Preventing HIV Risk Behaviors Among Hispanic Adolescents

Forms and Documents

Document Name	Status
Project Officer Letter-0920-09AU Revised 11_22.pdf Supplementary Document	2010-11-22
Family Relations 1.pdf Supplementary Document	2010-11-22
Social Provisions.pdf Supplementary Document	2010-11-22
Rev Beh Prob Checklist.pdf Supplementary Document	2010-11-22
Project Officer Letter-0920-09AU.pdf Supplementary Document	2010-11-22
Prado_JC CP_2007.pdf Supplementary Document	2010-11-22
Prado_et[1].al_HealthEducation Behavior_2010.pdf Supplementary Document	2010-11-22
Parenting Practices 2.pdf Supplementary Document	2010-11-22
Parental assessment battery master_ENG.pdf Supplementary Document	2010-11-22
Parent-Adolescent Communication 2.pdf Supplementary Document	2010-11-22
Parent-Adolescent Communication 1.pdf Supplementary Document	2010-11-22
Pantin_PS_2003.pdf Supplementary Document	2010-11-22
Hispanic Stress Inventory_Eng.pdf Supplementary Document	2010-11-22
Hispanic Stress Inventory.pdf Supplementary Document	2010-11-22
Family Relations 2.pdf Supplementary Document	2010-11-22
Communication about Sex.pdf Supplementary Document	2010-11-22
CDC Office of Info[1] and Reg. Affairs.pdf Supplementary Document	2010-11-22
Bicultural Involvement Scale.pdf Supplementary Document	2010-11-22
0920-09AU_SS_Sect B Revised 11_22.doc Supporting Statement B	2010-11-22
att7_Certificate of Confidentiality.doc Supplementary Document	2010-07-23
att6b_Local IRB Approval.doc Supplementary Document	2010-07-23
att6a_ CDC Project Determination.doc Supplementary Document	2010-07-23
att4d_Youth Assent Form_SPA.doc Supplementary Document	2010-07-23
att4c_Parent or Primary Caregiver Consent Form_SPA.doc Supplementary Document	2010-07-23
att4b_Youth Assent Form_ENG.doc Supplementary Document	2010-07-23
att4a_Parent or Primary Caregiver Consent Form_ENG.doc Supplementary Document	2010-07-23
att3a_Screening Form.doc Supplementary Document	2010-07-23
Attachment 2a 60-day comment .doc Supplementary Document	2010-07-23
Att3e_Adolescent_Battery_SPA.pdf Supplementary Document	2010-07-23
Att3d_Parental_Battery_SPA.pdf Supplementary Document	2010-07-23
att5d_RecruitLetter_SPA.doc Supplementary Document	2010-07-23
att5a_Recruitment Flyer.doc Supplementary Document	2010-07-23
att5b_RecruitLetter_ENG.doc Supplementary Document	2010-07-23
0920-09AU SS A Revised 11_22.doc Supporting Statement A	2010-11-22

IC Document Collections

IC ID	Document Title	Status
194323	Adolescent Assessment Battery Instruction	New
194322	Parent Assessment Battery Instruction	New
194321	Caregiver and Adolescent Screening Form Instruction	New
194320	Recruitment telephone Script Instruction	New

ICR Details

OMB Control No: 0920-0871	ICR Reference No: 201008-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Preventing HIV Risk Behaviors Among Hispanic Adolescents
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: 11/23/2010
	Date Received in OIRA: 08/19/2010
Terms of Clearance: The results of this case study shall not be used as the basis for programmatic decisions.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2013	36 Months From Approved
Responses	2,160	0	0
Time Burden (Hours)	940	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This study will assess the impact of a parent-centered, eco-developmental prevention intervention (Familias Unidas) intended to reduce HIV risk behaviors (i.e., substance use and unsafe sexual behaviors) among Hispanic adolescents living in Miami-Dade County.

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Authorizing Statute(s): US Code: 42 USC 308d Name of Law: Public Health Service Act
   US Code: 42 USC 301 Name of Law: Public Health Service Act
  

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:
	75 FR 4567	01/28/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 43985	07/27/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Recruitment telephone Script
Caregiver and Adolescent Screening Form
Parent Assessment Battery
Adolescent Assessment Battery

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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	2,160	0	0	2,160	0	0
Annual Time Burden (Hours)	940	0	0	940	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 information collection request.

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Annual Cost to Federal Government: $295,594

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? Yes

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: 08/19/2010

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