CrossWalk of Changes

Crosswalk of Changes_OMB_No.0920-1130.DOCX

Monitoring and Reporting System for Rape Prevention and Education (RPE) Program Awardees

CrossWalk of Changes

OMB: 0920-1130

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Crosswalk of Changes

Monitoring and Reporting System (MRS) for

Rape Prevention and Education (RPE) Program Awardees

(OMB no. 0920-1130; Exp. date 08/31/2019)


Current Tool

Current Items

Requested Changes

Work Plan Tool: Home Tab, page 1


Program Report Tool: Home Tab, page 1

Select a state or territory.

Revise question wording:

  • Which RPE awardee are you reporting on? Select from the drop down menu.


[Work Plan Tool updated, Page 1 and Program Report Tool, Page 1]

Work Plan Tool: Component 1 and Component 2 Tabs

For all goals:

Goal #

Revise current question format to include annual reporting status updates to increase accuracy and relevance of reporting:

(For All Goal Items)

  • What is the status of this goal for Year 4?

    • Planned

    • In-progress and on track

    • In-progress but delayed

    • Completed

    • Discontinued

  • If you selected ‘Discontinued’, please provide an explanation in the space below:

  • Has this goal changed since the previous reporting period for the Year 5 Work Plan?

    • No, it is ongoing from Year 4

    • Yes, it has been revised from Year 4

  • If you selected ‘Yes, it has been revised from Year 4’, please provide your revised goal below.


[Work Plan Tool updated, Page 2]

Work Plan Tool: Component 1 and Component 2 Tabs


For all potential challenges for goal:

Please describe potential challenges and needed support for completing the activities within this goal.

Revise current question format to include annual reporting status updates to increase accuracy and relevance of reporting:

(For all potential challenges for goal)


  • Please describe any challenges related to this goal that you experienced in Year 4.

  • Please describe any successes related to this goal that you achieved in Year 4.

  • Please describe any potential challenges you anticipate for completing this goal in Year 5.

  • Please describe any needed supports for completing this goal in Year 5.


[Work Plan Tool updated, Page 2 &3]

Work Plan Tool: Component 1 and Component 2 Tabs

For all Objective Questions:


Annual Objective,

What is the status of this objective?

    • Not Yet Started

    • Scheduled

    • Ongoing

    • Complete

Revise current question format and answer options to include annual reporting status updates to increase accuracy and relevance of reporting:(For all Objective Questions)

  • What is the status of this objective for Year 4?

    • Planned

    • In-progress and on track

    • In-progress but delayed

    • Completed

    • Discontinued

  • If you selected ‘Discontinued’, please provide an explanation in the space below:

  • Has this objective changed since the previous reporting period for the Year 5 Work Plan?

    • No, it is ongoing from Year 4

    • Yes, it has been revised from Year 4

  • If you selected ‘Yes, it has been revised from Year 4’, please provide your revised objective below.


[Work Plan Tool updated, Page 3]

Work Plan Tool: Component 1 and Component 2 Tabs

For all Activity Status:


Activity Status

    • Not Yet Started

    • Scheduled

    • Ongoing

    • Complete

Revise answer options: (For all Activity Status)

  • Activity Status

    • Planned

    • In-progress and on track

    • In-progress but delayed

    • Completed

    • Discontinued


[Work Plan Tool updated, Page 3]

Work Plan Tool: Component 1 and Component 2 Tabs

Features to add activity or goal not included.

Add new features:

For all goal and activity section:

  • Add New Activity [Button that adds an additional activity row]

  • Add New Goal [Button that adds an additional goal table]


[Work Plan Tool updated, Page 3 & 4]

Work Plan Tool: Component 2 Tab

Goal 1: To provide proactive, regularly scheduled, and on-demand training and technical assistance to local organizations

Goal 2: To provide additional resources aimed at improving local organization’s capacities related to implementing their primary prevention strategies

Goal 3: Ensure there is staff at the state level that has the expertise and sufficient time to provide proactive, regularly scheduled, and on-demand TA to local programs

Revised question formatting for evaluation related goals, objectives, and activities and moved to separate section titled ‘For RPE Outcome Monitoring and Evaluation Goals Only’ to increase consistency and relevance of reporting:

  • Since the last reporting period, what additional enhancements have you made to your evaluation plan? Please also describe any additional outcomes you added to your evaluation plan.

  • Has this objective changed since the previous reporting period?

  • If status is ‘In progress but delayed’ or ‘Discontinued’, explain why.

  • Since the last reporting period, what additional resources were needed to fully implement this objective? (Check all that apply)

  • What additional resources were most useful? (Select up to two)

  • What additional resources were least useful? (Select up to two)

  • Answer options are the same for the above three questions:

  • No additional resources needed

  • In-kind support

  • State funding

  • External grant

  • Free public resources

  • Internal partners

  • External partners

  • TA from CDC

  • TA from University of Rochester

  • Other: [Open Text Field]

  • In-kind support

  • State funding

  • External grant

  • Free public resources

  • Internal partners

  • External partners

  • TA from CDC

  • TA from University of Rochester

  • Other: [Open Text Field]

  • Since the last reporting period, what challenges does your organization continue to face in implementing this objective, if any?

  • How did your organization overcome any previous challenges in implementing this objective


[Work Plan Tool updated, Page 4-6]



Current Tool

Current Items

Requested Changes


Program Report Tool: Background Tab

  • Background Tab

Delete Background Tab. Questions on that tab are to be deleted or incorporated into other tab in the same tool or in the Work Plan Tool.

Program Report Tool: Background Tab

  • Prevention Strategy Tab

Revise name of tab “Prevention Strategy #” for Prevention Strategy Tab to “Implementing_Org_#” for Implementing Organization Tab.

Program Report Tool: Prevention Strategy Tab, Target Population

  • Target Population section


Revise section name of “Target Population” to “Sexual Violence Problem and Target Population” and move section up to align with the public health approach, which grantee uses when planning for implementation.


Program Report Tool: Prevention Strategy Tab

  • Prevention Strategy Selection and Risk and Protective Factors sections

Merge section and revise name to “Prevention Strategy Selection” and move section to after “Sexual Violence and Target Population”

Program Report Tool: Home Tab and Prevention Strategy Tab

  • Add Prevention Strategy [Button that adds an additional strategy tab]

Move feature from Home Tab and Prevention Strategy Tab to the Implementing Organization Tab:

  • Add New Prevention Strategy [Button that adds additional strategy questions]

Program Report Tool: Background Tab

  • Q2: For each of the prevention strategies reported in this tool, please indicate which state-level RPE work plan goal(s) the prevention strategy relates to or addresses.

Revise existing question in the Program Report Tool Background Tab with the following question in the Work Plan Tool:

  • In a few sentences, please describe how your goals and objectives align with the prevention strategies listed in your Program Report Tool. If there are areas of misalignment between goals and prevention strategies please describe why.


[Work Plan Tool updated, Page 4]

Program Report Tool: Background Tab

  • Q4 .Please select all that best describe the sector of the implementing organization. (Check all that apply)

  • Q8. Provide any additional information or elaborate on any of the above questions as needed.

Delete questions

Program Report Tool: Background Tab

  • Q5. What is the total annual RPE budget for the implementing organization?


Revise question wording and move question to Program Report Tool, Implementing Organization Tab, Implementing Organization:

  • Q2. What is the implementing organization’s total annual RPE budget? Provide information in dollar amounts.


[Program Report Tool updated, Page 3]

Program Report Tool: Background tab


  • Q6. How much funding is allocated for the implementation of each prevention strategy?

  • Q7. Are funds allocated to evaluate the prevention strategy(s)?

  • Q7a. How much funding is allocated for the evaluation for each prevention strategy?

  • Q7b. How much funding is allocated for the evaluation?

Revise question wording and move question to Program Report Tool, Implementing Organization Tab, Information Collection and Evaluation Section:

  • Q21. How much funding is allocated for the implementation of this prevention strategy?

  • Q22. Is funding allocated for the evaluation of this prevention strategy?

  • Q22a. How much funding is allocated for the evaluation of this prevention strategy?

  • Q22b. How much funding is allocated for evaluation at the implementing organization level?


[Program Report Tool updated, Page 9]

Program Report Tool: Prevention Strategy Tab, Prevention Strategy Description Section

  • Q2. Describe your prevention strategy. Use the following questions to help you describe the strategy. What are the goals of the prevention strategy? What does it aim to change? What methods are used to affect that change (e.g., potential impact)? What are the components and activities of the prevention (e.g., theory of change, roadmap, or logic)? What are the key messages or topics of the strategy?

Revise question wording:

  • Q4. Describe the prevention strategy. Use the following questions as a guide: What are the goals and components of the prevention strategy (e.g., theory of change)? How do the goals and/or components of this strategy relate to primary prevention of sexual violence?


[Program Report Tool updated, Page 3]


Program Report Tool: Prevention Strategy Tab, Prevention Strategy Description Section, Prevention Strategy Characteristics Sub-section

  • Q3. Which of the following strategies from the RPE Cooperative Agreement (14-1401) does this prevention strategy relate to? According to the Violence against Women Act of 1994 (VAWA), allotments of RPE funds may only be used for seven permitted uses (first seven listed).

Revise question wording:

  • Q5. Which of the following permitted uses/approaches from the RPE Cooperative Agreement (14-1401) does the implementation of this prevention strategy relate to? (Check all that apply).


[Program Report Tool updated, Page 4]


Program Report Tool: Prevention Strategy Tab, Prevention Strategy Description Section, Prevention Strategy Characteristics Sub-section

  • Q5. Provide any additional information or elaborate on any of the above as needed.

Revise existing question format to increase accuracy and relevance of the information about prevention strategies being implemented:

  • Q6. Which of the following best describes the development of this prevention strategy?

    • Prevention strategy developed locally

    • Pre-packaged prevention strategy developed by another organization

    • Prevention strategy developed by combining pre-packaged components with locally developed components


  • Q7. Which strategy from the CDC’s STOP SV technical package best aligns with the focus of this prevention strategy?

    • Promote Social Norms that Protect Against Violence

    • Teach Skills to Prevent Sexual Violence

    • Provide Opportunities to Empower and Support Girls and Women

    • Create Protective Environments

    • Support Victims/Survivors to Lessen Harms


  • Q8. How many unique cycles of this prevention strategy have been implemented by your organization this reporting year?


[Program Report Tool updated, Page 4]


Program Report Tool: Prevention Strategy Tab, Prevention Strategy Characteristics

  • Q4. What sources of information or data did you use to inform your selection of the prevention strategy and determine that it may be effective in changing sexual violence-related outcomes and/or address identified risk and protective factors? (Check all that apply)

Revise question wording and move to Prevention Strategy Selection:

  • Q17. What sources of information or data informed your selection of the prevention strategy and helped determine that it may be effective in changing sexual violence-related outcomes and/or addressing identified risk and protective factors in the selected target population? (Mark an "X" in all that apply).


[Program Report Tool updated, Page 8]


Program Report Tool: Prevention Strategy Tab, Risk and Protective Factors Section

  • Q8. Which of the following risk factors does this strategy seek to address? (Check all that apply)

  • Q9. Which of the following protective factors does this strategy seek to address? (Check all that apply)

Revise question wording and move to “Prevention Strategy Selection” section:

  • Q14. Which of the following risk factors does this strategy directly address for your target population? (Check all that apply)

  • Q15. Which of the following protective factors does this strategy directly address for your target population? (Check all that apply)


[Program Report Tool updated, Page 6 & 7]


Program Report Tool: Prevention Strategy Tab, Target Population

  • Q10. Who or what entities will change or be affected as a result of the prevention strategy? (Check all that apply)

  • Q11. What are the characteristics related to the selected target population described above? (Check all that apply)

Revise question wording:

  • Q9. Who is, or what entities are, the primary target population of the prevention strategy? (Check all that apply)

  • Q10. What are the characteristics of the primary target population selected above? (Check all that apply)


[Program Report Tool updated, Page 4 & 5]


Program Report Tool: Prevention Strategy Tab, Prevention Strategy Selection

  • Q6. Describe the rationale for selecting this prevention strategy to implement. Use the following questions to help you describe the rationale: To what extent does the prevention strategy align with the needs and defined sexual violence problem in the selected target population? How will this strategy achieve the intended outcomes for the selected target population? A later section will ask about the selected target population.

Revise existing question wording and format to be more clear and specific, and to move the first question to the “Sexual Violence Problem and Target Population”:

  • Q13. In a few sentences describe the needs and sexual violence problem(s) of the selected target population. Use the following questions as a guide: What is the sexual violence problem that needs to be prevented among the target population? What factors protect the target population or put them at risk for experiencing or perpetrating sexual violence?

  • Q16. In a few sentences describe the rationale for selecting this prevention strategy to implement for the selected population. Use the following questions as a guide: To what extent does the prevention strategy align with the needs and defined sexual violence problem in the selected target population described above? To what extent does the prevention strategy address the identified risk and protective factors in the target population?


[Program Report Tool updated, Page 6 & 7]


Program Report Tool: Prevention Strategy Tab, Reach

  • Q14. Complete this for each of your target populations for this prevention strategy. You may use the button below to add as many rows as needed to this table.

Revise question format to ask for an aggregate number for each unit of analysis instead of for each target population and revise instruction:

Q19. Use the table below to report the total number of individuals, organizations, and/or communities reached with this prevention strategy by this implementing organization across implementation sites. In most cases reach should be reported using only one unit of analysis (individual, organizational, or community). The number of individuals reached is likely to be the appropriate unit of analysis for most prevention strategies (e.g. prevention strategies that most immediately target individual knowledge, attitude and behavior change). For prevention strategies that directly aim to change organizational or community-wide policies, environments, or other structures, the organizational or community unit of analysis may be appropriate. Reach can be reported using more than one unit of analysis only if the prevention strategy is a multi-component strategy with multiple targets of change (e.g. prevention strategy that aims to change both individuals with educational curriculum and organizations with policy change efforts). Please consult the RPE Monitoring and Reporting System Guidance for further instructions and examples on how to report reach.


[Program Report Tool updated, Page 8]

Program Report Tool: Prevention Strategy Tab, Information Collection and Evaluation Section

  • Q16. What types of information or data do you collect about the implementation of the prevention strategy?

  • Q16b. What are the sources of information or data that you use? (Check all that apply).

  • Needs assessment

  • Capacity or assets assessment

  • Environmental scan

  • Strategy theory or Logic model

  • Evaluation report

  • Literature review

  • Administrative records

  • Tracking logs

  • Other: [Open Text Field]

Revise question wording & answer options:

  • Q23a. What types of information does your organization collect about the implementation of this prevention strategy?

  • Recruitment

  • Attendance

  • Participant satisfaction and/or engagement

  • Number of sessions/events/services etc. delivered or provided

  • Fidelity

  • Adaptation

  • Implementation barriers and facilitators

  • Contextual information

  • Other: [Open Text Field]

  • Q23b. What data sources does your organization use to measure implementation? (Check all that apply).

  • Needs assessment

  • Capacity or assets assessment

  • Environmental scan

  • Strategy theory or Logic model

  • Evaluation report

  • Literature review

  • Administrative records

  • Observations

  • Tracking logs

  • Surveys

  • Focus groups

  • In-depth interviews

  • Other: [Open Text Field]


[Program Report Tool update, Page 9 & 10]

Program Report Tool: Prevention Strategy Tab, Information Collection and Evaluation Section

  • Q17a. What types of data or information do you collect about the outcomes of the prevention strategy (e.g., risk/protective factors, knowledge, skills, behaviors, attitudes, victimization, perpetration, practices)?

  • Q17b. What sources of information or data do you use to measure those outcomes?

Revise question wording & answer options:

  • Q24a. What types of data or information do you collect about the outcomes of the prevention strategy? (Check all that apply).

  • Risk/protective factors

  • Rates of victimization

  • Rates of perpetration

  • Knowledge/skills

  • Behaviors/attitudes

  • Social norms

  • Change in policy or practice

  • Environmental change

  • Other: [Open Text Field]

  • Q24b. What data sources does your organization use to measure those outcomes?


[Program Report Tool update, Page 10]

Program Report Tool: Prevention Strategy Tab, Information Collection and Evaluation Section

  • Q18a. How do you use information or data you collect?

  • Q19. Do you disseminate information (e.g., impact) or lessons learned about the prevention strategy?

    • Yes

    • No

  • Q19a. What information or lessons learned do you share?

  • Q19b. To whom and how do you disseminate or share the information or lessons learned?

Replace existing questions with one new question to streamline:

  • Q26. In a few sentences describe how you use the information or data you collect. If relevant, mention how you disseminate or share the information or data you collect and with whom.


[Program Report Tool updated, Page 11]



Revisions to Instructions


Current Tool

Current Items

Requested Changes

Work Plan Tool: Home Tab, Page 1

Please use this Tool to prepare a work plan for the Rape Prevention and Education Program.

Revise instructions:

  • Please use this Tool to report on previous work plan progress for Year 4 (February 1, 2017 - January 31, 2018) and update your work plan for Year 5 (February 1, 2018 - January 31, 2019) for the Rape Prevention and Education Program.


[Work Plan Tool updated, Page 1]

Work Plan Tool: Component 1 Tab, Page 2

Instructions on annual reporting status updates not included in current tool.

Add instructions at the beginning of the tab:

  • Please complete your Year 5 (February 1, 2018 - January 31, 2019) Work Plan and report on progress made to date toward your Year 4 goals and objectives (February 1, 2017 - January 31, 2018). If any of your goals or objectives that have carried over from Year 4 need revising, you may edit them in this section. If any of your goals or objectives from Year 4 have been completed or are discontinued for Year 5, please choose ‘Completed’ or ‘Discontinued’ under the status question. You may then add new ones using the dynamic ‘Add Goal’ and ‘Add Objective’ buttons. You are also able to add new activities for Year 5 by selecting the ‘Add Activity’ button. Please ensure that you do not exceed the maximum of 5 goals for Year 5 under Component 1.


[Work Plan Tool updated, Page 2]

Work Plan Tool: Component 1 Tab

Instructions for evaluation related goals, objectives, and activities not included.

Add instructions only for evaluation related goals, objectives, and activities to increase consistency and relevance of reporting:

  • Please update your progress on your action steps and provide any new recommendations. Recommendations should be reported as annual objectives and action steps as activities. If any of your recommendations that have carried over from the previous reporting period need revising, you may edit them in this section. You are also able to add new action steps by selecting the ‘Add Activity’ button. After you have provided updates on your existing recommendations under each Area, you may add new ones using the dynamic ‘Add New Objective’ buttons.


[Work Plan Tool updated, Page 4]

Work Plan Tool: Component 3 Tab

Instructions for reporting on CDC-sponsored RPE Program Support Activities not included.

Add instructions at the beginning of the tab:

  • Using the table below, please list the CDC-sponsored RPE Program Support Activities that you intend to participate in during Year 5 (February 1, 2018 - January 31, 2019).


[Work Plan Tool updated, Page 10]

Program Report Tool: Background Tab

  • Q3: What is the name of the implementing organization?

Revise instructions and move from Background Tab to the Home Tab:

  • 2. List the names of each of your implementing organizations. All organizations in your state or territory that implemented violence prevention strategies with RPE funding during this reporting period must be listed. This includes both direct awardees and sub-awardees of your state or territory’s RPE program and organizations that implement preventions strategies at the state and/or local level. Examples of implementing organizations include but are not limited to state sexual violence coalitions, sub-contractors of the state sexual violence coalition, local rape crisis centers, and the state health department. Collaborating or partnering organizations that do not receive RPE funding should not be reported. You may add as many implementing organizations as you need.

Each implementing organization listed below needs to be reported on a corresponding implementing organization tab.

Once you enter the name of the implementing organization here, click the validate button to generate a tab for this implementing organization. The delete button may be used at any time to delete an implementing organization registered on the home page and its corresponding tab in the workbook.

To add another row and a subsequent tab in the workbook, for an additional implementing organization, click the grey button below at any time.


[Program Report Tool updated, Page 2]

Program Report Tool: Prevention Strategy Tab, Prevention Strategy Description Section

  • One of the effective prevention principles is that prevention strategies should be based on the best available evidence (See CDC’s Understanding Evidence for more information about levels of evidence). At a minimum, prevention strategies should have an articulated theory base to address modifiable risk and protective factors related to sexual violence.

Revise instructions:

  • Please complete the following questions for each prevention strategy this implementing organization is carrying out. A prevention strategy is a specific set of prevention activities intended to work together toward a desired goal or outcome. A prevention strategy may be a specific activity referenced as one of the seven permitted uses, curriculum, program, policy, or community effort.


Each distinct prevention strategy should be reported separately by name (i.e. prevention strategies should not be grouped together under generic categories). Other essential public health services like evaluation and surveillance that do not meet the definition of a prevention strategy should not be reported here. You may use the dynamic ‘Add Prevention Strategy’ button at the bottom of this tab to add as many prevention strategies as you need for this implementing organization.


One of the effective prevention principle is that prevention strategy should be based on the best available evidence (See CDC’s Understanding Evidence for more information about levels of evidence). At a minimum, prevention strategies should have an articulated theory base to address modifiable risk and protective factors related to sexual violence.


[Program Report Tool updated, Page 3]


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorChowdhary, Pari (CDC/ONDIEH/NCIPC) (CTR)
File Modified0000-00-00
File Created2021-01-22

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