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

Formative Data Collections for ACF Program Support

OMB: 0970-0531

IC ID: 254552

⚠️ Notice: This information collection may be referencing outdated material.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

2024-03-05 - No material or nonsubstantive change to a currently approved collection
2024-01-25 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
Instrument 1. Facilitator Pre-Training Survey 11.03.2021.docx Other-Survey
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 2. Facilitator Post Training Survey 11.03.2021.docx Other-Survey
Instrument 3. Facilitator Interview Guide 11.03.2021.docx Other-Interview Guide
Instrument 3. Facilitator Interview Guide 11.03.2021.docx Other-Interview Guide
Instrument 4. Youth Focus Group Protocol v2 11.03.21.docx Other-Focus Group Protocol
Instrument 4. Youth Focus Group Protocol v2 11.03.21.docx Other-Focus Group Protocol
Generics SSA - CIS Proof of Concept 11.03.2021.docx SSA - SRAENE CIS GenIC IC Document
Generics SSA - CIS Proof of Concept 11.03.2021.docx SSA - SRAENE CIS GenIC IC Document
Generics SSB - CIS Proof of Concept 11.03.2021.docx SSB - SRAENE CIS GenIC IC Document
Generics SSB - CIS Proof of Concept 11.03.2021.docx SSB - SRAENE CIS GenIC IC Document
Appendix A. Facilitator Survey Invitation Email 11.03.2021.docx Appendix A. Facilitator Survey Invitation Email 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
Appendix B. Parent Consent and Youth Assent Forms 11.03.2021.docx Appendix B. Parent Consent and Youth Assent Forms IC Document
NOA_SRAENE CIS GenIC_0970-0531_11.26.21.pdf NOA - SRAENE CIS GenIC IC Document
NOA_SRAENE CIS GenIC_0970-0531_11.26.21.pdf NOA - SRAENE CIS GenIC IC Document

Information Collection (IC) Details

View Information Collection (IC)

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:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Instrument 1. Facilitator Pre-Training Survey 11.03.2021.docx	Yes	Yes	Fillable Fileable
Other-Survey	Instrument 2. Facilitator Post Training Survey 11.03.2021.docx	Yes	Yes	Fillable Fileable
Other-Interview Guide	Instrument 3. Facilitator Interview Guide 11.03.2021.docx	Yes	Yes	Paper Only
Other-Focus Group Protocol	Instrument 4. Youth Focus Group Protocol v2 11.03.21.docx	Yes	Yes	Paper Only

Federal Enterprise Architecture Business Reference Module

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 %

	Requested	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

Title	Document	Date Uploaded
SSA - SRAENE CIS GenIC	Generics SSA - CIS Proof of Concept 11.03.2021.docx	07/08/2022
SSB - SRAENE CIS GenIC	Generics SSB - CIS Proof of Concept 11.03.2021.docx	07/08/2022
Appendix A. Facilitator Survey Invitation Email	Appendix A. Facilitator Survey Invitation Email 11.03.2021.docx	07/08/2022
Appendix B. Parent Consent and Youth Assent Forms	Appendix B. Parent Consent and Youth Assent Forms 11.03.2021.docx	07/08/2022
NOA - SRAENE CIS GenIC	NOA_SRAENE CIS GenIC_0970-0531_11.26.21.pdf	07/08/2022

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