Generic Clearance Form Healthy Native Babies Project Train-the-Trainer Follow-Up Assessment

0925-0701_Generic ICR_Healthy Native Babies_Train-the-Trainer Survey_rev 10-28-14.doc

Generic Clearance to Support the Safe to Sleep Campaign at the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD)

Generic Clearance Form Healthy Native Babies Project Train-the-Trainer Follow-Up Assessment

OMB: 0925-0701

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SUBMISSION OF INFORMATION COLLECTION UNDER THE

SAFE TO SLEEP GENERIC CLEARANCE



DATE OF REQUEST: October 10, 2014


SUB AGENCY (I/C): NICHD


TITLE: Healthy Native Babies (HNB) Project Train-the-Trainer Follow-up Assessment Survey


GENERIC CLEARANCE UNDER OMB#: 0925-0701 EXP. DATE: 07/31/2017


ABSTRACT:


The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) propose conducting a follow-up survey of participants in the Healthy Native Babies (HNB) Project train-the-trainer sessions. The HNB Project is a collaboration between the NICHD and representatives from five American Indian/Alaskan Native (AI/AN) communities in the U.S. Northern Tier - Aberdeen, Alaska, Billings, Bemidji, and Portland. This innovative collaboration is part of the Safe to Sleep® (STS) campaign and aims to spread safe sleep messages within AI/AN communities.


NICHD will collect information using the Healthy Native Babies Project Train-the-Trainer Follow-Up Assessment survey (Attachment 1). HNB Project trainees will receive a follow-up survey 3-6 months after completing the training. The follow-up survey will gather information on the participants’ community outreach and education activities since taking the training as well as their level of confidence in conducting these activities. The follow-up survey will also assess the participants’ use of and satisfaction with HNB Project training tools and materials.

TOTAL ANNUAL BURDEN APPROVED: 3,000

BURDEN USED TO DATE: 0

BURDEN THIS REQUEST: 16 for Individual-Household


FEDERAL COST: The estimated annual cost to the Federal government is $3,324.83.


IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ___X___ NO ______ N/A


OBLIGATION TO RESPOND:

___X___ VOLUNTARY

______ REQUIRED TO OBTAIN OR RETAIN BENEFITS

______ MANDATORY


HOW WILL THIS SURVEY BE OFFERED?

_____ WEB SITE

_____ TELEPHONE INTERVIEW

_____ MAIL RESPONSE

_____ IN PERSON INTERVIEW

__X___ OTHER: In-person Survey


CONTACT INFORMATION:

NAME: Shavon Artis

TELEPHONE NUMBER: 301-435-3459

EMAIL ADDRESS: [email protected]

File Typeapplication/msword
File TitleGeneric Clearance Form - 04/28/2008
SubjectGeneric Clearance Form - 04/28/2008
AuthorOD/USER
Last Modified ByCurrie, Mikia (NIH/OD) [E]
File Modified2014-11-10
File Created2014-09-23

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