Information Collection

Data Collection to Inform a Curriculum Adaptation for the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) Project

IC 252712 under ICR 202206-0970-010 · 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⚠️ Notice: This information collection may be referencing outdated material.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_Fidelity log.docx	Other-Fidelity Log
Instrument 2_Facilitator interview guide.docx	Other-Interview Guide
Instrument 3_Youth focus group guide.docx	Other-Focus Group Guide
Generic SSA_CUY Pilots_rev_4.5_CLEAN.docx SSA - Prog Supp GenIC: PREP PYP Curriculum Adaptation	IC Document
Generic_SSB_CUY_Pilots_rev_4.6_clean.docx SSB - Prog Supp GenIC: PREP PYP Curriculum Adaptation	IC Document
Appendix A_ Consent form for parents_4.5_Clean.docx Appendix A: Consent form for parents of youth with IDD	IC Document
Appendix B_Consent form for youth over 18_4.6_clean.docx Appendix B: Consent form for youth with IDD over 18	IC Document
Appendix C_Assent form for youth_4.6_clean.docx Appendix C: Assent form for youth with IDD participants	IC Document
Appendix D_ Consent form for Lesson Facilitators_4.6_clean.docx Appendix D: Consent for facilitators	IC Document

IC Title:

Data Collection to Inform a Curriculum Adaptation for the Personal Responsibility Education Program (PREP): Promising Youth Programs (PYP) Project

Agency IC Tracking Number:

OPRE

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Fidelity Log	Instrument 1_Fidelity log.docx	Yes	Yes	Fillable Fileable
Other-Interview Guide	Instrument 2_Facilitator interview guide.docx	Yes	Yes	Printable Only
Other-Focus Group Guide	Instrument 3_Youth focus group guide.docx	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: 120

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	204	204
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Prog Supp GenIC: PREP PYP Curriculum Adaptation	Generic SSA_CUY Pilots_rev_4.5_CLEAN.docx	04/08/2022
SSB - Prog Supp GenIC: PREP PYP Curriculum Adaptation	Generic_SSB_CUY_Pilots_rev_4.6_clean.docx	04/08/2022
Appendix A: Consent form for parents of youth with IDD	Appendix A_ Consent form for parents_4.5_Clean.docx	04/08/2022
Appendix B: Consent form for youth with IDD over 18	Appendix B_Consent form for youth over 18_4.6_clean.docx	04/08/2022
Appendix C: Assent form for youth with IDD participants	Appendix C_Assent form for youth_4.6_clean.docx	04/08/2022
Appendix D: Consent for facilitators	Appendix D_ Consent form for Lesson Facilitators_4.6_clean.docx	04/08/2022

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