Change Request

Request for Nonmaterial/Non-substantive Change to an OMB Approved Information Collection

DELTA Impact Recipient Monitoring and Assessment Tools

OMB # 0920-1247

Exp. Date: 11/30/2021

Justification and Explanation for the Change

Date of Submission:

Project Description

This is a change request for the Center for Disease Control and Prevention’s (CDC) DELTA Impact Recipient Monitoring and Assessment Tools. CDC’s Division of Violence Prevention (DVP) administers the DELTA Impact Program, which provides funding to ten state domestic violence coalitions. DELTA Impact recipients submit data annually into the online data system, DVP Partners Portal. The Annual Reporting in the DVP Partners Portal consists of five forms for recipients to monitor and report progress on their goals, objectives, and activities, as well as relevant information on the implementation of their prevention strategies, outcomes, evaluation, and state action plan.

The purpose of this request is to seek OMB approval of proposed modifications and reformatting of questions, in the data system. The requested changes mostly include modifications to question formats and responses. In addition, a few questions were added or deleted/collapsed to improve their relevance to the recipients’ prevention work and to capture data accurately. Changes included in this request were identified through recipients’ and CDC program officers’ feedbacks on the data elements and other programs’ analysis of initial data collected through this data system. The proposed changes will improve the clarity and accuracy of the questions, answer options, and instructions, which in turn will improve the quality of data reported. In addition, the formatting and question changes will improve user experience and alignment to DELTA Impact recipients’ work and approach. These proposed changes will not alter the purpose of the project, the methods for data collection, the burden on respondents, or the interpretation of data reported by recipients.

Proposed Changes

The proposed changes will improve clarity and accuracy of reporting, increase the tools’ alignment and relevance with the DELTA Impact recipients’ work and strategies, and allow recipients to track existing efforts and report on any new efforts. The proposed changes include the following:

• Adding clarification by making more specific wording of questions and responses to improve clarity

• Streamlining questions by combining or collapsing questions to improve clarity and reduce data burden

• Replacing existing questions with more relevant questions to streamline and improve relevance

• Adding answer options to offset writing open-ended responses when selecting “Other”

• Streamlining how recipients are reporting on their evaluation progress and findings to reduce burden and increase utility. Recipients will report on summary of findings for each evaluation question instead of reporting on each question.

• Adding optional questions for recipients who wish to add comments and provide more context

The below table is a summary of the proposed changes specific to each form. The number in the table corresponds to each form as follows:

1. Work Plan Form

2. Continuation Application Form

3. State Action Plan Form

4. NOFO Evaluation Form

5. Program and Policy Effort Form

Proposed Changes Form Number:	1	2	3	4	5
Change wording to clarify question			X
Change from open-ended response to specific answer options			X
Refine answer choices			X	X	X
Delete question that may be irrelevant, unclear, or not useful		X	X
Combine existing questions to streamline data collection			X	X	X
Add open-ended question useful for descriptive information that may be difficult to categorize to improve relevance and reduce burden			X	X	X
Add optional questions for recipient to add context or other information as desired			X		X

Please see the Crosswalk of Changes for the detailed list of changes for each section/question set within each form.

Change to Burden and/or Cost

These proposed changes to information collection do not change the currently approved burden and/or costs. The proposed changes—replacing, collapsing, or deleting existing questions—offset the burden of adding questions or instructions by making the forms more aligned with recipients’ processes and work. Therefore, CDC estimates that the time gained and lost will be approximately equal, and thus there is no change in the current burden estimate. Table A from the existing OMB package is attached for informational purposes.

Table A. Estimated Annualized Burden Hours

Type of respondents	Form Name	Number of respondents	Number of responses per respondent	Average burden per response (in hours)	Total burden per year (in hours)
DELTA Impact Program Recipients State Domestic Violence Coalitions	APR Tool – Year 1 (Att. 3)	10	1	5	50
	APR Tool - Year 2 and 3 (Att. 3)	10	2	3.3	67
	Total				117

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