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Sexual Risk Avoidance Education National Evaluation Program Components Impact Study: Proof of Concept Pilot Phase
Formative Data Collections for ACF Program Support
OMB: 0970-0531
IC ID: 254552
OMB.report
HHS/ACF
OMB 0970-0531
ICR 202410-0970-003
IC 254552
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:
2024-11-12 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Instrument 1. Facilitator Pre-Training Survey 11.03.2021.docx
Other-Survey
Instrument 2. Facilitator Post Training Survey 11.03.2021.docx
Other-Survey
Instrument 3. Facilitator Interview Guide 11.03.2021.docx
Other-Interview Guide
Instrument 4. Youth Focus Group Protocol v2 11.03.21.docx
Other-Focus Group Protocol
Generics SSA - CIS Proof of Concept 11.03.2021.docx
SSA - SRAENE CIS GenIC
IC Document
Generics SSB - CIS Proof of Concept 11.03.2021.docx
SSB - SRAENE CIS GenIC
IC Document
Appendix A. Facilitator Survey Invitation Email 11.03.2021.docx
Appendix A. Facilitator Survey Invitation Email
IC Document
Appendix B. Parent Consent and Youth Assent Forms 11.03.2021.docx
Appendix B. Parent Consent and Youth Assent Forms
IC Document
NOA_SRAENE CIS GenIC_0970-0531_11.26.21.pdf
NOA - SRAENE CIS GenIC
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Sexual Risk Avoidance Education National Evaluation Program Components Impact Study: Proof of Concept Pilot Phase
Agency IC Tracking Number:
OPRE
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Survey
Instrument 1. Facilitator Pre-Training Survey 11.03.2021.docx
Yes
Yes
Fillable Fileable
Other-Survey
Instrument 2. Facilitator Post Training Survey 11.03.2021.docx
Yes
Yes
Fillable Fileable
Other-Interview Guide
Instrument 3. Facilitator Interview Guide 11.03.2021.docx
Yes
Yes
Paper Only
Other-Focus Group Protocol
Instrument 4. Youth Focus Group Protocol v2 11.03.21.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
396
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
792
0
0
0
0
792
Annual IC Time Burden (Hours)
336
0
0
0
0
336
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA - SRAENE CIS GenIC
Generics SSA - CIS Proof of Concept 11.03.2021.docx
07/08/2022
SSB - SRAENE CIS GenIC
Generics SSB - CIS Proof of Concept 11.03.2021.docx
07/08/2022
Appendix A. Facilitator Survey Invitation Email
Appendix A. Facilitator Survey Invitation Email 11.03.2021.docx
07/08/2022
Appendix B. Parent Consent and Youth Assent Forms
Appendix B. Parent Consent and Youth Assent Forms 11.03.2021.docx
07/08/2022
NOA - SRAENE CIS GenIC
NOA_SRAENE CIS GenIC_0970-0531_11.26.21.pdf
07/08/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.