Fast Track Application

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION: Sexual Risk Avoidance Education (SRAE) Grantee Topical Training Feedback Survey

PURPOSE: The Family and Youth Services Bureau’s (FYSB) Sexual Risk Avoidance Education (SRAE) grantees (Title V State, Title V Competitive, and GD-SRAE) are required to participate in a topical training to build their skills and capacity to deliver SRAE programming to youth. The purpose of the proposed survey is to collect grantee input on this SRAE topical training which will be conducted in March 2023. The survey is necessary to capture perspectives and experiences with the training. The information collected will enable us to improve the quality of trainings and will inform the development of future training and technical assistance opportunities, including topical trainings.

SRAE Grantee Topical Training Satisfaction Survey (Attachment A)

The topical training survey will be administered in-person in a paper-based format. Participants will receive a paper survey at the end of the training and will have an opportunity to complete it before the training concludes. The survey includes multiple choice and open-ended questions and is estimated to take no longer than 10 minutes to complete.

The contractor (RTI International) will perform analysis of the responses.

DESCRIPTION OF RESPONDENTS: Respondents are all SRAE grantees (Title V State, Title V Competitive, and GD-SRAE).

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software) [ ] Small Discussion Group

[ ] Focus Group [ ] Other:

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:__Corey Palmer, Program Manager, Adolescent Pregnancy Prevention Program

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [ X ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No Not applicable

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No Not applicable

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No

BURDEN HOURS

Estimated Annual Reporting Burden
Type of Collection	No. of Expected Respondents	Frequency per Response	Hours per Response	Total Hours
SRAE Grantee Topical Training Survey	90	1	10 min (0.16 hours)	14.4
Total estimated burden hours				14.4

FEDERAL COST: The estimated cost to the Federal government is $__5,000______

Item/Activity	Details	$ Amount
FYSB oversight of contractor and project	1% of FTE: GS-13 Program Specialist	$1,000
Deployment of survey instrument, reminders to grantees for completion, analysis of results (Contractor)	Labor hours (1.5% of FTE for contractor staff)	$4,000
Total		$_5,000

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

There are currently 171 SRAE grantees and all grantees are invited to participate in at least one topical training annually. The topical training has space accommodations for 90 staff of SRAE grantees.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[] Web-based

[ ] Telephone

[X] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ X ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

The survey instrument is attached along with this form as Attachment A.

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