Form 1 Resource Center Performance Progress Report

Generic Performance Progress Reports

FVPSA PPR for National Special Issue and Culturally Specific Resource Centers SPD 15 CLEAN HD 6 7 24

Family Violence Prevention and Services: National, Special Issue, and Culturally Specific Resource Centers

OMB: 0970-0490

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Resource Center Performance Progress Report

ACF-OFVPS-FVPSA-PPR COVER PAGE

Office of Family Violence Prevention and Services (OFVPS)

Administration for Children and Families

U.S. Department of Health and Human Services

National, Special Issue, and Culturally Specific Resource Centers Grant Report


1. Federal Agency and Organization Element

to Which Report is Submitted


ACF-OFVPS-FVPSA

2. Federal Grant or Other Identifying

Number Assigned by Federal Agency



[Enter text here]


3.a DUNS Number


[Enter text here]

3b. EIN


[Enter text here]

4. Recipient Organization (Name and Complete Address Including Zip Code)


[Enter text here]


5. Recipient Identifying Number or

Account Number


[Enter text here]

6. Project Reporting Period

Start date: End date:

[Enter text here] [Enter text here]

7. Final Report

Y ( ) N ( )


8. Report Frequency

Semi-annual

9. Performance Narrative (performance narrative is covered in the attached PPR forms)



10. Attachments



11. Certification: I certify to the best of my knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents.

12a. Typed or Printed Name and Title of Authorized Certifying Official


[Enter text here]

12c. Telephone (area code, number and

extension)

[Enter text here]


12d. Email Address

[Enter text here]

12b. Signature of Authorized Certifying Official


[Enter text here]


12e. Date Report Submitted (Month, Day, Year)


[Enter text here]


Program Indicators Narrative   


Major activities and accomplishments during this period: Describe your progress during the reporting period in completing the activities described in your most recent application.  Provide information on your successes and challenges in meeting the terms of the cooperative agreement as outlined in the Award Letter as of the end of the current reporting period. Please limit your response to 2,500 words.  

 

Problems: Comment on any barriers that prevented you from meeting accomplishments or milestones that should have occurred during this reporting period. Use this report section to advise Project Officer and Grants Management Specialist of assistance needs. Please limit your response to 2,500 words.  

 

Dissemination activities: Briefly describe project related inquiries and information dissemination activities carried out over the reporting period. Itemize and include a copy of any newspaper, newsletter, magazine articles or other published materials considered relevant to project activities, or used for project information or public relations purposes.  

 

Other activities: 

Partnerships (optional): Describe any meaningful relationships and/or partnerships (both new and ongoing) that have assisted in meeting your objectives and/or increased the effectiveness of your programs for this reporting period. Please limit your response to 1,000 words.   

 

Emerging issues (optional): What do you see as the most significant emerging issues for your training and technical assistant recipients for this reporting period? Describe the types of support, technical assistance, or other needs of the populations that you serve. Please limit your response to 1,000 words.   

 

Activities planned for next reporting period: Briefly describe any activities planned for the next reporting period that align with the terms of the cooperative agreement as outlined in the Award Letter. Please limit your response to 1,000 words.  

 

Additional significant findings and events (optional): What other details regarding your work from this reporting period would you like the OFVPS to know? This could include but is not limited to systems-level changes, community collaboration, barriers or challenges to delivering training and technical assistance, and/or promising practices if not already addressed in your report. Please limit your response to 1,000 words.   


















National Resource Center, Special Issue, and Culturally Specific Resource Centers Training

Data Tables 


Table A. Type and Number of Training Events Provided    


Total number of training/ community engagement events   

Types of Training/ Community Engagement    


National    

Tribal    

International    

State/  

Regional  

  

Local  

Total # of Events Held Virtually    

Overall Total # of Events  

Total # of People Trained w/ Grant Funds  

A. Conferences/ Institutes Hosted by Organization    

  

    

    

    

    

    

    

    

   

  

B. Workshop Presentations    

    

    

    

    

    

    

    

   

  

C. New Grantee Orientation    

    

    

    

    

    

    

    

   

  

D. Training of Trainers (ToT) Sessions    

    

    

    

    

    

    

    

   

  

E. Listening Sessions    

    

    

    

    

    

    

    

   

  

F. Other Community Engagement Events    

  

  

    

    

    

    

    

    

    

   

  

G. Social Media-Based Events/Trainings    

  

  

    

    

    

    

    

    

    

   

  

H. Podcasts   

    

    

    

    

    

    

    

   

  

I. Other: Lecture, Advisory council meeting, Community of Practice    

  

  

    

    

    

    

    

    

    

   

  

TOTAL    

  

  

  [AUTO SUM]

[AUTO SUM]

    [AUTO SUM]

   [AUTO SUM]

[AUTO SUM]

   [AUTO SUM]

  [AUTO SUM]  

[AUTO SUM]

  




For all ‘Conferences/Institutes Hosted by Organization’ listed above, please detail: 

 

 

Total # or Percentage 

Plenaries/Keynotes 

 

Workshops 

 

% Funded under grant 

 


Table B. Number of Individuals Reached through Training and Community Engagement During Reporting Period    

Categories of Individuals Trained    

Number Trained    

Adult Protective Services  

    

Anti-Trafficking Agencies (Non-Governmental)  

    

Attorneys   

    

Batterer Intervention Programs (BIPs)   

    

Child Support System (Administrative and Judicial Agency Personnel, System-Based Victim Advocates)  

    

Child Welfare System (Judges, Social Workers, Administrators, Foster Care, System-Based Advocates)  

    

Child Care/Head Start Agencies   

    

Civil Justice System (Judges, Clerks, Custody Evaluators, 3rd Party Neutrals, System-Based Victim Advocates)  

    

Coordinated Community Response (CCR) Entities   

    

Corrections System (Probation, Parole, and Correctional Facilities)   

    

Criminal Justice System (Clerks, Prosecutors, Expert Witnesses, System-Based Victims, Witness Specialists)  

    

Culturally-Specific Community-Based Programs- DV/SA Programs  

    

Culturally-Specific Community-Based Programs- Other   

    

Disability Rights/Deaf Organizations  

    

Domestic/Dating Violence Programs and Dual Domestic Violence/Sexual Assault Programs (Including Advocates, Boards, Volunteers)  

    

Domestic Violence State/Territory Coalitions and Dual Domestic Violence/Sexual Assault State/Territory Coalitions (Including Advocates and Boards)  

    

Educators (Teachers/Faculty from Elementary through College) and School/Campus Personnel   

    

Economic Security, Asset-Building, Anti-Poverty Programs (Non-Governmental)   

    

Elder Abuse Organizations (Non-Governmental)  

    

Emergency Preparedness Agencies 

    

Employers  

    

Faith-Based/Spiritual Leaders/Organizations   

    

Fatherhood Programs   

    

Funders- Private Foundations, Corporate Funders   

    

FVPSA/ ACF Staff

    

General Public   

    

Health Care Providers Working with Adults   

    

Health Care Providers Working with Children  

    

Home Visitation Agencies   

    

Housing Agencies and Transitional Housing Programs (Non-DV Focused)   

    

Immigrant Organizations (Non-Governmental)   

    

Interpreters and Translators   

    

Judges   

    

Juvenile Delinquency System (Probation, Other Personnel)   

    

Law Enforcement Agencies   

    

LGBTQ / Two-Spirit Community Organizations    

    

Media   

    

Mental Health Professionals   

    

Military Family Advocacy Program   

    

Military Justice Personnel (Military Police, JAGs, Other)   

    

Multi-Disciplinary Groups   

    

NGOs (Non-DV)- International (UN Women, Other)   

    

NGOs (Non-DV)- National/Tribal (NCAAP, NCAI, Nat’l Council of La Raza, NASW)  

    

NGOs (Non-DV)- State, Territorial, or Local (State/Local Chapter, Other CBOs)  

    

Policymakers- Federal Government (Congress, White House, Federal Agencies including OVW and OVC) 

    

Policymakers- State/Territorial and Local   

    

Policymakers- Tribal   

    

Public Benefits Agencies (TANF, SNAP, WIC, Other)  

    

Researchers/Scholars   

    

Refugee Organizations (Including those Working with Asylees)  

    

Reproductive and Sexual Health and Rights Programs   

    

Sexual Assault Center and Programs and Rape Crisis Centers

    

Sexual Assault Coalitions


Students (K-12, Undergraduate, Graduate, Including Law School and Medical School) and Student Groups   

    

Substance Misuse Programs  

    

Supervised Visitation Programs  

    

Social Services for Adults, Children, and Families (Non-Governmental)  

    

TA Providers- DVRN Members   

    

TA Providers- Other DV/SA/Stalking TA Providers  

    

Tribal Domestic Violence and Sexual Assault Coalitions   

    

Tribal Domestic Violence and Sexual Assault Programs  

    

Tribal Governments (Including Tribal Councils)    

    

Tribal Justice System (Judges, Clerks, Prosecutors, Probation, Other)   

    

Tribal Law Enforcement  

    

Other Individuals and Groups (Social Clubs, Beauty Salons, Community Organizers)   

    

Other Underserved Communities    

    

University/Campus Administrators and Campus Police  

    

Victims/Survivors of Domestic Violence, Dating Violence, Sexual Assault, Stalking   

    

Victims/Survivors and Other Individuals Charged with Crimes   

    

Victims/Survivors’ Family and Friends   

    

Youth Serving Organizations   

    

Other: Please Specify _____________________ 

Add additional rows as needed. 

(For example, Primary Care Associations; State Departments of Health/Public Health; HRSA Workforce Development Agencies) 

    

TOTAL    

    [AUTO SUM]

    

Table C. Training Content Areas During the Reporting Period    

Training Topics (Check All that Apply) 

X    

Accessibility (ADA, language, programming)  

    

Adolescent/Teen Relationship Abuse   

    

Advocacy   

    

Batterers Intervention Programs/Reducing Abusive Behavior   

    

Child Custody Related Issues   

    

Child Support   

    

Child Welfare/Child Protection Issues (Co-Occurrence, System Response)   

    

Children and Youth Exposed to Domestic Violence  

    

Civil Legal Issues (Including Family Court Response, POs, Civil Legal Assistance)  

    

Community Organizing, Engagement, and Mobilization  

    

Confidentiality/Privacy (HIPAA, Privileged Communication, Tech Safety)  

    

Corrections (Probation/Parole, Programs in Prison and Related)   

    

Coordinated Community Response  

    

Creating and Sustaining Culturally-Specific Organizations and Communities   

    

Criminal Legal Issues (Law Enforcement, Prosecution, Court, and Defense Responses)   

    

Cultural Competency for NGOs and Systems   

    

Curricula and Training Issues   

    

Data Collection and Evaluation  

    

Domestic and Dating Violence (Dynamics, Incidence/Prevalence, Response)   

    

Domestic Violence Victims Charged with Crimes   

    

Economic Empowerment   

    

Elder Abuse  

    

Emergency Preparedness  

    

Engaging Men and Boys   

    

Evidence-Based, Evidence-Informed, and Promising Practices (Including Practice-Based Evidence)   

    

Faith/Religion   

    

Fatherhood and Domestic Violence   

    

Firearms and Domestic Violence   

    

Grants and Funding   

    

HIV and AIDS   

    

Health Care and Domestic Violence   

    

Housing (Transitional Housing, Discrimination, Affordable Housing)   

    

Homicide (Lethality/Dangerousness Assessments, Fatality Reviews, Homicide Prevention)   

    

Juvenile System Issues (Delinquency, Dependency, Foster Care, Other)   

    

Immigration Issue, Including Response to Immigrant Survivors   

    

Language Access, Interpretation, and Translation   

    

LGBTQ / Two Spirit Communities, Including Response to Survivors of Abuse    

    

Male Victims   

    

Mandatory Reporting (Child Welfare, Law Enforcement)   

    

Mental Health and Domestic Violence   

    

Military (Programming, Advocacy, System Response)  

    

Organizational Development (Fund Development, Boards, Strategic Planning, Other)   

    

Primary Prevention  

    

Program Development   

    

Program Evaluation   

    

Public Benefits (TANF, SNAP, Other)  

    

Re-Entry, Including for Incarcerated Women   

    

Refugees, Including Response to Refugee Survivors   

    

Research and Statistics   

    

Disabilities/Deafness, Including Response to Survivors with Disabilities or Who are Deaf   

    

Runaway and Homeless Youth   

    

Rural Communities, Including Survivors Living in Rural/Remote Areas   

    

Safety Audits (Organizations, Systems)   

    

Safety Planning   

    

Stalking, Including Response to Stalking Survivors  

    

Substance Misuse and Domestic Violence   

    

Supervised Visitation and Exchange  

    

Technology and Technology Capacity   

    

Technology Safety and Security   

    

Trauma-Informed Practice   

    

Tribal Nations (Sovereignty, Services, Legal and Health Response, Child Welfare, Other)  

    

Tribal Justice Issues (Law Enforcement, Prosecution, Court, and Correction Responses)   

    

Workplace Issues   

    

Other: Please Specify_______________ 

Add additional rows as needed 

(For example: Addressing DV During COVID, COVID-19 and Telehealth, Partner Inflicted Brain Injury, Following Young Peoples’ Lead on Online Youth Engagement for SV Prevention in Times of COVID)  

    



Table D. Recipients of TA and Type and Number of TA Activities    

Site Visit: An in-person visit made to an agency/location for the purpose of providing TA consultation.    

TA Consultation: TA consultations involve substantive contact with individuals or organizations via phone, email, or in-person that does not rise to the level of a site visit.    

Information and Referral (I & R) Services: I & R services involve the provision of information, materials, or referrals to other resources in response to specific requests.   

 

Categories of Individuals Trained    

# of Site Visits    

# of TA Consultations    

# of I & R Responses    

Adult Protective Services  

    

    

    

Anti-Trafficking Agencies (Non-Governmental)  

    

    

    

Attorneys   

    

    

    

Batterer Intervention Programs (BIPs)   

    

    

    

Child Support System (Administrative and Judicial Agency Personnel, System-Based Victim Advocates)   

    

    

    

Child Welfare System (Judges, Social Workers, Administrators, Foster Care, System-Based Advocates)   

    

    

    

Child Care/Head Start Agencies   

    

    

    

Civil Justice System (Judges, Clerks, Custody Evaluators, 3rd Party Neutrals, System-Based Victim Advocates)   

    

    

    

Coordinated Community Response (CCR) Entities   

    

    

    

Corrections System (Probation, Parole, and Correctional Facilities)  

    

    

    

Criminal Justice System (Clerks, Prosecutors, Expert Witnesses, System-Based Victims, Witness Specialists)  

    

    

    

Culturally-Specific Community-Based Programs- DV/SA Programs   

    

    

    

Culturally-Specific Community-Based Programs- Other   

    

    

    

Disability Rights/Deaf Organizations   

    

    

    

Domestic/Dating Violence Programs and Dual Domestic Violence/Sexual Assault Programs (Including Advocates, Boards, Volunteers)   

 

    

    

    

Domestic Violence State/Territory Coalitions and Dual Domestic Violence/Sexual Assault State/Territory Coalitions (Including Advocates and Boards)   

    

    

    

Educators (Teachers/Faculty from Elementary through College) and School/Campus Personnel   

    

    

    

Economic Security, Asset-Building, Anti-Poverty Programs (Non-Governmental)   

    

    

    

Elder Abuse Organizations (Non-Governmental)   

    

    

    

Emergency Preparedness Agencies   

    

    

    

Employers   

    

    

    

Faith-Based/Spiritual Leaders/Organizations   

    

    

    

Fatherhood Programs  

    

    

    

Funders- Private Foundations, Corporate Funders   

    

    

    

FVPSA/FYSB Program   

    

    

    

General Public   

    

    

    

Health Care Providers Working with Adults  

    

    

    

Health Care Providers Working with Children   

    

    

    

Home Visitation Agencies   

    

    

    

Housing Agencies and Transitional Housing Programs (Non-DV Focused)   

    

    

    

Immigrant Organizations (Non-Governmental)  

    

    

    

Interpreters and Translators   

    

    

    

Judges  

    

    

    

Juvenile Delinquency System (Probation, Other Personnel)  

    

    

    

Law Enforcement Agencies   

    

    

    

LGBTQ / Two Spirit Community Organizations   

    

    

    

Media   

    

    

    

Mental Health Professionals   

    

    

    

Military Family Advocacy Program   

    

    

    

Military Justice Personnel (Military Police, JAGs, Other)   

    

    

    

Multi-Disciplinary Groups   

    

    

    

NGOs (Non-DV)- International (UN Women, Other)   

    

    

    

NGOs (Non-DV)- National/Tribal (NCAAP, NCAI, Nat’l Council of La Raza, NASW)   

    

    

    

NGOs (Non-DV)- State, Territorial, or Local (State/Local Chapter, Other CBOs)   

    

    

    

Policymakers- Federal Government (Congress, White House, Federal Agencies including OVW and OVC)   

  

    

    

    

Policymakers- State/Territorial and Local   

    

    

    

Policymakers- Tribal   

    

    

    

Public Benefits Agencies (TANF, SNAP, WIC, Other)   

    

    

    

Researchers/Scholars   

    

    

    

Refugee Organizations (Including those Working with Asylees)   

    

    

    

Reproductive and Sexual Health and Rights Programs   

    

    

    

Sexual Assault Programs and Coalitions   

    

    

    

Students (K-12, Undergraduate, Graduate, Including Law School and Medical School) and Student Groups   

    

    

    

Substance Misuse Programs   

    

    

    

Supervised Visitation Programs   

    

    

    

Social Services for Adults, Children, and Families (Non-Governmental)   

    

    

    

TA Providers- DVRN Members   

    

    

    

TA Providers- Other DV/SA/Stalking TA Providers   

    

    

    

Tribal Domestic Violence and Sexual Assault Coalitions   

    

    

    

Tribal Domestic Violence and Sexual Assault Programs   

    

    

    

Tribal Governments (Including Tribal Councils)   

    

    

    

Tribal Justice System (Judges, Clerks, Prosecutors, Probation, Other)   

    

    

    

Tribal Law Enforcement   

    

    

    

Other Individuals and Groups (Social Clubs, Beauty Salons, Community Organizers)   

    

    

    

Other Underserved Communities    

    

    

    

University/Campus Administrators and Campus Police   

    

    

    

Victims/Survivors of Domestic Violence, Dating Violence, Sexual Assault, Stalking   

    

    

    

Victims/Survivors and Other Individuals Charged with Crimes   

    

    

    

Victims/Survivors’ Family and Friends   

    

    

    

Youth Serving Organizations   

    

    

    

Other: Please Specify:__________________ 

Add additional rows as needed. 

(For example: Primary Care Associations; State Departments of Health/Public Health; HRSA Workforce Development Agencies)    

    

    

    

TOTAL    

    [AUTOSUM]

        [AUTOSUM

        [AUTOSUM

    


Table E. TA Content Areas During the Reporting Period    

Training Topics (Check All that Apply)

X    

Accessibility (ADA, language, programming) 

    

Adolescent/Teen Relationship Abuse   

    

Advocacy   

    

Batterers Intervention Programs/Reducing Abusive Behavior   

    

Child Custody Related Issues   

    

Child Support   

    

Child Welfare/Child Protection Issues (Co-Occurrence, System Response)   

    

Children and Youth Exposed to Domestic Violence   

    

Civil Legal Issues (Including Family Court Response, POs, Civil Legal Assistance)   

    

Community Organizing, Engagement, and Mobilization   

    

Confidentiality/Privacy (HIPPAA, Privileged Communication, Tech Safety   

    

Corrections (Probation/Parole, Programs in Prison and Related)   

    

Coordinated Community Response   

    

Creating and Sustaining Culturally-Specific Organizations and Communities   

    

Criminal Legal Issues (Law Enforcement, Prosecution, Court, and Defense Responses)   

    

Cultural Competency for NGOs and Systems   

    

Curricula and Training Issues   

    

Data Collection and Evaluation   

    

Domestic and Dating Violence (Dynamics, Incidence/Prevalence, Response)    

    

Domestic Violence Victims Charged with Crimes   

    

Economic Empowerment   

    

Elder Abuse   

    

Emergency Preparedness   

    

Engaging Men and Boys   

    

Evidence-Based, Evidence-Informed, and Promising Practices (Including Practice-Based Evidence)   

    

Faith/Religion   

    

Fatherhood and Domestic Violence   

    

Firearms and Domestic Violence   

    

Grants and Funding   

    

HIV and AIDS   

    

Health Care and Domestic Violence   

    

Housing (Transitional Housing, Discrimination, Affordable Housing)   

    

Homicide (Lethality/Dangerousness Assessments, Fatality Reviews, Homicide Prevention)   

    

Juvenile System Issues (Delinquency, Dependency, Foster Care, Other)   

    

Immigration Issue, Including Response to Immigrant Survivors   

    

Language Access, Interpretation, and Translation   

    

LGBTQ /Two Spirit Communities, Including Response to Survivors of Abuse    

    

Male Victims   

    

Mandatory Reporting (Child Welfare, Law Enforcement)   

    

Mental Health and Domestic Violence   

    

Military (Programming, Advocacy, System Response)    

    

Organizational Development (Fund Development, Boards, Strategic Planning, Other)   

    

Primary Prevention   

    

Program Development   

    

Program Evaluation   

    

Public Benefits (TANF, SNAP, Other)   

    

Re-Entry, Including for Incarcerated Women   

    

Refugees, Including Response to Refugee Survivors   

    

Research and Statistics   

    

Disabilities/Deafness, Including Response to Survivors with Disabilities or Who are Deaf   

    

Runaway and Homeless Youth   

    

Rural Communities, Including Survivors Living in Rural/Remote Areas   

    

Safety Audits (Organizations, Systems)   

    

Safety Planning   

    

Stalking, Including Response to Stalking Survivors   

    

Substance Misuse and Domestic Violence   

    

Supervised Visitation and Exchange   

    

Technology and Technology Capacity   

    

Technology Safety and Security   

    

Trauma-Informed Practice   

    

Tribal Nations (Sovereignty, Services, Legal and Health Response, Child Welfare, Other)   

    

Tribal Justice Issues (Law Enforcement, Prosecution, Court, and Correction Responses)   

    

Workplace Issues   

    

Other: Please Specify:_________________ 

Add additional rows as needed. 

(For example: Addressing DV During COVID, COVID-19 and Telehealth, Partner Inflicted Brain Injury, Following Young Peoples’ Lead on Online Youth Engagement for SV Prevention in Times of COVID)   

    

    


Table F. Activities Addressing Culturally-Specific Populations    

Activities    

Lead/ Primary Activity    

Partner/ Support Activity    

Developing materials and other resources to increase the field’s awareness of and education about the needs and strengths of ethnic and racial minority groups   

    

    

Engaging in systems advocacy and collaboration to identify and maximize systems’ support and access and minimize barriers for racial and ethnic minority groups   

    

    

Engaging in community organizing, outreach, advocacy, movement building, and/or collaboration to enhance culturally-specific community supports and to minimize barriers for that population   

    

    

Identifying and increasing awareness about critical issues affecting target populations of the CSSIRCs to increase culturally-specific and culturally-competent services and access to all programs serving survivors   

    

    

Increasing participation and visibility of culturally-specific communities in shaping intervention and prevention policy initiatives   

    

    

Increasing participation and visibility of culturally-specific communities in shaping intervention and prevention research initiatives and methodologies to enhance healing and well-being for racial and ethnic minority groups   

    

    

Providing training regarding culturally appropriate services for communities   

    

    

Analyzing critical issues and new trends in order to develop survivor-centered and community-defined advocacy and community engagement strategies   

    

    

Contributing content-area expertise to national, state, federal, and local issues   

    

    

Developing, supporting, and enhancing leadership in racial and ethnic communities   

    

    

Identifying, adapting, and implementing evidence-based, trauma informed, culturally-relevant strategies and program models   

    

    

  

Table G. Culturally-Specific Populations Served  

[Race/Ethnicity: Report the race and/or ethnicity of the clients served, including children and youth. Clients may self-identify in more than one category, e.g., White and Hispanic.]


Defining race and ethnicity. In accordance with the Office of Management and Budget (OMB) Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (SPD 15), the race and ethnicity categories set forth are sociopolitical constructs and are not an attempt to define race and ethnicity biologically or genetically.  The SPD 15 race and ethnicity categories are intended to result in more accurate and useful race and ethnicity data across the Federal government.


Developing/Enhancing Response for Victims/Survivors Who Are:     

Lead/ Primary Activity    

Partner/ Support Activity    

American Indian or Alaska Native (AIAN)

=Sum(Below)

=Sum(Below)

For example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.



Asian

=Sum(Below)

=Sum(Below)

Chinese



Asian Indian



Filipino



Vietnamese



Korean



Japanese



Enter, for example, Pakistani, Hmong, Afghan, etc.



Black or African American

=Sum(Below)

=Sum(Below)

African American



Jamaican



Haitian



Nigerian



Ethiopian



Somali



Enter, for example, Trinidadian and Tobagonian, Ghanaian, Congolese, etc.



Hispanic or Latino

=Sum(Below)

=Sum(Below)

Mexican



Puerto Rican



Salvadoran



Cuban



Dominican



Guatemalan



Enter, for example, Colombian, Honduran, Spaniard, etc.



Middle Eastern or North African

=Sum(Below)

=Sum(Below)

Lebanese



Iranian



Egyptian



Syrian



Iraqi



Israeli



Enter, for example, Moroccan, Yemeni, Kurdish, etc.



Native Hawaiian or Pacific Islander

=Sum(Below)

=Sum(Below)

Native Hawaiian



Samoan



Chamorro



Tongan



Fijian



Marshallese



Enter, for example, Chuukese, Palauan, Tahitian, etc.



White

=Sum(Below)

=Sum(Below)

English



German



Irish



Italian



Polish



Scottish



Enter, for example, French, Swedish, Norwegian, etc.



Multi-Racial



    






Table H. Activities at the Intersection of other Social, Personal, Demographic Identifiers    

Victims/Survivors who:    

Primary/ Lead    

Partner/ Support    

AI/

AN   

Asian

Black/ African American    

Hispanic or Latino    

Middle Eastern or North African

Native Hawaiian/

Pacific Islander    

White 

Mutli-Racial 

General Population    

Are deaf or hard of hearing   

    

    

    

    

    

    


    

    

    

    

Have physical disabilities   

    

    

    

    

    

    


    

    

    

    

Have cognitive disabilities   

    

    

    

    

    

    


    

    

    

    

Are elders   

    

    

    

    

    

    


    

    

    

    

Are homeless or living in poverty   

    

    

    

    

    

    


    

    

    

    

Are immigrants   

    

    

    

    

    

    


    

    

    

    

Are refugees or asylum seekers   

    

    

    

    

    

    


    

    

    

    

Are lesbian, gay, bisexual, transgender, or intersex   

    

    

    

    

    

    


    

    

    

    

Are torture victims or were victimized in conflict zones   

    

    

    

    

    

    


    

    

    

    

Are victims of trafficking   

    

    

    

    

    

    


    

    

    

    

Have limited English proficiency   

    

    

    

    

    

    


    

    

    

    

Are experiencing mental health issues   

    

    

    

    

    

    


    

    

    

    

Are experiencing substance misuse issues   

    

    

    

    

    

    


    

    

    

    

Are charged, incarcerated, or re-entering the community after incarceration   

    

    

    

    

    

    


    

    

    

    

Have barriers accessing services because of religion   

    

    

    

    

    

    


    

    

    

    

Live in rural areas   

    

    

    

    

    

    


    

    

    

    

Other    

    

    

    

    

    

    


    

    

    

    

    


Table I. Activities Addressing Racial and Ethnic Minority Groups and/or Underserved Populations    

Activities    

Lead/ Primary Activity    

Partner/ Support Activity    

Developing materials and other resources to increase the field’s awareness of and education about the needs and strengths of ethnic and racial minority groups and/or underserved populations   

    

    

Engaging in systems advocacy and collaboration to identify and maximize systems’ support and access and minimize barriers for racial and ethnic minority groups and/or underserved populations   

    

    

Engaging in community organizing, outreach, advocacy, movement building, and/or collaboration to enhance community supports and to minimize barriers for specific racial and ethnic minority populations and/or underserved populations   

    

    

Increasing participation and visibility of racial and ethnic minority groups and underserved populations in shaping intervention and prevention policy initiatives   

    

    

Increasing participation and visibility of racial and ethnic minority groups and underserved populations in shaping intervention and prevention research initiatives and methodologies to enhance healing and well-being for survivors   

    

    

Providing training regarding culturally appropriate services for communities   

    

    

Analyzing critical issues and new trends in order to develop survivor-centered and community-defined advocacy and community engagement strategies   

    

    

Contributing content-area expertise to national, state, federal, and local issues   

    

    

Developing, supporting, and enhancing leadership in racial and ethnic communities   

    

    

Identifying, adapting, and implementing evidence-based, trauma informed, culturally-relevant strategies and program models   

    

    

    

Table J. Developing/Enhancing Response to Racial and Ethnic Minority Groups and Underserved Populations    

Developing/Enhancing Response for Victims/Survivors Who Are:     

Lead/ Primary Activity    

Partner/ Support Activity    

American Indian or Alaska Native (AIAN)   

    

    

Asian 

    

    

Black of African American   

    

    

Hispanic or Latino  

    

    

Middle Eastern or North African



Native Hawaiian or Pacific Islander   

    

    

White



Multi-Racial



Are deaf or hard of hearing   

    

    

Have physical disabilities   

    

    

Have cognitive disabilities   

    

    

Are elders   

    

    

Are homeless or living in poverty   

    

    

Are immigrants   

    

    

Are refugees or asylum seekers   

    

    

Are lesbian, gay, bisexual, transgender, queer, intersex or Two Spirit

    

    

Are torture victims or were victimized in conflict zones   

    

    

Are victims of trafficking   

    

    

Have limited English proficiency   

    

    

Are experiencing mental health issues   

    

    

Are experiencing substance misuse issues   

    

    

Are charged, incarcerated, or re-entering the community after incarceration   

    

    

Have barriers accessing services because of religion   

    

    

Live in rural areas   

    

    

Other    

    

    

    


Table K. Use of Grant Award Funds to Develop, Substantially Revise, or Distribute Products During the Reporting Period    

Product Types (During Reporting Period)   

# Developed and/or Substantially Revised    

# Printed (# Hard Copies Distributed)    

# Disseminated Online (# of Copies Viewed/Downloaded from Website, if known)    

Produced in Other Languages/Formats (Identify Language)    

Annotated Bibliography   

    

    

    

    

Brochure   

    

    

    

    

Benchcard/ Deskcard   

    

    

    

    

Fact Sheet/ Tip Sheet   

    

    

    

    

Funding Alert   

    

    

    

    

Journal Article/ Book Chapter   

    

    

    

    

Manual   

    

    

    

    

Newsletter/ Magazine   

    

    

    

    

Online Collection   

    

    

    

    

Podcasts    

    

    

    

    

Reports- Legislative/ Policy/ Other   

    

    

    

    

Research/ News Alerts   

    

    

    

    

Resource Guide/ Directory   

    

    

    

    

Social Media Posts





TA Packet/ Guide/ Brief   

    

    

    

    

Toolkits   

    

    

    

    

Training Curriculum   

    

    

    

    

Training Materials   

    

    

    

    

Videos/ CDs   

    

    

    

    

Webinar Recordings   

    

    

    

    

Formal Permission Granted to Other Organization to Reprint Existing Publications   

    

    

    

    

Other Publications: Posters, Samples, and Templates, Worksheets, Digital Tools, Billboard Files   

    

    

    

    

TOTALS    

     [AUTOSUM

     [AUTOSUM

     [AUTOSUM

     [AUTOSUM]

    


Table L. Website Usage    

   

Prior 6 Months    

Current 6 Months    

12-Month Total    

% Change    

Views    

    

    

    

    

Visitors    

    

    

    

    

Daily Visits    

    

    

    

    

Virtual Event Registrants  


# of Events ___ 

 

 

 

 


   

Table M. Online Newsletters and eLerts/ Subscriptions    

Name of eNewsletters, eLerts, and other Online Subscriptions    

# Produced during Reporting Period    

Subscriptions on 1st day of Reporting Period    

Subscriptions on Last Day of Reporting Period    

% Change    

Health e-Bulletin   

    

    

    

    

Health listserv   

    

    

    

    

  

Please refer to the follow definitions for all data tables. 

Term 

Definition from 45 CFR 1370.2 

Dating violence 

Violence committed by a person who is or has been in a social relationship of a romantic or intimate nature with the victim and where the existence of such a relationship shall be determined based on a consideration of the following factors: The length of the relationship, the type of relationship, and the frequency of interaction between the persons involved in the relationship. Dating violence also includes but is not limited to the physical, sexual, psychological, or emotional violence within a dating relationship, including stalking. It can happen in person or electronically and may involve financial abuse or other forms of manipulation which may occur between a current or former dating partner regardless of actual or perceived sexual orientation or gender identity. 

Domestic violence 

Felony or misdemeanor crimes of violence committed by a current or former spouse or intimate partner of the victim, by a person with whom the victim shares a child in common, by a person who is cohabitating with or has cohabitated with the victim as a spouse or intimate partner, by a person similarly situated to a spouse of the victim under the domestic or family violence laws of the jurisdiction receiving grant monies, or by any other person against an adult or youth victim who is protected from that person’s acts under the domestic or family violence laws of the jurisdiction. This definition also includes but is not limited to criminal or non-criminal acts constituting intimidation, control, coercion and coercive control, emotional and psychological abuse and behavior, expressive and psychological aggression, financial abuse, harassment, tormenting behavior, disturbing or alarming behavior, and additional acts recognized in other Federal, Tribal, State, and local laws as well as acts in other Federal regulatory or subregulatory guidance. The definition applies to individuals and relationships regardless of actual or perceived sexual orientation or gender identity. 

Primary prevention 

Strategies, policies, and programs to stop both first-time perpetration and first-time victimization. Primary prevention is stopping domestic and dating violence before they occur. Primary prevention includes, but is not limited to: School-based violence prevention curricula, programs aimed at mitigating the effects on children of witnessing domestic or dating violence, community campaigns designed to alter norms and values conducive to domestic or dating violence, worksite prevention programs, and training and education in parenting skills and self-esteem enhancement. 

Underserved populations 

Populations who face barriers in accessing and using victim services, and includes populations underserved because of geographic location, religion, sexual orientation, gender identity, underserved racial and ethnic populations, and populations underserved because of special needs including language barriers, disabilities, immigration status, and age. Individuals with criminal histories due to victimization and individuals with substance use disorders and mental health issues are also included in this definition. 



PAPERWORK REDUCTION ACT (PRA) OF 1995 (Public Law 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to implement the use of a PPR specific to the Resource Center grantees will allow OFVPS to collect more relevant information from these grantees to measure Resource Centers’ reach and impact. Public reporting burden for this collection of information is estimated to average 8 hours per grantee, including the time for reviewing instructions, gathering, and maintaining the data needed, and reviewing the collection of information. This collection of information is required to retain a benefit related to and funded by the Family Violence Prevention and Services Act (FVPSA), 42 U.S.C. 10401 et seq., which authorizes the U.S. Department of Health and Human Services to award grants to the National Domestic Violence Hotline and National, Special Issue, and Culturally Specific Resource Centers. 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 PRA of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of information, please contact Holi Dahl [holi.dahl@acf.hhs.gov].

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