EVALUATION OF THE HEALTH DIARY HANDBOOK

Forms and Documents

Document	Type	Status	Availability

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Collection	Type	Status	Form
110408	EVALUATION OF THE HEALTH DIARY HANDBOOK		Migrated

ICR Details

OMB Control No: 0915-0175	ICR Reference No: 199405-0915-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: EVALUATION OF THE HEALTH DIARY HANDBOOK
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/10/1994
	Date Received in OIRA: 05/16/1994
Terms of Clearance: Approved for use through 12/94 with the understanding that the title of each of the instruments will be amended to clarify that this effort is a "Health Diary Case Study Evaluation" not a generalizable "Health Diary Evaluation." In addition, any summary reports should explain that this study is primarily a case study model and that it provides descriptive data that cannot be generalized to a broader population or even a particular sub group. OMB believes that this clarification is important because of several considerations. First, the six sites for this study were not selected to be representative, but are participati because they volunteered, possibly introducing bias. Second, many of the instruments include questions regarding administrator and staff perceptions (e.g. questions 40 and 41 in the Project Director Intervie Guide and questions 42 and 43 in the Staff Interview Guide.) OMB believes that because these merely are impressions of client character istic differences and are not empirically-based, it is critical that this data is not published and only used for HRSA's internal purposes. Third, the District of Columbia pilot revealed significant problems wi client non-response. If this problem persists with the full case stud bias further may diminish this study's potential to be generalized to the Healthy Start population.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1994	12/31/1994
Responses	348	0	0
Time Burden (Hours)	276	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: THE HEALTH DIARY, A MATERNAL AND CHILD HEALTH HANDBOOK, WAS DESIGNED TO CONTRIBUTE TO INFANT MORTALITY REDUCTION EFFORTS BY ENCOURAGING WOMEN TO BECOME MORE INVOLVED IN THEIR PREGNANCIES AND IN CARING FOR THEIR INFANTS. TO EVALUATE THE HEALTH DIARY, INFORMATION WILL BE COLLECTED FROM EXECUTIVE DIRECTORS, STAFF, PROVIDERS, AND CLIENTS AT SIX HEALTHY START SITES.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
EVALUATION OF THE HEALTH DIARY HANDBOOK

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ICR Summary of Burden

	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	348	0	0	348	0	0
Annual Time Burden (Hours)	276	0	0	276	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/16/1994

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