Formative Research for the Adaptation of a Risky Drinking and Sexual Assault Prevention Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Permission Memo Example_8.17.2022.pdf	Supplementary Document	Uploaded 2023-02-21	Repair queued
eCHECKUP TO GO overview.docx	Supplementary Document	Uploaded 2023-02-15	Repair queued
LetterSAPRODirector_v4 1-31-23.pdf	Supplementary Document	Uploaded 2023-02-08	Repair queued
0703-NSAP_Recruitment Flyers_11.30.2022.pdf	Supplementary Document	Uploaded 2023-02-08	Repair queued
0703-NSAP_Recruitment Emails_11.30.2022.pdf	Supplementary Document	Uploaded 2023-02-08	Repair queued
0703-NSAP_Consent Forms_11.7.2022.pdf	Supplementary Document	Uploaded 2023-02-08	Repair queued
0703-NSAP_SSB_2.7.2023.docx	Supporting Statement B	Uploaded 2023-02-08	Repair queued
0703-NSAP_SSA_2.21.2023.docx	Supporting Statement A	Uploaded 2023-02-21	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
258400	Leaders, Managers, and Program Staff Interviews	Other-Interview Guide	New
256547	Focus Groups and Questionnaire	Other-Focus Group Guide	New

ICR Details

OMB Control No: 0703-0085	ICR Reference No: 202210-0703-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOW/NAVY	Agency Tracking No: 0703-NSAP
Title: Formative Research for the Adaptation of a Risky Drinking and Sexual Assault Prevention Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/01/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/22/2023
Terms of Clearance: DOD is reminded that any report generated and publicly released by the Department must be reviewed and cleared by OMB before release.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2026	36 Months From Approved
Responses	84	0	0
Time Burden (Hours)	114	0	0
Cost Burden (Dollars)	2,249	0	0

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Abstract: The aim of this information collection is to collect feedback from military service members and behavioral health program staff on a sexual assault prevention program, Sexual Communication and Consent (SCC), originally developed for the U.S. Air Force Academy, so it can be adapted to be optimally relevant for additional service member and training academy audiences.

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Authorizing Statute(s): None

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 72465	11/25/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 10503	02/21/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Focus Groups and Questionnaire
Leaders, Managers, and Program Staff Interviews

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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	84	0	0	84	0	0
Annual Time Burden (Hours)	114	0	0	114	0	0
Annual Cost Burden (Dollars)	2,249	0	0	2,249	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: No

Burden Reduction Due to:

Short Statement: This is a new collection with a new associated burden.

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Annual Cost to Federal Government: $21,050

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: 02/22/2023

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