Attachment B - Formative for Program Support Ongoing Burden

Attachment B: Ongoing Burden – Formative Data Collections for ACF Program Support

(OMB #0970-0531)

July 2022

Office of Planning, Research, and Evaluation

Administration for Children and Families

U.S. Department of Health and Human Services

Mary Switzer Building

330 C St., SW

Washington, D.C. 20201

Previously Approved Information Collections

At the time of this extension request, 30 GenICs are ongoing, with a total of 13,652 burden hours.

Ongoing

The following data collections are ongoing at the time of this submission. Detailed burden tables follow Table 1. Total Ongoing. Burden.

Table 1. Total Ongoing Burden

Project	# Respondents	Burden Hours
Healthy Marriage and Responsible Fatherhood Grantee Data Collection Plan Template (BUILD)	113	678
Strengthening the Implementation of Responsible Fatherhood Programs (SIRF)	1,476	3,157
Youth Empowerment Information, Data Collection, and Exploration on Avoidance of Sex (IDEAS) – Case Study of Parent Reflections	240	147
Collection of Information for Local Evaluations as part of the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) (PREP PYP Part 2 – Local Eval templates)	60	750
Tribal Maternal, Infant, and Early Childhood Home Visiting (TMIECHV) Grantee Technical Assistance (TA) Needs Assessment	38	38
Human Trafficking Youth Prevention Education (HTYPE) Demonstration Grant Program Implementation Surveys	11,539	2,658
Standard Evaluation Survey for the National Center for Early Childhood Development, Teaching, and Learning's (NCECDTL's) Training and Technical Assistance Offerings	4,500	195
ACF Privacy and Confidentiality Toolkit Case Studies	99	41
Next Generation of Enhanced Employment Strategies Project - MOMS Partnership	468	255
Justification for the Collection of Information for Local Evaluations as part of the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) - MARCH 2020 (PREIS and TPREP templates)	42	420
Rapid-Cycle Learning Plan Template for Community Services Block Grant (CSBG) Project Impact Grant Recipients	16	64
Sexual Risk Avoidance Education National Evaluation Program Components Impact Study: Proof of Concept Pilot Phase	396	336
Usability Testing of Resources to Support the Identification and Care of Children with Prenatal Substance or Alcohol Exposure in the Child Welfare System	21	375
OFA Training and Technical Assistance (TTA)	111	111
Personal Responsibility Education Program (PREP) Local Evaluation Support	24	80
Information to Inform the Office of Child Care about Implementation of Child Care American Rescue Plan Act (ARPA) Funds	52	156
Information to Inform the Office of Child Care about Implementation of Child Care American Rescue Plan Act (ARPA) Funds for Tribal Lead Agencies – Exploration Stage	265	265
Information to Inform the Office of Child Care about Implementation of Child Care American Rescue Plan Act (ARPA) Funds for Tribal Lead Agencies in the Initial and Full Implementation Stages	265	265
Information to Inform the Office of Child Care about Implementation of Child Care American Rescue Plan Act (ARPA) Funds for Tribal Lead Agencies in the Developing Stage	265	265
Strengthening the Implementation of Marriage and Relationship Programs (SIMR)	720	1895
Administration for Children and Families External Speaker Request Form	60	30
Data Collection to Inform a Curriculum Adaptation for the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) Project	120	120
Operation Allies Welcome (OAW) Resettlement State Refugee Coordinator (SRC) Monthly Report	25	600
Tribal Early Learning Initiative (TELI) Statement of Interest	45	90
Pandemic Emergency Assistance Fund (PEAF) Recipients Feedback Survey	135	101
Family Economic Mobility (FEM) Training and Technical Assistance Feedback	50	59
Multi-Site Study of State-Tribal Collaboration in Home Visiting	42	63
Tribal Home Visiting Continuous Quality Improvement Collaboratives	23	138
HMRF Grantee Site Visits and Community Group Listening Sessions to Support Race Equity for Fatherhood, Relationship, and Marriage Programs to Empower Black Families (REFRAME)	168	277
Services for Survivors of Torture Medical Care Survey	35	23
Totals:	21,413	13,652

Healthy Marriage and Responsible Fatherhood Grantee Data Collection Plan Template (BUILD)

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Total Burden Hours	Annual Burden Hours
Data collection plan template	113	3	6	2,034	678

Strengthening the Implementation of Responsible Fatherhood Programs (SIRF)

Instrument	Respondent	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Instrument #1: SIRF Observation	Learning Cycle Manager and Program Staff	69	55	.6	2,277
Instrument #2: SIRF End of Learning Cycle Site Reflections	Program Staff	60	4	0.25	60
Instrument #3: SIRF Reflections	Fathers	774	2	0.25	387
Instrument #4: SIRF Staff Semi-Structured Discussion Topics	Program Staff	60	1	1	60
Instrument #5: SIRF Program Participant Semi-Structured Discussion Topics	Fathers	100	1	1	100
Instrument #6: Non-Grantee Use of nFORM’s Applicant Characteristics Survey	Fathers	400	1	0.25	100
Instrument #7: Non-Grantee Use of nFORM – Staff Data Entry	Program Staff	3	1,334	0.04	160
Instrument #8: Non-Grantee Use of nFORM’s Program Operations Survey	Program staff	10	4	.32	13
Totals		1,476		3.71	3,157

Youth Empowerment Information, Data Collection, and Exploration on Avoidance of Sex (IDEAS) – Case Study of Parent Reflections

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
1. Parent Screener Script	150	1	.08	12
2. Parent Discussion Guide	90	1	1.5	135
Totals	240			147

Collection of Information for Local Evaluations as part of the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) (PREP PYP Part 2 – Local Eval templates)

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Total Burden Hours	Annual Burden Hours
Impact final report template	36	1	25	900	450
Descriptive final report template	24	1	25	600	300
Totals:	60	1	25	1,500	750

Tribal Maternal, Infant, and Early Childhood Home Visiting (TMIECHV) Grantee Technical Assistance (TA) Needs Assessment

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Total Burden Hours	Annual Burden Hours
Self-Reflection Survey Tool (Individual Response)	18	3	1	54	18
Self-Reflection Survey Tool (Team Response)	20 (5x4)	3	1	60	20
Totals:	38	3	1	114	38

Human Trafficking Youth Prevention Education (HTYPE) Demonstration Grant Program Implementation Surveys

Instrument	Total Number of Respondents Contributing for 8 Grantees	Annual Number of Respondents	Number of Responses Per Respondent	Average Burden Hours Per Response	Annual Burden Hours
HTYPE for Educators and Other Staff Pre- and Post-Implementation Survey (Instrument 1)	16,060	4,015	1	.20	803
HTYPE for Students Pre- and Post-Implementation Survey (Instruments 2, 3)	29,462	7,365	1	.25	1,841.25
HTYPE Training of Trainers (ToT) Post-Implementation Survey (Instrument 4)	638	159	1	.0835	13.28
Totals:		11,539	1	Avg .230301	2,657.53

Standard Evaluation Survey for the National Center for Early Childhood Development, Teaching, and Learning's (NCECDTL's) Training and Technical Assistance Offerings

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Total Burden Hours	Annual Burden Hours
Standard Evaluation Survey	4,500	1	0.13	585	195

ACF Privacy and Confidentiality Toolkit Case Studies

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Total Burden Hours	Annual Burden Hours
Instrument 1 - Questionnaire to help select orgs	27	1	.5	13.5	5
Instrument 2 - Semi-Structured Interviews	72	1	1.5	108	36
Totals:	99	1	Avg: 1.2424		41

Next Generation of Enhanced Employment Strategies Project - MOMS Partnership

Instrument	Respondent	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Total Burden Hours
Survey (A)	Orientation attendees	80	1	0.083	7
Focus group (B)	Orientation facilitators	8	4	1.000	32
Survey (C)	Stress Management Course attendees	80	2	0.083	13
Focus group (D)	Stress Management Course facilitators	8	4	1.000	32
Survey (E)	MOMS Moving Forward attendees	80	2	0.083	13
Focus group (F)	MOMS Moving Forward coaches	8	4	1.000	32
Survey (G)	Staff at referral agencies	60	4	0.083	20
Survey (H)	Attendees at recruitment events	120	1	0.083	10
Focus group (I)	Staff at referral agencies	16	4	1.000	64
Focus group (J)	Intake specialists	8	4	1.000	32
Totals:		468			255

Justification for the Collection of Information for Local Evaluations as part of the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) - MARCH 2020 (PREIS and TPREP templates)

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Impact analysis plan template	13	3	5	195
Descriptive analysis plan template	8	3	5	120
Lessons learned and promising practices template - PREIS	13	1	5	65
Lessons learned and promising practices template – Tribal PREP	8	1	5	40
Totals:	42	2	5	420

Rapid-Cycle Learning Plan Template for Community Services Block Grant (CSBG) Project Impact Grant Recipients

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Instrument 1: Rapid-Cycle Learning Plan Template	16	3	1.33	64

Sexual Risk Avoidance Education National Evaluation Program Components Impact Study: Proof of Concept Pilot Phase

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Instrument 1. Facilitator Pre-Training Survey	36	1	0.167	6
Instrument 2. Facilitator Post-Training Survey	36	1	0.167	6
Instrument 3. Facilitator Interview Guide	36	2	0.75	54
Instrument 4. Youth Focus Group Protocol	360	1	0.75	270
Estimated annual burden total				336

Usability Testing of Resources to Support the Identification and Care of Children with Prenatal Substance or Alcohol Exposure in the Child Welfare System

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Usability Testing Interview Protocol – Individual administration	9	1	5	45
Usability Testing Interview Protocol – Group administration	12	1	27.5	330
Total				375

OFA Training and Technical Assistance (TTA)

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
FastTRAC Updates	111	6	10 min (0.167 hrs)	111

Personal Responsibility Education Program (PREP) Local Evaluation Support

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Total Burden Hours	Annual Burden Hours
PREIS Evaluation Plan Template	12	1	12	144	48
PREIS Implementation Plan Template	12	1	8	96	32
Totals				240	80

Information to Inform the Office of Child Care about Implementation of Child Care American Rescue Plan Act (ARPA) Funds

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Child Care Stabilization Grants: Interviewer Guide	52	6	.17	53
Child Care Supplemental Funds: Interviewer Guide	52	6	.33	103
	52			156

Information to Inform the Office of Child Care about Implementation of Child Care American Rescue Plan Act (ARPA) Funds for Tribal Lead Agencies – Exploration Stage

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
TCBC ARP Act Stabilization Grants TA Exploring Guide	265	1	1	265

Information to Inform the Office of Child Care about Implementation of Child Care American Rescue Plan Act (ARPA) Funds for Tribal Lead Agencies in the Developing Stage

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
TCBC ARP Act Stabilization Grants TA Developing Guide	265	1	1	265

Information to Inform the Office of Child Care about Implementation of Child Care American Rescue Plan Act (ARPA) Funds for Tribal Lead Agencies in the Initial and Full Implementation Stages

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
TCBC ARP Act Stabilization Grants TA Implementing Guide (Attachment A)	265	1	1	265

Strengthening the Implementation of Marriage and Relationship Programs (SIMR)

Instrument	Respondent	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
SIMR staff survey	Frontline staff	60	52	0.17	530
SIMR participant focus groups	Program participants	560	1	1.5	840
SIMR staff interview topic guide	Program leaders, managers, and supervisors	40	7	0.75	210
	Frontline staff	60	7	0.75	315
Estimated burden total					1,895

Administration for Children and Families External Speaker Request Form

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Form requesting participation of ACF leadership or subject matter experts at external event	60	1	.5	30

Data Collection to Inform a Curriculum Adaptation for the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) Project

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Instrument 1: Fidelity logs	24	2	.17	8
Instrument 2: Facilitator interviews	16	1	1	16
Instrument 3: Post-intervention focus groups (youth)	96	1	1	96
Total				120

Operation Allies Welcome (OAW) Resettlement State Refugee Coordinator (SRC) Monthly Report

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Total Burden Hours	Annual Burden Hours1
OAW Resettlement SRC Monthly Report	25	18	2	900	600

Tribal Early Learning Initiative (TELI) Statement of Interest

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
TELI Statement of Interest	30	1	2	60
Tribal Leadership Statement of Support	15	1	2	30
Totals:	45	1	2	90

Pandemic Emergency Assistance Fund (PEAF) Recipients Feedback Survey

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Pandemic Emergency Assistance Fund (PEAF) Recipients Feedback Interview	135	1	.75	101

Family Economic Mobility (FEM) Training and Technical Assistance Feedback

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Pre-FEM Academy Participation Feedback	50	1	.17	8.5
Post-FEM Academy Participation Feedback	50	3	.33	16.5
Short-Term Outcome Interview Form	50	6	.67	33.5
Total Burden and Costs				58.5

Multi-Site Study of State-Tribal Collaboration in Home Visiting

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
INSTRUMENT A: Interview protocol	42	1	1.5	63

Tribal Home Visiting Continuous Quality Improvement Collaboratives

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Instrument 1: Plan-Do-Study-Act Planning Tool	23	6	1	138

HMRF Grantee Site Visits and Community Group Listening Sessions to Support Race Equity for Fatherhood, Relationship, and Marriage Programs to Empower Black Families (REFRAME)

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Instrument 1. Discussion Guide for REFRAME: HMRF Program Leadership Focus Groups	35	1	1.5	53
Instrument 2. Discussion Guide for REFRAME: HMRF Program Client-Facing Staff Focus Groups	35	1	1.5	53
Instrument 3. Discussion Guide for HMRF Client Focus Group	50	1	1.5	75
Instrument 4. Discussion Guide for REFRAME Community Listening Sessions	48	1	2	96
Totals	168			277

Services for Survivors of Torture Medical Care Survey

Instrument	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response	Burden Hours
Medical Needs Assessment	35	1	.667	23

1 Reflects 12 months of submissions.