Information Collection

Self-Regulation Training Approaches and Resources to Improve Staff Capacity for Implementing Healthy Marriage Services for Youth (SARHM)

IC 231707 under ICR 201802-0970-003 · OMB 0970-0355.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1_Educator questionnaire.2.docx	Other-Questionnaire
Instrument 2_Interview protocol.2.docx	Other-Interview
Instrument 3_Session assessment form.2.docx	Other-Session Assessment
Instrument 4_Observation tool.2.docx	Other-Observation Tool
Instrument 5_Youth questionnaire.2.docx	Other-Questionnaire
Instrument 6_Youth focus group protocol.3.clean.docx	Other-Focus Group Protocol
SARHM OMB 2 SSA_070218_revised.2_clean.docx SARHM Supporting Statement A	IC Document
SARHM OMB 2 SSB_070218_clean.docx SARHM Supporting Statement B	IC Document
Attachment A_SARHM_Legislative authority.pdf Attachment A - SARHM Legislative Authority	IC Document
Attaachment B_SARHM Mathematica Confidentiality Pledge.pdf Attaachment B_Mathematica Confidentiality Pledge	IC Document

IC Title:

Self-Regulation Training Approaches and Resources to Improve Staff Capacity for Implementing Healthy Marriage Services for Youth (SARHM)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire	Instrument 1_Educator questionnaire.2.docx	Yes	Yes	Fillable Fileable
Other-Interview	Instrument 2_Interview protocol.2.docx	No		Paper Only
Other-Session Assessment	Instrument 3_Session assessment form.2.docx	Yes	Yes	Fillable Fileable
Other-Observation Tool	Instrument 4_Observation tool.2.docx	Yes	Yes	Fillable Fileable
Other-Questionnaire	Instrument 5_Youth questionnaire.2.docx	Yes	Yes	Fillable Fileable
Other-Focus Group Protocol	Instrument 6_Youth focus group protocol.3.clean.docx	No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 197

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	116	116
Annual IC Time Burden (Hours)	397	397
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SARHM Supporting Statement A	SARHM OMB 2 SSA_070218_revised.2_clean.docx	07/16/2018
SARHM Supporting Statement B	SARHM OMB 2 SSB_070218_clean.docx	07/16/2018
Attachment A - SARHM Legislative Authority	Attachment A_SARHM_Legislative authority.pdf	06/12/2018
Attaachment B_Mathematica Confidentiality Pledge	Attaachment B_SARHM Mathematica Confidentiality Pledge.pdf	06/12/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.