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Federal forms, ICRs, and supporting documents

Information Collection Request

Measuring Preferences for Quality of Life for Child Maltreatment

ICR 201204-0920-001 · OMB 0920-0930 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form Attachment D Measuring Preferences for Quality of Life for Child Maltreatment Survey Instrument: Ages 18+ Form and Instruction New Available
Form Attachment D Measuring Preferences for Quality of Life for Child Maltreatment Survey Instrument: Ages 18-29 Form and Instruction New Repair queued
Attachment I - Pretest Report.docx Supplementary Document Uploaded 2012-04-23 Available
SSB - Clean 3-29-2012.docx Supporting Statement B Uploaded 2012-04-03 Available
Attachment G - IRB Renewal 2012.pdf Supplementary Document Uploaded 2012-04-03 Available
Attachment F_IRB-Consent-Form.docx Supplementary Document Uploaded 2012-04-03 Available
Attachment C_Survey-Invitation.docx Supplementary Document Uploaded 2012-04-03 Available
Attachment E_Survey-Instrument.docx Supplementary Document Uploaded 2012-04-03 Available
Attachment E_Survey-Instrument.docx Supplementary Document Uploaded 2012-04-03 Repair queued
SSA - Clean 3-29-2012.docx Supporting Statement A Uploaded 2012-04-03 Available
IC Document Collections
IC IDCollectionTypeStatusForm
201913 Measuring Preferences for Quality of Life for Child Maltreatment Survey Instrument: Ages 18+ Form and Instruction New
201912 Measuring Preferences for Quality of Life for Child Maltreatment Survey Instrument: Ages 18-29 Form and Instruction New
ICR Details
0920-0930 201204-0920-001
Historical Active
HHS/CDC
Measuring Preferences for Quality of Life for Child Maltreatment
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 04/23/2012
Retrieve Notice of Action (NOA) 04/11/2012
  Inventory as of this Action Requested Previously Approved
04/30/2014 24 Months From Approved
1,850 0 0
771 0 0
0 0 0
The US Department of Health and Human Services, among many others, has identified child maltreatment as a serious U.S. public health problem with substantial long-term physical and psychological consequences. Despite considerable qualitative research on the consequences of CM in adults, few studies have utilized standardized HRQOL techniques and none have quantified childhood HRQOL impacts. This gap in the literature means the full burden of CM on HRQOL has not been measured, inhibiting the evaluation of CM intervention programs and comparisons to other public health issues. This exploratory research study will improve public health knowledge and economic evaluation of the HRQOL impacts of CM, including effects specific to juvenile and adolescent victims, through the development and fielding a preference-based survey instrument. CDC has developed an exploratory survey instrument to quantify the HRQOL impacts of child maltreatment following standardized HRQOL methods. The survey was developed based on findings from a literature review of CM outcomes, focus groups with adults who were CM victims, and expert review of outcomes by clinician consultants who work with children and/or adults who were victims of CM, or who are researchers in the field of CM. The survey is designed to quantify two types of data. The main objective is the HRQOL decrement attributable to CM, measured as the difference in HRQOL scores by CM victimization history. A secondary objective is a statistical evaluation of these decrements, based on respondent preferences over a series of comparisons that will be shown to survey respondents.
US Code: 42 USC 241 Name of Law: General Powers and Duties of Public Health Service
  
None
Not associated with rulemaking
  75 FR 67092 11/01/2010
76 FR 60497 09/29/2011
No
  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 1,850 0 0 1,850 0 0
Annual Time Burden (Hours) 771 0 0 771 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a NEW ICR being resubmitted because OMB requested revisions.
$182,189
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Petunia Gissendaner 4046390164
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/11/2012