Information Collection Request

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

ICR 201407-0925-005 · OMB 0925-0593 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 45.1 Father Post-Natal Interview Form and Instruction Modified Repair queued
Form 45.1 Retrospective Pregnancy Interview Form and Instruction Unchanged Available
Form 43.1 Environmental Sample Collection (Prenatal) Form and Instruction Unchanged Repair queued
Form 42.1 Physical Activity Subsample Study Form and Instruction Unchanged Available
Form 41.1 Bioelectrical Impedance Analysis Subsample Study Form and Instruction Unchanged Available
Form 40.1 Noise Subsample Study Form and Instruction Unchanged Repair queued
Form 39.1 Participant Information Update - Incentive Substudy Form and Instruction Unchanged Repair queued
Form 38.2 36-Month Interview Form and Instruction Unchanged Available
Form 37.1 60-Month Interview Form and Instruction Modified Repair queued
Form 36.1 54-Month Interview Form and Instruction Modified Available
Form 35.2 48-Month Interview Form and Instruction Modified Available
Form 34.1 42-Month Interview Form and Instruction Modified Available
Form 33.1 Child-Focused Biospecimen Collection (Birth) Form and Instruction Unchanged Repair queued
Form 32.2 Adult-Focused Biospecimen Collection (Birth) Form and Instruction Unchanged Available
Form 31.1 Pregnancy Probability Group Follow-up Interview Form and Instruction Unchanged Available
Form 30.2 Adult-Focused Biospecimen Collection (Preconception) Form and Instruction Unchanged Repair queued
Form 29.1 Secondary Residence Interview Form and Instruction Unchanged Available
Form 28.1 Revised Parent-Caregiver & Child Death Interview Form and Instruction Modified Available
Form 27.1 30-Month Interview Form and Instruction Modified Available
Form 26.2 Core Questionnaire - Child, Adult, & Household Form and Instruction Unchanged Repair queued
Form 25.1 Adult-Focused Biospecimen Collection (Postnatal) Form and Instruction Unchanged Available
Form 24.1 Child-Focused Physical Measures (Postnatal) Form and Instruction Unchanged Available
Form 23.1 Child-Focused Biospecimen Collection (Postnatal) Form and Instruction Unchanged Available
Form 22.1 Environmental Sample Collection (Postnatal) Form and Instruction Unchanged Available
Form 21.1 Participant Verification & Tracing Interview Form and Instruction Unchanged Available
Form 20.1 Non-Interview Respondent Interview Form and Instruction Unchanged Available
Form 19.1 Pregnancy Loss, Stillbirth, & Neonatal Death Interview Form and Instruction Unchanged Available
Form 18.1 Pregnancy Screener Form and Instruction Unchanged Repair queued
Form 17.1 Formative Research Form and Instruction Unchanged Repair queued
Form 16.1 24-Month Interview Form and Instruction Modified Repair queued
Form 15.1 18-Month Interview Form and Instruction Modified Available
Form 14.1 12-Month Interview Form and Instruction Modified Available
Form 13.1 9-Month Interview Form and Instruction Modified Repair queued
Form 12.1 6-Month Interview Form and Instruction Modified Available
Form 11.1 3-Month Interview Form and Instruction Modified Repair queued
Form 10.1 Infant & Child Health Care Log Form and Instruction Unchanged Available
Form 8.1 Birth Interview Form and Instruction Modified Available
Form 7.1 Father Pre-Natal Interview Form and Instruction Modified Available
Form 6.1 Pregnancy Health Care Log Form and Instruction Unchanged Repair queued
Form 5.1 Pregnancy Visit 2 Interview Form and Instruction Modified Available
Form 4.1 Pregnancy Visit 1 Interview Form and Instruction Modified Available
Form 3.1 Validation Interview Form and Instruction Unchanged Available
Form 2.1 Pre-Pregnancy Interview Form and Instruction Modified Repair queued
Form 1.1 Adult-Focused Biospecimen Collection (Prenatal) Form and Instruction Unchanged Repair queued
VS Stage 2 Non-sub Change Memo_071814.docx Justification for No Material/Nonsubstantive Change Uploaded 2014-07-24 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 Available
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 Repair queued
36M_HomeSocialDirectObservationInstrument.docx Supplementary Document Uploaded 2013-11-08 Available
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 Available
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 Available
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
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 Available
BreastMilkKitLetter.docx Supplementary Document Uploaded 2013-11-06 Repair queued
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 Available
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 Available
VaccinationGridCoreModule.docx Supplementary Document Uploaded 2013-11-08 Available
AdultMicrobiomeRectalSwabInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
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 Repair queued
24M_ChildMicrobiomeStoolInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
ChildUrineBagInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
ChildUrineInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
60M_ChildTeethInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
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 Repair queued
PLSNDPhoneRemindCallScript.docx Supplementary Document Uploaded 2013-11-08 Available
PLSNDMailRemindCallScript.docx Supplementary Document Uploaded 2013-11-08 Available
PLSNDSAQReleaseLetter.docx Supplementary Document Uploaded 2013-11-08 Available
MCHATInPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
PAIRSAQInstructions.docx Supplementary Document Uploaded 2013-11-08 Available
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 Repair queued
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Repair queued
ASQ3InPersonMailInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
3M_InfantBehaviorRevised3SubscalesInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
3M_EdinburghPostnatalDepressionScaleInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
ASQ3PhoneInstructions.docx Supplementary Document Uploaded 2013-11-07 Available
MultiModeVisitInformationScript.docx Supplementary Document Uploaded 2013-11-14 Repair queued
AdultUrineInstructions.doc Supplementary Document Uploaded 2013-11-07 Repair queued
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 Modified
210036 Retrospective Pregnancy Interview Form and Instruction Unchanged
210035 Environmental Sample Collection (Prenatal) Form and Instruction Unchanged
210034 Physical Activity Subsample Study Form and Instruction Unchanged
210033 Bioelectrical Impedance Analysis Subsample Study Form and Instruction Unchanged
210032 Noise Subsample Study Form and Instruction Unchanged
210031 Participant Information Update - Incentive Substudy Form and Instruction Unchanged
210030 36-Month Interview Form and Instruction Unchanged
210029 60-Month Interview Form and Instruction Modified
210028 54-Month Interview Form and Instruction Modified
210027 48-Month Interview Form and Instruction Modified
210026 42-Month Interview Form and Instruction Modified
210025 Child-Focused Biospecimen Collection (Birth) Form and Instruction Unchanged
210024 Adult-Focused Biospecimen Collection (Birth) Form and Instruction Unchanged
210023 Pregnancy Probability Group Follow-up Interview Form and Instruction Unchanged
210022 Adult-Focused Biospecimen Collection (Preconception) Form and Instruction Unchanged
210021 Secondary Residence Interview Form and Instruction Unchanged
210020 Parent-Caregiver & Child Death Interview Form and Instruction Modified
202215 30-Month Interview Form and Instruction Modified
202214 Core Questionnaire - Child, Adult, & Household Form and Instruction Unchanged
202213 Adult-Focused Biospecimen Collection (Postnatal) Form and Instruction Unchanged
202212 Child-Focused Physical Measures (Postnatal) Form and Instruction Unchanged
202211 Child-Focused Biospecimen Collection (Postnatal) Form and Instruction Unchanged
202210 Environmental Sample Collection (Postnatal) Form and Instruction Unchanged
202209 Participant Verification & Tracing Interview Form and Instruction Unchanged
202208 Non-Interview Respondent Interview Form and Instruction Unchanged
202207 Pregnancy Loss, Stillbirth, & Neonatal Death Interview Form and Instruction Unchanged
202206 Pregnancy Screener Form and Instruction Unchanged
193580 Formative Research Form and Instruction Unchanged
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 Unchanged
193570 Birth Interview Form and Instruction Modified
193569 Father Pre-Natal Interview Form and Instruction Modified
193567 Pregnancy Health Care Log Form and Instruction Unchanged
193566 Pregnancy Visit 2 Interview Form and Instruction Modified
193565 Pregnancy Visit 1 Interview Form and Instruction Modified
193563 Validation Interview Form and Instruction Unchanged
193562 Pre-Pregnancy Interview Form and Instruction Modified
193560 Adult-Focused Biospecimen Collection (Prenatal) Form and Instruction Unchanged
ICR Details
0925-0593 201407-0925-005
Historical Active 201401-0925-004
HHS/NIH 20831
Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/09/2014
Retrieve Notice of Action (NOA) 07/25/2014
This package is being approved in stages due to breadth and complexity of the changes requested. As of August 2014, the following aspects of the request are approved for implementation by OMB: 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 , 42, 48, 54, and 60 months, d) implementing the noise and physical activity substudies in a subsample of 200 children, and e) update the consent form. Separate requests must be submitted to OMB before adding biospecimen sampling to prior approved visits, conducting additional substudies and incentive tests, and/or initiating the sibling cohort. 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 06/30/2017 06/30/2017
113,521 0 113,521
55,122 0 55,122
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
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 7.1, 7.2 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
18-Month Interview 15.1, 15.2, 15.4, 15.5, 15.6 Survey ,   Survey ,   Survey ,   Survey ,   Survey
Environmental Sample Collection (Postnatal) 22.3, 22.5, 22.1, 22.2 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
Core Questionnaire - Child, Adult, & Household 26.2, 26.3, 26.1 Revised 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 1, 2, 35.2, 35.3, 35.4, 35.7, 35.8, 35.9, 35.1 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   48M Questionnaire Adult ,   48M Questionnaire Child
54-Month Interview 1, 36.1, 36.3 Survey ,   Survey ,   54M Questionnaire Adult
60-Month Interview 1, 2, 37.1, 37.2, 37.3, 37.4, 37.6, 37.8 Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   Survey ,   60M Questionaire Child ,   60M Questionaire Househould
36-Month Interview 38.2, 38.3, 38.4, 38.5, 38.6, 38.7, 38.9, 38.10, 38.11, 38.1, 38.12 Revised 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 40.1, 40.2, 40.3 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
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
Participant Verification & Tracing Interview 21.1 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
Adult-Focused Biospecimen Collection (Prenatal) 1.1, 1.2, 1.4 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 113,521 113,521 0 0 0 0
Annual Time Burden (Hours) 55,122 55,122 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$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.
07/25/2014