Self-Regulation Training Approaches and Resources to Improve Staff Capacity for Implementing Healthy Marriage Services for Youth (SARHM)

Pre-testing of Evaluation Data Collection Activities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Document Name Document Type
Instrument 1_Educator questionnaire.2.docx Other-Questionnaire
Instrument 2_Interview protocol.2.docx Other-Interview
Instrument 3_Session assessment form.2.docx Other-Session Assessment
Instrument 4_Observation tool.2.docx Other-Observation Tool
Instrument 5_Youth questionnaire.2.docx Other-Questionnaire
Instrument 6_Youth focus group protocol.3.clean.docx Other-Focus Group Protocol
SARHM OMB 2 SSA_070218_revised.2_clean.docx SARHM Supporting Statement A IC Document
SARHM OMB 2 SSB_070218_clean.docx SARHM Supporting Statement B IC Document
Attachment A_SARHM_Legislative authority.pdf Attachment A - SARHM Legislative Authority IC Document
Attaachment B_SARHM Mathematica Confidentiality Pledge.pdf Attaachment B_Mathematica Confidentiality Pledge IC Document

Information Collection (IC) Details

IC Title:	Self-Regulation Training Approaches and Resources to Improve Staff Capacity for Implementing Healthy Marriage Services for Youth (SARHM)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire	Instrument 1_Educator questionnaire.2.docx	Yes	Yes	Fillable Fileable
Other-Interview	Instrument 2_Interview protocol.2.docx	No		Paper Only
Other-Session Assessment	Instrument 3_Session assessment form.2.docx	Yes	Yes	Fillable Fileable
Other-Observation Tool	Instrument 4_Observation tool.2.docx	Yes	Yes	Fillable Fileable
Other-Questionnaire	Instrument 5_Youth questionnaire.2.docx	Yes	Yes	Fillable Fileable
Other-Focus Group Protocol	Instrument 6_Youth focus group protocol.3.clean.docx	No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 197	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	116	116
Annual IC Time Burden (Hours)	397	397
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SARHM Supporting Statement A	SARHM OMB 2 SSA_070218_revised.2_clean.docx	07/16/2018
SARHM Supporting Statement B	SARHM OMB 2 SSB_070218_clean.docx	07/16/2018
Attachment A - SARHM Legislative Authority	Attachment A_SARHM_Legislative authority.pdf	06/12/2018
Attaachment B_Mathematica Confidentiality Pledge	Attaachment B_SARHM Mathematica Confidentiality Pledge.pdf	06/12/2018

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