Information Collection

Strategies To Respond to Intimate Violence Effectively (STRIVE)

IC 277217 under ICR 202606-0970-005 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1. HMRE pre and post survey.docx	Other-Survey
Instrument 2. RF pre and post survey.docx	Other-Survey
Instrument 3. Contact information form.docx	Other-Contact Info
Instrument 4. Implementation log.docx	Other-Log
Instrument 5. Interview protocol for HMRF staff.docx	Other-Interview protocol
STRIVE_Formative ACF Program Support_SSA_CLEAN.docx SSA Prog Support - STRIVE	IC Document
STRIVE_Formative ACF Program Support_SSB_clean.docx SSB Prog Support - STRIVE	IC Document
Attachment A. Study consent form for HMRF participants.docx Attachment A. Study consent form for HMRF participants	IC Document
Attachment B. Study consent form for HMRF staff interviews.docx Attachment B. Study consent form for HMRF staff interviews	IC Document
Attachment C. CUES safety card_HMRE programs.docx Attachment C. CUES safety card - HMRE programs	IC Document
Attachment D. CUES safety card_RF programs.docx Attachment D. CUES safety card_RF programs	IC Document
Attachment E. CUES safety card_AIAN participants CLEAN.docx Attachment E. CUES safety card_AIAN participants	IC Document
Attachment F. Information and outreach scripts.docx Attachment F. Information and outreach scripts	IC Document
NOA_OPRE STRIVE_Prog Supp GenIC_0970-0531_4.9.25.pdf NOA - STRIVE	IC Document

IC Title:

Strategies To Respond to Intimate Violence Effectively (STRIVE)

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Yes	Yes	Fillable Fileable
Other-Survey	Yes	Yes	Fillable Fileable
Other-Contact Info	Yes	Yes	Fillable Fileable
Other-Log	Yes	Yes	Fillable Fileable
Other-Interview protocol	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 356

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	392	392
Annual IC Time Burden (Hours)	175	175
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA Prog Support - STRIVE		08/25/2025
SSB Prog Support - STRIVE		08/25/2025
Attachment A. Study consent form for HMRF participants		08/25/2025
Attachment B. Study consent form for HMRF staff interviews		08/25/2025
Attachment C. CUES safety card - HMRE programs		08/25/2025
Attachment D. CUES safety card_RF programs		08/25/2025
Attachment E. CUES safety card_AIAN participants		08/25/2025
Attachment F. Information and outreach scripts		08/25/2025
NOA - STRIVE		08/25/2025

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

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