Information Collection

Sexual Risk Avoidance Education National Evaluation: Formative Evaluation for the Program Components Impact Study

IC 255626 under ICR 202310-0970-008 · OMB 0970-0356.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0356 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instr 1_Facilitator pre-training survey_for OMB.docx	Other-Survey
Instr 2_Facilitator post-training survey_for OMB.docx	Other-Survey
Instr 3_Facilitator end of semester survey.docx	Other-Survey
Instr 4_Facilitator interview guide_for OMB.docx	Other-Interview Protocol
Instr 5_Facilitator log_for OMB.docx	Other-Implementation Log
Instr 6_Youth focus group guide_for OMB.docx	Other-Focus Group Protocol
Supporting Statement A - CIS 08.25.22.docx SSA - SRAENE CIS GenIC	IC Document
Supporting Statement B - CIS 08.24.2022.docx SSB - SRAENE CIS GenIC	IC Document
Appendix A. Study Notification and Reminder Materials.docx Appendix A: Study Notification and Reminder Materials	IC Document
Appendix B. Youth Focus Group Consent and Assent Forms.docx Appendix B: Youth Focus Group Consent and Assent Forms	IC Document
Appendix C. SRAENE CIS Survey Crosswalk.docx Appendix C: SRAENE CIS Surveys Crosswalk and Research Questions	IC Document

IC Title:

Sexual Risk Avoidance Education National Evaluation: Formative Evaluation for the Program Components Impact Study

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-Survey	Instr 1_Facilitator pre-training survey_for OMB.docx	Yes	Yes	Fillable Fileable
Other-Survey	Instr 2_Facilitator post-training survey_for OMB.docx	Yes	Yes	Fillable Fileable
Other-Survey	Instr 3_Facilitator end of semester survey.docx	Yes	Yes	Fillable Fileable
Other-Interview Protocol	Instr 4_Facilitator interview guide_for OMB.docx	Yes	Yes	Printable Only
Other-Implementation Log	Instr 5_Facilitator log_for OMB.docx	Yes	Yes	Fillable Fileable
Other-Focus Group Protocol	Instr 6_Youth focus group guide_for OMB.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: 216

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	3,275	3,275
Annual IC Time Burden (Hours)	410	410
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - SRAENE CIS GenIC	Supporting Statement A - CIS 08.25.22.docx	08/25/2022
SSB - SRAENE CIS GenIC	Supporting Statement B - CIS 08.24.2022.docx	08/25/2022
Appendix A: Study Notification and Reminder Materials	Appendix A. Study Notification and Reminder Materials.docx	08/25/2022
Appendix B: Youth Focus Group Consent and Assent Forms	Appendix B. Youth Focus Group Consent and Assent Forms.docx	08/25/2022
Appendix C: SRAENE CIS Surveys Crosswalk and Research Questions	Appendix C. SRAENE CIS Survey Crosswalk.docx	08/25/2022

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