Replication of Recovery and Reunification Interventions for Families-Impact Study (R3-Impact)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
R3_NonSub Change Request_March 2024_clean.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-03-06	Available
R3_NonSub Change Request_March 2024_clean.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-03-06	Repair queued
Supporting Statement A - R3-Impact 02.22.24_clean.docx	Supporting Statement A	Uploaded 2024-03-06	Available
Supporting Statement A - R3-Impact 02.22.24_clean.docx	Supporting Statement A	Uploaded 2024-03-06	Repair queued
Appx.E_Crosswalk of Topic Guides to Research Questions.docx	Supplementary Document	Uploaded 2023-08-10	Available
Appx.E_Crosswalk of Topic Guides to Research Questions.docx	Supplementary Document	Uploaded 2023-08-10	Repair queued
Appx.D_Crosswalk of Survey Items to Research Questions_clean.docx	Supplementary Document	Uploaded 2024-03-06	Available
Appx.D_Crosswalk of Survey Items to Research Questions_clean.docx	Supplementary Document	Uploaded 2024-03-06	Repair queued
Appx.C_Informed Consent Form - Parent Interview.docx	Supplementary Document	Uploaded 2023-08-10	Available
Appx.C_Informed Consent Form - Parent Interview.docx	Supplementary Document	Uploaded 2023-08-10	Repair queued
Appx.B_Impact Evaluation Informed Consent_clean.docx	Supplementary Document	Uploaded 2024-03-06	Available
Appx.B_Impact Evaluation Informed Consent_clean.docx	Supplementary Document	Uploaded 2024-03-06	Repair queued
Appendix A_Text from SUPPORT Act Section C. 8082.docx	Supplementary Document	Uploaded 2023-08-10	Available
Appendix A_Text from SUPPORT Act Section C. 8082.docx	Supplementary Document	Uploaded 2023-08-10	Repair queued
Supporting Statement B - R3-Impact 02.22.24_clean.docx	Supporting Statement B	Uploaded 2024-03-06	Available
Supporting Statement B - R3-Impact 02.22.24_clean.docx	Supporting Statement B	Uploaded 2024-03-06	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
261538	Participant Interview Information Form	Other-Information Form	Unchanged
261537	Topic Guide – Parents	Other-Topic Guide	Unchanged
261536	Topic Guide – Parent/Family Mentors	Other-Topic Guide	Unchanged
261535	Topic Guide – Mentor Supervisors	Other-Topic Guide	Unchanged
261533	Topic Guide – Program Managers	Other-Topic Guide	Unchanged
261531	Topic Guide – Partners	Other-Topic Guide	Unchanged
261529	Topic Guide – Child Welfare Frontline Staff	Other-Topic Guide	Unchanged
261522	Topic Guide – Child Welfare Lead Staff	Other-Topic Guide	Unchanged
261521	Validation Interview Script	Other-Interview Script	Unchanged
261520	Contact Form	Other-Contact Form	Modified
261519	Baseline Parent Survey	Other-Survey	Modified

ICR Details

OMB Control No: 0970-0616	ICR Reference No: 202403-0970-007
Status: Historical Active	Previous ICR Reference No: 202308-0970-005
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Replication of Recovery and Reunification Interventions for Families-Impact Study (R3-Impact)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/26/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/06/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2026	09/30/2026	09/30/2026
Responses	3,626	0	3,626
Time Burden (Hours)	1,294	0	1,294
Cost Burden (Dollars)	0	0	0

---

Abstract: The Replication of Recovery and Reunification Interventions for Families-Impact Study (R3-Impact) is a large multi-site study that will provide evidence about the effectiveness of two programs that use recovery coaches and what it takes to implement them in multiple settings with diverse populations. Data collection for the R3-Impact study under this information collection request includes (1) a parent survey measuring parent well-being at study enrollment, (2) quarterly contact forms to update participant contact information, (3) in-person and phone interview topic guides for site staff involved in program referral and implementation, (4) in-person and phone interview topic guide for parents participating in the study, and (5) a participant interview information form for parents interviewed. OMB initially approved data collection instruments for this project on September 21, 2023. Since approval, the R3-Impact team has continued planning evaluation procedures with study sites, conducted a pretest of the parent baseline survey, and undergone a full Institutional Review Board (IRB) review. IRB approval for the PMP impact evaluation was received on February 16, 2024. These efforts have resulted in some proposed nonsubstantive changes.

---

Authorizing Statute(s): PL: Pub.L. 115 - 271 C. 8082 Name of Law: 2018 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Pat
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 37067	06/06/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 55050	08/14/2023
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 11

table that charts list of burden

IC Title	Form No.	Form Name
Baseline Parent Survey
Contact Form
Participant Interview Information Form
Topic Guide – Child Welfare Frontline Staff
Topic Guide – Child Welfare Lead Staff
Topic Guide – Mentor Supervisors
Topic Guide – Parent/Family Mentors
Topic Guide – Parents
Topic Guide – Partners
Topic Guide – Program Managers
Validation Interview Script

---

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	3,626	3,626	0	0	0	0
Annual Time Burden (Hours)	1,294	1,294	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $1,491,468

Does this IC contain surveys, censuses, or employ statistical methods? No

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.     Yes

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.     Yes

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

---

Common Form ICR:  No

---

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: 03/06/2024

---