Testing Identified Elements for Success in Fatherhood Programs

Forms and Documents

Document Name	Status
TIES_Supporting Statement A_Clean.docx Supporting Statement A	2023-10-04
TIES_Supporting Statement B_Clean.docx Supporting Statement B	2023-10-04
Appendix 2_TIES_IRB Approval Letter.pdf Supplementary Document	2023-10-04

IC Document Collections

IC ID	Document Title	Status
262665	TIES Reflection from Fathers Other-Reflection	New
262664	TIES Reflection from Staff Other-Reflections	New
262663	Program Information and management tool (TIES Table Template) Other-Template	New
262662	TIES Baseline Survey Other-Survey	New
262661	TIES Consent Materials for Fathers (over 18 years old) Other-Consent material	New

ICR Details

OMB Control No:	ICR Reference No: 202310-0970-003
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Testing Identified Elements for Success in Fatherhood Programs
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: 10/06/2023

	Requested	Previously Approved
Expiration Date	28 Months From Approved
Responses	5,828	0
Time Burden (Hours)	1,344	0
Cost Burden (Dollars)	0	0

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Abstract: This is the first of two information collection requests for the Testing Identified Elements for Success in Fatherhood Programs (Fatherhood TIES) study. In this request, approval is being sought for the first phase of study data collection to gather consent from fathers to participate in the study, to ask fathers baseline survey questions when they enroll in the study beyond what the program already collects as part of their program enrollment processes, and to obtain information about program processes and outcomes during the study period to support the study teams’ understanding of implementation and how it could be improved.

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Authorizing Statute(s): None

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:
	88 FR 47884	07/25/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 69641	10/06/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Program Information and management tool (TIES Table Template)
TIES Baseline Survey
TIES Consent Materials for Fathers (over 18 years old)
TIES Reflection from Fathers
TIES Reflection from Staff

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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	5,828	0	0	5,828	0	0
Annual Time Burden (Hours)	1,344	0	0	1,344	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: $740,314

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.     Yes

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.     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? 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: 10/06/2023

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