Teen Pregnancy Prevention Replication Evaluation: Baseline Data

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
TPP Replication Study Baseline-Safer Sex Youth Consent revised 05.14.12.docx	Supplementary Document	Uploaded 2012-06-06	Available
TPP Replication Study Baseline-Safer Sex Parent Consent 5.17.12.docx	Supplementary Document	Uploaded 2012-06-06	Available
TPP Replication Study Baseline-30-Day FRN.doc	Supplementary Document	Uploaded 2012-06-06	Available
TPP Replication Study Baseline-RtRCuidate consent revised 05.14.12.docx	Supplementary Document	Uploaded 2012-06-06	Available
TPP Replication Study Baseline-Attachment J youth assent 0516.docx	Supplementary Document	Uploaded 2012-06-06	Available
TPP Replication Study Baseline-Attachment H Audio-CASI.docx	Supplementary Document	Uploaded 2012-06-06	Available
TPP Replication Study Baseline - Attachment I - Published 60 day FRN.pdf	Supplementary Document	Uploaded 2012-06-06	Available
TPP Baseline-Supporting Statement Part B_052012 final (clean).docx	Supporting Statement B	Uploaded 2012-06-06	Available
TPP Replication Study Baseline-Attachment C Sources referenced.docx	Supplementary Document	Uploaded 2012-06-06	Available
TPP Replication Study Baseline-Attachmen B Topics & Justification.docx	Supplementary Document	Uploaded 2012-06-06	Available
TPP Replication Study Baseline-Attachment A Item Crosswalk Table_0517.docx	Supplementary Document	Uploaded 2012-06-06	Available
TPP Baseline-Supporting Statement A 052012 final (clean).docx	Supporting Statement A	Uploaded 2012-06-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
200819	Non Sexually active youth Part B2 of the baseline survey to be used with youth who have	Other-Survey	New
200818	B1 Safer Sex sites and youth who have ever had sex	Other-Survey	New
200817	Part A Reducing the Risk and Cuidate	Other-Survey	New
200816	Sexuallly Active Youth Part A Safer Sex	Other-Survey	New

ICR Details

OMB Control No: 0990-0394	ICR Reference No: 201201-0990-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Teen Pregnancy Prevention Replication Evaluation: Baseline Data
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: 06/08/2012
	Date Received in OIRA: 01/18/2012
Terms of Clearance: This information collection request is approved as revised by HHS.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2015	36 Months From Approved
Responses	8,551	0	0
Time Burden (Hours)	2,139	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: OAH, in collaboration with ASPE, is conducting the TPP Replication Study evaluation, which is specifically designed to determine whether the replications of evidence-based program models, funded as part of the OAH evidence-based Teen Pregnancy Prevention Program, are effective in preventing teen pregnancy, reducing sexually transmitted infections, and/or preventing or reducing sexual risk behaviors. This evaluation focuses on the replication of a small number of program models across multiple sites with the goals of determining the extent to which program impacts are replicated as well as addressing questions about the extent to which aspects of program implementation are associated with program impacts.

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Authorizing Statute(s): None

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:
	76 FR 60840	09/30/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 507	01/05/2012
Did the Agency receive public comments on this ICR? No

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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
Sexuallly Active Youth Part A Safer Sex
Part A Reducing the Risk and Cuidate
B1 Safer Sex sites and youth who have ever had sex
Non Sexually active youth Part B2 of the baseline survey to be used with youth who have

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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	8,551	0	0	8,551	0	0
Annual Time Burden (Hours)	2,139	0	0	2,139	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: $800,000

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]? 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: 01/18/2012

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