6 - B3 tracking of attendance in services for program group members

                                                                                                                                                         OMB #: XXXX-XXXX

                                                                                                                                             EXPIRATION: XX/XX/201X

6 - B3 tracking of attendance in services for program group members

[The nFORM MIS is being developed by the Fatherhood and Marriage Local Evaluation and Cross-site (FaMLE Cross-site) Project for federal Responsible Fatherhood Grantees. This MIS has already been approved by the OMB (0970-0460). Staff members at the Grantees will enter information into nFORM about fathers and their program participation. This instrument describes additional information that will be collected in nFORM for sites in the B3 study.]

[Staff members will be asked to check the appropriate check boxes after each service session for program group members in sites testing the parenting intervention. The information will be collected on the new service form screen:]

□ Training

□ Child Interaction

□ Feedback

□ Session 1

□ Session 2

□ Session 3

□ Session 4

□ Session 5

[Before the first session in sites testing the parenting intervention, staff members will be asked to mark the following box and record the date that the first session is scheduled for. The information will be collected on the new service form screen:]

□ Scheduled

Date scheduled for _____________

[In one of the first sessions in sites testing the parenting intervention, staff members will also be asked to mark the following box if and when an app has been downloaded to a program group member’s phone. The information will be collected on the new service form screen:]

□ App Installed

[In sites testing the employment intervention, staff members will be asked to enter the session number after each service session for program group members. The information will be collected on the workshop attendance screen for workshops and on the new service form screen for one-on-one or make-up services:]

Session # _________________[drop-down box]

[This box will appear on the client profile page in nFORM. The text is slightly modified from the text that was approved as part of the FaMLE Cross-site OMB package (0970-0460). The modifications include adding detail about the additional burden required for the B3 study and adding a sentence at the end to indicate the additional way that the nFORM data will be used for the B3 study.]

THE PAPERWORK REDUCTION ACT OF 1995

Public reporting burden for this collection of information is estimated to average 2 minutes per response for weekly service data entry for the FaMLE Cross-site data collection, 1 minute per response for eligibility data entry for the B3 study, 9 minutes per response for entry of B3 enrollment data, and 1 minute per response for weekly service data entry for the B3 study. These averages include the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The information requested in this template will be used to document how programs receiving HMRF grant funding operate. The data gathered will allow ACF to better monitor grantee progress and performance. The data will also be used to learn about the effects of parenting and employment services for fathers.