Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Communication-2013 Communication-2013	Form and Instruction	New	Available
Form Attachment C Moder Attachment C Moderator Guides	Form and Instruction	New	Available
Form Attachment B Scree Attachment B Screeners	Form and Instruction	New	Available
Form APPENDIX 5 NATURAL EXPOSURE FOLLOW-UP SURVEY	Form and Instruction	New	Available
Form APPENDIX 4 NATURAL EXPOSURE BASELINE SURVEY	Form and Instruction	New	Available
Form APPENDIX 3 FORCED EXPOSURE FOLLOW-UP SURVEY	Form and Instruction	New	Available
Form APPENDIX 2 FORCED EXPOSURE BASELINE SURVEY	Form and Instruction	New	Available
Form APPENDIX 1 QUANTITATIVE PRE-LAUNCH PRE-TEST	Form and Instruction	New	Available
Form Attachment 6: Chil Attachment 6: Child Screener	Form	New	Available
Form Attachment 2: Male Attachment 2: Male Screener	Form	New	Available
Form Attachment 3: Fema Attachment 3: Female Screener	Form	New	Available
0196-SS-2010.doc	Supporting Statement B	Uploaded 2010-07-14	Available
0196-SS-2010.doc	Supporting Statement A	Uploaded 2010-07-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
206455	Strategic Communications Plan Key Informat Interviews	Form and Instruction	New	Communication-2013
203037	KA and Transfer for Youth Violence and Suicide Prevention Disaster Distress Helpline Campaign Focus Groups	Form and Instruction	New	Attachment C Moderator Guides
203037	KA and Transfer for Youth Violence and Suicide Prevention Disaster Distress Helpline Campaign Focus Groups	Form and Instruction	New	Attachment B Screeners
202099	Underage Drinking Prevention National Media Campaign	Form and Instruction	New	NATURAL EXPOSURE FOLLOW-UP SURVEY
202099	Underage Drinking Prevention National Media Campaign	Form and Instruction	New	NATURAL EXPOSURE BASELINE SURVEY
202099	Underage Drinking Prevention National Media Campaign	Form and Instruction	New	FORCED EXPOSURE FOLLOW-UP SURVEY
202099	Underage Drinking Prevention National Media Campaign	Form and Instruction	New	FORCED EXPOSURE BASELINE SURVEY
202099	Underage Drinking Prevention National Media Campaign	Form and Instruction	New	QUANTITATIVE PRE-LAUNCH PRE-TEST
196724	Underage Alcohol Use Prevention Media Campaign Focus Groups Phases 2 & 3	Form	New	Attachment 6: Child Screener
196724	Underage Alcohol Use Prevention Media Campaign Focus Groups Phases 2 & 3	Form	New	Attachment 2: Male Screener
196724	Underage Alcohol Use Prevention Media Campaign Focus Groups Phases 2 & 3	Form	New	Attachment 3: Female Screener

ICR Details

OMB Control No: 0930-0196	ICR Reference No: 201008-0930-002
Status: Historical Active	Previous ICR Reference No: 200706-0930-004
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages
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 without change	Conclusion Date: 09/01/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/09/2010
Terms of Clearance: Previous terms of clearance apply: This request for a generic clearance of pretesting materials is approved. Consistent with other generic clearances, HHS/SAMHSA will submit each individual pretest for OMB review, along with a brief description of the purpose of the pretest, sample design if applicable, any respondent incentives planned, and individual burden.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2013	36 Months From Approved	08/31/2010
Responses	11,700	0	11,700
Time Burden (Hours)	9,290	0	9,290
Cost Burden (Dollars)	0	0	0

---

Abstract: This submission is for generic approval for pretesting of educational and information materials for various consumer publics and the professional communities in the areas of substance abuse prevention, addiction treatment, and mental health services. To assure that brochures, posters, information kits, public service announcements, videos news releases, web site and direct response messages communicate their messages effectively to the intended components of the population it is essential to pretest them to assure that they are received, understood, and accepted by those for whom they are intended.

---

Authorizing Statute(s): US Code: 5 USC 501 Name of Law: SAMHSA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 56200	10/30/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 41497	07/16/2010
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
KA and Transfer for Youth Violence and Suicide Prevention Disaster Distress Helpline Campaign Focus Groups	Attachment B Screeners, Attachment C Moderator Guides	Attachment B Screeners ,   Attachment C Moderator Guides
Strategic Communications Plan Key Informat Interviews	Communication-2013	Communication-2013
Underage Alcohol Use Prevention Media Campaign Focus Groups Phases 2 & 3	Attachment 3: Female Screener, Attachment 2: Male Screener, Attachment 6: Child Screener	Attachment 3: Female Screener ,   Attachment 2: Male Screener ,   Attachment 6: Child Screener
Underage Drinking Prevention National Media Campaign	APPENDIX 1, APPENDIX 2, APPENDIX 3, APPENDIX 4, APPENDIX 5	QUANTITATIVE PRE-LAUNCH PRE-TEST ,   FORCED EXPOSURE BASELINE SURVEY ,   FORCED EXPOSURE FOLLOW-UP SURVEY ,   NATURAL EXPOSURE BASELINE SURVEY ,   NATURAL EXPOSURE FOLLOW-UP SURVEY

---

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	11,700	11,700	0	0	0	0
Annual Time Burden (Hours)	9,290	9,290	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:

---

Annual Cost to Federal Government: $305,000

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]? No

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

---

Common Form ICR:  No

---

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: 08/09/2010

---