A Controlled Evaluation of Expect Respect Support Groups (ERSG): Preventing and Interrupting Teen Dating Violence among At-Risk Middle and High School Students

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
ERSG OMB SSB.docx	Supporting Statement B	Uploaded 2013-07-15	Available
Att M - Public Comment.docx	Supplementary Document	Uploaded 2013-07-15	Available
Att H - Expect Respect Safety Procedures and Mandatory Reporting Requirements 7.19.10.doc	Supplementary Document	Uploaded 2013-07-15	Available
Att G - Student Assent Form and Parent Notification Form (v3).doc	Supplementary Document	Uploaded 2013-07-15	Available
Att F - CDC IRB Approval.docx	Supplementary Document	Uploaded 2013-07-15	Available
Att B - Published 60-Day FRN.pdf	Supplementary Document	Uploaded 2013-07-15	Available
Att A - PHS Act Sec 301.pdf	Supplementary Document	Uploaded 2013-07-15	Available
ERSG OMB SSA - 7-1-2013 - REVISED.docx	Supporting Statement A	Uploaded 2013-07-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
204304	ERSG Facilitator End of Year Qualitative Interview	Other-WORD	Modified
204303	ERSG Facilitator Mid-Year Qualitative Interview	Other-WORD	Modified
197246	ERSG Observational Program Implementation Fidelity Measure	Other-WORD	Modified
197245	ERSG Facilitator Program Implementation Fidelity Measure	Other-WORD	Modified
194255	Teen Dating Violence Support Group Evaluation Survey (Baseline Survey)	Other-WORD	Modified
194254	Intake Assessment Screening Form for Expect Respect Support Groups (Intake Assessment)	Other-WORD	Modified
194253	Intervention and Control Schools (Follow-Up Survey)	Other-WORD	Modified
194251	Intervention and Control Schools (Completion Survey)	Other-WORD	Modified

ICR Details

OMB Control No: 0920-0861	ICR Reference No: 201307-0920-008
Status: Historical Active	Previous ICR Reference No: 201209-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 20003
Title: A Controlled Evaluation of Expect Respect Support Groups (ERSG): Preventing and Interrupting Teen Dating Violence among At-Risk Middle and High School Students
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: 08/21/2013
	Date Received in OIRA: 07/18/2013
Terms of Clearance: Previous terms continue: Approved with the understanding that CDC will maintain a strong oversight role in the evaluation of the intervention.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2016	36 Months From Approved	08/31/2013
Responses	2,248	0	2,248
Time Burden (Hours)	1,622	0	1,622
Cost Burden (Dollars)	0	0	0

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Abstract: The prevalence and consequences of teen dating violence make it a public health concern that requires early and effective prevention. To date, only three prevention strategies - Safe Dates, the Youth Relationships Project, and 4th R - have demonstrated reductions in dating violence behaviors in rigorous, controlled evaluations. In order to protect young people and build an evidence-base of effective prevention strategies, evaluation of additional programs is needed, including those programs currently in the field. Expect Respect Support Groups (ERSG) were identified by CDC through the empowerment evaluation process as a program in the field that is in need of rigorous evaluation. The ERSG program has demonstrated favorable, albeit preliminary, results in a pre-post program evaluation, which strongly suggest that a controlled evaluation is needed to more rigorously examine program effects. The study has two primary goals and two exploratory aims. The primary goals are: 1) To evaluate the effectiveness of Expect Respect Support Groups (ERSG) in preventing and reducing teen dating violence and 2) To compare whether there are increased healthy conflict resolution skills reported by at-risk male and female middle and high school students participating in ERSG, compared to at-risk students in control schools who do not receive ERSG. The exploratory aims are: 1) To evaluate whether the effectiveness of ERSG is enhanced by the presence of a universal, school-wide prevention programs, and 2) To examine whether participants with different characteristics (e.g., girls vs. boys) respond differently to the intervention.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Research and Investigation Generally
  

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:
	78 FR 18985	03/28/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 42079	07/15/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Intervention and Control Schools (Completion Survey)
Intervention and Control Schools (Follow-Up Survey)
Intake Assessment Screening Form for Expect Respect Support Groups (Intake Assessment)
Teen Dating Violence Support Group Evaluation Survey (Baseline Survey)
ERSG Facilitator Program Implementation Fidelity Measure
ERSG Observational Program Implementation Fidelity Measure
ERSG Facilitator Mid-Year Qualitative Interview
ERSG Facilitator End of Year Qualitative Interview

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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	2,248	2,248	0	0	0	0
Annual Time Burden (Hours)	1,622	1,622	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: $227,005

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: 07/18/2013

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