# Agency Information Collection Activities: Submission for OMB Review; Comment Request
Periodically, the Substance Abuse and Mental Health Services Administration (SAMHSA) will publish a summary of information collection requests under OMB review, in compliance with the Paperwork Reduction Act (44 U.S.C. Chapter 35). To request a copy of these documents, call the SAMHSA Reports Clearance Officer on (301) 443-7978.
National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program, Phase Two—(OMB No. 0930-0192, Revision)—SAMHSA's Center for Mental Health Services (CMHS) is conducting Phase II of this national evaluation project. Phase II collects data on child mental health outcomes, family life, and service system development and performance. Child and family outcomes of interest include the following: child symptomatology and functioning, family functioning and material resources, and caregiver strain. Delivery system variables of interest include the following: system of care development, adherence to system of care principles, coordination and linkages among agencies, and congruence between services planned versus those received.
To address the research questions in the national evaluation, a longitudinal quasi-experimental design is being used that includes data collection in all grantee sites and comparison sites (where services are delivered in a more traditional manner). This multi-level evaluation is comprised of several major components. Data collection methods include interviews with caregivers and youth, site visits, case record reviews, service diaries, and provider surveys.
Data collection for this evaluation will be conducted over a six-year period. The length of time that families will participate in the study ranges from 18 to 36 months depending on when they enter the evaluation. The average annual respondent burden is estimated below; this represents an annual average burden reduction of 6,237 hours from the level currently approved by the Office of Management and Budget.
This revision to the currently approved data collection activities involves: (1) Reducing the number of sites where data collection will occur from 27 to 25, (2) extending the time frame for data collection by an additional 18 months, (3) adding a treatment effectiveness study in two sites including assessment of outcomes, treatment fidelity, and interaction of the treatment with the larger system of care, (4) adding a survey of clinicians/practitioners on their use of evidence-based treatments, and (5) adding a study of how systems of care are sustained after program funding ends.
| Instrument | Respondent | Number of respondents | Average number of total responses/respondent | Hours per response | Total burden hours | Annual |
| --- | --- | --- | --- | --- | --- | --- |
| System-level Assessment: | | | | | | |
| Interview Guides and Data Collection Forms—Round One Sites | Key site informants | 325 | 5 | 1.000 | 1,625 | 250 |
| Interview Guides and Data Collection Forms—Round Two Sites | Key site informants | 350 | 4 | 1.000 | 1,400 | 215 |
| Services and Costs Study: | | | | | | |
| No respondent burden is associated with this study | na | na | na | na | na | na |
| Cross-sectional Descriptive Study: | | | | | | |
| Descriptive Interview Questionnaire (DIQ) | Caregiver | 5,550 | 6 | 0.166 | 5,528 | 850 |
| Child and Family Outcome Study: | | | | | | |
| Restrictiveness of Living Environment and Placement Stability Scale (ROLES) | Caregiver | 5,550 | 6 | 0.083 | 2,764 | 425 |
| Child and Adolescent Functional Assessment Scale (CAFAS)—subscales or Preschool and Early Childhood Functional Assessment Scale (PECFAS) | Caregiver | 5550 | 6 | 0.333 | 11,089 | 1,706 |
| Education Questionnaire (EQ)—formerly one of the CAFAS subscales | Caregiver | 5,550 | 6 | 0.166 | 5,528 | 850 |
| Behavioral and Emotional Rating Scale (BERS) | Caregiver | 5,550 | 6 | 0.166 | 5,528 | 850 |
| Child Behavior Checklist (CBCL) or CBCL Ages 2-3 | Caregiver | 5,550 | 6 | 0.333 | 11,089 | 1,706 |
| Family Assessment Device (FAD) | Caregiver | 5,550 | 6 | 0.166 | 5,528 | 850 |
| Family Resource Scale (FRS) | Caregiver | 5,550 | 6 | 0.166 | 5,528 | 850 |
| Caregiver Strain Questionnaire (CGSQ) | Caregiver | 5,550 | 6 | 0.166 | 5,528 | 850 |
| Delinquency Survey (formerly one of CAFAS subscales) | Youth | 3,330 | 6 | 0.083 | 1,658 | 255 |
| Substance Abuse Survey A and B (formerly one of CAFAS subscales) | Youth | 3,330 | 6 | 0.166 | 3,317 | 510 |
| Youth Self-Report (YSR) | Youth | 3,330 | 6 | 0.333 | 6,653 | 1,024 |
| Family Assessment Device (FAD) | Youth | 3,330 | 6 | 0.166 | 3,317 | 510 |
| Intervention-level Assessment: | | | | | | |
| Family Satisfaction Questionnaire—Abbreviated (FSQ-A) | Caregiver | 5,550 | 4 | 0.116 | 2,575 | 396 |
| Multi-sector Service Contacts (MSSC) | Caregiver | 5,550 | 4 | 0.250 | 5,550 | 854 |
| Service Experience Questionnaire (SEQ) | Caregiver | 1,012 | 4 | 0.333 | 1,348 | 207 |
| Experience with Service System Questionnaire (ESSQ) | Caregiver | 1,012 | 4 | 0.250 | 1,012 | 156 |
| Service and Support Diary and Interview | Caregiver | 200 | 9 | 0.500 | 900 | 138 |
| Youth Satisfaction Questionnaire—Abbreviated (YSQ-A) | Youth | 3,330 | 4 | 0.083 | 1,106 | 170 |
| Service Experience Questionnaire (SEQ) | Youth | 607 | 4 | 0.250 | 607 | 93 |
| Provider Service Log and Interview | Provider | 200 | 9 | 0.500 | 900 | 138 |
| Provider Attitudes and Practices Survey (PAPS) | Provider | 480 | 2 | 0.166 | 159 | 25 |
| Treatment Effectiveness Study: | | | | | | |
| Diagnostic Interview Schedule for Children | Caregiver | 300 | 1 | 0.500 | 150 | 23 |
| DSM-IV Structured Interview for Disruptive Behavior Disorders | Caregiver | 300 | 4 | 0.166 | 199 | 31 |
| Eyberg Child Behavior Inventory (ECBI) | Caregiver | 200 | 4 | 0.166 | 133 | 20 |
| Dyadic Parent-Child Ineteraction Coding System II (DPICS-II) | Caregiver | 200 | 2 | 0.250 | 100 | 15 |
| Dyadic Parent-Child Interaction Coding System II (DPICS-II) | Child | 200 | 2 | 0.250 | 100 | 15 |
| Sutter-Eyberg Student Behavior Inventory-Revised (SESBI-R) | Teacher | 200 | 4 | 0.166 | 133 | 20 |
| PCIT Caregiver Integrity Checklist | Caregiver | 100 | 12 | 0.050 | 60 | 9 |
| PCIT Therapist Integrity Checklist | Clinician | 100 | 12 | 0.050 | 60 | 9 |
| Caregiver Session Review Form | Caregiver | 200 | 12 | 0.033 | 79 | 12 |
| Therapist Session Review Form | Clinician | 200 | 12 | 0.033 | 79 | 12 |
| Therapy Procedures Checklist (TPC) | Caregiver | 200 | 1 | 0.083 | 17 | 3 |
| Therapy Procedures Checklist (TPC) | Clinician | 200 | 1 | 0.166 | 33 | 5 |
| System of Care Practice Review (SOCPR) | Caregiver | 60 | 1 | 1.000 | 60 | 9 |
| System of Care Practice Review (SOCPR) | Child | 60 | 1 | 0.750 | 45 | 7 |
| System of Care Practice Review (SOCPR) | Clinician | 60 | 1 | 1.000 | 60 | 9 |
| System of Care Practice Review (SOCPR) | Informal Helper | 60 | 1 | 0.250 | 15 | 2 |
| Evidence-based Treatment Survey: | | | | | | |
| Evidence-based Treatment Survey | Clinicians | 1,000 | 1 | 0.250 | 250 | 38 |
| Sustainability Survey: | | | | | | |
| Sustainability Survey (Web survey) | Local Site Informants | 204 | 1 | 0.750 | 153 | 23 |
| Sustainability telephone follow-up interview | Local site and State-level Informants | 153 | 1 | 1.000 | 153 | 24 |
| Total | | | | | 92,116 | 14,164 |
Written comments and recommendations concerning the proposed information collection should be sent within 30 days of this notice to: Allison Herron Eydt, Human Resources and Housing Branch, Office of Management and Budget, New Executive Office Building, Room 10235, Washington, DC 20503.
Dated: October 23, 2002.
Richard Kopanda,
Executive Officer, SAMHSA.