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

Formative Data Collections for ACF Program Support

OMB: 0970-0531

IC ID: 254573

⚠️ Notice: This information collection may be referencing outdated material.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_Fidelity log.docx Other-Fidelity Log
Instrument 1_Fidelity log.docx Other-Fidelity Log
Instrument 2_Facilitator interview guide.docx Other-interview guide
Instrument 2_Facilitator interview guide.docx Other-interview guide
Instrument 3_Youth focus group guide.docx Other-Focus Group 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 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
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 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 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 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
Appendix D_ Consent form for Lesson Facilitators_4.6_clean.docx Appendix D: Consent for facilitators IC Document
NOA_PREP PYP CUY Curriculum_Prog Supp GenIC_0970-0531_4.13.22.pdf NOA - Prog Supp GenIC: PREP PYP Curriculum Adaptation IC Document
NOA_PREP PYP CUY Curriculum_Prog Supp GenIC_0970-0531_4.13.22.pdf NOA - Prog Supp GenIC: PREP PYP Curriculum Adaptation IC Document

Information Collection (IC) Details

View Information Collection (IC)

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: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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	Paper Only
Other-Focus Group Guide	Instrument 3_Youth focus group guide.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: 120	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
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

Title	Document	Date Uploaded
SSA - Prog Supp GenIC: PREP PYP Curriculum Adaptation	Generic SSA_CUY Pilots_rev_4.5_CLEAN.docx	07/11/2022
SSB - Prog Supp GenIC: PREP PYP Curriculum Adaptation	Generic_SSB_CUY_Pilots_rev_4.6_clean.docx	07/11/2022
Appendix A: Consent form for parents of youth with IDD	Appendix A_ Consent form for parents_4.5_Clean.docx	07/11/2022
Appendix B: Consent form for youth with IDD over 18	Appendix B_Consent form for youth over 18_4.6_clean.docx	07/11/2022
Appendix C: Assent form for youth with IDD participants	Appendix C_Assent form for youth_4.6_clean.docx	07/11/2022
Appendix D: Consent for facilitators	Appendix D_ Consent form for Lesson Facilitators_4.6_clean.docx	07/11/2022
NOA - Prog Supp GenIC: PREP PYP Curriculum Adaptation	NOA_PREP PYP CUY Curriculum_Prog Supp GenIC_0970-0531_4.13.22.pdf	07/11/2022

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