	Unchanged
252917	CHCs: Training on data entry into DREaM	Unchanged
252916	CBO Qualtrics Survey Form and Instruction	Unchanged
252916	CBO Qualtrics Survey Form and Instruction	Unchanged
252914	CHC Qualtrics Survey Other-instruction and form	Unchanged

ICR Details