Information Collection Request

Understanding Relationship Dynamics and Conflict Survey--Formative Study

ICR 201703-0920-015 · OMB 0920-1206 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Survey - Incarcerated Respondents Form New Repair queued
Survey - MT Respondents Form New Repair queued
Screener Form New Repair queued
OMB Table 10.25.17.docx Supplementary Document Uploaded 2017-11-08 Available
OMB BJS question responses 10.25.17.docx Supplementary Document Uploaded 2017-11-08 Available
Attachment I - authorization from OHRP DHHS.pdf Supplementary Document Uploaded 2017-11-08 Available
Attachment H NCIPC Research Determination Form.pdf Supplementary Document Uploaded 2017-03-29 Available
Attachment G - PIA for SRG.pdf Supplementary Document Uploaded 2017-03-29 Available
Attachment F Consent Forms_072616.docx Supplementary Document Uploaded 2017-03-29 Repair queued
Attachment C2 - IRB Approval of Changes to Protocol.pdf Supplementary Document Uploaded 2017-03-29 Available
Attachment C1 - IRB Approval .pdf Supplementary Document Uploaded 2017-03-29 Available
Attachment C - IRB Application Full Protocol.doc Supplementary Document Uploaded 2017-03-29 Available
Attachment B2 Responses to Public Comment.pdf Supplementary Document Uploaded 2017-03-29 Available
Attachment B1 Public Comment.pdf Supplementary Document Uploaded 2017-03-29 Repair queued
Attachment B - 60 Day FRN.pdf Supplementary Document Uploaded 2017-03-29 Available
Attachment A-Authorizing Legislation.doc Supplementary Document Uploaded 2017-03-29 Available
SSB_17FB_11.8.17.docx Supporting Statement B Uploaded 2017-11-08 Available
SSA_17FB_11.8.17.docx Supporting Statement A Uploaded 2017-11-08 Available
IC Document Collections
IC IDCollectionTypeStatusForm
226225 Survey - Incarcerated Respondents Form New
226224 Survey - MT Respondents Form New
226223 Screener Form New
ICR Details
0920-1206 201703-0920-015
Historical Active
HHS/CDC 17FB
Understanding Relationship Dynamics and Conflict Survey--Formative Study
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 11/17/2017
Retrieve Notice of Action (NOA) 04/20/2017
Approved consistent with the understanding that HHS/CDC will consult with the HHS or CDC Privacy Program/Office and clarify the applicability of its privacy responsibilities, described in OMB circular A-130 and 5 USC §552a(e)(3), to this information collection. CDC will document the reasons it has determined that a Privacy Act system records notice, Privacy Act statement, and privacy impact assessment are or are not required, and submit such documentation as deemed necessary to OMB as a change request within 6 months of the date of approval for the current ICR.
  Inventory as of this Action Requested Previously Approved
11/30/2019 24 Months From Approved
5,405 0 0
1,322 0 0
0 0 0

This is an exploratory study to gather data from a diverse and targeted convenience sample to better understand factors or groups of factors that may influence violence perpetration that occurs within adult intimate partner relationships. The study is the first component of a larger research agenda that will and is intended to inform the next phase identifying latent classes of intimate partner violence (IPV) perpetrators. For this exploratory study, the focus is gathering extensive data from the diverse convenience sample across multiple domains (e.g., attitudes, perceptions, personal experiences, victimization, etc.) identified by IPV experts and the peer reviewed literature as correlating to IPV perpetration. The information collected in this study is not intended to be generalizable to the population. Rather, these data are intended to inform future research with additional populations and more rigorous sampling strategies.

US Code: 42 USC 241 Name of Law: PHSA
  
None

Not associated with rulemaking

  81 FR 87037 12/02/2016
82 FR 18649 04/20/2017
Yes

3
IC Title Form No. Form Name
Screener none Screener
Survey - MT Respondents none Survey
Survey - Incarcerated Respondents none Survey

  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 5,405 0 0 5,405 0 0
Annual Time Burden (Hours) 1,322 0 0 1,322 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.

$110,420
Yes Part B of Supporting Statement
    Yes
    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.
04/20/2017