Cross-site Evaluation of the Minority Serving Institutions' HIV/AIDS Demonstration Initiative and Capacity Building Project

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990-Cross-Site_Part_B.docx	Supporting Statement B	Uploaded 2012-05-01	Available
0990-Cross-Site_MSI HIV _REVISED 05 01 12.doc	Supporting Statement A	Uploaded 2012-05-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
201329	Focus Groups\Interviews	Other-(survey)	New
201328	Pre-Post Test Students	Other-survey	New
201327	Pre-and Post Surveys Students	Other-survey	New
201326	Annual Site Visit Partner Key Informant Interview	Other-interviews	New
201325	Semi-Annual Reporting of Site Evaluation Findings MSI HIV staff	Other-report	New
201324	Monthly Progress Reports MSI HIV staff	Other-reports	New
201323	Annual Staff Key Informant interview MSI staff	Other-survey	New

ICR Details

OMB Control No: 0990-0395	ICR Reference No: 201202-0990-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Cross-site Evaluation of the Minority Serving Institutions' HIV/AIDS Demonstration Initiative and Capacity Building Project
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: 06/11/2012
	Date Received in OIRA: 02/27/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2015	36 Months From Approved
Responses	3,114	0	0
Time Burden (Hours)	2,652	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The data collected in this cross-site evaluation will provide information about the effectiveness of different approaches to HIV/AIDS prevention, including numbers of students reached and engaged, changes in knowledge and awareness of HIV/AIDS, and behaviors related to prevention, testing and treatment. The data collected will also be used to identify best practices that offer the greatest promise for sustained effectiveness and expansion to other minority youth.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: 241 Public Health Sevice 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:
	76 FR 36131	06/21/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 79683	12/22/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Annual Staff Key Informant interview MSI staff
Monthly Progress Reports MSI HIV staff
Semi-Annual Reporting of Site Evaluation Findings MSI HIV staff
Annual Site Visit Partner Key Informant Interview
Pre-and Post Surveys Students
Pre-Post Test Students
Focus Groups\Interviews

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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	3,114	0	0	3,114	0	0
Annual Time Burden (Hours)	2,652	0	0	2,652	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: $627,975

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: 02/27/2012

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