Information Collection Request

Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months and Sibling Birth Enrollment

ICR 201401-0925-004 · OMB 0925-0593 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 45.1 Father Post-Natal Interview Form and Instruction New Available
Form 45.1 Retrospective Pregnancy Interview Form and Instruction New Available
Form 43.1 Environmental Sample Collection (Prenatal) Form and Instruction New Repair queued
Form 42.1 Physical Activity Subsample Study Form and Instruction New Available
Form 41.1 Bioelectrical Impedance Analysis Subsample Study Form and Instruction New Repair queued
Form 40.1 Noise Subsample Study Form and Instruction New Repair queued
Form 39.1 Participant Information Update - Incentive Substudy Form and Instruction New Repair queued
Form 38.2 36-Month Interview Form and Instruction New Available
Form 37.1 60-Month Interview Form and Instruction New Repair queued
Form 36.1 54-Month Interview Form and Instruction New Repair queued
Form 35.2 48-Month Interview Form and Instruction New Available
Form 34.1 42-Month Interview Form and Instruction New Repair queued
Form 33.1 Child-Focused Biospecimen Collection (Birth) Form and Instruction New Available
Form 32.2 Adult-Focused Biospecimen Collection (Birth) Form and Instruction New Available
Form 31.1 Pregnancy Probability Group Follow-up Interview Form and Instruction New Repair queued
Form 30.2 Adult-Focused Biospecimen Collection (Preconception) Form and Instruction New Available
Form 29.1 Secondary Residence Interview Form and Instruction New Available
Form 28.1 Revised Parent-Caregiver & Child Death Interview Form and Instruction New Repair queued
Form 27.1 30-Month Interview Form and Instruction Modified Available
Form 26.3 Core Questionnaire - Child, Adult, & Household Form and Instruction Modified Available
Form 25.1 Adult-Focused Biospecimen Collection (Postnatal) Form and Instruction Modified Available
Form 24.1 Child-Focused Physical Measures (Postnatal) Form and Instruction Modified Available
Form 23.1 Child-Focused Biospecimen Collection (Postnatal) Form and Instruction Modified Repair queued
Form 22.1 Environmental Sample Collection (Postnatal) Form and Instruction Modified Available
Form 21.1 Participant Verification & Tracing Interview Form and Instruction Modified Repair queued
Form 20.1 Non-Interview Respondent Interview Form and Instruction Modified Repair queued
Form 19.1 Pregnancy Loss, Stillbirth, & Neonatal Death Interview Form and Instruction Modified Available
Form 18.1 Pregnancy Screener Form and Instruction Modified Repair queued
Form 17.1 Formative Research Form and Instruction Modified Available
Form 16.1 24-Month Interview Form and Instruction Modified Available
Form 15.6 18-Month Interview Form and Instruction Modified Repair queued
Form 14.1 12-Month Interview Form and Instruction Modified Repair queued
Form 13.1 9-Month Interview Form and Instruction Modified Available
Form 12.1 6-Month Interview Form and Instruction Modified Repair queued
Form 11.1 3-Month Interview Form and Instruction Modified Available
Form 10.1 Infant & Child Health Care Log Form and Instruction Modified Available
Form 14.1 Low-Intensity Questionnaire (Birth focus) (TT-LI) Form and Instruction Removed Repair queued
Form 8.1 Birth Interview Form and Instruction Modified Available
Form 7.1 Father Pre-Natal Interview Form and Instruction Modified Repair queued
Form 6.1 Pregnancy Health Care Log Form and Instruction Modified Available
Form 5.1 Pregnancy Visit 2 Interview Form and Instruction Modified Repair queued
Form 4.1 Pregnancy Visit 1 Interview Form and Instruction Modified Available
Form 3.1 Validation Interview Form and Instruction Modified Repair queued
Form 2.1 Pre-Pregnancy Interview Form and Instruction Modified Repair queued
Form 1.1 Adult-Focused Biospecimen Collection (Prenatal) Form and Instruction Modified Available
NCS Vanguard Study Request for Revision SSB_REVISED.docx Supporting Statement B Uploaded 2014-05-19 Available
Attach. 1 NCS Vanguard Study Informed Consent 12092013.pdf Supplementary Document Uploaded 2013-12-09 Available
Attach. 5 Instruments by Data Collection Activity As of May152014.docx Supplementary Document Uploaded 2014-05-19 Available
Attach. 2 Instruments by Event and Stage of OMB Review As of May152014.docx Supplementary Document Uploaded 2014-05-19 Repair queued
Interviewer Observation (Data Collector Completed).pdf Supplementary Document Uploaded 2013-12-09 Available
Note to File - Informed Consents.docx Supplementary Document Uploaded 2013-11-13 Repair queued
Attach. 4 Description of NCS Vanguard Study Visits.docx Supplementary Document Uploaded 2013-11-08 Available
Attach. 3 NCS Certificate of Confidentiality.pdf Supplementary Document Uploaded 2013-11-08 Available
PhysicalActivityMonitorGPSInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
36M_HomeSocialDirectObservationInstrument.docx Supplementary Document Uploaded 2013-11-08 Repair queued
MajorLifeEventsInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
SWANBehaviorRatingScalesInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
MajorLifeEventsInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
SWANBehaviorRatingScalesInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
Birth_ChildBiospecimenPickUpInstrument.docx Supplementary Document Uploaded 2013-11-08 Available
AdultMicrobiomeRectalSwabInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
BreastMilkInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
AdultUrineInstructions.doc Supplementary Document Uploaded 2013-11-07 Repair queued
BreastMilkKitLetter.docx Supplementary Document Uploaded 2013-11-06 Available
AdultUrineInstructions.doc Supplementary Document Uploaded 2013-11-07 Available
30M_InfantToddlerSensoryProfilePhoneInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
30M_InfantToddlerSensoryProfileMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
30M_BSIMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
BITSEAPhoneInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
BITSEAInPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
VaccinationGridCoreModule.docx Supplementary Document Uploaded 2013-11-08 Repair queued
AdultMicrobiomeRectalSwabInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
BreastMilkInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
AdultUrineInstructions.doc Supplementary Document Uploaded 2013-11-07 Available
BreastMilkKitLetter.docx Supplementary Document Uploaded 2013-11-06 Repair queued
24M_ChildMicrobiomeStoolInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
ChildUrineBagInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
ChildUrineInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
60M_ChildTeethInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
OutdoorStructureObservationInstrument.docx Supplementary Document Uploaded 2013-11-08 Repair queued
PVTKeyDataVerificationForm.docx Supplementary Document Uploaded 2013-11-08 Repair queued
PVTContactVerificationForm.docx Supplementary Document Uploaded 2013-11-08 Available
PLSNDPhoneRemindCallScript.docx Supplementary Document Uploaded 2013-11-08 Available
PLSNDMailRemindCallScript.docx Supplementary Document Uploaded 2013-11-08 Repair queued
PLSNDSAQReleaseLetter.docx Supplementary Document Uploaded 2013-11-08 Available
MCHATInPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
PAIRSAQInstructions.docx Supplementary Document Uploaded 2013-11-08 Repair queued
MCHATInPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
BITSEAPhoneInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
BITSEAInPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
3M_InfantBehaviorRevised3SubscalesInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
3M_EdinburghPostnatalDepressionScaleInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
ASQ3PhoneInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
MultiModeVisitInformationScript.docx Supplementary Document Uploaded 2013-11-14 Repair queued
AdultUrineInstructions.doc Supplementary Document Uploaded 2013-11-07 Available
NCS Vanguard Study Request for Revision SSA_REVISED.docx Supporting Statement A Uploaded 2014-05-19 Available
IC Document Collections
IC IDCollectionTypeStatusForm
210037 Father Post-Natal Interview Form and Instruction New
210036 Retrospective Pregnancy Interview Form and Instruction New
210035 Environmental Sample Collection (Prenatal) Form and Instruction New
210034 Physical Activity Subsample Study Form and Instruction New
210033 Bioelectrical Impedance Analysis Subsample Study Form and Instruction New
210032 Noise Subsample Study Form and Instruction New
210031 Participant Information Update - Incentive Substudy Form and Instruction New
210030 36-Month Interview Form and Instruction New
210029 60-Month Interview Form and Instruction New
210028 54-Month Interview Form and Instruction New
210027 48-Month Interview Form and Instruction New
210026 42-Month Interview Form and Instruction New
210025 Child-Focused Biospecimen Collection (Birth) Form and Instruction New
210024 Adult-Focused Biospecimen Collection (Birth) Form and Instruction New
210023 Pregnancy Probability Group Follow-up Interview Form and Instruction New
210022 Adult-Focused Biospecimen Collection (Preconception) Form and Instruction New
210021 Secondary Residence Interview Form and Instruction New
210020 Parent-Caregiver & Child Death Interview Form and Instruction New
202215 30-Month Interview Form and Instruction Modified
202214 Core Questionnaire - Child, Adult, & Household Form and Instruction Modified
202213 Adult-Focused Biospecimen Collection (Postnatal) Form and Instruction Modified
202212 Child-Focused Physical Measures (Postnatal) Form and Instruction Modified
202211 Child-Focused Biospecimen Collection (Postnatal) Form and Instruction Modified
202210 Environmental Sample Collection (Postnatal) Form and Instruction Modified
202209 Participant Verification & Tracing Interview Form and Instruction Modified
202208 Non-Interview Respondent Interview Form and Instruction Modified
202207 Pregnancy Loss, Stillbirth, & Neonatal Death Interview Form and Instruction Modified
202206 Pregnancy Screener Form and Instruction Modified
193580 Formative Research Form and Instruction Modified
193579 24-Month Interview Form and Instruction Modified
193578 18-Month Interview Form and Instruction Modified
193577 12-Month Interview Form and Instruction Modified
193576 9-Month Interview Form and Instruction Modified
193575 6-Month Interview Form and Instruction Modified
193574 3-Month Interview Form and Instruction Modified
193572 Infant & Child Health Care Log Form and Instruction Modified
193571 Low-Intensity Questionnaire (Birth focus) (TT-LI) Form and Instruction Removed
193570 Birth Interview Form and Instruction Modified
193569 Father Pre-Natal Interview Form and Instruction Modified
193567 Pregnancy Health Care Log Form and Instruction Modified
193566 Pregnancy Visit 2 Interview Form and Instruction Modified
193565 Pregnancy Visit 1 Interview Form and Instruction Modified
193563 Validation Interview Form and Instruction Modified
193562 Pre-Pregnancy Interview Form and Instruction Modified
193560 Adult-Focused Biospecimen Collection (Prenatal) Form and Instruction Modified
ICR Details
0925-0593 201401-0925-004
Historical Active 201211-0925-001
HHS/NIH 20831
Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months and Sibling Birth Enrollment
Revision of a currently approved collection   No
Regular
Approved with change 06/03/2014
Retrieve Notice of Action (NOA) 01/13/2014
This package is being approved in stages due to breadth and complexity of the changes requested. The approval granted May 2014 ONLY covers the following elements: a) the continuation of already established data collection events (age-defined Study Visits or trigger-based collections) including all associated instruments protocols and consent documents, b) revision to the previously approved 30 month Study Visit, c) establishment of new Study Visits at 36 and 42 months. Although subsequent approval must be sought before implementing new Study Visits at ages 48, 54, and 60 months, adding biospecimen sampling to prior approved visits, conducting substudies and incentive tests, and initiating the sibling cohort, no additional public comment is required for the re-submission of the refined requests for these study components because public comment has already been sought and preliminary instruments were provided in the original submission. Additional discussion is also required to ensure that datasets are made available to non-NCS researchers in a manner consistent with the context in which they were approved.
  Inventory as of this Action Requested Previously Approved
06/30/2017 36 Months From Approved 08/31/2014
113,521 0 55,748
55,122 0 22,791
0 0 0

The purpose of the Vanguard (Pilot) Study is to assess the feasibility, acceptability, and cost of the recruitment strategy, study logistics and operations, and study visit assessments that will be used in the NCS Main Study. This Information Collection Request (ICR) serves as a formal request for renewal of the Vanguard Study clearance. It also covers several other important requests, including initiating a new cohort to be enrolled, revisions to the NCS protocol with both new and revised Study visits, and the initiation of methodological substudies. The Vanguard Study has yielded valuable data and field experience related to participant recruitment, the conduct of Study assessments, and operational requirements associated with NCS infrastructure and field efforts. The purpose of the proposed data collection is to obtain further operational and performance data on processes and administration Study visit measures. The NCS Main Study design is being informed by the experience obtained in the NCS Vanguard Study, substudies and methodological research projects.

PL: Pub.L. 106 - 310 1004 Name of Law: Childrens Health Act of 2000
  
None

Not associated with rulemaking

  78 FR 52548 08/23/2013
78 FR 76629 12/18/2013
Yes

44
IC Title Form No. Form Name
18-Month Interview 15.1, 15.2, 15.4, 15.5, 15.6 Survey ,   Survey ,   Survey ,   Survey ,   Survey
24-Month Interview 16.1, 16.2, 16.4, 16.5, 16.6, 16.7, 16.3 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Formative Research 17.1 Survey
Pregnancy Screener 18.1 Survey
Pregnancy Loss, Stillbirth, & Neonatal Death Interview 19.1, 19.2 Survey ,   Survey
Non-Interview Respondent Interview 20.1 Survey
Pre-Pregnancy Interview 2.1, 2.2, 2.3 Survey ,   Survey ,   Survey
Validation Interview 3.1 Survey
Pregnancy Visit 1 Interview 4.1, 4.2, 4.4, 4.3 Survey ,   Survey ,   Survey ,   Survey
Pregnancy Visit 2 Interview 5.1, 5.2, 5.3 Survey ,   Survey ,   Survey
Pregnancy Health Care Log 6.1 Survey
Father Pre-Natal Interview 7.2, 7.1 Survey ,   Survey
Birth Interview 8.1, 8.2, 8.3 Survey ,   Survey ,   Survey
Infant & Child Health Care Log 10.1 Survey
3-Month Interview 11.1, 11.2, 11.3, 11.4, 11.5, 11.6, 11.7, 11.8 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
6-Month Interview 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
9-Month Interview 13.1 Survey
12-Month Interview 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Core Questionnaire - Child, Adult, & Household 26.1 Revised, 26.2, 26.3 Survey ,   Survey ,   Survey
30-Month Interview 27.1, 27.2, 27.3, 27.4, 27.5 Survey ,   Survey ,   Survey ,   Survey ,   Survey
Parent-Caregiver & Child Death Interview 28.1 Revised , 28.2 Revised Survey ,   Survey
Secondary Residence Interview 29.1 Survey
Adult-Focused Biospecimen Collection (Preconception) 30.2, 30.1, 30.3 Survey ,   Survey ,   Survey
Pregnancy Probability Group Follow-up Interview 31.1 Survey
Adult-Focused Biospecimen Collection (Birth) 32.2, 32.3, 32.5, 32.7, 32.8, 32.4, 32.6, 32.9, 32.10, 32.1 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Child-Focused Biospecimen Collection (Birth) 33.1 Survey
42-Month Interview 34.1, 34.3, 34.5, 34.6, 34.7, 34.4 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
48-Month Interview 35.2, 35.3, 35.4, 35.5, 35.6, 35.7, 35.8, 35.9, 35.1 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
54-Month Interview 36.1, 36.2, 36.3 Survey ,   Survey ,   Survey
60-Month Interview 37.1, 37.2, 37.3, 37.4, 37.5, 37.6, 37.7, 37.8 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
36-Month Interview 38.12 Revised, 38.2, 38.3, 38.4, 38.5, 38.6, 38.7, 38.9, 38.10, 38.11, 38.1 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Participant Information Update - Incentive Substudy 39.1, 39.2, 39.3, 39.4 Survey ,   Survey ,   Survey ,   Survey
Noise Subsample Study 40.3, 40.1, 40.2 Survey ,   Survey ,   Survey
Bioelectrical Impedance Analysis Subsample Study 41.1 Survey
Physical Activity Subsample Study 42.1, 42.2, 42.3, 42.4 Survey ,   Survey ,   Survey ,   Survey
Environmental Sample Collection (Prenatal) 43.1 Survey
Retrospective Pregnancy Interview 45.1, 45.3, 45.2 Survey ,   Survey ,   Survey
Father Post-Natal Interview 45.1, 45.2, 45.3 Survey ,   Survey ,   Survey
Low-Intensity Questionnaire (Birth focus) (TT-LI) 14.1 Survey
Adult-Focused Biospecimen Collection (Prenatal) 1.1, 1.2, 1.4 Survey ,   Survey ,   Survey
Participant Verification & Tracing Interview 21.1 Survey
Environmental Sample Collection (Postnatal) 22.1, 22.2, 22.3, 22.5 Survey ,   Survey ,   Survey ,   Survey
Child-Focused Biospecimen Collection (Postnatal) 23.1, 23.2, 23.3, 23.4, 23.5, 23.6, 23.7, 23.8 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey
Child-Focused Physical Measures (Postnatal) 24.1, 24.2, 24.3, 24.4, 24.5 Survey ,   Survey ,   Survey ,   Survey ,   Survey
Adult-Focused Biospecimen Collection (Postnatal) 25.1, 25.2, 25.3, 25.4, 25.5, 25.6, 25.7, 25.8 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey

  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 113,521 55,748 0 57,773 0 0
Annual Time Burden (Hours) 55,122 22,791 0 32,331 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
As noted in A.2, program changes/adjustments that affect burden include the initiation of a new enrollment cohort, the establishment of new Study visits, and revisions to already-established Study visits. The two proposed methodological substudies are designed to understand the impact of variable incentives on participation in existing and proposed study visits. On their own, these substudies do not impose additional participant burden. Currently, the NCS is approved for 22,911 annualized burden hours. With this ICR, the total annualized hour burden for the NCS Vanguard Study is approximately 51,402 hours, which is an increase in burden.

$20,479,000
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Saleda Perryman

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/10/2014