Itemized Burden Estimate

Itemized Burden Estimate Tables

(Revised for data collection dates only)

Table 1. Estimated hour burden and annual cost for pilot respondents—Year 1

Data Collection Activity	Year 1 (January 2009 - December 2009)
	Type of Respondent	Number of Respondents	Responses Per Respondent	Hours Per Response	Annual Hour Burden	Hourly Wage Rate	Annual Respondent Cost
Screening Activities
Household Enumeration	HH reporters	76,911	1	0.08	6,153	$12	$73,836
Pregnancy Screening	Age-Eligible Women	45,316	1	0.08	3,625	$12	$43,500
Neighbor Report	Neighbors	7,691	1	0.05	385	$12	$4,620
Preconception Activities
P1 Visit	High Prob. Women	380	1	3	1,140	$12	$13,680
P1 SAQs and Self-Collections	High Prob. Women	380	1	1	380	$12	$4,560
P1 Pickup Visit	High Prob. Women	380	1	0.5	190	$12	$2,280
High Probability Phone Calls	High Prob. Women	8,194	2 (avg.)	0.08	1,311	$12	$15,732
Moderate Prob. Phone Calls	High Prob. Women	5,500	3	0.08	1,320	$12	$15,840
Low Probability Phone Calls	High Prob. Women	3,578	1	0.08	286	$12	$3,432
Pregnancy Activities
T1 Visit	Pregnant Women	954	1	3	2,862	$12	$34,344
T1 Visit	Father	954	1	1	954	$12	$11,448
T1 SAQs & Self-Collections	Pregnant Women	954	1	1	954	$12	$11,448
T1 Pickup Visit	Pregnant Women	954	1	0.5	477	$12	$5,724
1st Trimester Ultrasound (if needed)	Pregnant Women	477	1	1.5	716	$12	$8,592
16-17 wk Phone Call	Pregnant Women	961	1	0.5	481	$12	$5,772

Table 1. Estimated hour burden and annual cost for pilot respondents—Year 1 (cont’d)

Data Collection Activity	Year 1 (January 2009 - December 2009) - cont'd
	Type of Respondent	Number of Respondents	Responses Per Respondent	Hours Per Response	Annual Hour Burden	Hourly Wage Rate	Annual Respondent Cost
T2 Ultrasound	Pregnant Women	883	1	1.5	1,324	$12	$15,888
T3 Visit	Pregnant Women	443	1	3	1,329	$12	$15,948
T3 SAQs and Self-Collections	Pregnant Women	443	1	1	443	$12	$5,316
T3 Pickup Visit	Pregnant Women	443	1	0.5	221	$12	$2,652
36 wk Phone Call	Pregnant Women	242	1	0.5	121	$12	$1,452
Birth-Related Activities
B1 Visit	Mother/Baby	254	1	0.75	190	$12	$2,280
B2 Visit	Mother/Baby	203	1	0.75	152	$12	$1,824
B2 SAQs	Breastfeeding Mother/Baby	203	1	0.75	152	$12	$1,824
Post-Natal Activities
1 mo. Visit	Mother/Baby	51	1	0.75	38	$12	$456
1 mo. SAQs	Mother/Baby	51	1	0.5	26	$12	$312
3 mo. Phone Call	Mother	40	1	0.5	20	$12	$240
6 mo. Visit	Mother/Baby	40	1	3	120	$12	$1,440
6 mo. SAQs	Mother	40	1	1	40	$12	$480
6 mo. SAQs	Father or partner	40	1	1	40	$12	$480
6 mo. Pickup Visit	Mother	40	1	0.5	20	$12	$240
Community Activities
Health Care Provider Questionnaire	Health care providers	400	1	0.05	20	$90	$1,800
Community Leader Questionnaire	Community leaders	400	1	0.05	20	$75	$1,500
Child Care Provider Activities
Phone interview with provider	Child care provider / director	92	1	1	92	$25	$2,300
Total - Year 1:					25,602		$311,240

Table 2. Estimated hour burden and annual cost for pilot respondents—Year 2

Data Collection Activity	Year 2 (January 2010 - December 2010)
	Type of Respondent	Number of Respondents	Responses Per Respondent	Hours Per Response	Annual Hour Burden	Hourly Wage Rate	Annual Respondent Cost
Pregnancy Activities
16-17 wk Phone Call	Pregnant Women	145	1	0.5	73	$12	$876
T2 Ultrasound	Pregnant Women	150	1	1.5	225	$12	$2,700
T3 Visit	Pregnant Women	477	1	3	1,431	$12	$17,172
T3 SAQs and Self-Collections	Pregnant Women	477	1	1	477	$12	$5,724
T3 Pickup Visit	Pregnant Women	477	1	0.5	239	$12	$2,868
36 wk Phone Call	Pregnant Women	623	1	0.5	311	$12	$3,732
Birth-Related Activities
B1 Visit	Mother/Baby	658	1	0.75	494	$12	$5,928
B2 Visit	Mother/Baby	527	1	0.75	395	$12	$4,740
B2 SAQs	Breastfeeding Mother/Baby	527	1	0.75	395	$12	$4,740
Post-Natal Activities
1 mo. Visit	Mother/Baby	131	1	0.75	98	$12	$1,176
1 mo. SAQs	Mother	131	1	0.5	66	$12	$792
3 mo. Phone Call	Mother	853	1	0.5	493	$12	$5,916
6 mo. Visit	Mother/Baby	835	1	3	2,505	$12	$30,060
6 mo. SAQs	Mother	835	1	1	835	$12	$10,020
6 mo. SAQs	Father	835	1	1	835	$12	$10,020
6 mo. Pickup Visit	Mother	835	1	0.5	418	$12	$5,016
9 mo. Phone Call	Mother	667	1	0.5	333	$12	$3,996
9 mo SAQs	Father/Partner	667	1	0.5	333	$12	$3,996
12 mo. Visit	Mother/Baby	220	1	3	660	$12	$7,920
12 mo. Dad Visit	Father or partner	220	1	1	220	$12	$2,640
12 mo. SAQs	Mother	220	1	1	220	$12	$2,640
12 mo. SAQs	Father/Partner	220	1	1	220	$12	$2,640
18 mo. Phone Call	Mother	18	1	0.5	9	$12	$108
18 mo. SAQs	Father/Partner	18	1	0.5	9	$12	$108
Community Activities
Health Care Provider Questionnaire	Health care providers	100	1	0.05	5	$90	$450
Community Leader Questionnaire	Community leaders	100	1	0.05	5	$75	$375
Child Care Provider Activities
Phone interview with provider	Child care provider/director	136	1	1	136	$25	$3,400
Total - Year 2:					11,440		$139,753

Table 3. Estimated hour burden and annual cost for pilot respondents—Year 3

Data Collection Activity	Year 3 (January 2011 - December 2011)
	Type of Respondent	Number of Respondents	Responses Per Respondent	Hours Per Response	Annual Hour Burden	Hourly Wage Rate	Annual Respondent Cost
Post-Natal Activities
9 mo. Phone Call	Mother	190	1	0.5	95	$12	$1,140
9 mo SAQs	Father/Partner	190	1	0.5	95	$12	$1,140
12 mo. Visit	Mother/Baby	525	1	3	1,575	$12	$18,900
12 mo. Dad Visit	Father or partner	525	1	1	525	$12	$6,300
12 mo. SAQs	Mother	525	1	1	525	$12	$6,300
12 mo. SAQs	Father/Partner	525	1	1	525	$12	$6,300
18 mo. Phone Call	Mother	706	1	0.5	353	$12	$4,236
18 mo. SAQs	Father/Partner	706	1	0.5	353	$12	$4,236
24 mo. Phone Call	Mother	200	1	0.5	100	$12	$1,200
24 mo. self-collected samples	Mother	200	1	0.5	100	$12	$1,200
Child Care Provider Activities
Phone interview with provider	Child care provider/director	136	1	1	136	$25	$3,400
Total - Year 3:					4,382		$54,352

Table 4. Estimated hour burden and annual cost for pilot respondents—Total

Data Collection Activity	Years 1 - 3 (January 2009 - December 2011)
	Total Number of Respondents	Total Hour Burden	Total Respondent Cost
Screening Activities
Household Enumeration	76,911	6,153	$73,836
Pregnancy Screening	45,316	3,625	$43,500
Neighbor Report	7,691	385	$4,620
Preconception Activities
P1 Visit	380	1,140	$13,680
P1 SAQs and Self-Collections	380	380	$4,560
P1 Pickup Visit	380	190	$2,280
High Probability Phone Calls	8,194	1,311	$15,732
Moderate Prob. Phone Calls	5,500	1,320	$15,840
Low Probability Phone Calls	3,578	286	$3,432
Pregnancy Activities
T1 Visit (mother)	954	2,862	$34,344
T1 Visit (father)	954	954	$11,448
T1 SAQs & Self-Collections	954	954	$11,448
T1 Pickup Visit	954	477	$5,724
1st Trimester Ultrasound (if needed)	477	716	$8,592
16-17 wk Phone Call	1106	554	$6,648

Table 4. Estimated hour burden and annual cost for pilot respondents—Total (cont’d)

Data Collection Activity	Years 1 - 3 (January 2009 - December 2011) – cont’d
	Total Number of Respondents	Total Hour Burden	Total Respondent Cost
Pregnancy Activities (cont’d)
T3 Visit	920	2760	$33,120
T3 SAQs and Self-Collections	920	920	$11,040
T3 Pickup Visit	920	460	$5,520
36 wk Phone Call	865	432	$5,184
Birth-Related Activities
B1 Visit	912	684	$8,208
B2 Visit	730	547	$6,564
B2 SAQs	730	547	$6,564
Post-Natal Activities
1 mo. Visit	182	136	$1,632
1 mo. SAQs	182	92	$1,104
3 mo. Phone Call	893	513	$6,156
6 mo. Visit	875	2625	$31,500
6 mo. SAQs	875	875	$10,500
6 mo. SAQs	875	875	$10,500
6 mo. Pickup Visit	875	438	$5,256
9 mo. Phone Call	857	428	$5,136
9 mo SAQs	857	428	$5,136
12 mo. Visit	745	2235	$26,820
12 mo. Dad Visit	745	745	$8,940
12 mo. SAQs	745	745	$8,940
12 mo. SAQs	745	745	$8,940
18 mo. Phone Call	724	362	$4,344
18 mo. SAQs	724	362	$4,344
24 mo. Phone Call	200	100	$1,200
24 mo. self-collected samples	200	100	$1,200
Community Activities
Health Care Provider Questionnaire	500	25	$2,250
Community Leader Questionnaire	500	25	$1,875
Child Care Provider Activities
Phone interview with provider	364	364	$9,100
Totals (Year 1 - 3):		41,424	$505,345
Annualized total estimates	----------	13,808	$168,448