The National Intimate Partner and Sexual Violence Surveillance System (NISVSS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
National Intimate Partner and Sexual Violence Surveillance System - Survey	Form	Modified	Available
OMB Change Request 2011 questionnaire changes 10-22-2010.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2010-10-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
189767	National Intimate Partner and Sexual Violence Surveillance System (NISVSS) - Screen	Other-WORD	Modified
189766	National Intimate Partner and Sexual Violence Surveillance System - Survey	Form	Modified

ICR Details

OMB Control No: 0920-0822	ICR Reference No: 201011-0920-004
Status: Historical Active	Previous ICR Reference No: 201004-0920-003
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: The National Intimate Partner and Sexual Violence Surveillance System (NISVSS)
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: 11/19/2010
	Date Received in OIRA: 11/09/2010
Terms of Clearance: Terms of clearance continue: The agency acknowledges that the estimates derived from this study are likely to be, in some measure, an under estimate of the true prevalence and should be interpreted as such.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2012	09/30/2012	09/30/2012
Responses	108,318	0	108,318
Time Burden (Hours)	18,249	0	18,249
Cost Burden (Dollars)	0	0	0

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Abstract: A critical need exists for a national surveillance system that will produce frequent, consistent, and reliable data on the magnitude and nature of intimate partner violence (IPV), sexual violence (SV), and stalking using consistent definitions and survey methods to evaluate trends over time. To address this need, the Centers for Disease Control and Prevention's (CDC) National Center for Injury Prevention and Control (NCIPC), in collaboration with the National Institute of Justice (NIJ), and the Department of Defense (DoD) has developed the National Intimate Partner and Sexual Violence Surveillance System (NISVSS). The collaborative effort between agencies is motivated by the need to improve the understanding of IPV, SV, and stalking in the civilian, military, and American Indian/Alaska Native populations. The survey will be conducted among English and/or Spanish speaking male and female adults (18 years and older) living in the United States. NISVSS will collect population-based surveillance data, generating stable and precise annual prevalence estimates for IPV, SV, and stalking victimization at the national level. Lifetime, 12 month and 36 month prevalence data will be collected. As data collection continues across multiple years, sample sizes will increase and stable state-level lifetime prevalence data will also be available for both women and men. During the first year data will also be collected from: 1) female members of the active duty component of the US Armed Forces; and 2) female spouses of married male service members. NISVSS data will help inform public policies and prevention strategies at both the national and state levels and will help guide and evaluate progress toward reducing the substantial health and social burden associated with IPV, SV, and stalking.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
   PL: Pub.L. 109 - 162 904 Name of Law: Violence Against Women and Department of Justice Reauthorization Act of 2005
   US Code: 5 USC 9 Name of Law: Federal Advisory Committee 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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
National Intimate Partner and Sexual Violence Surveillance System - Survey	none	NIVSS survey
National Intimate Partner and Sexual Violence Surveillance System (NISVSS) - Screen

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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	108,318	108,318	0	0	0	0
Annual Time Burden (Hours)	18,249	18,249	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: $2,709,255

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: 11/09/2010

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