Assessment of the Underage Drinking Prevention Initiative

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Organizer Survey – Organizer Survey – 6 Month Follow-up	Form and Instruction	Removed	Repair queued
Form Organizer Survey – Organizer Survey - 6 month Follow Up	Form and Instruction	Removed	Repair queued
Form Participant Form - Participant Form - Spanish	Form and Instruction	Removed	Available
Form Participant Form - Participant Form - English	Form and Instruction	Removed	Available
Form Participant Form - Participant Form	Form and Instruction	Removed	Repair queued
Form Organizer Survey f Organizer Survey for Initial and Follow-up	Form and Instruction	Modified	Available
Form Organizer Survey f Organizer Survey for Initial and Follow-up	Form and Instruction	Modified	Repair queued
0930-0288 CommunitiesTalk_OMB_SS-B_09-21-21.docx	Supporting Statement B	Uploaded 2022-03-28	Repair queued
0930-0288 CommunitiesTalk_OMB_SS-A_09-21-21.docx	Supporting Statement A	Uploaded 2022-03-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
225234	Organizer Survey - 6 month Follow Up	Form and Instruction	Removed	Organizer Survey – 6 Month Follow-up
225234	Organizer Survey - 6 month Follow Up	Form and Instruction	Removed
194189	Participant Form	Form and Instruction	Removed	Participant Form - Spanish
194189	Participant Form	Form and Instruction	Removed	Participant Form - English
194189	Participant Form	Form and Instruction	Removed
182093	Organizer Survey for Initial and Follow-up	Form and Instruction	Modified	Organizer Survey for Initial and Follow-up
182093	Organizer Survey for Initial and Follow-up	Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0288	ICR Reference No: 202203-0930-005
Status: Historical Active	Previous ICR Reference No: 201701-0930-002
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 20346
Title: Assessment of the Underage Drinking Prevention Initiative
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/06/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/28/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2025	36 Months From Approved
Responses	1,000	0	0
Time Burden (Hours)	167	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: To help address the problem of underage drinking (UAD) and its consequences, SAMHSA sponsors nationwide Communities Talk activities approximately every 2 years. These activities are intended to work at the grassroots level to raise awareness of the public health dangers of UAD and to engage communities in evidence-based prevention. Notably, Communities Talk activities provide a forum for communities to discuss ways they can best prevent UAD by reducing the availability of alcohol and by creating community norms that discourage demand. The information is collected to document the implementation efforts of this nationwide initiative, determine if the federally sponsored activities lead to additional activities within the community that are aimed at preventing and reducing UAD, identify what these activities may possibly include, and help plan for future rounds of Communities Talk.

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Authorizing Statute(s): US Code: 42 USC 505 Name of Law: Data Collection
  

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:
	87 FR 2882	01/19/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 17316	03/28/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Organizer Survey - 6 month Follow Up	Organizer Survey – 6 Month Follow-up	Organizer Survey – 6 Month Follow-up
Organizer Survey for Initial and Follow-up	Organizer Survey for Initial and Follow-up	Organizer Survey for Initial and Follow-up
Participant Form	Participant Form - English, Participant Form - Spanish	Participant Form - English ,   Participant Form - Spanish

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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	1,000	0	0	-4,500	0	5,500
Annual Time Burden (Hours)	167	0	0	-416	0	583
Annual Cost Burden (Dollars)	0	0	0	0	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: SAMHSA is requesting a decrease of 416 hours due to the following: • Adjustment of -42 hours due to the reduction in the amount of time it will take respondents to complete the Organizer Survey—Follow-Up (from 15 to 10 minutes; based on comments from consultations outside the agency); and • Adjustment of -374 hours due to the elimination of the Participant Survey (from 4,500 to 0 participants and 374 hours to 0; due to initiative funding clarifications).

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Annual Cost to Federal Government: $43,519

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.     No

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.     No

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? No

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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: 03/28/2022

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