Assessment of the Underage Drinking Prevention: Town Hall Meetings Initiative

Forms and Documents

Document Name	Status
Form Participant Form_E Participants Survey Form and Instruction	Modified
Form Organizer Survey Organizers Survey Form and Instruction	Modified
Attachment 4-ICF IRB Review Findings Form_12 19 13.pdf Supplementary Document	2014-01-02
THM_OMB_SS-B_12 19 13.docx Supporting Statement B	2014-01-02
Attachment 7-Invitation to Participate E-mail_052313.doc Supplementary Document	2013-08-20
Attachment 4-ICF IRB Review Findings Form_052313.pdf Supplementary Document	2013-08-20
Attachment 6-Reminder E-mail to Organizers-Organizer Survey_052313.doc Supplementary Document	2013-08-20
Attachment 5-Initial E-mail to Organizers-Organizer Survey_052313.doc Supplementary Document	2013-08-20
THM_OMB_SS-A_12 19 13.docx Supporting Statement A	2014-01-02

IC Document Collections

IC ID	Document Title	Status
194189	Participants Survey Form and Instruction	Modified
182093	Organizers Survey Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0288	ICR Reference No: 201309-0930-001
Status: Historical Active	Previous ICR Reference No: 201008-0930-003
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 20346
Title: Assessment of the Underage Drinking Prevention: Town Hall Meetings Initiative
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/02/2014
	Date Received in OIRA: 09/24/2013
Terms of Clearance: SAMHSA shall continue to focus its respondent population to minimize burden while achieving the stated purpose of the collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2017	36 Months From Approved	12/31/2013
Responses	6,720	0	15,400
Time Burden (Hours)	1,113	0	2,696
Cost Burden (Dollars)	0	0	0

---

Abstract: SAMHSA/CSAP intends to support annual Town Hall Meetings (THMs). The information collected will be used by SAMHSA/CSAP to help plan for those annual events and to provide technical assistance and training to organizations that sponsor the events. The information will provide a descriptive picture of the nation-wide initiative, and it will indicate how the THMs were received and some factors that may be associated with well-received events.

---

Authorizing Statute(s): US Code: 42 USC 501 Name of Law: SAMHSA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 37558	06/21/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 52206	08/22/2013
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Organizers Survey	Organizer Survey	Organizer Survey
Participants Survey	Participant Form_English, Participant Form_Spanish	Participant Form_English ,   Participant Form_Spanish

---

ICR Summary 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	6,720	15,400	0	0	-8,680	0
Annual Time Burden (Hours)	1,113	2,696	0	0	-1,583	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: In 2008, the THM collection utilized one data collection instrument (for THM event organizers only). Under the currently approved collection, two instruments and respondent pools are utilized (for THM event organizers and participants of the THM events) and there are 2,696 burden hours in the OMB inventory. SAMHSA/CSAP is requesting a decrease of 1,583.26 hours due to the reduction in the amount of time it will take respondents to complete the Organizer Survey (from 30 to 20 minutes; based on comments from consultations outside the agency), and reductions in the number of respondents to the Organizer Survey (from 3,400 to 2,220; due to initiative funding clarifications) and Participant Form (from 12,000 to 4,500 potential respondents; due to a decrease from 400 to 150 sampled CBOs to take part in this collection).

---

Annual Cost to Federal Government: $34,749

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

---

Common Form ICR:  No

---

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: 09/24/2013

---