ClearanceForm_HNB Survey _NICHD OMB 0925-0532 (2)

SUBMISSION OF INFORMATION COLLECTION

UNDER GENERIC CLEARANCES

DATE OF REQUEST: _____7-26-10_________

SUB AGENCY (I/C): ______NICHD_________

TITLE: ___________Healthy Native Babies Post-training Survey____________________

GENERIC CLEARANCE UNDER OMB# ­_0925-0532__ EXP. DATE: __1/31/2011___________

ABSTRACT:

The Healthy Native Babies Project conducted 14 one-day training sessions in 2009 to assist health professionals and community workers with skills needed to effectively communicate SIDS risk-reduction messages to American Indian and Alaska Native families. Attendees received a Workbook, Resource CD, and Toolkit CDROM to assist them in providing outreach efforts in local communities. A follow-up post-training survey is proposed to find out if attendees have been conducting outreach in their communities over the last year and utilizing the information, materials, and tools provided. We would also like to know the reasons for not conducting outreach and/or the challenges faced along with any other suggestions as we move forward with the project. The survey will be sent out to all 152 attendees via email with a link to complete the survey online using a web-based survey tool.

TOTAL ANNUAL BURDEN APPROVED: _1961_________

BURDEN USED TO DATE: ___120.4_______

BURDEN THIS REQUEST: __26 hours________

IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ______NO___x___N/A

OBLIGATION TO RESPOND:

___x___ VOLUNTARY

______ REQUIRED TO OBTAIN OR RETAIN BENEFITS

______ MANDATORY

HOW WILL THIS SURVEY BE OFFERED?

___x__ WEB SITE

_____ TELEPHONE INTERVIEW

_____ MAIL RESPONSE

_____ IN PERSON INTERVIEW

_____ OTHER: ___________________________________

CONTACT INFORMATION:

NAME: ____________Shavon Artis_______________________________

TELEPHONE NUMBER: ___________301-435-3459_______________

EMAIL ADDRESS: [email protected] ___________________