Evaluation of the National Youth Violence Prevention Resource Center (NYVPRC)

Forms and Documents

Document Name	Status
Form No number Coalition Leader Interview Form	New
Form No number Coalition Member Survey Form	New
Form No number User Feedback Survey Form	New
Form No number Online Training Survey Form	New
ICR_NYVPRC_Attachment-G-Coalition-Member-Survey(2).doc Supplementary Document	2009-09-17
ICR_NYVPRC_Attachment-F-Coalition-Leader-Interview(2).doc Supplementary Document	2009-09-17
lynk promotional flyer text - cleared 080309.doc Supplementary Document	2009-09-17
Attachment H -- Consent Forms (2).doc Supplementary Document	2009-09-17
Attachment E -- Training Survey Questions_revised.doc Supplementary Document	2009-09-17
ICR_NYVPRC_Supporting Statement.B.9.15.09.doc Supporting Statement B	2009-09-15
Attachment I -- IRB Determination.pdf Supplementary Document	2009-04-02
Attachment C FW PUBLIC CMOMENT ON FEDERAL REGISTER.htm Supplementary Document	2009-04-02
Attachment B -- NYVPRC Evaluation 60-day notice.pdf Supplementary Document	2009-04-02
Attachment A -- Section 301 of the Public Health Services Act.doc Supplementary Document	2009-04-02
ICR_NYVPRC_Supporting-Statement.A.9.15.09.doc Supporting Statement A	2009-09-15

IC Document Collections

IC ID	Document Title	Status
188800	Coalition Leader Interview Form	New
188799	Coalition Member Survey Form	New
188798	User Feedback Survey Form	New
188797	Online Training Survey Form	New

ICR Details

OMB Control No: 0920-0823	ICR Reference No: 200904-0920-008
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Evaluation of the National Youth Violence Prevention Resource Center (NYVPRC)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/28/2009
	Date Received in OIRA: 04/14/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2012	36 Months From Approved
Responses	1,740	0	0
Time Burden (Hours)	353	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In October 1999 the White House established the Council on Youth Violence to coordinate youth violence prevention activities of all federal agencies. The Council in collaboration with CDC would like to evaluate a pilot implementation of the revised NYVPRC website which targets local government and community leaders.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 45010	08/01/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 14991	04/02/2009
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
User Feedback Survey	No number	User Feedback Survey
Coalition Member Survey	No number	Coalition Member Survey
Coalition Leader Interview	No number, No number	Coalition-Leader-Interview
Online Training Survey	No number	Online Training Survey

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,740	0	0	1,740	0	0
Annual Time Burden (Hours)	353	0	0	353	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new data collection.

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Annual Cost to Federal Government: $285,100

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/14/2009

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