OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

The National Intimate Partner and Sexual Violence Survey (NISVS)

ICR 201305-0920-005 · OMB 0920-0822 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
National Intimate Partner and Sexual Violence Survey - Screener Form Modified Repair queued
National Intimate Partner and Sexual Violence Survey Form Modified Repair queued
Supporting Statement B - 2-27-2013.docx Supporting Statement B Uploaded 2013-05-01 Available
Attachment J - NISVS Questionnaire Changes.docx Supplementary Document Uploaded 2013-05-01 Repair queued
Attachment I - Advance Letter of Introduction_v3.doc Supplementary Document Uploaded 2013-05-01 Repair queued
Attachment H - RTI Confidentiality Agreement.doc Supplementary Document Uploaded 2013-05-01 Available
Attachment E - Interagency Agreement.pdf Supplementary Document Uploaded 2013-05-01 Repair queued
Attachment D - Outside Consultation.pdf Supplementary Document Uploaded 2013-05-01 Available
Attachment C - Public Comment.docx Supplementary Document Uploaded 2013-05-01 Available
Attachment B - Published 60-Day Notice.pdf Supplementary Document Uploaded 2013-05-01 Repair queued
Attachment F - Local IRB Approval.pdf Supplementary Document Uploaded 2013-05-01 Available
Attachment A - Authorizing Legislation.docx Supplementary Document Uploaded 2013-05-01 Available
Attachment I - Advance Letter of Introduction_v3.doc Supplementary Document Uploaded 2013-05-01 Available
Supporting Statement A - 5-1-2013.doc Supporting Statement A Uploaded 2013-05-01 Available
IC Document Collections
IC IDCollectionTypeStatusForm
189767 National Intimate Partner and Sexual Violence Survey - Screener Form Modified
189766 National Intimate Partner and Sexual Violence Survey Form Modified
ICR Details
0920-0822 201305-0920-005
Historical Active 201209-0920-002
HHS/CDC 19428
The National Intimate Partner and Sexual Violence Survey (NISVS)
Revision of a currently approved collection   No
Regular
Approved without change 06/10/2013
Retrieve Notice of Action (NOA) 05/10/2013
Approved for one year for the pilot test of the revised intstruments. Any changes made as a result of the pilot phase will be described in a revision request to continue the collection beyond the pilot phase. Also, previous terms of clearance continue: The agency acknowledges that the estimates derived from this study are likely to be, in some measure, an under estimate of the true prevalence and should be interpreted as such.
  Inventory as of this Action Requested Previously Approved
06/30/2014 36 Months From Approved 11/30/2013
54,096 0 88,318
6,078 0 9,916
0 0 0
The National Intimate Partner and Sexual Violence Survey is an ongoing, nationally representative survey to assess experiences of intimate partner violence, sexual violence and stalking among adults in the US. It measures lifetime victimization for these types of violence as well as in the previous 12 months.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  77 FR 75165 12/19/2012
78 FR 26032 05/03/2013
Yes
  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 54,096 88,318 0 -34,222 0 0
Annual Time Burden (Hours) 6,078 9,916 0 -3,838 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
There is a decrease in burden due to the decrease in the number of respondents for the year of pilot testing. The changes to the instrument are twofold: first, the current NISVS survey instrument has been shortened in efforts to reduce the burden on respondents and to develop a core instrument that will be administered on an annual basis. Second, topic specific modules contain questions to produce data that are needed on a regular basis but are not needed annually.
$2,552,004
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]
  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.
05/10/2013