Generic Clearance Form Healthy Native Babies Project Materials Distribution

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 Materials Distribution

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 an assessment of its Healthy Native Babies (HNB) Project Materials Distribution activities. The HNB Project is a collaboration between the NICHD and representatives from five American Indian and Alaska 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. As part of this project, the NICHD provides tribal governments and community-based organizations across the Indian Health Service (IHS) areas with HNB Project materials tailored to the AI/AN communities. Materials include brochures, door hangers, one-page flyers, and training materials. Participating organizations receive resource stipends to copy and distribute HNB materials during home visits, local community events, and/or through their organization’s training workshops.

The NICHD will collect information using the HNB Project Materials Distribution Tracking Form (Attachment 2). The tracking form collects information on the types of materials distributed (e.g., brochures), the location of distribution (e.g., community event, home visit), the number of materials provided to all participants, and the number of materials distributed to the target population(s). Participating organizations will also be asked to describe the activities conducted, the results of these activities, and successes and challenges in distributing materials.

TOTAL ANNUAL BURDEN APPROVED: 3,000

BURDEN USED TO DATE: 0

BURDEN THIS REQUEST: 3 for Private Sector

FEDERAL COST: The estimated annual cost to the Federal government is 2,001.72.

IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ___X___ NO ______ N/A

OBLIGATION TO RESPOND:

______ VOLUNTARY

______ REQUIRED TO OBTAIN OR RETAIN BENEFITS

___X___ MANDATORY (as part of stipend agreement)

HOW WILL THIS SURVEY BE OFFERED?

_____ WEB SITE

_____ TELEPHONE INTERVIEW

_____ MAIL RESPONSE

_____ IN PERSON INTERVIEW

__X___ OTHER: Email Response

CONTACT INFORMATION:

NAME: Shavon Artis

TELEPHONE NUMBER: 301-435-3459

EMAIL ADDRESS: [email protected]