Assessments to Inform Program Refinement for HIV, other STD, and Pregnancy Prevention among Middle and High-School Aged Youth

ICR 202112-0920-005

OMB: 0920-1235

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Supplementary Document
2022-01-12
Supplementary Document
2022-01-12
Supplementary Document
2022-01-12
Supporting Statement A
2022-01-12
Supporting Statement B
2022-01-12
IC Document Collections
ICR Details
0920-1235 202112-0920-005
Received in OIRA 201903-0920-003
HHS/CDC 0920-1235
Assessments to Inform Program Refinement for HIV, other STD, and Pregnancy Prevention among Middle and High-School Aged Youth
Extension without change of a currently approved collection   No
Regular 01/13/2022
  Requested Previously Approved
36 Months From Approved 05/31/2022
87,000 67,000
57,584 57,584
0 0

The goal of this generic ICR is to conduct qualitative and quantitative data collection from adolescents (ages 11-19) and their parents/caregivers for the purpose of needs assessment and program refinement for programs and services designed to prevent HIV, STDs, and pregnancy among middle and high school aged adolescents. Data will be used to improve program and service.

US Code: 42 USC Sec 301.241(a) Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  86 FR 41474 08/02/2021
86 FR 73283 12/27/2021
Yes

  Total Request 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 87,000 67,000 0 20,000 0 0
Annual Time Burden (Hours) 57,584 57,584 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$46,238
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Thelma Sims 4046394771

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/13/2022


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