Recruitment Strategy Substudy for the National Children's Study (NICHD)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 8 Survey	Form and Instruction	New	Available
Form 7 Survey	Form and Instruction	New	Available
Form 6 Survey	Form and Instruction	New	Available
Form 3.1 Consent	Form and Instruction	New	Available
Form 5.2 Survey	Form and Instruction	New	Available
Form 5.1 Survey	Form and Instruction	New	Repair queued
Form 4 Survey	Form and Instruction	New	Available
Form 2 Survey	Form and Instruction	New	Available
Form 9 Survey	Form and Instruction	New	Available
Form 9 Survey	Form and Instruction	New	Available
Form 5.1 Survey	Form and Instruction	New	Available
Form 5.2 Survey	Form and Instruction	New	Repair queued
Form 9 Survey	Form and Instruction	New	Repair queued
Form 3.3 Consent	Form and Instruction	New	Available
Form 3.2 Consent	Form and Instruction	New	Available
Form 2.2 Survey	Form and Instruction	New	Available
Form 8 Survey	Form and Instruction	New	Available
Form 7 Survey	Form and Instruction	New	Available
Form 6 Survey	Form and Instruction	New	Available
Form 3.1 Consent	Form and Instruction	New	Available
Form 5.2 Survey	Form and Instruction	New	Repair queued
Form 5.1 Survey	Form and Instruction	New	Available
Form 4 Survey	Form and Instruction	New	Available
Form 10 Form	Form	New	Available
Form 8 Survey	Form and Instruction	New	Available
Form 7 Survey	Form and Instruction	New	Available
Form 6 Survey	Form and Instruction	New	Repair queued
Form 3.1 Consent	Form and Instruction	New	Available
Form 5.1 Survey	Form and Instruction	New	Available
Form 5.2 Survey	Form and Instruction	New	Available
Form 4 Survey	Form and Instruction	New	Available
Form 2.3 Survey	Form and Instruction	New	Repair queued
Form C.10.5 Instruments	Form and Instruction	Removed	Available
Form C.9.4 Instruments	Form and Instruction	Removed	Available
Form A.2.3 Instruments	Form and Instruction	Removed	Available
Form A.2.1 Instruments	Form and Instruction	Removed	Available
Form C.9.3 Instruments	Form and Instruction	Removed	Available
Form A.3.3 Survey	Form and Instruction	Removed	Available
Form A.3.1 Survey	Form and Instruction	Removed	Available
Form A.2.3.m1 Survey	Form and Instruction	Removed	Available
Form A.2.3.L3 Survey	Form and Instruction	Removed	Available
Form A.2.3.j3 Survey	Form and Instruction	Removed	Repair queued
Form A.2.3.j2 Survey	Form and Instruction	Removed	Available
Form A.2.3.j1 Survey	Form and Instruction	Removed	Available
Form A.2.3.i Survey	Form and Instruction	Removed	Available
Form A.2.3.i Survey	Form and Instruction	Removed	Available
Form A.2.3.f Survey	Form and Instruction	Removed	Available
Form A.2.3.b3 Survey	Form and Instruction	Removed	Available
Form A.2.2.e Survey	Form and Instruction	Removed	Available
Form A.2.2.d Survey	Form and Instruction	Removed	Available
Form A.2.2.c Survey	Form and Instruction	Removed	Available
Form A.2.2.b Survey	Form and Instruction	Removed	Available
Form A.2.2.a Survey	Form and Instruction	Removed	Available
Form A.1.3.b Survey	Form and Instruction	Removed	Available
Form A.2.3.f Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survery	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form A.1.1.c Survey	Form and Instruction	Removed	Available
Form A.1.1.a Survey	Form and Instruction	Removed	Repair queued
Form A.2.1.h Survey	Form and Instruction	Removed	Available
Form A.3.2 Survey	Form and Instruction	Removed	Available
Form A.2.3.L5 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form A.1.2.b Survey	Form and Instruction	Removed	Available
Form A.1.2.b Survey	Form and Instruction	Removed	Available
Form A.1.2.b Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Repair queued
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 1 Survey	Form and Instruction	Removed	Available
Form 2 Survey	Form and Instruction	Modified	Available
Form 1 Survey	Form and Instruction	Modified	Available
Supporting Statement Part B 20100714.docx	Supporting Statement B	Uploaded 2010-07-15	Available
List of NCS Instruments, by Recruitment Strategy (July Launch).docx	Supplementary Document	Uploaded 2010-06-15	Available
Itemized Burden Estimate.docx	Supplementary Document	Uploaded 2010-06-14	Available
Birth Visit July Launch VIS 20100607.pdf	Supplementary Document	Uploaded 2010-06-07	Available
Pregnancy Visit 2 July Launch Visit Information Sheet 20100607.pdf	Supplementary Document	Uploaded 2010-06-07	Available
Pregnancy Visit 1 July Launch Visit Information Sheet 20100607.docx	Supplementary Document	Uploaded 2010-06-07	Available
Pre--pregnancy interview July Launch VIS 20100615.pdf	Supplementary Document	Uploaded 2010-06-15	Available
Pregnancy Visit 1 July Launch Visit Information Sheet 20100607.docx	Supplementary Document	Uploaded 2010-06-07	Available
Birth Visit July Launch VIS 20100607.pdf	Supplementary Document	Uploaded 2010-06-07	Available
Pregnancy Visit 2 July Launch Visit Information Sheet 20100607.pdf	Supplementary Document	Uploaded 2010-06-07	Available
Pregnancy Visit 1 July Launch Visit Information Sheet 20100607.docx	Supplementary Document	Uploaded 2010-06-07	Available
Pre--pregnancy interview July Launch VIS 20100615.pdf	Supplementary Document	Uploaded 2010-06-15	Available
Pregnancy Visit 1 July Launch Visit Information Sheet 20100607.docx	Supplementary Document	Uploaded 2010-06-07	Available
Pregnancy Visit 1 July Launch Visit Information Sheet 20100607.docx	Supplementary Document	Uploaded 2010-06-07	Repair queued
Birth Visit July Launch VIS 20100607.pdf	Supplementary Document	Uploaded 2010-06-07	Available
Pregnancy Visit 2 July Launch Visit Information Sheet 20100607.pdf	Supplementary Document	Uploaded 2010-06-07	Available
Pregnancy Visit 1 July Launch Visit Information Sheet 20100607.docx	Supplementary Document	Uploaded 2010-06-07	Available
Pre--pregnancy interview July Launch VIS 20100615.pdf	Supplementary Document	Uploaded 2010-06-15	Available
Supporting Statement Part A 20100604.docx	Supporting Statement A	Uploaded 2010-06-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
193580	Two-Tier (High): Birth Visit Interview	Form and Instruction	New	Survey
193579	Two Tier (High): Pregnancy Visit 2 Interview	Form and Instruction	New	Survey
193578	Two Tier (High): Pregnancy Visit 1 Interview	Form and Instruction	New	Survey
193577	Two Tier (High): Women's Informed Consent Form	Form and Instruction	New	Consent
193576	Two Tier (High): Pregnancy Probability Group Follow Up Script	Form and Instruction	New	Survey
193576	Two Tier (High): Pregnancy Probability Group Follow Up Script	Form and Instruction	New	Survey
193575	Two Tier (High): Pre-Pregnancy Interview	Form and Instruction	New	Survey
193574	Two Tier (High): Pregnancy Screening	Form and Instruction	New	Survey
193573	Two Tier (Low): Low-Intensity CATI Questionnaire (Birth-Related Activities)	Form and Instruction	New	Survey
193572	Two Tier (Low): Low-Intensity CATI Questionnaire (Pregnancy Activities)	Form and Instruction	New	Survey
193571	Two Tier (Low): Pregnancy Probability Group Follow Up Script	Form and Instruction	New	Survey
193571	Two Tier (Low): Pregnancy Probability Group Follow Up Script	Form and Instruction	New	Survey
193570	Two Tier (Low): Low-Intensity CATI Questionnaire (Age-Eligible Women)	Form and Instruction	New	Survey
193569	Two Tier (Low): Low-Intensity Consent Script	Form and Instruction	New	Consent
193569	Two Tier (Low): Low-Intensity Consent Script	Form and Instruction	New	Consent
193568	Two Tier (Low): Low-Intensity CATI Pregnancy Screener	Form and Instruction	New	Survey
193567	Enhanced Household: Birth Visit Interview	Form and Instruction	New	Survey
193566	Enhanced Household: Pregnancy Visit 2 Interview	Form and Instruction	New	Survey
193565	Enhanced Household: Pregnancy Visit 1 Interview	Form and Instruction	New	Survey
193564	Enhanced Household: Women's Informed Consent Form	Form and Instruction	New	Consent
193563	Enhanced Household: Pregnancy Probability Group Follow Up Script	Form and Instruction	New	Survey
193563	Enhanced Household: Pregnancy Probability Group Follow Up Script	Form and Instruction	New	Survey
193562	Enhanced Household: Pre-pregnancy Interview	Form and Instruction	New	Survey
193561	Enhanced Household: Neighbor Report	Form	New	Form
193560	Provider-Based: Birth Visit Interview	Form and Instruction	New	Survey
193559	Provider-Based: Pregnancy Visit 2 Interview	Form and Instruction	New	Survey
193558	Provider-Based: Pregnancy Visit 1 Interview	Form and Instruction	New	Survey
193557	Provider-Based: Women's Informed Consent Form	Form and Instruction	New	Consent
193556	Provider-Based: Pregnancy Probability Group Follow Up Script	Form and Instruction	New	Survey
193556	Provider-Based: Pregnancy Probability Group Follow Up Script	Form and Instruction	New	Survey
193555	Provider-Based: Pre-Pregnancy Visit	Form and Instruction	New	Survey
193554	Provider-Based: Pregnancy Screening	Form and Instruction	New	Survey
193553	Provider-Based: Address Look-Up	Instruction	New
184283	Child Care Providers	Form and Instruction	Removed	Instruments
184282	Community Leaders	Form and Instruction	Removed	Instruments
184281	Health Care Providers	Form and Instruction	Removed	Instruments
184281	Health Care Providers	Form and Instruction	Removed	Instruments
184281	Health Care Providers	Form and Instruction	Removed	Instruments
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184280	Fathers	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survery
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184279	Postnatal Activities - Mother and Children	Form and Instruction	Removed	Survey
184278	Birth Activities-Mother and Children	Form and Instruction	Removed	Survey
184278	Birth Activities-Mother and Children	Form and Instruction	Removed	Survey
184278	Birth Activities-Mother and Children	Form and Instruction	Removed	Survey
184278	Birth Activities-Mother and Children	Form and Instruction	Removed	Survey
184278	Birth Activities-Mother and Children	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Other-Results Letter	Removed
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184277	Pregnancy Activities	Form and Instruction	Removed	Survey
184276	Low Probability Women	Form and Instruction	Removed	Survey
184275	Moderate Probability Women	Form and Instruction	Removed	Survey
184274	High Probability Women w/o Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184273	High Probability Women w/Pre-pregnancy Visit	Form and Instruction	Removed	Survey
184272	Enhanced Household: Pregnancy Screening	Form and Instruction	Modified	Survey
184271	Enhanced Household: Household Enumeration Script	Form and Instruction	Modified	Survey

ICR Details

OMB Control No: 0925-0593	ICR Reference No: 201007-0925-001
Status: Historical Active	Previous ICR Reference No: 200803-0925-005
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Recruitment Strategy Substudy for the National Children's Study (NICHD)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/23/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/02/2010
Terms of Clearance: Previous terms of clearance remain in effect.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2013	36 Months From Approved	09/30/2011
Responses	390,068	0	64,598
Time Burden (Hours)	128,042	0	13,797
Cost Burden (Dollars)	0	0	0

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Abstract: The Initial Vanguard Study protocol was designed to enroll approximately 1,750 pregnant women through seven study locations after 12 months of data collection. Two of the locations began recruitment in January 2009 and the remaining 5 in April 2009. As of May 2010, however, approximately 900 pregnant women have been enrolled, leading to questions about the assumptions underlying the Initial Vanguard Study recruitment model. The seven Initial Vanguard sites use a household enumeration and screening strategy to identify eligible women for recruitment into the study. Although household enumeration is often considered a gold standard for maximizing coverage, in that all dwelling units are identified and enumerated, for the NCS Initial Vanguard Study this method has not yielded the target number of births in the time frame projected from initial models. Consequently, additional methodological research is needed to evaluate the feasibility, acceptability, and cost of alternate recruitment strategies for enrollment of pregnant women into the NCS. This research will be conducted through the NCS Recruitment Substudy. The Recruitment Substudy will assess three alternate recruitment strategies - (1) a provider-based recruitment strategy; (2) an enhanced version of a household enumeration strategy; and (3) a two-tier recruitment strategy involving high-intensity and low-intensity data collection efforts.

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Authorizing Statute(s): PL: Pub.L. 106 - 310 1004 Name of Law: Childrens Health Act of 2000
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 14165	03/24/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 35042	06/21/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 30

table that charts list of burden

IC Title	Form No.	Form Name
Birth Activities-Mother and Children	A.3.2, A.2.1.h, A.2.3.L5, A.1.1.a, A.1.1.c	Survey ,   Survey ,   Survey ,   Survey ,   Survey
Child Care Providers	C.10.5	Instruments
Community Leaders	C.9.4	Instruments
Enhanced Household: Birth Visit Interview	8	Survey
Enhanced Household: Household Enumeration Script	1	Survey
Enhanced Household: Neighbor Report	10	Form
Enhanced Household: Pre-pregnancy Interview	4	Survey
Enhanced Household: Pregnancy Probability Group Follow Up Script	5.1, 5.2	Survey ,   Survey
Enhanced Household: Pregnancy Screening	2	Survey
Enhanced Household: Pregnancy Visit 1 Interview	6	Survey
Enhanced Household: Pregnancy Visit 2 Interview	7	Survey
Enhanced Household: Women's Informed Consent Form	3.1	Consent
Fathers	A.2.3.f, A.1.3.b, A.2.2.a, A.2.2.b, A.2.2.c, A.2.2.d, A.2.2.e, A.2.3.b3, A.2.3.f, A.2.3.i, A.2.3.i, A.3.1, A.3.3, A.2.3.j1, A.2.3.j2, A.2.3.j3, A.2.3.L3, A.2.3.m1	Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Health Care Providers	A.2.1, A.2.3, C.9.3	Instruments ,   Instruments ,   Instruments
High Probability Women w/Pre-pregnancy Visit	1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1	Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
High Probability Women w/o Pre-pregnancy Visit	A.1.2.b	Survey
Low Probability Women	A.1.2.b	Survey
Moderate Probability Women	A.1.2.b	Survey
Postnatal Activities - Mother and Children	1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1	Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survery ,   Survey ,   Survey ,   Survey ,   Survey
Pregnancy Activities	1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1	Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Provider-Based: Address Look-Up
Provider-Based: Birth Visit Interview	8	Survey
Provider-Based: Pre-Pregnancy Visit	4	Survey
Provider-Based: Pregnancy Probability Group Follow Up Script	5.1, 5.2	Survey ,   Survey
Provider-Based: Pregnancy Screening	2.3	Survey
Provider-Based: Pregnancy Visit 1 Interview	6	Survey
Provider-Based: Pregnancy Visit 2 Interview	7	Survey
Provider-Based: Women's Informed Consent Form	3.1	Consent
Two Tier (High): Pre-Pregnancy Interview	4	Survey
Two Tier (High): Pregnancy Probability Group Follow Up Script	5.1, 5.2	Survey ,   Survey
Two Tier (High): Pregnancy Screening	2	Survey
Two Tier (High): Pregnancy Visit 1 Interview	6	Survey
Two Tier (High): Pregnancy Visit 2 Interview	7	Survey
Two Tier (High): Women's Informed Consent Form	3.1	Consent
Two Tier (Low): Low-Intensity CATI Pregnancy Screener	2.2	Survey
Two Tier (Low): Low-Intensity CATI Questionnaire (Age-Eligible Women)	9	Survey
Two Tier (Low): Low-Intensity CATI Questionnaire (Birth-Related Activities)	9	Survey
Two Tier (Low): Low-Intensity CATI Questionnaire (Pregnancy Activities)	9	Survey
Two Tier (Low): Low-Intensity Consent Script	3.2, 3.3	Consent ,   Consent
Two Tier (Low): Pregnancy Probability Group Follow Up Script	5.2, 5.1	Survey ,   Survey
Two-Tier (High): Birth Visit Interview	8	Survey

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ICR Summary of Burden

table that charts list 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	390,068	64,598	0	325,470	0	0
Annual Time Burden (Hours)	128,042	13,797	0	114,245	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: Miscellaneous Actions

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The NCS Initial Vanguard Study, which consists of 7 Study locations, utilized the Household Enumeration and Screening Strategy, but did not yield the target number of births in the time frame projected from initial models. As a result, additional methodological research is needed to evaluate the feasibility, acceptability, and cost of alternate recruitment strategies for enrollment of pregnant women into the NCS. This research will be conducted through the NCS Recruitment Substudy. The Recruitment Substudy will assess three alternate recruitment strategies (1) a provider-based recruitment strategy; (2) an enhanced version of a household enumeration strategy; and (3) a two-tier recruitment strategy involving high-intensity and low-intensity data collection efforts. Each recruitment approach would occur in 10 study locations, for a total of 30 study locations implementing alternate recruitment strategies. Recruitment strategies will be assessed and compared on the basis of feasibility (including success in recruiting and retaining sufficient numbers of participants), acceptability (including the extent of selection bias in recruitment, effect on respondent burden, and impact on study infrastructure), and cost. Ultimately, these comparisons will inform the recruitment approach or approaches to be taken for the NCS Main Study. Each recruitment strategy will be provided with approximately equally resources, and will be associated with a specific communications theme appropriate for its mode of participant enrollment.

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Annual Cost to Federal Government: $110,000,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? No

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)? No

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: 07/02/2010

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