Personal Responsibility Education Program (PREP) Multi-Component Evaluation

Forms and Documents

Document Name	Status
PREP Eval - PAS+Baseline - Supp Stat B - Clean - 11-28-12.docx Supporting Statement B	2013-03-12
PREP PAS+Baseline - Attachment H - Confidentiality Pledge - 6-7-12.pdf Supplementary Document	2012-06-15
PREP PAS+Baseline - Attachment G - Consent Letters and Forms and Youth Assent Form - 6-7-12.docx Supplementary Document	2012-06-15
PREP PAS+Baseline - Attachment F - Persons Consulted - 6-7-12.docx Supplementary Document	2012-06-15
PREP PAS+Baseline - Attachment D - Sources Referenced for the Baseline - 6-7-12.docx Supplementary Document	2012-06-15
Attachment C_Question by Question Source Table for the Baseline_updated 081312.docx Supplementary Document	2012-08-16
PREP Eval - P+B - Attachment B - Analysis Plan PREP Impact - Clean - 11-12.docx Supplementary Document	2013-03-12
PREP PAS+Baseline - Attachment A - Overview of the PREP Evaluation - 6-7-12.docx Supplementary Document	2012-06-15
Instrument 5[1].docx Supplementary Document	2012-06-26
PREP Eval - PAS+Baseline -Supporting Statement A - Clean version - 2-27-13.docx Supporting Statement A	2013-03-12

IC Document Collections

IC ID	Document Title	Status
203228	New Instrument 6: Baseline Survey Other-Survey	New
203227	New Instrument 5: Sub-awardee data collection and reporting Other-Data Reporting	New
203226	New Instrument 4: Performance Reporting System Data Entry Form Other-PRS Entry Form	New
203225	New Instrument 3: Implementation site data collection Other-Data Collection	New
203224	New Instrument 2: Participant exit survey Other-Survey	New
203223	New Instrument 1: Participant entry survey Other-Survey	New
202667	Discussion Guide for Use with School Administrators Other-Discussion Guide	Modified
202666	Discussion Guide for Use with Program Staff Other-Discussion Guide	Modified
202665	Discussion Guide for Use with Program Directors Other-Discussion Guide	Modified
202664	Discussion Guide for use with Macro-Level Coordinators Other-Disscussion Guide	Modified
198489	Design Survey Discussion Guide for use with Researchers, Policy Experts, and Macro-Level Coordinators Other-#1 Interview guide for use with PREP state-level coordinat	Modified

ICR Details

OMB Control No: 0970-0398	ICR Reference No: 201207-0970-002
Status: Historical Active	Previous ICR Reference No: 201206-0970-006
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Personal Responsibility Education Program (PREP) Multi-Component Evaluation
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/12/2013
	Date Received in OIRA: 07/12/2012
Terms of Clearance: Approved consistent with ACF's revisions and responses to OMB comments.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	36 Months From Approved	03/31/2014
Responses	83,582	0	206
Time Burden (Hours)	31,342	0	286
Cost Burden (Dollars)	1,124	0	1,723

---

Abstract: The Patient Protection and Affordable Care Act, signed into law in March of 2010, established the Personal Responsibility Education Program (PREP) which funds programs designed to educate adolescents on both abstinence and contraception for the prevention of pregnancy and sexually transmitted infections, including HIV/AIDS, and at least three adulthood preparation subjects. The goal of the PREP Multi-Component Evaluation will be to document how programs funded through the State PREP program are designed and implemented in the field and to assess selected PREP-funded programs' effectiveness. The evaluation has three main components: (1) the Design and Implementation Study; (2) the Performance Analysis Study; and (3) the Impact and In-depth Implementation Study. This submission pertains to the latter two of these three components.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 3590 Name of Law: Patient Protection and Affordable Care Act (ACA)
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 77538	12/13/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 37411	06/21/2012
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 11

IC Title	Form No.	Form Name
Design Survey Discussion Guide for use with Researchers, Policy Experts, and Macro-Level Coordinators
New Instrument 1: Participant entry survey
New Instrument 2: Participant exit survey
New Instrument 3: Implementation site data collection
New Instrument 4: Performance Reporting System Data Entry Form
New Instrument 5: Sub-awardee data collection and reporting
New Instrument 6: Baseline Survey
Discussion Guide for use with Macro-Level Coordinators
Discussion Guide for Use with Program Directors
Discussion Guide for Use with Program Staff
Discussion Guide for Use with School Administrators

---

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	83,582	206	0	83,376	0	0
Annual Time Burden (Hours)	31,342	286	0	31,056	0	0
Annual Cost Burden (Dollars)	1,124	1,723	0	-599	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: OMB gave approval on March 7, 2012 for the Design Survey under the DIS (OMB Control No.: 0970-0398). We now seek approval for the data collections associated with the Performance Analysis Study and for the collection of baseline data under the In-depth Impact and Implementation Study. This request will increase the total burden requested for the PREP Evaluation, under OMB Control No. 0970-0398.

---

Annual Cost to Federal Government: $878,419

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]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 07/11/2012

---