Information Collection

Sexual Risk Avoidance Education National Evaluation Program Components Impact Study: Proof of Concept Pilot Phase

IC 250100 under ICR 202108-0970-004 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1. Facilitator Pre-Training Survey 11.03.2021.docx	Other-Survey
Instrument 2. Facilitator Post Training Survey 11.03.2021.docx	Other-Survey
Instrument 3. Facilitator Interview Guide 11.03.2021.docx	Other-Interview Guide
Generics SSA - CIS Proof of Concept 11.03.2021.docx Generics SSA - CIS Proof of Concept	IC Document
Generics SSB - CIS Proof of Concept 11.03.2021.docx Generics SSB - CIS Proof of Concept	IC Document
Appendix A. Facilitator Survey Invitation Email 11.03.2021.docx Appendix A. Facilitator Survey Invitation Email	IC Document
Appendix B. Parent Consent and Youth Assent Forms 11.03.2021.docx Appendix B. Parent Consent and Youth Assent Forms	IC Document

IC Title:

Sexual Risk Avoidance Education National Evaluation Program Components Impact Study: Proof of Concept Pilot Phase

Agency IC Tracking Number:

OPRE

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Yes	Yes	Fillable Fileable
Other-Survey	Yes	Yes	Fillable Fileable
Other-Interview Guide	Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 396

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	792	792
Annual IC Time Burden (Hours)	336	336
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generics SSA - CIS Proof of Concept		11/04/2021
Generics SSB - CIS Proof of Concept		11/04/2021
Appendix A. Facilitator Survey Invitation Email		11/04/2021
Appendix B. Parent Consent and Youth Assent Forms		11/04/2021

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

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