List of Instruments

OMB Collection #: 0925-0593

Expiration Date: 8/31/2014

README – POSTING INSTRUCTIONS

NOTE: File titles include the word “Attach” ahead of the file name.

File #	File Title	Instrument Title	Document Type	NOTES
A1.	PLSND Interview	A1. Pregnancy Loss, Stillbirth, and Neonatal Death (PLSND) Interview	Instrument	IC #4
A2.	PLSND Follow-Up SAQ	A2. Follow-Up Questionnaire: PLSND Specification	Instrument	IC #4
A3.	PLSND Medical Records Release Form	A3. Medical Records Release Form: PLSND	Supplementary / Other	IC #4
A4.	PLSND Death Certificate Release Form	A4. Death Certificate Release Form: PLSND	Supplementary / Other	IC #4
A5.	PLSND Items NR Rates	A5. Pregnancy Loss, Stillbirth, and Neonatal Death Instrument Item Nonresponse Rates for Source Questions and Related Survey Questions	Supplementary / Other	IC #4
A6.	PLSND Follow-Up SAQ and Release Forms Letter	A6. Follow-Up Questionnaire and Release Forms Letter: PLSND	Supplementary / Other	IC #4
A7.	PLSND Telephone Medical Records Release Forms Letter	A7. Telephone Medical Records Release Forms Letter: PLSND	Supplementary / Other	IC #4
A8.	PLSND Telephone Medical Records and Death Cert Release	A8. Telephone Medical Records and Death Certificate Release Forms Letter: PLSND	Supplementary / Other	IC #4
A9.	PLSND Mail Reminder Script	A9. Mail Reminder Call Script: PLSND	Supplementary / Other	IC #4
A10.	PLSND Telephone Reminder Script	A10. Telephone Reminder Call Script: PLSND	Supplementary / Other	IC #4
A11.	Multi-Mode Introductory Script	A11. Multi-Mode Introductory Script for all study calls and visits	Supplementary / Other	Files (“Consent Documents”)
A12.	Pregnancy Visit 1 Interview	A12. Pregnancy Visit 1 Interview	Instrument	IC #4 – replaces existing PV1 Interview
A13.	Pregnancy Visit 2 Interview	A13. Pregnancy Visit 2 Interview	Instrument	IC #5 – replaces existing PV2 Interview
A14.	Pregnancy Visit 1 SAQ	A14. Pregnancy Visit 1 SAQ Specification	Instrument	IC #4 – replaces existing PV1 SAQ
A15.	Validation Instrument	A15. Validation Instrument	Instrument	IC #3 – replaces existing Validation Instrument
A16.	Tracing Interview	A16. Tracing Interview	Instrument	IC #22 – replaces existing Tracing Interview
A17.	PFQ Refusal Letter for Providers	A17. Provider-Based Sampling Frame Questionnaire Refusal Letter for Providers	Supplementary / Other	IC #19

File #		File Title	Instrument Title		Document Type	NOTES
B1.		LOI2-QUEX-14-Phase 2 OIRA Template	B1. LOI2-QUEX-14 Phase 2 OIRA Template		Supplementary / Other	IC #17 Supports LOI2-QUEX-14
B2.		LOI2-QUEX-14 Exemplar Consent	B2. LOI2-QUEX-14 Consent Form		Supplementary / Other
B3.		LOI2-QUEX-14 SocioDemographics	B3. LOI2-QUEX-14 Nutrition LOI Socio-demographics Instrument (Infants and Preschoolers)		Instrument
B4.		LOI2-QUEX-14 ASA24 Instructions	B4. LOI2-QUEX-14 ASA24 Instructions		Instruction
B5.		LOI2-QUEX-14 ASA24 Protocol	B5. LOI2-QUEX-14 NCS ASA24 Protocol		Instruction
B6.		LOI2-QUEX-14 Food Diary Instructions- Parent	B6. LOI2-QUEX-14 Food Diary Instructions for Parent		Instruction
B7.		LOI2-QUEX-14 Infant Acceptability Questionnaire #1	B7. LOI2-QUEX-14 Acceptability Questionnaire #1 (Infant Version)		Instrument
B8.		LOI2-QUEX-14 Infant Acceptability Questionnaire #2	B8. LOI2-QUEX-14 Acceptability Questionnaire #2 (Infant Version)		Instrument
B9.		LOI2-QUEX-14 Child Acceptability Questionnaire #1	B9. LOI2-QUEX-14 Acceptability Questionnaire #1 (Child Version)		Instrument
B10.		LOI2-QUEX-14 Child Acceptability Questionnaire #2	B10. LOI2-QUEX-14 Acceptability Questionnaire #2 (Child Version)		Instrument
B11.		LOI2-QUEX-14 Infant Feeding Questionnaire	B11. LOI2-QUEX-14 NCS 12-Month Infant Feeding Follow-up Questionnaire		Instrument
B12.		LOI2-QUEX-14 Child Food Questionnaire	B12. LOI2-QUEX-14 NCS Child Feeding Follow-up Questionnaire		Instrument
B13.		LOI2-QUEX-14 IRB Approval Letters	B13. LOI2-QUEX-14 IRB Approval Letters		Supplementary / Other
B14.		LOI2-QUEX-14 Manual of Procedures	B14. LOI2-QUEX-14 Manual of Procedures		Supplementary / Other
B15.		LOI2-QUEX-14 Exemplar Recruitment Flyer	B15. LOI2-QUEX-14 Exemplar Recruitment Flyer		Supplementary / Other
B16.		LOI2-QUEX-14 Recruitment Screener	B16. LOI2-QUEX-14 Recruitment Screener (Script)		Instrument
B17.	Vanguard Pilot Study Biospecimen Collection Chart			B17. Vanguard (Pilot) Study Sample Collection (limited to Biospecimens)	Supplementary / Other	IC #17 Supports PBS Birth Visit Specimen Collection
B18.	Parental Permission for Child’s Participation with Samples			B18. The National Children’s Study Parental Permission for Child’s Participation - Birth Through 6-Months of Age (with Samples)	Supplementary / Other	Located in the updated “Consent Documents” file.
B19.	Biospecimen Adult Blood Instrument			B19. Biospecimen Adult Blood Instrument	Instrument	IC #1 - replace Bio Blood and Urine Instruments
B20.	Biospecimen Adult Urine Instrument			B20. Biospecimen Adult Urine Instrument	Instrument
B21.	Biospecimen Infant Blood Spot Instrument			B21. Biospecimen Infant Blood Spot Instrument	Instrument	IC #17 Supports PBS Birth Visit Specimen Collection
B22.	Biospecimen Cord Blood Instrument			B22. Biospecimen Cord Blood Instrument	Instrument
B23.	Biospecimen Placenta and Umbilical Cord Data Collection			B23. Biospecimen Placenta and Umbilical Cord Data Collection Instrument	Instrument
B24.	Sample Collection Visit Information Sheet Scripts			B24. Sample Collection Visit Information Sheet Scripts	Supplementary / Other	Located in the updated “Consent Documents” file.
B.25	PBS Birth Cohort Participant Verification Questionnaire			B.25 PBS Birth Cohort Participant Verification Questionnaire	Instrument	IC #17
N/A	Note to File – Formative Research (updated 20130118)			Note to File	Supplementary / Other	IC #17
N/A	Cover Memorandum			Justification for No Material / Nonsubstantive Change	Supplementary / Other	Files

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