Memorandum
Date:
To: Karen Matsuoka, OMB Desk Officer, Food and Nutrition Service
Through: Dawn Wolfgang, Food and Nutrition Service, Information Clearance
Officer
From: Steven Carlson, Director,
Office of Research, Nutrition, and Analysis (ORNA)
Judy Wilson, Staff Director, Nutrition Services Staff, ORNA
Food and Nutrition Service
Re: Under Approved Generic OMB Clearance No. 0584-0524
Request Approval to Perform Formative Research –
User Response, Feedback, and Request Forms
______________________________________________________________________________
The Food and Nutrition Service (FNS) of the USDA Food, Nutrition and Consumer Services is requesting approval for formative research under Approved Generic OMB Clearance No. 0584-0524.
The following information is provided for your review:
Title of Project: User Response, Feedback, and Request Forms
Control Number: 0584-0524
Public affected by this Project:
FNS Program stakeholders who consist of State and local agency program staff such as nutrition education providers and administrators that work with FNS nutrition assistance programs.
FNS Program audiences which consist of program participants and potential eligible persons.
Number of respondents:
Instrument |
Respondents |
|
250 |
|
250 |
|
250 |
|
200 |
|
700 |
|
350 |
|
100 |
|
100 |
|
250 |
|
250 |
Total Surveys = 10 |
Total Respondents = 2,700 |
5. Time needed per Response: The total response burden for each form will be 10 minutes (.167 hours).
6. Total Burden Hours on Public: .167 hours x 2,500 respondents = 450 total hours
Project Purpose, Methodology and Design:
Background
The U.S. Department of Agriculture, Food and Nutrition Services (USDA, FNS) continues to meet its organizational strategic goal of developing science-based nutrition education efforts to promote healthier eating habits and lifestyles through several nutrition education initiatives. FNS strives to strengthen nutrition education delivery through its nutrition assistance programs by collecting feedback from program providers, stakeholders and program participants. FNS has a need to collect information about how stakeholders use various nutrition education initiatives and to obtain feedback on these activities and resource. FNS use this information to improve these initiatives, to better meet the needs of both partners and consumers and to inform guidance and training decisions.
FNS has developed tools that will allow providers, stakeholders and program participants to voluntarily share their perceptions of FNS nutrition education efforts, to request use of education resources and to partner with the agency in implementing these initiatives. Each form includes brief questions that ask the user to: provide feedback on the products, describe how they have or intend to use them, request use of products and share information on their experience in using them. FNS will review the information provided to identify common themes in feedback provided, assess needs of users and use this information to guide future efforts. The nutrition education initiatives are described below.
Eat Smart. Play Hard. TM Campaign promotes healthy nutrition and physical activity behaviors based on the Dietary Guidelines for Americans and MyPyramid guidance. Campaign resources include print materials, public service announcements, lesson plans and related support materials, web pages, and a spokescharacter, Power Panther. The primary target audience is children 8-10 years of age and their low-income caregivers (parents or other adults). Eat Smart. Play Hard.™ offers a variety of materials for professionals, parents and children. State and local program may borrow the Power Panther costume from FNS and request materials to support and to add excitement educational activities for both kids and their parents.
Take Action: Make a Difference! is a web-based resource designed to encourage FNS program participants and staff to take actions to improve their health by making positive changes in key dietary and related behaviors. The resources are intended to help communities encourage healthy behaviors by providing practical tips and strategies. Current topics offer information about how FNS staff can encourage co-workers and FNS program participants to breastfeed and increase fruit and vegetable consumption.
Loving Your Family, Feeding Their Future is a publication designed for low-income mothers participating in the Food Stamp Program. The materials convey the messages in the 2005 Dietary Guidelines for Americans (DGA) and MyPyramid in a format that is easily understood by low-literacy and non-English speaking groups. Loving Your Family resources include a guidebook, brochures and handouts for participants prepared in both English and Spanish.
Eat Smart, Live Strong: Nutrition Education for Older Adults is an intervention designed to improve fruit and vegetable consumption and physical activity among 60-74 year olds participating in or eligible for FNS nutrition assistance programs. The intervention is based on the 2005 Dietary Guidelines for Americans (DGA) and MyPyramid as well as a review of promising practices shown to be effective in achieving behavior change among the target audience. Components of the Eat Smart, Live Strong Activity Kit includes a leader’s guide, four session and participant handouts.
Purpose
The purpose of this data collection is to obtain information from users about their perceptions of the nutrition education products, allow user to request products available and to gather information about how these products are used. The information will be submitted voluntarily by users. The information obtained from will be analyzed to identify common themes reported by users and assessed to identify ways to improve the materials to better meet the needs of target populations.
FNS has developed product specific forms that may be completed at the discretion of the user. All forms will be posted to a FNS Public web site. Those interested in submitting feedback will voluntarily fill out the forms and email or fax them to a designated email address or fax number. FNS will periodically review the information submitted and assess responses at least once per year. Feedback and information will be summarized and shared with relevant FNS staff to guide decision making and to improve materials and initiatives when they are updated as well as any new activities. Information collection instruments include:
Eat Smart. Play Hard. feedback forms for the educators, caregivers and kids websites; a partners commitment form, a costume request and agreement form, and a Power Panther event feedback form.
Take Action - Breastfeeding Feedback Form and Promote Fruits and Vegetables In Your Workplace and Community Feedback Form
Loving Your Family, Feeding Their Future User Response Card
Eat Smart, Live Strong User Response Form
Respondents
The respondents will include all users willing to complete the forms and submit them electronically to a designated FNS email address. The respondents will include FNS program stakeholders such as providers and educators as well as program participants. However, since the information is available to anyone who visits the websites or reviews the materials and products, others may also choose to submit responses.
Data Collection
Forms will be accessible to the public on the FNS web sites. Respondents will voluntarily complete the forms and submit them to FNS at their discretion. To minimize burden for stakeholders, FNS plans to post the forms on the Web and allow users to email their responses. This move toward the electronic sharing of feedback and request forms is consistent with methods employed by other Federal agencies. No compensation will be provided to users for voluntarily sharing their feedback.
Specific forms will be available for each initiative. These forms will be available as long as the materials and products are available. As a result, FNS requests an exemption from displaying the expiration date on the forms listed in the Attachments. This will allow users to continuously share their feedback and suggestions about nutrition education materials and products and help FNS to continue to improve products.
Users can also choose to print the form and submit it by fax. To ensure privacy, the respondent’s personal information such as name, address, telephone or email address will be used for administrative purposes only, such as clarifying responses, confirming requests for materials or maintaining partnership information.
Burden Estimate
FNS estimates that the response burden for these forms will be an average of ten minutes per respondent. Thus, the total response burden will be 10 minutes (.167 hours) x 2,700 respondents (see estimated number of annual respondent in question 4), which equals 450 total hours. The information collection will involve no startup or operational costs. Each of the web-based forms will display the OMB Burden Statement.
Outcome
The information obtained from the forms will be used to inform decision makers and assist them in identifying ways to improve materials to increase functionality and usefulness of education websites and products. Staff persons in the Office of Research, Nutrition and Analysis will be responsible for the data collection.
Federal Costs: $0.00
Requested Approval Date: January 15, 2008.
Attachments:
Attachment 1: |
Eat Smart. Play Hard.™ Educators’ Web Site User Response Form |
Attachment 2: |
Eat Smart. Play Hard.™ Healthy Lifestyle Web Site User Response Form |
Attachment 3: |
Eat Smart. Play Hard.™ Kids’ Web Site User Response Form |
Attachment 4 |
Partner Commitment Form |
Attachment 5: |
Eat Smart. Play Hard.™ Power Panther Costume Request and Agreement Form |
Attachment 6: |
Power Panther Event Feedback Form |
Attachment 7: |
Take Action: Promote and Support Breastfeeding Feedback Form |
Attachment 8: |
Take Action: Promote Fruits and Vegetables In Your Workplace and Community Feedback Form |
Attachment 9: |
Loving Your Family, Feeding Their Future User Response Card |
Attachment 10: |
Eat Smart, Live Strong User Response Form |
Attachment 11: |
OMB Burden Statement |
Contact Information
Questions regarding this data collection request can be directed to Donna Johnson-Bailey at 703-305-2975.
| File Type | application/msword |
| File Title | Nutrition Education Feedback Form |
| Author | Dbailey |
| Last Modified By | Administrator |
| File Modified | 2007-12-20 |
| File Created | 2007-12-20 |