“Talk. They Hear You.” Campaign Evaluation: Case Studies

Forms and Documents

Document Name	Status
Form Teacher Script for Individual Interviews with Parents and Caregivers Form and Instruction	Modified
Form Pre- and Post-Pare Pre- and Post-Parent and Caretaker Survey Form and Instruction	Modified
Form Pre- and Post-Yout Pre- and Post-Youth Survey Form and Instruction	Modified
Attachment_8_Campaign Intervention Checklist_OMB-0930-0373_12.4.19.docx Supplementary Document	2020-02-06
Attachment_7_Youth Survey Parent Permission and Opt-Out Forms_OMB-0930-0373_12.4.19.docx Supplementary Document	2020-02-06
Attachment_6_Parent & Caregiver Interview Guide_OMB-0930-0373_12.4.19.docx Supplementary Document	2020-02-06
Attachment_4_Consent Form_Parent Caregiver Interviews Consent Form_OMB-0930-0373_12.4.19.docx Supplementary Document	2020-02-06
Attachment_D_Parent Caregiver Survey Invitation and Reminder-OMB-0930-0373 REV 06302020.docx Supplementary Document	2020-07-17
SS-B_THHY Case Study OMB No 0930 0373 11.4.19.docx Supporting Statement B	2019-12-03
SS-A_TTHY Case Study OMB_OMB_0930-0373 11.29.19.docx Supporting Statement A	2019-12-03

IC Document Collections

IC ID	Document Title	Status
225439	Individual Interviews with Parents and Caregivers Form and Instruction	Modified
225434	Pre- and Post-Parent and Caretaker Survey Form and Instruction	Modified
225433	Pre- and Post-Youth Survey Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0373	ICR Reference No: 201912-0930-005
Status: Active	Previous ICR Reference No: 201701-0930-004
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: “Talk. They Hear You.” Campaign Evaluation: Case Studies
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/21/2020
	Date Received in OIRA: 02/06/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2023	36 Months From Approved	07/31/2020
Responses	3,596	0	3,596
Time Burden (Hours)	637	0	637
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of the case studies component of the campaign evaluation is the following: 1) To identify evidence regarding the relationship between campaign exposure and changes in parents’ attitudes and behavior regarding underage drinking in the selected sites; and 2) To collect information on whether changes in parent/caregiver attitudes and/or behaviors identified in align with measurable changes in youth attitudes and/or behaviors on underage drinking during the same period.

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Authorizing Statute(s): US Code: 42 USC 505 Name of Law: Data Collection
  

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 65829	11/29/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 6568	02/05/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Individual Interviews with Parents and Caregivers	Teacher Script for Youth Survey	Teacher Script for Youth Survey
Pre- and Post-Youth Survey	Pre- and Post-Youth Survey	Pre- and Post-Youth Survey
Pre- and Post-Parent and Caretaker Survey	Pre- and Post-Parent and Caretaker Survey	Pre- and Post-Parent and Caretaker Survey

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ICR Summary 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	3,596	3,596	0	0	0	0
Annual Time Burden (Hours)	637	637	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $67,212

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]? No

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? No

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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: 02/06/2020

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