0920-0952 Change Request

Change Request

September 19, 2013

Information Collection Request: “Process Evaluation of “Teenage Pregnancy Prevention: Integrating Services, Programs, and Strategies through Community-Wide Initiatives”

(OMB no. 0920-0952, exp. date 12/31/2015)

Summary

CDC is currently approved to collect information from 9 state and community grantees funded under the cooperative agreement “Teenage Pregnancy Prevention: Integrating Services, Programs, and Strategies through Community-Wide Initiatives.” Paper-based collection instruments that are administered annually to the grantee organization include the “Community and Clinical Partner Clinical Partner Needs Assessment” (Attachment 4) and the “Community and Clinical Partner Program Implementation Partner Needs Assessment” (Attachment 5). To improve usability and respondent satisfaction in completing the assessment, CDC proposes to implement an electronic form-fill response option for these instruments.

There are no changes to the number of respondents or the estimated burden per response. CDC plans to begin administering the revised instruments in 2013.  OMB approval is requested, effective immediately.

Information Collection Instruments Affected by Changes

Community and Clinical Partner Clinical Partner Needs Assessment

• The form-fill version is included as Attachment 4 (electronic).

Community and Clinical Partner Program Implementation Partner Needs Assessment”

• The form-fill version is included as Attachment 5 (electronic).

Background and Justification

CDC is approved to collect information needed for a process and intermediate outcome evaluation of awardees funded under the Teen Pregnancy Prevention (TPP) Initiative (OMB No. 0920-0952, exp. 12/31/2015). An integral part of the process evaluation requires documenting both capacity building and implementation activities. In order to conduct this process evaluation, needs assessment information is collected from community and clinical partners. Paper-based versions of these instruments were approved in December 2012 (Attachments 4 and 5). The Information Collection Request indicated that

“Attachments 4-8 will initially be fielded in hard copy only and a web-based option may become available at a later date to allow for flexibility based on awardee preferences.” (See Supporting Statement, Section A.1, page 6.)

CDC requests OMB approval to implement electronic form-fill versions of Attachments 4 and 5 using adobe acrobat software. This form does not alter the content or format of the survey, or the estimated burden per response. The format allows for easier entry of information for grantees and their partners.

CDC will monitor the percentage of responses received electronically and the percentage of responses submitted on paper instruments. We will include this information in the Revision ICR that will be needed to complete information collection for all years of project funding.

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