Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is XXXX–XXXX. Public reporting burden for this collection of information is estimated to average 3 hours per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 5600 Fishers Lane, Room 15E57A, Rockville, MD 20857.
Evidence-Based Practices, Policies, and Programs (EBPPPs) 1
Grantee-Level Evidence-Based Practices, Policies, and Programs (EBPPPs) 1
Subrecipient-Level Evidence-Based Practices, Policies, and Programs (EBPPPs) 2
Add/Edit Community-Level Outcome Data for Subrecipients 7
Substitute Data Source Request 10
Substitute Data Source Request Detail 11
Additional Fields for Survey Data Sources Only 13
Note: This document is intended as a supplement to the Division of State Programs– Management Reporting Tool (DSP–MRT) for the Partnerships for Success (PFS) grant program. Please refer to the DSP–MRT document where applicable.
Use this section to report Evidence-Based Practices, Policies, and Programs (EBPPPs) and the numbers served and reached through your prevention interventions. EBPPPs are interventions that come from a federal registry, were reported as being effective for your target substance in a published scientific journal article, were based on a documented theory of change, or were deemed effective by a panel of experts.i A panel of experts may include qualified prevention researchers, local prevention practitioners, and key community leaders (such as law enforcement and education representatives, elders within indigenous
cultures).
NEW MEASURE: What are the Evidence-Based Practices, Policies, or Programs (EBPPs) you intend to |
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implement through this grant? Who is the intended audience? What is the non-duplicative number of |
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individuals you intend to serve each year of your grant? |
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Data Item |
Response Options |
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Did you or your subrecipients actively deliver any Prevention Interventions that are evidence-based programs, policies, or practices (EBPPP)ii during the last fiscal year? |
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If no, explain why? |
Free text |
Data Item |
Response Options |
Status of Intervention |
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Prevention Intervention Name |
Drop-down menu with prevention intervention names |
Was this EBPPP intervention actively implemented in this community prior to receiving funding for this grant? |
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Target of the Intervention |
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Data Item |
Response Options |
Other (Please specify) |
Free text |
Number Servediii |
Open-ended numerical response |
Number Reachediv |
Open-ended numerical response |
REMINDER: After completing the required information, select “Add EBPPP” to add the entry to your list, then select “Save.” After you add the EBPPP, it will appear on the EBPPP main screen.
Data Item |
Response Options |
Select Subrecipient |
Drop-down menu with subrecipient names |
Status of Intervention |
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Prevention Intervention Name |
Drop-down menu with prevention intervention names |
Was this EBPPP intervention actively implemented in this community prior to receiving funding for this grant? |
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Target of the Intervention |
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Other (Please specify) |
Free text |
Number Served |
Free text |
Number Reached |
Free text |
REMINDER: After completing the required information, select “Add EBPPP” to add the entry to your list, then select “Save.” After you add the EBPPP, it will appear on the EBPPP main screen.
Use this section to enter community outcome data for your subrecipients. Grantees that do not have subrecipients will also use this section to enter grantee-level outcome data. When you are ready to begin entering data for your subrecipients, select a subrecipient from the drop-down menu. Once you add records, you will be able to view previously added records for the selected subrecipient.
Community outcomes data include survey data and administrative data:
Survey data is data collected from individuals, usually a sample of the population, by asking questions either in person, on paper, by phone, or online. Examples of survey data include the National Survey of Drug Use and Health (NSDUH), Youth Risk Behavior Survey (YRBS), and Behavioral Risk Factor Surveillance System (BRFSS).
Administrative data refers to information collected primarily for administrative— not research—purposes. Government departments and other organizations often collect this type of data for the purposes of registration, transaction, and record keeping, and often the data include program outcome indicators. Examples of administrative data include educational records, client information from financial institutions, and hospital records of patient visits and health outcomes.
If you are providing data to meet requirements for a specific PFS Required Outcome Measure, and your data source does not match the PFS Required Outcome exactly (survey item wording/response options or administrative data measure calculation) nor does the data source match the list of acceptable PFS Required Outcome Measure substitutes, you must receive approval from your Project Officer for the substitute data source. Use the Substitute Data Source Request Page to submit a request for review and approval.
Survey data is data collected from individuals by asking questions either in person, on paper, by phone, or online. Examples of survey data include the NSDUH, YRBS, and BRFSS.
To enter Survey Data, select “Add Data Source,” enter the name of the survey, and select “Save.”
Fields that Appear if "Survey data" Is Selected in the Data Source Type Field |
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Data Item |
Response Options |
Data Source Name |
Free text |
Specified Substance |
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Other (If “Other” is selected for Specified Substance) |
Free text |
PFS Required Outcome Measure |
Alcohol Outcome Measure Response Options
Prescription Drug Outcome Measure Response Options
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Fields that Appear if "Survey data" Is Selected in the Data Source Type Field |
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Data Item |
Response Options |
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Other Substance Outcome Measure Response Options
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Other Outcome Measure |
Free text |
Are you reporting an exact PFS Required Outcome, an approved substitute PFS Required Outcome, or neither? |
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Survey Item |
Free text |
Response Option |
Free text |
Reported Outcome Description |
Free text |
Click on “Add Follow-up Data” to add follow-up data for a previously entered baseline record.
To edit existing records, click “Edit” next to the Survey Item name.
To enter Subrecipient Survey Response Data, select “Add Subrecipient Response Data.”
If you are entering survey data at the grantee level, select “Add Baseline Response Data.”
Data Item |
Response Options |
Subrecipient [Item only appears if applicable] |
Drop-down menu with subrecipient names |
Data Collection Date |
Date Field |
Population Parameters |
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Age Range Minimum (If “Enter age range” is selected for Population Parameters) |
Numerical |
Age Range Maximum (If “Enter age range” is selected for Population Parameters) |
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Data Item |
Response Options |
Grades (If “Enter grade[s]” is selected for Population Parameters) (Check all that apply) |
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Other Sample Descriptors |
Free text |
Description of Sampling Design |
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Multiple Year Pooled Estimate |
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Multiple Year Estimate Description: (If “Yes” is selected) |
Free text |
Value Type |
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Other (Please specify) |
Free text |
Calculated Value |
Numerical |
Standard Error |
Numerical |
Standard Deviation |
Numerical |
Survey Item Valid N |
Numerical |
Comments |
Free text |
Administrative data is data collected for the purposes of registration, transaction, and record keeping, but often also includes indicators of program outcomes. Examples of
administrative data include educational records, client information from financial institutions, and hospital records of patient visits and health outcomes.
To enter Administrative Data, select “Add Data Source,” enter the name of the new data source, and select “Save.”
Data Item |
Response Options |
Data Source Name |
Free text |
Specified Substance |
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Other Substance (If “Other” is selected) |
Free text |
PFS Required Outcome Measure |
Alcohol Outcome Measure Response Options
Prescription Drug Outcome Measure Response Options
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Data Item |
Response Options |
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Other Substance Outcome Measure Response Options
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Other Outcome Measure |
Free text |
Are you reporting an exact PFS Required Outcome, an approved substitute PFS Required Outcome, or neither? |
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Reported Outcome/Measure Calculation Description |
Free text |
Click on “Add Follow-up Data” to add follow-up data for a previously entered baseline record.
To edit existing records, click “Edit.”
To enter Subrecipient Administrative Response Data, select “Add Subrecipient Response Data.”
If you are entering administrative data at the grantee level, select “Add Baseline Response Data.”
Fields that Appear if "Administrative data" Is Selected in the Data Source Type Field |
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Data Item |
Response Options |
Select Subrecipient* [Item only appears if applicable] |
Drop-down menu with subrecipient names |
Data Source Time Frame Begin Date |
Date field |
Data Source Time Frame End Date |
Date field |
Population Parameters |
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Age Range Minimum (If “Enter age range” is selected for Population Parameters) |
Numerical |
Age Range Maximum (If “Enter age range” is selected for Population Parameters) |
Numerical |
Fields that Appear if "Administrative data" Is Selected in the Data Source Type Field |
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Data Item |
Response Options |
Grades (If “Enter grade[s]” is selected for Population Parameters) (Check all that apply) |
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Other Sample Descriptors |
Free text |
Number of Events |
Numerical |
Denominator Definition |
Free text |
Denominator Value |
Numerical |
Value Type |
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Other Value Type* (If “Other” is selected) |
Free text |
Calculated Value |
Numerical |
Comments |
Free text |
Use this section to obtain approval from your State Project Officer for the use of substitute outcome measures in place of PFS Required Outcome Measures.
Note that SAMHSA only requires grantees to submit a substitute data request for measures that they are using to meet the annual exact/substitute measure requirement (one annual measure for alcohol and one for prescription drugs for each community). You do not need to submit a substitute data request for any of the other/additional measures you plan to submit.
To begin the substitute measure approval process:
First, decide whether SAMHSA is likely to approve your proposed substitute. To review the PFS Required Outcome Measures, review appendix A, table A.2 in the Division of State Programs–Management Reporting Tool (DSP–MRT) Question-by-Question Instruction Guide for Strategic Prevention Framework–Partnerships for Success (SPF–PFS) Grantees. For a comparison between PFS Required Outcome Measure survey items and items from commonly used surveys, see table A.3.
Note: If table A.3 lists an item as an acceptable PFS Required Outcome Measure substitute, you will not need to submit a substitute data request for the measure. If an item is not an acceptable PFS Required Outcome Measure, SPARS will not accept that item as a substitute data source.
To submit a Substitute Data Request through SPARS, go to your SPARS Dashboard and select the plus sign (+) next to Substitute Data Request in the Work Plans section, then select “View” to open the section.
To submit a Substitute Data Request for Survey Data, select the arrow next to Survey Data and then select “Add Data Source.” To submit a request for Administrative Data, select the arrow next to Administrative Data and then select “Add Data Source.”
Data Item |
Response Options |
Label of the PFS Required Outcome Measure(s) indicator for which grantee is requesting a substituted proxy measure (e.g., 30-day use of alcohol) |
Survey Data Response Options
Administrative Data Response Options
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Data source name |
Free text |
Exact wording of the proxy item and response options the grantee is requesting to substitute for the PFS Required Outcome Measure |
Free text |
Exact wording of the outcome that will be reported to SAMHSA/CSAP |
Free text |
Formulae for calculating or deriving the prevalence estimate (reported outcomes) |
Free text |
Summarize how the collection and reporting of community-level PFS Required Outcome Measure was written in your approved PFS Strategic Plan, if applicable |
Free text |
Does the requested substitution differ from what was written in your approved PFS Strategic Plan? |
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If yes, why? (If “Yes” is selected) |
Free text |
Reason for the substitution request |
Free text |
Agency/organization responsible for data collection |
Free text |
Fields that Appear if "Survey data" Is Selected in the Data Source Type Field |
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Data Item |
Response Options |
Were there validity and reliability tests of the survey items constituting the substitute measure? |
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Description of the reliability/validity study(ies): (If “Yes” is chosen) |
Free text |
Are there any published validity/reliability studies for this instrument? |
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Bibliographic Information: (If “Yes” is chosen) |
Free text |
Substitute Data Source Request Supporting Document |
Upload feature |
For each data file, describe the contents of the data record(s) field that will be displayed. |
Free text |
Select “Save” to add your data source. Your outcome measure will then appear in the list of data sources.
If you are entering community outcomes at the subrecipient level, select “Add Subrecipient Response Data” to complete data entry to the substitute data request.
If you are entering community outcome data at the grantee level, select “Add Baseline Response Data.”
Data Item |
Response Options |
In the MRT, grantees will select their subrecipients from a prepopulated list to access the following required items for submitting a substitute data source request. |
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Subrecipient* [item only appears if applicable.] |
Drop-down menu |
Do the data approximate the community (e.g., county, city, town, school) where SPF–PFS interventions are delivered? |
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If no, indicate how they differ (If “No” is selected) |
Free text |
Most recent month and year for which data are available? |
Date field |
Is there a data point collected at least 6 months prior to the implementation of SPF–PFS interventions in the community? (i.e., a baseline prevalence estimate) |
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Is the data collection repeated every year? |
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Frequency of data collection (If “No” is selected) |
Free text |
Are trend data available? |
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Start year of trend data (If “Yes” is selected) |
Date field |
Data Item |
Response Options |
Fields that Appear if "Survey data" Is Selected in the Data Source Type Field in the Previous Section |
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Date of Data Collection |
Date field |
Sample Size |
Numerical |
Sampling Ratio |
Free text |
What type of sampling strategy was used to select respondents? |
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If “Random sample” or “Stratified random sample” is selected: |
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Stratified Sampling – Identify each stratum |
Free text |
Cluster Sampling – Identify the clustering unit |
Free text |
Data Item |
Response Options |
Multistage design – Identify the unit sampled at each stage |
Free text |
Potential sources of bias in the sample design |
Free text |
Method of Administration |
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Other Method (Specify) (If “Other” is selected) |
Free text |
Was this a computer-assisted interview? |
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What was the survey response rate? |
Free text |
Once your Substitute Data Request data entry is complete, return to your Dashboard in SPARS, select the gear icon under “Actions” next to Substitute Data Request, and select “Submit to Project Officer.” Enter your information in the submission form that appears and select “Submit.”
i Panel of Experts: Panel of Experts may include qualified prevention researchers, local prevention practitioners, and key community leaders (e.g., law enforcement and education representatives, elders within indigenous cultures).
ii Evidence-Based Practices, Policies, and Programs: EBPPPs are interventions that come from a federal registry, were reported
as effective for your target substance in a published scientific journal article, were based on a documented theory of change, or were deemed effective by a panel of experts.
iii Number Served: Refers to individual-based prevention strategies or services directly delivered to individuals, either on a one- on-one basis or in a group format. Typically, the service provider and the participant are at the same location during the service encounter. Since providers have direct interaction with these individuals, they are able to keep accurate counts and in many cases, to collect data about the characteristics and outcomes of these participants through attendance lists and pre-post surveys. Examples include training sessions and educational classes.
iv Number Reached: Refers to population-based prevention strategies aimed at impacting an entire population. Since there is no direct interaction with the populations affected by the services, counts of people reached are typically estimates obtained from sources such as the census (the population of the targeted community) or media outlets (estimated readership or audience size).
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | DSP-MRT Supplement for PFS Grants |
Subject | A supplement to the DSP-MRT tool for the Partnerships for Success (PFS) grant program (unique items) |
Author | Center for Substance Abuse Prevention (CSAP) |
File Modified | 0000-00-00 |
File Created | 2021-11-01 |