Diaper Distribution Demonstration and Research Pilot (DDDRP) Administrative Data Infrastructure Survey

Diaper Distribution Demonstration and Research Pilot

Partner Organizations Data Infrastructure Survey

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to understand the information collected by ACF grant recipients and their partners. This information will inform technical assistance and evaluation activities. Public reporting burden for this collection of information is estimated to average 30 minutes per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0531and the expiration date is 09/30/2025. If you have any comments on this collection of information, please contact Nicole Deterding at [email protected]

1. Outside of DDDRP, does your organization distribute diapers and/or diapering supplies? Yes/No

[If 1== no, skip to 3]

2. [If 1== yes] Outside of DDRP, how does your organization collect information about the people receiving diapers or diapering supplies?

1. We only collect overall counts of people, families, or the diapering supplies we distribute

2. We collect more than overall counts. We collect the following information about people receiving diapers or diapering services:

Information that identifies individuals
Name	Yes	No
Address	Yes	No
Phone Number	Yes	No
Email	Yes	No
Date of Birth	Yes	No
Social Security Number	Yes	No
Demographic information
Race/ethnicity	Yes	No
Family Size	Yes	No
Child age(s)	Yes	No
Income	Yes	No
Employment Status	Yes	No
Gender	Yes	No
Other (Please Describe)	Yes	No

3. What non-diaper services does your organization currently offer?

Type of Service	Within this organization	Via external referral	Not Offered	Unknown
Employment Services
Skills training and opportunities for job experience
Career counseling
Job search
Post-employment supports
Employment supplies
Education and Cognitive Development Services
Early child educational programs   (Head Start, Early Head Start, Other 0-5 education)
K-12 education supports
Extracurricular programs
School Supplies
College readiness supports
Postsecondary education supports
Adult education programs
Financial aid assistance
Home visits
Income and Asset Building Services
Training and Counseling Services
Benefit Coordination and Advocacy
Asset Building
Loans and Grants
Housing Services
Housing payment assistance
Eviction prevention services
Utility payment assistance
Housing placement/rapid re-housing
Housing maintenance and improvements
Weatherization services
Health and Social/Behavioral Development Services
Health services, screening, and assessments
Reproductive health services
Wellness education
Mental/behavioral health
Support groups
Dental services, screenings, and exams
Nutrition and food/meals
Family skills development
Emergency hygiene assistance
Civic Engagement and Community Involvement Services
Voter education, Leadership training, Citizenship classes

4. At your organization, are multiple customer needs assessed using a single intake process? Yes/No
   
   
   

5. Is diaper need currently assessed at the time you assess need for other services? Yes/No
   
   
   

6. Does your organization’s main data system currently include the following information:

(a) Information that identifies individuals
Name		Yes	No
Address		Yes	No
Phone Number		Yes	No
Email		Yes	No
Date of Birth		Yes	No
Social Security Number	Yes		No
(b) Demographic information
Race/ethnicity		Yes	No
Family Size		Yes	No
Child age(s)		Yes	No
Employment status		Yes	No
Gender		Yes	No
Income		Yes	No
Other (Please Describe)		Yes	No
Assessment of service needs
Diaper need		Yes	No
Need for other services provided by our organization		Yes	No
Need for services not provided by our organization		Yes	No
(d) The services that individuals or households receive
Diapers/Diapering Supplies		Yes	No
Non-diaper services provided by your organization		Yes	No
Referrals to external service organizations		Yes	No

(7) If your organization currently stores client, assessment, or service information in more than one data system, please describe. (text)

(8) How often does your organization face the following challenges with data collection and reporting?
(1= not at all, 2= some of the time, 3= regularly 0= unsure)

1. Inadequate technology to collect and/or report data

2. Inadequate training for staff or volunteers doing data entry

3. Insufficient staff time for data reporting

4. Known data quality challenges, such as incomplete or inaccurate records

5. Coordinating client information across the services they receive

6. Other (please describe)
   
   
   

(9) Do you currently anticipate any challenges for data collection under DDDRP? Please explain.

For example: are there data elements or data collection methods that are a consistent challenge for you and/or your partners? Are there particular types of questions that would be difficult for you to collect information on given your current data infrastructure?

(10) Please provide contact information in case we find that your responses require clarification:

• Name

• Title

• Email Address

• Phone Number