Youth Education and Relationship Services (YEARS)

Forms and Documents

Document Name	Status
Attachment 4 YEARS Program observation protocol_final.xlsx Supplementary Document	2015-12-04
Appendix S Thank You Letter YEARS Interviews_12-4-15_clean.docx Supplementary Document	2015-12-04
Appendix R Reminder Email YEARS Interviews_8-4-15.docx Supplementary Document	2015-08-11
Appendix Q Reminder Call Script YEARS Interviews_8-4-15.docx Supplementary Document	2015-08-11
Appendix P Reminder email YEARS Site Visit_11.30.15_clean.docx Supplementary Document	2015-12-04
Appendix O Introduction to Study Letter YEARS Interviews_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix N Recruitment Script YEARS Interviews_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix M Follow up Letter YEARS Site Visit_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix K Recruitment Script YEARS Site Visits_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix J Letter to grantees YEARS Site Visits_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix I Reminder Call Script YEARS Survey_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix H Reminder Email YEARS Survey_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix G Thank You Letter YEARS Web-based Staff Survey_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix F Letter to Grantees YEARS Web-based Staff Survey_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix E Screening Matrix YEARS Site Visits_8-4-15.docx Supplementary Document	2015-08-11
Appendix D Consent Form YEARS Interviews_11-30-15_clean.docx Supplementary Document	2015-12-04
Appendix C Consent Form YEARS Web-based Staff Survey_11 30 15.docx Supplementary Document	2015-12-04
Appendix B YEARS Research Questions, Data Sources, and Respondents_v2_clean.docx Supplementary Document	2015-12-04
Appendix A Preexisting data sources_8-4-15.docx Supplementary Document	2015-08-11
YEARS SS-Part B REVISED 11.30.15_clean.doc Supporting Statement B	2015-12-04
YEARS SS-Part A REVISED 11 30 15_clean.doc Supporting Statement A	2015-12-04

IC Document Collections

IC ID	Document Title	Status
217849	Semi-structured interview (Partner organization/Provider) Other-Semi Structured Protocol	New
217848	Semi-structured interview (Program Facilitator) Other-Semi Structured Protocol	New
217847	Semi-structured interview (Program director/Administrator) Other-Semi Structured Protocol	New
217846	Site visit screening and recruiting Other-Screener	New
217845	YEARS web-based staff survey (Program Facilitator) Other-Survey	New
217844	YEARS web-based staff survey (Program director/Administrator) Other-Survey	New

ICR Details

OMB Control No: 0970-0470	ICR Reference No: 201508-0970-008
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Youth Education and Relationship Services (YEARS)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/17/2015
	Date Received in OIRA: 08/20/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	12 Months From Approved
Responses	118	0	0
Time Burden (Hours)	67	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of Planning, Research and Evaluation (OPRE) at the U.S. Department of Health and Human Services (HHS) seeks approval for information collection (IC) activities as part of their effort to better understand the services that Office of Family Assistance (OFA)-funded Healthy Marriage and Relationship Education (HMRE) grantees are providing to youth aged 14 to 24. In order to carry out this work, OPRE has contracted with Child Trends. The study team will draw from both existing documentation and grantee reports (see Appendix A: Pre Existing Data Sources) and newly collected data from a web-based staff survey and information collected during three grantee pilot site visits and six grantee site visits, which will include semi-structured interviews with program staff. The team will also draw on information from program observations conducted during the site visits. These observations do not impose any respondent burden. The major goal of this project is to help OPRE understand the current state of HMRE programming for youth.

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Authorizing Statute(s): US Code: 42 USC 613 Name of Law: Social Security Act: Research, Evaluations and National Studies
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 10492	02/26/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 48536	08/13/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
YEARS web-based staff survey (Program director/Administrator)
YEARS web-based staff survey (Program Facilitator)
Site visit screening and recruiting
Semi-structured interview (Program director/Administrator)
Semi-structured interview (Partner organization/Provider)
Semi-structured interview (Program Facilitator)

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ICR Summary 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	118	0	0	118	0	0
Annual Time Burden (Hours)	67	0	0	67	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new data collection.

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Annual Cost to Federal Government: $95,437

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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? Uncollected

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Common Form ICR:  No

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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: 08/20/2015

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