Evaluation of HIV Prevention Program for Women

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
EvaluationofHIV Prevention.doc	Supporting Statement B	Uploaded 2008-08-26	Available
0990-Eval of HIV Prev Prog for Young Women attending Minority Institutions final Sept 3 2008.doc	Supporting Statement A	Uploaded 2008-09-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
186700	Process Evaluation Interview: Peer Educators	Other-questionnaire	New
186699	Process Evaluation Interview: Program Directors		New
186698	Process Evaluation Interview: Program Staff	Other-questionnaire	New
186697	Data capture: data entry into database		New
186696	HIV Prevention Questionnaire for College Women: Pre-test; Post-test; Follow-up)	Other-survey	New

ICR Details

OMB Control No: 0990-0334	ICR Reference No: 200809-0990-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Evaluation of HIV Prevention Program for Women
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: 03/16/2009
	Date Received in OIRA: 09/22/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2012	36 Months From Approved
Responses	2,742	0	0
Time Burden (Hours)	910	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In 1998, as the result of the HIV/AIDS state of emergency declared by African American community leaders and supported by the Congressional Black Caucus (CBC), Congress funded an initiative to address this crisis through increased funding and outreach. This initiative would eventually become known as the Minority AIDS Initiative (MAI). These funds targeted HIV/AIDS programs that directly benefit racial and ethnic minority communities.

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Authorizing Statute(s): PL: Pub.L. 3 - 105 277 Name of Law: Omnibus Consolidated and Emergency Supplemental Appropriations Act of 1999
  

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 36327	06/26/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 52860	09/11/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
HIV Prevention Questionnaire for College Women: Pre-test; Post-test; Follow-up)
Data capture: data entry into database
Process Evaluation Interview: Program Staff
Process Evaluation Interview: Program Directors
Process Evaluation Interview: Peer Educators

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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	2,742	0	0	2,742	0	0
Annual Time Burden (Hours)	910	0	0	910	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: New Collection

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Annual Cost to Federal Government: $194,325

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: 09/22/2008

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