OMB control number

Pilot Implementation of the Violence Against Children and Youth Survey (VACS) in the US

OMB 0920-1356 · HHS/CDC.

OMB 0920-1356

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-22HW Youth ages 13-24 in Baltimore City or Garrett County, Maryland (Pre-test 2, rural feasibility pilot, full implementation pilot) Youth Respondent Questionnaire Form and Instruction
Youth ages 13-24 in Baltimore City or Garrett County, Maryland (Pre-test 2, rural feasibility pilot, full implementation pilot) Youth Respondent Consent/Assent Form and Instruction
Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Head of Household Questionnaire Form and Instruction
Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Head of Houehold Consent Form and Instruction
Form 0920-22HW Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Screener Questionnaire Form and Instruction
Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Invitation Letter Form
Pre-Test 1 (Youth ages 13-24) Cognitive Interview Protocol Form and Instruction
Pre-Test 1 (Youth ages 13-24) Cognitive interviewing consent/assent Form and Instruction
Pre-Test 1 (Parents of youth ages 13-17) Informed Parental Consent Form and Instruction
Pre-Test 1 (Parents of youth ages 13-17) Cognitive Interview Screening Form and Instruction
Pre-Test 1 (Parents of youth ages 13-17) Cognitive interview response to flyer/ telephone inquiry Form and Instruction
Pre-Test 1 - (Youth Ages 18-24) - Cognitive interview screening Form and Instruction
Pre-Test 1 - (Youth Ages 18-24) - Cognitive interview response to flyer/ telephone inquiry Form and Instruction
Attachment X_Cognitive Interview Report Final.docx Supplementary Document
OMB_Change_Request_DVACS_Pilot_7 22 22.docx Justification for No Material/Nonsubstantive Change
Attachment K_Screenshots.pdf Supplementary Document
Attachment P_VACS Adaptation Expert Consultation Report_July 2017.pdf Supplementary Document
Attachment O_Colombia 2017_VACS Cognitive Lab Report.pdf Supplementary Document
Attachment N_Malawi 2013 NCHS_VACS Cognitive Lab Report.pdf Supplementary Document
Attachment M_Philippines 2012 NCHS_VACS Cognitive Lab Report.pdf Supplementary Document
Attachment L_Response Plan Distress Protocol_US VACS Adaptation.docx Supplementary Document
AttachmentG_IRB Approval.pdf Supplementary Document
AttachmentC_Privacy Impact Assessment (PIA).pdf Supplementary Document
AttachmentB_ 60 Dy FRN VACS.pdf Supplementary Document
AttachmentA_ Authorizing Legislation.docx Supplementary Document
SSB__VACS_FINAL_v2.docx Supporting Statement B
SSA__VACS_FINAL_v2.docx Supporting Statement A
Youth ages 13-24 in Baltimore City or Garrett County, Maryland (Pre-test 2, rural feasibility pilot, full implementation pilot) Youth Respondent Questionnaire Form and Instruction
Youth ages 13-24 in Baltimore City or Garrett County, Maryland (Pre-test 2, rural feasibility pilot, full implementation pilot) Youth Respondent Consent/Assent Form and Instruction
Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Head of Household Questionnaire Form and Instruction
Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Head of Houehold Consent Form and Instruction
Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Screener Questionnaire Form and Instruction
Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Invitation Letter Form
Pre-Test 1 (Youth ages 13-24) Cognitive Interview Protocol Form and Instruction
Pre-Test 1 (Youth ages 13-24) Cognitive interviewing consent/assent Form and Instruction
Pre-Test 1 (Parents of youth ages 13-17) Informed Parental Consent Form and Instruction
Pre-Test 1 (Parents of youth ages 13-17) Cognitive Interview Screening Form and Instruction
Pre-Test 1 (Parents of youth ages 13-17) Cognitive interview response to flyer/ telephone inquiry Form and Instruction
Pre-Test 1 - (Youth Ages 18-24) - Cognitive interview screening Form and Instruction
Pre-Test 1 - (Youth Ages 18-24) - Cognitive interview response to flyer/ telephone inquiry Form and Instruction

All Historical Document Collections

202208-0920-008 Withdrawn and continue	No material or nonsubstantive change to a currently approved collection	2022-08-11
202012-0920-010 Approved with change	New collection (Request for a new OMB Control Number)	2021-01-11