Program attendance and content coverage protocol

Instrument #5
Protocol to collect attendance and content coverage data

This page has been left blank for double-sided copying.

OMB Control No:
Expiration Date:

PROGRAM ATTENDANCE and content coverage protocol

In order to understand the dosage of program services received in the treatment group, we will collect program attendance data from the PAF sites and the extent to which the core program content was covered during the visits. Program attendance will be collected either through 1) extractions from pre-existing administrative records data on program attendance already collected by the program or 2) a data collection tool created by Mathematica Policy Research (see Table 5.1). Data will need to be provided for each youth in the evaluation sample randomized to receive programming, so that it can be linked to the outcome data for analysis. A unique identifier will be assigned for each youth so that no sensitive information will be transmitted. That identifier will be used to match attendance data to outcome data.

Table 5.1: Program Attendance Data Collection Tool

Study ID

Name

Current Participation Status

Prenatal or Postnatal

Date of Visit

Visit Time (in minutes)

Participants

Content 1 Discussed

Content 2 Discussed

Content 3 Discussed

Content 4 Discussed

Content 5 Discussed

Content 6 Discussed

Content 7 Discussed

Content 8 Discussed

Content 9 Discussed

Content 10 Discussed

Contraception Status

Contraception Type

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-xxxx . The time required to complete this information collection is estimated to average one hour per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer