Evaluation of the Text4baby Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Stakeholder 1 Stakeholder Interview Guide	Form	Modified	Available
Form 1 Key Informant Interview Discussion Guide	Form	Modified	Available
Form Focus Group-1 Focus Group Discussion Protocol	Form	Modified	Available
Form Focus Group-3 Focus Group: Participant Information Form (Postpartum Women)	Form	Modified	Available
Form Focus Group-2 Focus Group: Participant Information Form (Pregnant Women)	Form	Modified	Available
Form 2 R2 HPP Survey Revised Jan 2012 Access Questions	Form	Modified	Available
Form 1 Safety Net Consumer Survey R1	Form	Modified	Available
Supporting Statement B_1 22 12.docx	Supporting Statement B	Uploaded 2012-08-17	Available
Justification for Two New Questions on EED OMB.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2012-08-17	Available
Part B Attachment C Text4baby Technical Advisory Group[1].docx	Supplementary Document	Uploaded 2012-08-17	Available
Part B Attachment B Pretest Report and Recommendations.docx	Supplementary Document	Uploaded 2012-08-17	Available
Part A Attachment I Text4baby Evaluation Questions[1].docx	Supplementary Document	Uploaded 2012-08-17	Available
Part A Attachment A Authorizing Legislation[1].docx	Supplementary Document	Uploaded 2012-08-17	Available
Part A Attachment C Electronic Health Records Elements.docx	Supplementary Document	Uploaded 2012-08-17	Available
Supporting Statement A_1 22 12.docx	Supporting Statement A	Uploaded 2012-08-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
200144	Prenatal Patient and Parent of Minor Consent	Other-Explanation of burden associated with consent	Modified
200143	Consent Training and Coordination	Other-Explanation of Burden	Modified
200142	Stakeholder Interviews	Form	Modified	Stakeholder Interview Guide
200141	Key Informant Interviews	Form	Modified	Key Informant Interview Discussion Guide
200140	Consumer Focus Groups	Form	Modified	Focus Group Discussion Protocol
200140	Consumer Focus Groups	Form	Modified	Focus Group: Participant Information Form (Postpartum Women)
200140	Consumer Focus Groups	Form	Modified	Focus Group: Participant Information Form (Pregnant Women)
200139	Safety Net Consumer Survey Round 2	Form	Modified	R2 HPP Survey Revised Jan 2012 Access Questions
200138	Safety Net Consumer Survey Round 1	Form	Modified	Safety Net Consumer Survey R1

ICR Details

OMB Control No: 0915-0347	ICR Reference No: 201208-0915-006
Status: Historical Active	Previous ICR Reference No: 201207-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Evaluation of the Text4baby Program
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/22/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/17/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2015	02/28/2015	02/28/2015
Responses	5,266	0	5,266
Time Burden (Hours)	1,196	0	1,196
Cost Burden (Dollars)	0	0	0

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Abstract: Text4baby is a mobile health education program that provides free, brief, evidence-based, health messages to women who are pregnant or have an infant under one year of age. The goal of this program evaluation is to examine the characteristics of women who utilize the Text4baby mobile phone-based program, to assess their experience with the program, and to determine whether enrollment in Text4baby is associated with healthy behaviors and timely access to health care during pregnancy and an infant's first year of life.

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Authorizing Statute(s): PL: Pub.L. 42 - 241 301 Name of Law: Public Health Service Act
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Consent Training and Coordination
Consumer Focus Groups	Focus Group-2, Focus Group-3, Focus Group-1	Focus Group: Participant Information Form (Pregnant Women) ,   Focus Group: Participant Information Form (Postpartum Women) ,   Focus Group Discussion Protocol
Key Informant Interviews	1	Key Informant Interview Discussion Guide
Prenatal Patient and Parent of Minor Consent
Safety Net Consumer Survey Round 1	1	Safety Net Consumer Survey R1
Safety Net Consumer Survey Round 2	2	R2 HPP Survey Revised Jan 2012 Access Questions
Stakeholder Interviews	Stakeholder 1	Stakeholder Interview Guide

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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	5,266	5,266	0	0	0	0
Annual Time Burden (Hours)	1,196	1,196	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $418,827

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]? No

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: 08/17/2012

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