NICHD Safe to Sleep® Campaign Healthy Native Babies (HNB) Focus Group Guides

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NICHD)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0643 can be found here:

Documents and Forms

Document Name Document Type
0925-0643_HNB_focus_group_Family_RECRUITMENT_SCREENER rev_1-7-15.docx Other-Screener
0925-0643_HNB_focus_group_professionals_RECRUITMENT_SCREENER rev_1-7-15.docx Other-Screener
1 Focus Group Guide GENERAL PROVIDERS 0925-0643_HNB FocusGroupGuide GENERAL Providers rev_1-7-15.docx Form and Instruction
2 Focus Group Guide HEALTH PROVIDERS 0925-0643_HNB FocusGroupGuide HEALTH Providers rev_1-7-15.docx Form and Instruction
3 Focus Group Guide ELDERS 0925-0643_HNB FocusGroupGuide ELDERS rev_1-7-15.docx Form and Instruction
4 Focus Group Guide FATHERS 0925-0643_HNB FocusGroupGuide FATHERS rev_1-7-15.docx Form and Instruction
5 Focus Group Guide MOTHERS 0925-0643_HNB FocusGroupGuide MOTHERS rev_1-7-15.docx Form and Instruction
0925-0643_Gen Clearance Template_HNB Focus Group Guides_Indiv-HH rev_1-7-15 (2).doc Generic Clearance Form Healthy Native Babies Project Focus Group IC Document

Information Collection (IC) Details

IC Title:	NICHD Safe to Sleep® Campaign Healthy Native Babies (HNB) Focus Group Guides	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Other-Screener			0925-0643_HNB_focus_group_Family_RECRUITMENT_SCREENER rev_1-7-15.docx	No	Paper Only
Other-Screener			0925-0643_HNB_focus_group_professionals_RECRUITMENT_SCREENER rev_1-7-15.docx	No	Paper Only
Form and Instruction	1	Focus Group Guide GENERAL PROVIDERS	0925-0643_HNB FocusGroupGuide GENERAL Providers rev_1-7-15.docx	No	Paper Only
Form and Instruction	2	Focus Group Guide HEALTH PROVIDERS	0925-0643_HNB FocusGroupGuide HEALTH Providers rev_1-7-15.docx	No	Paper Only
Form and Instruction	3	Focus Group Guide ELDERS	0925-0643_HNB FocusGroupGuide ELDERS rev_1-7-15.docx	No	Paper Only
Form and Instruction	4	Focus Group Guide FATHERS	0925-0643_HNB FocusGroupGuide FATHERS rev_1-7-15.docx	No	Paper Only
Form and Instruction	5	Focus Group Guide MOTHERS	0925-0643_HNB FocusGroupGuide MOTHERS rev_1-7-15.docx	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	125	125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Form Healthy Native Babies Project Focus Group	0925-0643_Gen Clearance Template_HNB Focus Group Guides_Indiv-HH rev_1-7-15 (2).doc	01/20/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.