Youth Engagement in Sports (YES) Performance Measures

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 YES Physical Activity and Nutrition Survey	Form and Instruction	New	Available
30-day FRN 0990-YES.pdf	Supplementary Document	Uploaded 2019-08-20	Available
60-day FRN 0990-YES Initiative.pdf	Supplementary Document	Uploaded 2019-08-14	Available
YES Initiative - Attachment_D Analysis Plan.docx	Supplementary Document	Uploaded 2019-08-14	Available
YES Initiative - Attachment C NDA template.docx	Supplementary Document	Uploaded 2019-08-14	Available
Attachment A_Question by Question Source List_YES INITIATIVE.docx	Supplementary Document	Uploaded 2019-08-14	Available
YES Initiative - Attachment_B Persons Consulted.docx	Supplementary Document	Uploaded 2019-08-14	Available
Supporting statement B Yes Initiative.docx	Supporting Statement B	Uploaded 2019-08-14	Available
Supporting Statement A_YES Initiative OMH OWH.docx	Supporting Statement A	Uploaded 2019-08-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
237364	Program Participation	Other-Recording sheet	New
237363	Sports Literacy Form	Other-Instructions and recording sheet	New
237362	Sports Inventory	Other-Instructions and recording form	New
237360	YES Physical Activity and Nutrition Survey	Form and Instruction	New

ICR Details

OMB Control No: 0937-0209	ICR Reference No: 201908-0937-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/OASH	Agency Tracking No:
Title: Youth Engagement in Sports (YES) Performance Measures
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/07/2019
	Date Received in OIRA: 08/20/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2022	36 Months From Approved
Responses	22,428	0	0
Time Burden (Hours)	6,184	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of Minority Health (OMH) and Office of Women’s Health (OWH) are seeking an approval by OMB on a new information collection, Youth Engagement in Sports (YES Initiative) Performance Measures (hereafter YES Initiative Performance Measures). The purpose of this data collection is to gather quantitative data from YES grant recipients to monitor project performance in achieving process and outcome measures over the course of the three-year project. Grantees will collect a small set of process and outcome measures from program participants to assess the degree to which YES Initiative projects increase sports participation and physical activity and improve nutrition in adolescents.

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Authorizing Statute(s): PL: Pub.L. 101 - 527 5702 Name of Law: Disadvantaged Minority Health Improvement Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 26689	06/07/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 43147	08/20/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
YES Physical Activity and Nutrition Survey	1	YES Initiative Performance Measures: Physical Activity and Nutrition Survey
Sports Inventory
Sports Literacy Form
Program Participation

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ICR Summary of Burden

table that charts list 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	22,428	0	0	22,428	0	0
Annual Time Burden (Hours)	6,184	0	0	6,184	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: New Collection

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Annual Cost to Federal Government: $77,242

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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

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Common Form ICR:  No

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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: 08/20/2019

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