Brain Power! The NIDA Junior Scientist Program and the Companion Program, Brain Power! Challenge

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form F Survey	Form and Instruction	Modified	Repair queued
Form E Survey	Form and Instruction	Modified	Available
Form D Survey	Form and Instruction	Modified	Available
Form A Survey	Form and Instruction	Modified	Available
Form C Survey	Form and Instruction	Modified	Available
Form B Survey	Form and Instruction	Modified	Available
Form R Survey	Form and Instruction	New	Available
Form Q Survey	Form and Instruction	New	Available
Form P Survey	Form and Instruction	New	Available
Form O Survey	Form and Instruction	New	Available
Form N Survey	Form and Instruction	New	Available
Form M Survey	Form and Instruction	New	Available
Form L Survey	Form and Instruction	New	Available
Form K Survey	Form and Instruction	New	Available
Form J Survey	Form and Instruction	New	Available
Form I Survey	Form and Instruction	New	Available
Form H Survey	Form and Instruction	New	Available
Form S Instrument	Form and Instruction	New	Available
Form S Instrument	Form and Instruction	New	Available
Form G Survey	Form and Instruction	New	Available
Danya Request for OMB Extension (0925-0542) SSB 3-31-08 Rev 1.doc	Supporting Statement B	Uploaded 2008-04-14	Available
Danya Request OMB Extension (0925-0542) Attachment 20 - Form T Protocol Parent Interview Rev 1.doc	Supplementary Document	Uploaded 2008-04-14	Repair queued
Danya Request OMB Extension (0925-0542) Attachment 21 IRB Approved Assent and Consent Forms.doc	Supplementary Document	Uploaded 2008-04-14	Available
Danya Request for OMB Extension (0925-0542) SSA 3-31-08 Revision 2.doc	Supporting Statement A	Uploaded 2008-04-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7466	Grades K-5	Form and Instruction	Modified	Survey
7466	Grades K-5	Form and Instruction	Modified	Survey
7466	Grades K-5	Form and Instruction	Modified	Survey
7466	Grades K-5	Form and Instruction	Modified	Survey
7466	Grades K-5	Form and Instruction	Modified	Survey
7466	Grades K-5	Form and Instruction	Modified	Survey
184695	Teacher Online Evaluation	Form and Instruction	New	Survey
184695	Teacher Online Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184694	Teacher Full Evaluation	Form and Instruction	New	Survey
184693	Parents Grades 6-9	Form and Instruction	New	Instrument
184692	Parents Grades K-5	Form and Instruction	New	Instrument
184691	Grades 6-9	Form and Instruction	New	Survey

ICR Details

OMB Control No: 0925-0542	ICR Reference No: 200804-0925-002
Status: Historical Active	Previous ICR Reference No: 200410-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Brain Power! The NIDA Junior Scientist Program and the Companion Program, Brain Power! Challenge
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/23/2008
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/30/2008
Terms of Clearance: This extension does NOT authorize the collection of data. The extension is only designed to give NIH a couple of months to send in a more complete package. Extension of the current ICR does not constitute concurrence with the design of the proposed Phase II study. We will review Phase II on its own merits once the package arrives. The program will resubmit after substantially rewriting both portions of the supporting statement. The rewrite will include discussion of the broader context within which this project sits (Phase I, II, and III of the initiative) and tie it to the prior approval. The rewrite will provide more detail as to the sample design and the degree to which the design meets the goals of second phase of the project. The incentive section will be re-written in line with OMB guidelines. This submittal should be done as a substantive change, but no additional FR notice is required.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2009	07/31/2010	09/30/2008
Responses	2,637	0	479
Time Burden (Hours)	1,305	0	434
Cost Burden (Dollars)	0	0	0

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Abstract: NIDA seeks to assess the effectiveness of the Brain Power! materials to stimulate interest in scientific learning about the biology of the brain and neurobiology of drug addiction and to lay the foundation for drug abuse prevention.

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Authorizing Statute(s): None

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:
	73 FR 10262	02/26/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 23473	04/30/2008
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Grades 6-9	G	Survey
Grades K-5	B, C, A, D, E, F	Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Parents Grades 6-9	S	Instrument
Parents Grades K-5	S	Instrument
Teacher Full Evaluation	H, I, J, K, L, M, N, O, P	Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Teacher Online Evaluation	Q, R	Survey ,   Survey

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ICR Summary of Burden

table that charts list 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	2,637	479	0	2,158	0	0
Annual Time Burden (Hours)	1,305	434	0	871	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 continuation project and a continuation of collection of information.

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Annual Cost to Federal Government: $261,629

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: 04/30/2008

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