Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Phase II Questionnaire - attachment 11	Form	Modified	Available
Form 3 Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 2-Screening for Main Survey)	Form and Instruction	Modified	Available
Form 2 Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 1-Cognitive Interview)	Form and Instruction	Modified	Available
Form 1 (Phase 1-Cognitive Interview)	Form and Instruction	Modified	Available
Description of Changes to OMB Survey_v3.docx	Supplementary Document	Uploaded 2010-03-04	Available
Justification for Requested Changes.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2010-03-04	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
184876	Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 2- Main Survey)	Form	Modified	Phase II Questionnaire - attachment 11
184875	Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 2-Screening for Main Survey)	Form and Instruction	Modified	Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 2-Screening for Main Survey)
184874	Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 1-Cognitive Interview)	Form and Instruction	Modified	Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 1-Cognitive Interview)
184873	Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 1-Cognitive Interview)	Form and Instruction	Modified	(Phase 1-Cognitive Interview)

ICR Details

OMB Control No: 0920-0796	ICR Reference No: 201003-0920-006
Status: Historical Active	Previous ICR Reference No: 200805-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/30/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/16/2010
Terms of Clearance: Approved consistent with the following terms of clearance: due to the essentially anecdotal nature of the survey CDC will not use results from this collection to project estimates related to the incidence of sexual violence in the general population or in any of the specific subgroups surveyed. Upon completion of the survey CDC will share a copy of findings with OMB.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2012	01/31/2012	01/31/2012
Responses	2,031	0	2,031
Time Burden (Hours)	646	0	646
Cost Burden (Dollars)	0	0	0

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Abstract: This study examines the definitions of sexual violence in three racial/ethnic minority communities: African-American, American Indian, and Hispanic. The purpose of this project is to develop an understanding of sexual violence in these communities. The developed survey will include the following: projecting estimates of sexual violence; describing the type of sexual violence; and developing a strategy that will increase awareness of sexual violence in minority communities. In addition, this project will establish the groundwork for similar future research.

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Authorizing Statute(s): PL: Pub.L. 42 - 301 241 Name of Law: Public Health Service Act
   PL: Pub.L. 42 - 391 241 Name of Law: Public Health Service Act
  

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:
	72 FR 29168	05/24/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 23465	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: 4

table that charts list of burden

IC Title	Form No.	Form Name
Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 1-Cognitive Interview)	1	(Phase 1-Cognitive Interview)
Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 1-Cognitive Interview)	2	Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 1-Cognitive Interview)
Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 2- Main Survey)	none	Phase II Questionnaire - attachment 11
Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 2-Screening for Main Survey)	3	Testing of Sexual Violence Definitions and Recommended Data Elements in Three Different Racial/Ethnic Minority Communities (Phase 2-Screening for Main 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	2,031	2,031	0	0	0	0
Annual Time Burden (Hours)	646	646	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $201,637

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)? No

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: 03/16/2010

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