Programs to Reduce Underage Drinking

Forms and Documents

Document Name	Status
Form Parents Night Out Parents Night Out Participant Survey Form and Instruction	New
Form Parents Night Out Parents Night Out Presenter Survey Form and Instruction	New
Form Campaign Partner E Campaign Partner Evaluation Focus Group Form and Instruction	New
Form Parent Evaluation Parent Evaluation Focus Group Form and Instruction	New
Form Talk.They Hear You Talk.They Hear You Mobile App Parent Survey Form and Instruction	New
Form Talk.They Hear You Talk.They Hear You.Mobile App Satisfaction Survey Form and Instruction	New
Form “Talk. They Hear Y “Talk. They Hear You.” Newsletter Survey Form and Instruction	New
Form Talk.TheyHear You. Talk.TheyHear You.Community Partner License Survey Form and Instruction	New
Form Talk. They Hear Yo Talk. They Hear You. Partner Feedback Survey Form and Instruction	New
Form TalkTheyHearYouPro TalkTheyHearYouProduct Design Request Survey Form and Instruction	New
Form Pre-Screener Pre-Screener Form and Instruction	New
Form Screen4Success Scr Screen4Success Screener Form and Instruction	New
Form Parental Informed Parental Informed Consent and Assent Form and Instruction	New
Form Participant Consen Participant Consent/Assent Form and Instruction	New
Form Six month Post Pol Six month Post Policy Academy Follow-up Form and Instruction	Modified
Form Post Policy Academ Post Policy Academy Follow Form and Instruction	Modified
Form Policy Academy Bas Policy Academy Baseline Form and Instruction	Modified
Form Policy Academy Coa Policy Academy Coach Post Coaching Survey Form and Instruction	Modified
Form Participant Post-T Participant Post-Training Call Survey Form and Instruction	Modified
Form Participant Post-C Participant Post-Coaching Call Survey Form and Instruction	Modified
Form Evaluation Focus G Evaluation Focus Group Form and Instruction	Modified
Form Parents Night Out Parents Night Out Materials Download Survey Form and Instruction	Modified
Form STOP State Survey STOP State Survey Form and Instruction	Modified

IC Document Collections

IC ID	Document Title	Status
279391	Parents Night Out Participant Survey Form and Instruction	New	Parents Night Out Participant Survey
279391	Parents Night Out Participant Survey Form and Instruction	New
279390	Parents Night Out Presenter Survey Form and Instruction	New	Parents Night Out Presenter Survey
279390	Parents Night Out Presenter Survey Form and Instruction	New
279389	Campaign Partner Evaluation Focus Group Form and Instruction	New	Campaign Partner Evaluation Focus Group
279389	Campaign Partner Evaluation Focus Group Form and Instruction	New
279388	Parent Evaluation Focus Group Form and Instruction	New	Parent Evaluation Focus Group
279388	Parent Evaluation Focus Group Form and Instruction	New
279387	Talk. They Hear You. Mobile App Parent Survey Form and Instruction	New	Talk.They Hear You Mobile App Parent Survey
279387	Talk. They Hear You. Mobile App Parent Survey Form and Instruction	New
279386	Talk. They Hear You."Mobile App Satisfaction Survey Form and Instruction	New	Talk.They Hear You.Mobile App Satisfaction Survey
279386	Talk. They Hear You."Mobile App Satisfaction Survey Form and Instruction	New
279384	"Talk. They Hear You." Newsletter Survey Form and Instruction	New	“Talk. They Hear You.” Newsletter Survey
279384	"Talk. They Hear You." Newsletter Survey Form and Instruction	New
279383	"Talk. They Hear You." Community Partner License Survey Form and Instruction	New	Talk.TheyHear You.Community Partner License Survey
279383	"Talk. They Hear You." Community Partner License Survey Form and Instruction	New
279382	Talk. They Hear You. Partner Feedback Survey Form and Instruction	New	Talk. They Hear You. Partner Feedback Survey
279382	Talk. They Hear You. Partner Feedback Survey Form and Instruction	New
279381	Talk. They Hear You"® Product Design Request Survey Form and Instruction	New	TalkTheyHearYouProduct Design Request Survey
279381	Talk. They Hear You"® Product Design Request Survey Form and Instruction	New
279380	Pre-Screener Form and Instruction	New	Pre-Screener
279380	Pre-Screener Form and Instruction	New
279379	Screen4Success Screener Form and Instruction	New	Screen4Success Screener
279379	Screen4Success Screener Form and Instruction	New
279378	Parental Informed Consent and Assent Form and Instruction	New	Parental Informed Consent and Assent
279378	Parental Informed Consent and Assent Form and Instruction	New
279375	Participant Consent/Assent Form and Instruction	New	Participant Consent/Assent
279375	Participant Consent/Assent Form and Instruction	New
269308	Policy Academy 6-Month Follow-Up Form and Instruction	Modified	Six month Post Policy Academy Follow-up
269308	Policy Academy 6-Month Follow-Up Form and Instruction	Modified
269307	Policy Academy Follow-Up Form and Instruction	Modified	Post Policy Academy Follow
269307	Policy Academy Follow-Up Form and Instruction	Modified
269306	Policy Academy Baseline Form and Instruction	Modified	Policy Academy Baseline
269306	Policy Academy Baseline Form and Instruction	Modified
269305	Policy Academy Coach Post Coaching Form Form and Instruction	Modified	Policy Academy Coach Post Coaching Survey
269305	Policy Academy Coach Post Coaching Form Form and Instruction	Modified
269303	Policy Academy Participant Post Training Form Form and Instruction	Modified	Participant Post-Training Call Survey
269303	Policy Academy Participant Post Training Form Form and Instruction	Modified
269302	Policy Academy Participant Post Coaching Call Survey Form and Instruction	Modified	Participant Post-Coaching Call Survey
269302	Policy Academy Participant Post Coaching Call Survey Form and Instruction	Modified
269301	Policy Academy Focus Group Form and Instruction	Modified	Evaluation Focus Group
269301	Policy Academy Focus Group Form and Instruction	Modified
269298	Parents Night Out Materials Download Survey Form and Instruction	Modified	Parents Night Out Materials Download Survey
269298	Parents Night Out Materials Download Survey Form and Instruction	Modified
194214	State Survey Form and Instruction	Modified	STOP State Survey
194214	State Survey Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0316	ICR Reference No: 202603-0930-001
Status: Received in OIRA	Previous ICR Reference No: 202407-0930-001
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Programs to Reduce Underage Drinking
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/12/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2027
Responses	7,751	1,132
Time Burden (Hours)	1,896	1,169
Cost Burden (Dollars)	0	0

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Abstract: The purpose of the data collection through the State Survey will be to create a compendium of the States' best practices and performances in enacting, enforcing, and creating laws, regulations, and programs to prevent or reduce underage drinking. Congress mandated the collection of these data to provide policymakers and the public with currently unavailable but much-needed information regarding State underage drinking prevention policies and programs.

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Authorizing Statute(s): US Code: 42 USC 290 Name of Law: Data Collection
  

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:
	90 FR 52982	11/24/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 10099	03/02/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 23

IC Title	Form No.	Form Name
"Talk. They Hear You." Community Partner License Survey	Talk.TheyHear You.Community Partner License Survey	Talk.TheyHear You.Community Partner License Survey
"Talk. They Hear You." Newsletter Survey	“Talk. They Hear You.” Newsletter Survey	“Talk. They Hear You.” Newsletter Survey
Campaign Partner Evaluation Focus Group	Campaign Partner Evaluation Focus Group	Campaign Partner Evaluation Focus Group
Parent Evaluation Focus Group	Parent Evaluation Focus Group	Parent Evaluation Focus Group
Parental Informed Consent and Assent	Parental Informed Consent and Assent	Parental Informed Consent and Assent
Parents Night Out Participant Survey	Parents Night Out Participant Survey	Parents Night Out Participant Survey
Parents Night Out Materials Download Survey	Parents Night Out Materials Download Survey	Parents Night Out Materials Download Survey
Parents Night Out Presenter Survey	Parents Night Out Presenter Survey	Parents Night Out Presenter Survey
Participant Consent/Assent	Participant Consent/Assent	Participant Consent/Assent
Policy Academy 6-Month Follow-Up	Six month Post Policy Academy Follow-up	Six month Post Policy Academy Follow-up
Policy Academy Baseline	Policy Academy Baseline	Policy Academy Baseline
Policy Academy Coach Post Coaching Form	Policy Academy Coach Post Coaching Survey	Policy Academy Coach Post Coaching Survey
Policy Academy Focus Group	Evaluation Focus Group	Evaluation Focus Group
Policy Academy Follow-Up	Post Policy Academy Follow-up	Post Policy Academy Follow
Policy Academy Participant Post Coaching Call Survey	Participant Post-Coaching Call Survey	Participant Post-Coaching Call Survey
Policy Academy Participant Post Training Form	Participant Post-Training Call Survey	Participant Post-Training Call Survey
Pre-Screener	Pre-Screener	Pre-Screener
Screen4Success Screener	Screen4Success Screener	Screen4Success Screener
State Survey	STOP State Survey	STOP State Survey
Talk. They Hear You"® Product Design Request Survey	TalkTheyHearYouProduct Design Request Survey	TalkTheyHearYouProduct Design Request Survey
Talk. They Hear You. Mobile App Parent Survey	Talk.They Hear You Mobile App Parent Survey	Talk.They Hear You Mobile App Parent Survey
Talk. They Hear You. Partner Feedback Survey	Talk. They Hear You. Partner Feedback Survey	Talk. They Hear You. Partner Feedback Survey
Talk. They Hear You."Mobile App Satisfaction Survey	Talk.They Hear You.Mobile App Satisfaction Survey	Talk.They Hear You.Mobile App Satisfaction Survey

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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	7,751	1,132	0	6,619	0	0
Annual Time Burden (Hours)	1,896	1,169	0	727	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden estimates provided in this section include substantial changes from the previous package given the additional data collection activities proposed under this revision. The burden change for the previously included data collection activity, the State Survey, is minimal—a change of less than one hour per survey participant for a total of fewer than 41 additional burden hours added.

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Annual Cost to Federal Government: $582,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 03/12/2026

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