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Data Collection to Inform a Curriculum Adaptation for the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) Project
Formative Data Collections for ACF Program Support
OMB: 0970-0531
IC ID: 254573
OMB.report
HHS/ACF
OMB 0970-0531
ICR 202412-0970-005
IC 254573
( )
Documents and Forms
Document Name
Document Type
Instrument 1_Fidelity log.docx
Other-Fidelity Log
Instrument 2_Facilitator interview guide.docx
Other-interview guide
Instrument 3_Youth focus group guide.docx
Other-Focus Group Guide
Generic SSA_CUY Pilots_rev_4.5_CLEAN.docx
SSA - Prog Supp GenIC: PREP PYP Curriculum Adaptation
IC Document
Generic_SSB_CUY_Pilots_rev_4.6_clean.docx
SSB - Prog Supp GenIC: PREP PYP Curriculum Adaptation
IC Document
Appendix A_ Consent form for parents_4.5_Clean.docx
Appendix A: Consent form for parents of youth with IDD
IC Document
Appendix B_Consent form for youth over 18_4.6_clean.docx
Appendix B: Consent form for youth with IDD over 18
IC Document
Appendix C_Assent form for youth_4.6_clean.docx
Appendix C: Assent form for youth with IDD participants
IC Document
Appendix D_ Consent form for Lesson Facilitators_4.6_clean.docx
Appendix D: Consent for facilitators
IC Document
NOA_PREP PYP CUY Curriculum_Prog Supp GenIC_0970-0531_4.13.22.pdf
NOA - Prog Supp GenIC: PREP PYP Curriculum Adaptation
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Data Collection to Inform a Curriculum Adaptation for the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) Project
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-Fidelity Log
Instrument 1_Fidelity log.docx
Yes
Yes
Fillable Fileable
Other-interview guide
Instrument 2_Facilitator interview guide.docx
Yes
Yes
Paper Only
Other-Focus Group Guide
Instrument 3_Youth focus group guide.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:
120
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
204
0
0
0
0
204
Annual IC Time Burden (Hours)
120
0
0
0
0
120
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA - Prog Supp GenIC: PREP PYP Curriculum Adaptation
Generic SSA_CUY Pilots_rev_4.5_CLEAN.docx
07/11/2022
SSB - Prog Supp GenIC: PREP PYP Curriculum Adaptation
Generic_SSB_CUY_Pilots_rev_4.6_clean.docx
07/11/2022
Appendix A: Consent form for parents of youth with IDD
Appendix A_ Consent form for parents_4.5_Clean.docx
07/11/2022
Appendix B: Consent form for youth with IDD over 18
Appendix B_Consent form for youth over 18_4.6_clean.docx
07/11/2022
Appendix C: Assent form for youth with IDD participants
Appendix C_Assent form for youth_4.6_clean.docx
07/11/2022
Appendix D: Consent for facilitators
Appendix D_ Consent form for Lesson Facilitators_4.6_clean.docx
07/11/2022
NOA - Prog Supp GenIC: PREP PYP Curriculum Adaptation
NOA_PREP PYP CUY Curriculum_Prog Supp GenIC_0970-0531_4.13.22.pdf
07/11/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.