Preventing HIV Risk Behaviors Among Hispanic Adolescents

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Project Officer Letter-0920-09AU Revised 11_22.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Family Relations 1.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Social Provisions.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Rev Beh Prob Checklist.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Project Officer Letter-0920-09AU.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Prado_JC CP_2007.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Prado_et[1].al_HealthEducation Behavior_2010.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Parenting Practices 2.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Parental assessment battery master_ENG.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Parent-Adolescent Communication 2.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Parent-Adolescent Communication 1.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Pantin_PS_2003.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Hispanic Stress Inventory_Eng.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Hispanic Stress Inventory.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Family Relations 2.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Communication about Sex.pdf	Supplementary Document	Uploaded 2010-11-22	Available
CDC Office of Info[1] and Reg. Affairs.pdf	Supplementary Document	Uploaded 2010-11-22	Available
Bicultural Involvement Scale.pdf	Supplementary Document	Uploaded 2010-11-22	Available
0920-09AU_SS_Sect B Revised 11_22.doc	Supporting Statement B	Uploaded 2010-11-22	Available
att7_Certificate of Confidentiality.doc	Supplementary Document	Uploaded 2010-07-23	Available
att6b_Local IRB Approval.doc	Supplementary Document	Uploaded 2010-07-23	Available
att6a_ CDC Project Determination.doc	Supplementary Document	Uploaded 2010-07-23	Available
att4d_Youth Assent Form_SPA.doc	Supplementary Document	Uploaded 2010-07-23	Available
att4c_Parent or Primary Caregiver Consent Form_SPA.doc	Supplementary Document	Uploaded 2010-07-23	Available
att4b_Youth Assent Form_ENG.doc	Supplementary Document	Uploaded 2010-07-23	Available
att4a_Parent or Primary Caregiver Consent Form_ENG.doc	Supplementary Document	Uploaded 2010-07-23	Available
att3a_Screening Form.doc	Supplementary Document	Uploaded 2010-07-23	Available
Attachment 2a 60-day comment .doc	Supplementary Document	Uploaded 2010-07-23	Available
Att3e_Adolescent_Battery_SPA.pdf	Supplementary Document	Uploaded 2010-07-23	Available
Att3d_Parental_Battery_SPA.pdf	Supplementary Document	Uploaded 2010-07-23	Available
att5d_RecruitLetter_SPA.doc	Supplementary Document	Uploaded 2010-07-23	Available
att5a_Recruitment Flyer.doc	Supplementary Document	Uploaded 2010-07-23	Available
att5b_RecruitLetter_ENG.doc	Supplementary Document	Uploaded 2010-07-23	Available
0920-09AU SS A Revised 11_22.doc	Supporting Statement A	Uploaded 2010-11-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
194323	Adolescent Assessment Battery	Instruction	New
194322	Parent Assessment Battery	Instruction	New
194321	Caregiver and Adolescent Screening Form	Instruction	New
194320	Recruitment telephone Script	Instruction	New

ICR Details

OMB Control No: 0920-0871	ICR Reference No: 201008-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Preventing HIV Risk Behaviors Among Hispanic Adolescents
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 with change	Conclusion Date: 11/23/2010
	Date Received in OIRA: 08/19/2010
Terms of Clearance: The results of this case study shall not be used as the basis for programmatic decisions.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2013	36 Months From Approved
Responses	2,160	0	0
Time Burden (Hours)	940	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This study will assess the impact of a parent-centered, eco-developmental prevention intervention (Familias Unidas) intended to reduce HIV risk behaviors (i.e., substance use and unsafe sexual behaviors) among Hispanic adolescents living in Miami-Dade County.

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Authorizing Statute(s): US Code: 42 USC 308d Name of Law: Public Health Service Act
   US Code: 42 USC 301 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:
	75 FR 4567	01/28/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 43985	07/27/2010
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
Recruitment telephone Script
Caregiver and Adolescent Screening Form
Parent Assessment Battery
Adolescent Assessment Battery

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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	2,160	0	0	2,160	0	0
Annual Time Burden (Hours)	940	0	0	940	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 information collection request.

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Annual Cost to Federal Government: $295,594

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? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 08/19/2010

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