List of Instruments for Phase 1 and 2, NCS Vanguard (Pilot) Study

List of Instruments for Phase 1 and 2, NCS Vanguard (Pilot) Study.xlsx

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

List of Instruments for Phase 1 and 2, NCS Vanguard (Pilot) Study

OMB: 0925-0593

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List of Instruments, Recruitment Substudy for the National Children’s Study, by Recruitment Strategy, Phases 1 and 2




Recruitment Strategy Activity Type of Respondent Instruments
Provider-based: 10 Study Locations

Screening Activities

Address Lookup Tool Age-Eligible Women Address Lookup Tool (ALT) User's Guide

Pregnancy Screener Age-Eligible Women Pregnancy Screener (PB)

Healthcare Provider Questionnaire Healthcare Providers Healthcare Provider Questionnaire

Preconception Activities


Non-pregnant Women's Informed Consent Age-Eligible Women Non-pregnant Women's Informed Consent

Pre-Pregnancy Interview Age-Eligible Women Pre-Pregnancy Interview
Pre-Pregnancy Visit Information Sheet
Refusal of Biological/Environmental Samples

Pre-Pregnancy Blood and Urine Collection Age-Eligible Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Blood and Urine Collection

Pregnancy Probability Group Follow Up Script Age-Eligible Women Pregnancy Probability Group Follow Up - CATI Instrument
Pregnancy Probability Group Follow Up - SAQ

Validation Script Age-Eligible Women Interviewer Validation

Pregnancy Activities


Pregnant Women’s Informed Consent Form Pregnant Women Pregnant Women's Informed Consent Form

Pregnancy Visit 1 Interview Pregnant Women Pregnancy Visit 1 Interview and SAQ
Pregnancy Visit 1 Visit Information Sheet
Tap Water Collection Instructions
Vacuum Bag Participant Instructions
Refusal of Biological/Environmental Samples

Pregnancy Visit 1 Blood and Urine Collection Pregnant Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Fasting Blood, Urine, and Vacuum Collection
Pre-Visit Instructions for Blood, Urine, and Vacuum Collection
Pre-Visit Instructions for Blood and Urine Collection

Pregnancy Visit 2 Interview Pregnant Women Pregnancy Visit 2 Interview and SAQ
Pregnancy Visit 2 Visit Information Sheet
Tap Water Collection Instructions
Vacuum Bag Participant Instructions
Refusal of Biological/Environmental Samples

Pregnancy Visit 2 Blood and Urine Collection Pregnant Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Fasting Blood, Urine, and Vacuum Collection

Pregnancy Health Care Log Pregnant Women Pregnancy Health Care Log

Father Informed Consent Form Alternate Caregiver Informed Consent Form - Fathers

Father Interview Alternate Caregiver Father Interview
Father Visit Information Sheet

Birth-Related Activities


Birth Visit Interview Mother/Baby Birth Visit Interview
Birth Visit Information Sheet
Cord Blood Collection Visit Information Sheet
Refusal of Biological/Environmental Samples

Postnatal Activities


Infant Feeding Log Mother/Baby Infant and Child Health Care Log

3-Month Mother Phone Interview Mother/Baby 3-Month Mother Phone Interview

6-Month Visit Interview Mother/Baby 6-Month Mother Interview
6-Month Infant Feeding SAQ
6-Month Visit Information Sheet

9-Month Mother Phone Interview Mother/Baby 9-Month Mother Phone Interview

12-Month Mother Interview Mother/Baby 12-Month Mother Interview
12-Month SAQ
12-Month Visit Information Sheet

18-Month Mother Interview Call Mother/Baby 18-Month Mother Interview
18-Month SAQ (placeholder for copyrighted material -- Ages and Stages III Questionnaire)

24-Month Mother Interview Call Mother/Baby 24-Month Mother Interview
24-Month SAQ (placeholder for copyrighted material -- Ages and Stages III Questionnaire)
Enhanced Household: 10 Study Locations

Screening Activities


Household Enumeration Instrument HH Reporters Household Enumeration Instrument

Pregnancy Screener (EH) Age-Eligible Women Pregnancy Screener (EH)

Preconception Activities


Non-pregnant Women's Informed Consent Age-Eligible Women Non-pregnant Women's Informed Consent

Pre-Pregnancy Interview Age-Eligible Women Pre-Pregnancy Interview
Pre-Pregnancy Visit Information Sheet
Refusal of Biological/Environmental Samples

Pre-Pregnancy Blood and Urine Collection Age-Eligible Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Blood and Urine Collection

Pregnancy Probability Group Follow Up Script Age-Eligible Women Pregnancy Probability Group Follow Up - CATI Instrument
Pregnancy Probability Group Follow Up - SAQ

Validation Script Age-Eligible Women Interviewer Validation

Pregnancy Activities


Pregnant Women’s Informed Consent Form Pregnant Women Pregnant Women's Informed Consent Form

Pregnancy Visit 1 Interview Pregnant Women Pregnancy Visit 1 Interview and SAQ
Pregnancy Visit 1 Visit Information Sheet
Tap Water Collection Instructions
Vacuum Bag Participant Instructions
Refusal of Biological/Environmental Samples

Pregnancy Visit 1 Blood and Urine Collection Pregnant Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Fasting Blood, Urine, and Vacuum Collection
Pre-Visit Instructions for Blood, Urine, and Vacuum Collection
Pre-Visit Instructions for Blood and Urine Collection

Pregnancy Visit 2 Interview Pregnant Women Pregnancy Visit 2 Interview and SAQ
Pregnancy Visit 2 Visit Information Sheet
Tap Water Collection Instructions
Vacuum Bag Participant Instructions
Refusal of Biological/Environmental Samples

Pregnancy Visit 2 Blood and Urine Collection Pregnant Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Fasting Blood, Urine, and Vacuum Collection

Pregnancy Health Care Log Pregnant Women Pregnancy Health Care Log

Father Informed Consent Form Alternate Caregiver Informed Consent Form - Fathers

Father Interview Alternate Caregiver Father Interview
Father Visit Information Sheet

Birth-Related Activities


Birth Visit Interview Mother/Baby Birth Visit Interview
Birth Visit Information Sheet
Cord Blood Collection Visit Information Sheet
Refusal of Biological/Environmental Samples

Postnatal Activities


Infant Feeding Log Mother/Baby Infant and Child Health Care Log

3-Month Mother Phone Interview Mother/Baby 3-Month Mother Phone Interview

6-Month Visit Interview Mother/Baby 6-Month Mother Interview
6-Month Infant Feeding SAQ
6-Month Visit Information Sheet

9-Month Mother Phone Interview Mother/Baby 9-Month Mother Phone Interview

12-Month Mother Interview Mother/Baby 12-Month Mother Interview
12-Month SAQ
12-Month Visit Information Sheet

18-Month Mother Interview Call Mother/Baby 18-Month Mother Interview
18-Month SAQ (placeholder for copyrighted material -- Ages and Stages III Questionnaire)

24-Month Mother Interview Call Mother/Baby 24-Month Mother Interview
24-Month SAQ (placeholder for copyrighted material -- Ages and Stages III Questionnaire)
Two-Tier (High): 10 Study Locations across Both Tiers

Screening Activities


Low-intensity Invitation to High-intensity Script Age-Eligible Women Low-Intensity Invitation to High-Intensity Script

Pregnancy Screener Age-Eligible Women Pregnancy Screener (TT-LI, TT-HI)

Preconception Activities


Non-pregnant Women's Informed Consent Age-Eligible Women Non-pregnant Women's Informed Consent

Pre-Pregnancy Interview Age-Eligible Women Pre-Pregnancy Interview
Pre-Pregnancy Visit Information Sheet
Refusal of Biological/Environmental Samples

Pre-Pregnancy Blood and Urine Collection Age-Eligible Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Blood and Urine Collection

Pregnancy Probability Group Follow Up Script Age-Eligible Women Pregnancy Probability Group Follow Up - CATI Instrument
Pregnancy Probability Group Follow Up - SAQ

Validation Script Age-Eligible Women Interviewer Validation

Pregnancy Activities


Pregnant Women’s Informed Consent Form Pregnant Women Pregnant Women's Informed Consent Form

Pregnancy Visit 1 Interview Pregnant Women Pregnancy Visit 1 Interview and SAQ
Pregnancy Visit 1 Visit Information Sheet
Tap Water Collection Instructions
Vacuum Bag Participant Instructions
Refusal of Biological/Environmental Samples

Pregnancy Visit 1 Blood and Urine Collection Pregnant Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Fasting Blood, Urine, and Vacuum Collection
Pre-Visit Instructions for Blood, Urine, and Vacuum Collection
Pre-Visit Instructions for Blood and Urine Collection

Pregnancy Visit 2 Interview Pregnant Women Pregnancy Visit 2 Interview and SAQ
Pregnancy Visit 2 Visit Information Sheet
Tap Water Collection Instructions
Vacuum Bag Participant Instructions
Refusal of Biological/Environmental Samples

Pregnancy Visit 2 Blood and Urine Collection Pregnant Women Urine Collection Instructions
Biospecimens Urine Instrument
Biospecimens Blood Instrument
Pre-Visit Instructions for Fasting Blood, Urine, and Vacuum Collection

Pregnancy Health Care Log Pregnant Women Pregnancy Health Care Log

Father Informed Consent Form Alternate Caregiver Informed Consent Form - Fathers

Father Interview Alternate Caregiver Father Interview
Father Visit Information Sheet

Birth-Related Activities


Birth Visit Interview Mother/Baby Birth Visit Interview
Birth Visit Information Sheet
Cord Blood Collection Visit Information Sheet
Refusal of Biological/Environmental Samples

Postnatal Activities


Infant Feeding Log Mother/Baby Infant and Child Health Care Log

3-Month Mother Phone Interview Mother/Baby 3-Month Mother Phone Interview

6-Month Visit Interview Mother/Baby 6-Month Mother Interview
6-Month Infant Feeding SAQ
6-Month Visit Information Sheet

9-Month Mother Phone Interview Mother/Baby 9-Month Mother Phone Interview

12-Month Mother Interview Mother/Baby 12-Month Mother Interview
12-Month SAQ
12-Month Visit Information Sheet

18-Month Mother Interview Call Mother/Baby 18-Month Mother Interview
18-Month SAQ (placeholder for copyrighted material -- Ages and Stages III Questionnaire) (Placeholder for copyrighted material)

24-Month Mother Interview Call Mother/Baby 24-Month Mother Interview
24-Month SAQ (placeholder for copyrighted material -- Ages and Stages III Questionnaire) (Placeholder for copyrighted material)
Two-Tier (Low): 10 Study Locations across Both Tiers

Screening Activities


Pregnancy Screener (TT-LI, TT-HI) Age-Eligible Women Pregnancy Screener (TT-LI, TT-HI)

Low-Intensity Consent Script Age-Eligible Women Low-Intensity Consent Script
Low-Intensity Data Collection Participant Information Sheet

Preconception and Pregnancy Activities


Low-intensity Questionnaire (Non-Pregnant) Age-Eligible Women Low-Intensity Questionnaire (Non- & Pregnant)
Low-Intensity Data Collection Participant Information Sheet

Pregnancy Probability Group Follow Up Script Age-Eligible Women Pregnancy Probability Group Follow Up - CATI Instrument
Pregnancy Probability Group Follow Up - SAQ

Low-intensity Questionnaire (Found Pregnant) Pregnant Women Low-Intensity Questionnaire (Non- & Pregnant)
Low-Intensity Data Collection Participant Information Sheet

Validation Script Age-Eligible Women Interviewer Validation

Birth-Related Activities


Low-intensity Questionnaire (Birth-focus) Mother/Baby Low-Intensity Questionnaire (Non- & Pregnant)
Low-Intensity Data Collection Participant Information Sheet

Postnatal Activities


Low-intensity Questionnaire (Child-focus) Mother/Baby Low-Intensity Questionnaire (Non- & Pregnant)
Low-Intensity Data Collection Participant Information Sheet
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