The National Intimate Partner and Sexual Violence Survey (NISVS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Phase 3 - ABS inbound CATI	Form and Instruction	New	Available
Phase 3 - ABS paper survey	Form and Instruction	New	Available
Phase 3 - ABS web Survey	Form and Instruction	New	Available
Phase 3 - RDD (CATI) Survey	Form and Instruction	New	Available
Phase 3 - ABS Paper screener - YMOF method	Form and Instruction	New	Available
Phase 3 - ABS, paper screener - Roster method	Form and Instruction	New	Repair queued
Phase 3 - ABS, web screener	Form and Instruction	New	Available
Phase 3 - RDD (CATI) screener	Form and Instruction	New	Available
Phase 2 - Cognitive testing	Form and Instruction	New	Available
Phase 2 - Panel, web Survey	Form and Instruction	New	Available
Phase 2 - ABS, in-bound CATI	Form and Instruction	New	Available
Phase 2 - ABS Paper Survey	Form and Instruction	New	Available
Phase 2 - ABS web Survey	Form and Instruction	New	Available
Phase 2 - RDD (CATI) Survey	Form and Instruction	New	Available
Phase 2 - ABS screener, paper YMOF method	Form and Instruction	New	Available
Phase 2 - ABS, paper screener, Roster method	Form and Instruction	Modified	Available
Phase 2 - ABS web screener	Form and Instruction	Modified	Available
Phase 2- RDD (CATI) screener	Form and Instruction	Modified	Available
AttL_Cognitive Testing Protocol.docx	Supplementary Document	Uploaded 2020-01-06	Repair queued
AttK.2_NISVS Workgroup Summary.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttK.1_NISVS Workgroup Participants.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttJ_Crosswalk of Survey Revisions.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttI_Thank You Incentive Letter.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttH.6_RDD Advance Letter.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttH.5_ABS_Reminder Postcard.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttH.4_ABS NRFU Letter for Survey.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttH.3_ABS NRFU Letter for Screener.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttH.2_ABS Advance Letter for Survey.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttH.1_ABS Advance Letter for Screener.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttG_PIA_NISVS.pdf	Supplementary Document	Uploaded 2020-01-06	Available
AttF_Security Agreement.pdf	Supplementary Document	Uploaded 2020-01-06	Available
AttE.6_FAQs for Full Paper Survey.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttE.5_FAQs for ABS.docx	Supplementary Document	Uploaded 2020-01-06	Available
AttD_IRB Approval.pdf	Supplementary Document	Uploaded 2020-01-06	Available
AttC_Outside Consultation.pdf	Supplementary Document	Uploaded 2020-01-06	Available
AttB1_60Day - FRN-0822.pdf	Supplementary Document	Uploaded 2020-01-06	Available
AttA_AuthLeg_0822.docx	Supplementary Document	Uploaded 2020-01-06	Available
SSB _ 0822 NISVS _3.18.20.docx	Supporting Statement B	Uploaded 2020-03-19	Available
SSA _ 0822 NISVS _3.17.20.docx	Supporting Statement A	Uploaded 2020-03-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
239172	Phase 3 - ABS inbound CATI	Form and Instruction	New
239171	Phase 3 - ABS paper survey	Form and Instruction	New
239170	Phase 3 - ABS web Survey	Form and Instruction	New
239169	Phase 3 - RDD (CATI) Survey	Form and Instruction	New
239168	Phase 3 - ABS Paper screener - YMOF method	Form and Instruction	New
239167	Phase 3 - ABS, paper screener - Roster method	Form and Instruction	New
239165	Phase 3 - ABS, web screener	Form and Instruction	New
239163	Phase 3 - RDD (CATI) screener	Form and Instruction	New
239162	Phase 2 - Cognitive testing	Form and Instruction	New
239161	Phase 2 - Panel, web Survey	Form and Instruction	New
239159	Phase 2 - ABS, in-bound CATI	Form and Instruction	New
239157	Phase 2 - ABS Paper Survey	Form and Instruction	New
239156	Phase 2 - ABS web Survey	Form and Instruction	New
239155	Phase 2 - RDD (CATI) Survey	Form and Instruction	New
239154	Phase 2 - ABS screener, paper YMOF method	Form and Instruction	New
230016	Phase 2 - ABS, paper screener, Roster method	Form and Instruction	Modified
213548	Phase 2 - ABS web screener	Form and Instruction	Modified
213547	Phase 2- RDD (CATI) screener	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0822	ICR Reference No: 202001-0920-001
Status: Active	Previous ICR Reference No: 201906-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0822
Title: The National Intimate Partner and Sexual Violence Survey (NISVS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/20/2020
	Date Received in OIRA: 01/29/2020
Terms of Clearance: Previous terms continue. CDC will brief OIRA desk officers in advance of upcoming changes. Discussion stemming from this study will also include a discussion of how the Covid-19 response environment may have influenced the generalizability of these findings.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2023	36 Months From Approved	03/31/2020
Responses	4,258	0	239,700
Time Burden (Hours)	1,189	0	25,336
Cost Burden (Dollars)	31,405	0	0

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Abstract: The National Intimate Partner and Sexual Violence Survey is an ongoing, nationally representative survey of non-institutionalized adult men and women aged 18 years or older in the United States assessing lifetime experiences to assess experiences of intimate partner violence, sexual violence and stalking among adults in the US. It measures lifetime victimization for these types of violence as well as in the previous 12 months. This revision request describes the planned testing of a redesign of the National Intimate Partner and Sexual Violence Survey (NISVS) and the approach for collecting NISVS data using multiple data collection modes and sampling strategies. This revision request details 1) feasibility testing of the revised survey instruments, data collection modes, and incentive structures, and 2) pilot testing of the new design.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service 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 2019	10/09/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 4987	01/28/2020
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 18

table that charts list of burden

IC Title	Form No.	Form Name
Phase 2 - ABS, paper screener, Roster method	none	Paper screener using Roster Method
Phase 2 - ABS web screener	none	ABS web screener
Phase 2- RDD (CATI) screener	none	RDD Screener
Phase 2 - Cognitive testing	none	Cognitive Testing Protocol
Phase 3 - ABS Paper screener - YMOF method	none	ABS Paper screener using YMOF method
Phase 3 - ABS inbound CATI	none	ABS in-bound CATI survey
Phase 2 - ABS web Survey	none, none	ABS Web Survey ,   Web survey - screenshots
Phase 3 - ABS web Survey	none, none	ABS web Survey ,   ABS web Survey - screenshots
Phase 2 - ABS screener, paper YMOF method	none	Paper screener - YMOF method
Phase 2 - ABS, in-bound CATI	none	ABS, in-bound CATI survey
Phase 2 - Panel, web Survey	none, none	Panel, web Survey ,   Panel, web Survey screenshots
Phase 3 - ABS, web screener	none	ABS, web screener
Phase 3 - ABS paper survey	none	ABS paper Survey
Phase 2 - RDD (CATI) Survey	none	Phase 2 RDD (CATI) Survey
Phase 2 - ABS Paper Survey	none	ABS Paper Survey
Phase 3 - RDD (CATI) screener	none	RDD (CATI) Screener
Phase 3 - ABS, paper screener - Roster method	none	ABS, Paper screener using Roster method
Phase 3 - RDD (CATI) Survey	none	RDD (CATI) Survey

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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	4,258	239,700	0	-235,442	0	0
Annual Time Burden (Hours)	1,189	25,336	0	-24,147	0	0
Annual Cost Burden (Dollars)	31,405	0	0	31,405	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This revision includes a redesign of the NISVS and the approach for collecting data use multiple data collection modes and sampling strategies. This includes feasibility testing of revised instruments and incentive structures and pilot testing of the new design. Burden has been significantly reduced with these next phases of survey testing.

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Annual Cost to Federal Government: $3,725,698

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.     Yes

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.     Yes

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? 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: 01/29/2020

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