Fast-Track template High-risk States Outreach Program Customer Satisfaction Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0925-0643)

T ITLE OF INFORMATION COLLECTION: NICHD Safe to Sleep^® Campaign High-Risk States Outreach Program Customer Satisfaction Survey

PURPOSE:

The NICHD launched the Safe to Sleep^® (STS) campaign (formerly Back to Sleep), a national public health education campaign, in 1994 to raise awareness to reduce the risk of sudden infant death syndrome (SIDS). The campaign was expanded in 2012, to incorporate the American Academy of Pediatrics’ (AAP) recommendations for safe infant sleep that went beyond SIDS and addressed the shared risk factors for other sleep-related causes of infant death (e.g., accidental suffocation, entrapment, and overlay). The goals of the STS campaign are to: improve knowledge of SIDS and other sleep-related causes of infant death and risk-reduction behaviors among parents, caregivers, and the medical community; increase awareness of and educate stakeholder groups on the expanded STS campaign and its new resources; and contribute to the reduction of the SIDS death rate and other sleep-related causes of infant death. The STS campaign activities help to promote campaign messages to professional and lay audiences, train individuals and health professionals on safe sleep positions and environments for infants, and teach ways to reduce SIDS/Sudden Unexpected Infant Death (SUID). The STS campaign also supports the NICHD mission to ensure children have the chance to achieve their full potential for healthy and productive lives by contributing to the reduction of mortality rates from SIDS and SUID in the U.S.

The STS campaign includes both national activities and activities focused on a target group of 15 high-risk states – Alabama, Arkansas, Georgia, Hawaii, Iowa, Kentucky, Louisiana, Mississippi, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. These 15 states were chosen based on having either the highest SIDS and other sleep-related infant death mortality rates or the highest absolute number of SIDS and other sleep-related infant deaths in 2010.

As part of the STS outreach activities to these 15 high-risk states, a promotional e-toolkit was developed in 2013 to facilitate the efforts of organizations and groups that work locally or regionally to share the messages of the STS campaign. The promotional e-toolkit contains links to (and copies of) various materials that would support efforts to launch and sustain local campaigns. Examples of the types of materials that organizations are able to access include: links for ordering NICHD brochures and materials; a STS campaign logo to complement any of the partner’s publications and resources; print-ready files for all materials; a template label for organizations to add their contact information; STS/SIDS awareness event ideas; a fact sheet on the campaign; links to the latest statistics; a web banner and button; an image gallery containing the photos used; and various templates that partnering organizations can use within their existing communications channels to promote the availability of materials (such as PowerPoint slides, flyers, tweets with the appropriate links and popular hashtags, Facebook posts, blog posts, and e-newsletter articles).

In October 2013 (9 states) and in November 2014 (6 states), STS campaign staff distributed the promotional e-toolkit to state Maternal and Child Health (MCH) program coordinators, Women, Infants, and Children (WIC) coordinators, and WIC breastfeeding coordinators in the 15 high-risk states. STS campaign staff plan to conduct a customer satisfaction survey with these state participants to assess what promotional e-toolkit materials participants have used, how useful they found the materials, and whether the promotional e-toolkit materials helped the participants conduct their STS outreach activities. This survey will help the STS campaign staff better understand what materials state organizations find useful for different types of outreach activities, and determine if the promotional e-toolkit is an effective approach to promote and distribute campaign messages.

DESCRIPTION OF RESPONDENTS:

Respondents include all the MCH program coordinators, WIC coordinators, and WIC breastfeeding coordinators in the 15 high-risk states that received the STS campaign promotional e-toolkit materials in October 2013 and November 2014 from the STS campaign.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:___ Jamelle E. Banks _____________________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
State, Local or Tribal Governments	70	10/60	12
Totals	70	10/60	12

FEDERAL COST: The estimated annual cost to the Federal government is $6,087.00

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

The STS campaign maintained a spreadsheet database of the individuals that received the promotional e-toolkit materials. The database contains the names and professional email addresses of the MCH program coordinators, WIC breastfeeding coordinators, and WIC coordinators for the 15 high-risk states. The customer satisfaction survey will be distributed to this list of individuals.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [X] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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