An assessment of the determinations of HIV risk factors for African American and Hispanic women in the southeastern United States

Forms and Documents

Document Name	Status
Supporting Statement Part B.doc Supporting Statement B	2007-07-23
APPENDIX 14-3 power analysis.doc Supplementary Document	2007-07-23
APPENDIX 14-1 sample size.doc Supplementary Document	2007-07-23
APPENDIX 13 roles.doc Supplementary Document	2007-07-23
APPENDIX 11 contact info.doc Supplementary Document	2007-07-23
APPENDIX 2 60 day FRN.doc Supplementary Document	2007-07-20
APPENDIX 14-2 contact scripts.doc Supplementary Document	2007-07-23
APPENDIX 1 legal authorization.doc Supplementary Document	2007-07-20
Supporting Statement Part A.doc Supporting Statement A	2007-08-20

IC Document Collections

IC ID	Document Title	Status
181810	Eligibility Screening Interview Resfual Questionnaire Other-Refusal Questionnaire 6.1	New
181809	Eligibility Screening Interview Other-Eligibility Screening Interview	New
181808	HIV Testing & Counseling Other-HIV Testing & Counseling	New
181807	RDS Training Other-RDS Training	New
181806	ACASI Survey interview Other-ACASI survey	New
181805	Qualitative Interview Guide Other-Qualitative Interview Guide	New
181804	Venue Brief Intercept Interview Other-Venue Brief Intercept Interview	New

ICR Details

OMB Control No: 0920-0760	ICR Reference No: 200708-0920-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: An assessment of the determinations of HIV risk factors for African American and Hispanic women in the southeastern United States
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 without change	Conclusion Date: 01/24/2008
	Date Received in OIRA: 08/28/2007
Terms of Clearance: Approved consistent with the following terms of clearance: OMB approves the proposed collection for purposes of gathering data that may useful for CDC program planning purposes however data from the survey are not generalizable and will not be presented as such in reporting of results.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2011	36 Months From Approved
Responses	2,260	0	0
Time Burden (Hours)	905	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The proposed mixed methods study will enroll African-American and Hispanic women over a 12-month period. Mixed methods research uses quantitaive and qualitative approaches to collect and analyze data. A quantitative approach will be used to examine self-reported responses about protective and risk factors for HIV infection via standardized audio-computer adminstred self-interview (ACASI). Rapid oral HIV testing will be performed along with pre- and post-test HIV counseling. Qualitative data on relationship dynamics and gender roles that may contribute to risk for HIV infection and will supplement the survey data. The qualitative data will consist of individual in-depth interviews conducted among a subset of women who complete the ACASI survey.

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Authorizing Statute(s): US Code: 42 USC 301.241A Name of Law: General Power and Duties of Public Health Service
  

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:
	71 FR 66333	11/14/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 37234	07/09/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

IC Title	Form No.	Form Name
Venue Brief Intercept Interview
Qualitative Interview Guide
ACASI Survey interview
RDS Training
HIV Testing & Counseling
Eligibility Screening Interview
Eligibility Screening Interview Resfual Questionnaire

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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	2,260	0	0	2,260	0	0
Annual Time Burden (Hours)	905	0	0	905	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: $1,008,502

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)? Uncollected

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: 08/28/2007

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