Physical Activity Subsample Study

OMB #: 0925-0593

OMB Expiration Date: 08/31/2014

Environmental Physical Activity and GPS Monitor Shipping Instructions, Phase 2g

The National Children’s Study

Physical Activity and GPS Monitor

Shipping Instructions

Instructions for Returning the Physical Activity and GPS Monitors

The GPS and physical activity monitors should be shipped in the provided shipping kit. This kit contains bubble bags, packing material, tape strips, a prefilled FedEx airbill, pen, and a resealable plastic bag for the Physical Activity Monitoring Questionnaire and the Physical Activity and GPS Monitor Wear Log (Photo x).

Photo x: Shipping kit with text indicating each part

2. On the Physical Activity Monitoring Questionnaire, write the date, mark the day of the week, and write the time when you removed the GPS monitor from the child’s waist (Questions 1, 2, and 3). In addition, write the date, mark the day of the week, and write the time when you removed the physical activity monitor from your child’s wrist (Questions 8, 9, and 10). Complete the rest of the questions and make sure all the questions are answered.

3. On the Physical Activity and GPS Monitor Wear Log make sure your child’s name and age are present and that all entries in the log are complete. Record any additional comments you may have about both monitors in the appropriate section at the bottom of page.

Place the completed questionnaire and the wear log in the resealable plastic bag.

4. Insert the GPS monitor along with the pouch and elastic waistband in a bubble bag.

Insert the wall charger in a separate bubble bag.

Insert the physical activity monitor in a third bubble bag.

Place both monitors, the GPS wall charger, and the resealable plastic bag with the completed questionnaire and wear log in the shipping box provided (Photo x).

Photo x: Shipping box with completed questionnaire and wear log, both monitors, and GPS wall charger

6. Make sure that the shipping box includes the following:

• Completed Questionnaire and wear log in the resealable plastic bag.

• GPS monitor in a bubble bag

• GPS wall charger in a bubble bag

• Physical activity monitor in a bubble bag.

Fill the extra space in the box with the packing material provided.

Seal the shipping box with the tape strips provided. Write the date that the shipment is to be picked up or dropped off on the prepaid, prefilled FedEx airbill and attach the airbill to the shipping box.

Photo x: Prefilled FedEx airbill attached to the shipping box.

8. Call FedEx (1-800-463-3339 or 1-800-GO- FEDEX) to schedule a pickup or determine where to drop off the shipment. Monitors should be shipped as soon as the monitoring period is completed.

9. Have the following information ready when you call FedEx for FedEx Express (overnight delivery) shipment:

1. Your name

2. Address for pick-up

3. Approximate weight of the shipment

4. Date of pick-up

5. Time of pick-up

6. Exact location where the shipment will be picked-up

7. The FedEx account number to use for this prepaid shipment

Please refer to the pre-filled FedEx airbill for the approximate weight of the shipment and FedEx account number.

10. Leave the sealed shipping box for the FedEx to pick up or drop it off at a FedEx location.

The shipment will be shipped to the address indicated on the prefilled FedEx label.

_{Thank you for completing the physical activity monitoring questionnaire and the wear log and for sending} back the physical activity and GPS monitors.

Your continued participation in the National Children’s Study is greatly appreciated.

Please contact us if you have any questions about the physical activity measurement and/or shipping the physical activity and GPS monitors:

Include the contact information

(phone number, e-mail address etc.) here.

Please ship the monitors to the following address:

Include the address here.

For Office Use Only:

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Click here to insert Participant ID.

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Public reporting burden for this collection of information is estimated to average 4 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*). Do not return the completed form to this address.