Justification for Change

Change Request

November 8, 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 “State and Community Awardee Performance Measure Reporting Tool” (Attachment 6). To improve usability, data quality, and respondent satisfaction in completing the assessment, CDC proposes to add fields to allow awardees to enter supplemental information to clarify responses.

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

State and Community Awardee Performance Measure Reporting Tool

The revised paper version is included as Attachment 6 (rev)

Background and Justification

CDC is approved to collect information needed for a process and intermediate outcome evaluation of awardees funded under the TPP Initiative. An integral part of the process evaluation requires documenting implementation activities. In order to conduct this process evaluation, annual assessments of performance are conducted among the nine State and Community Awardees and their local partners. The collection of performance measures is critical to understanding the implementation practices associated with evidence-based programs and contraceptive access for each awardee community. Information will be collected via questionnaires and a web-based data entry system. Performance measures are collected via a paper questionnaire (see Attachment 6) annually in accordance with the standing approved ICR.

CDC requests OMB approval to modify the current form to include additional questions that are designed to improve usability and data quality based on feedback from respondents and CDC’s experience in providing technical assistance. This form does alter the content through the addition of questions that allow respondents to provide complete data and to provide clarification for reported measures (see itemized changes below). The items do not change the estimated burden per response.

Itemized Changes in Survey Content

The changes to the performance measure reporting tool include the addition of fields as indicated below.

Change 1. Added field to Table I.c. pages 3-4 for youth who did not report gender. Current field allows awardees to count only youth who report gender.

Characteristics of Program Youth1	Males		Females		Youth who did not report Gender
	# served	# retained	# served	# retained
Age (one response per participant)
10 years or younger
11-12 years
13-14 years
15-16 years
17-18 years
19 years or older
Grade (one response per participant)
6th grade or lower
7-8th grade
9-10th grade
11-12th grade
GED program
Technical/vocational training
College (any year)
Not currently in school
Ethnicity (one response per participant)
Hispanic or Latino
Not Hispanic or Latino
Unknown/unreported
Race (one response per participant)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other
More than one race
Unknown/unreported
Primary language spoken at home (one response per participant)
English
Spanish
Chinese
Other
Special populations (one response per participant)
None
Pregnant or parenting teens
Youth in foster care
Homeless youth
Youth in the juvenile justice system
Other (describe____________________)
Total

Change 2. The following 4 fields will be added to section I.c. page 4.

TOTAL NUMBER OF YOUTH SERVED_________________________

TOTAL NUMBER OF YOUTH RETAINED _______________________

Method of collection and reporting for youth served: _________________________________

Method of collection and reporting for youth retained: ________________________________

Change 3. The following field will be added to section I page 5.

ID_____________

Change 4. The following question will be added to section I page 5.

Please indicate the nature of the partnership: (Check all that apply)

• Signed MOU/MOA

• We provide funding to this partner

• We provide ongoing Technical Assistance and Training to this partner

• We have provided only Training to this partner

• This partner participates fully in the collection of Performance Measures

Change 5. The following will be added to section 2.b. page 9.

Data reporting period __________________ indicate the date range for the data provided below.

Change 6. The following will be added to section 2.f. page 11.

Data reporting period____________ indicate the date range for the data in all tables below.

Change 7. The following field will be added to section III.a.

# of Core Partner Leadership Team Members

Change 8. The following field will be added to section III.b.

# of Community Action Team Members

Change 9. The following field will be added to section III.c.

# of Youth Leadership Team Members

1 Characteristics may be obtained from attendance records or pre-/post-tests

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