Success Sequence Interviews

Forms and Documents

Document Name	Status
Appendix D. QualBoard Invitation Email Sample Screen Shots.docx Supplementary Document	2022-01-07
Appendix C. Success Sequence Interview Study Target Sample.docx Supplementary Document	2022-01-07
Appendix B. Consent Form_Jan 22.docx Supplementary Document	2022-01-07
Appendix A. Success Sequence Recruitment Materials_clean.docx Supplementary Document	2022-01-07
Supporting Statement Part A Success Sequence Interview Study v3_clean_jan 22.docx Supporting Statement A	2022-01-07
Supporting Statement Part B Success Sequence Interview Study v3_clean_jan 22.docx Supporting Statement B	2022-01-07

IC Document Collections

IC ID	Document Title	Status
251050	Instrument 2. Success Sequence Interview Protocol Other-Survey	New
251049	Instrument 1. Success Sequence Screener Other-Survey	New

ICR Details

OMB Control No:	ICR Reference No: 202201-0970-003
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No: OPRE
Title: Success Sequence Interviews
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/12/2022

	Requested	Previously Approved
Expiration Date	15 Months From Approved
Responses	900	0
Time Burden (Hours)	225	0
Cost Burden (Dollars)	0	0

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Abstract: This request is to collect interview data through virtual asynchronous interviews with adults to learn about their various pathways taken toward a set of life milestones – referred to as the success sequence – in the areas of high school graduation, employment, marriage, and childbearing. We will use the data to help understand the success sequence and the factors in the lives of young adults that may be associated with achieving economic self-sufficiency. The ultimate goal of the data collection is to guide Family and Youth Services Bureau Sexual Risk Avoidance Education programming and research efforts.

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Authorizing Statute(s): US Code: 42 USC 710 Name of Law: Title V, Section 510 of the Social Security 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:
	86 FR 62178	11/09/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 1754	01/12/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Instrument 1. Success Sequence Screener
Instrument 2. Success Sequence Interview Protocol

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ICR Summary of Burden

	Total Request	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	900	0	0	900	0	0
Annual Time Burden (Hours)	225	0	0	225	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: $173,659

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 01/12/2022

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