SFSP Burden Table Revised 6-28-17_aag

SFSP Burden Table Revised 6-28-17_aag.xlsx

FNS Generic Clearance For Pre-Testing, Pilot, And Field Test Studies

SFSP Burden Table Revised 6-28-17_aag

OMB: 0584-0606

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Respondent Type Respondent Description Type of Survey Instrument Appendix Sample size Number of Respondents Frequency of Response (annual) Total Annual Responses Average Hours per Response Sub-Total Annual Burden Number of non -respondents Frequency of Response (annual) Total Annual Responses Average Hours per response Sub-Total Annual Burden Total Burden Hours Hourly Rate Total Annualized Cost
State/Local Government
Telephone call to recruit Sponsors for instrument testing (a) (5 min) A.1 4 3 1 3 0.0835 0.2505 1 1 1 0.0167 0.02 0.2672 53.15 14.20
Email data collection instruments and discussion time to Sponsors (b) (1 min) A.2 3 3 1 3 0.0167 0.0501 0 1 0 0.0167 0 0.0501 53.15 2.66
Conduct cognitive testing and schedule QI interview time (b) (1 hour) A.3, A.4, A.5, A.6, D.1 2 2 1 2 1.0000 2.0000 0 1 0 0.0167 0 2.0000 53.15 106.30
Email with QI appointment time (b) (1 min) A.7 2 2 1 2 0.0167 0.0334 0 1 0 0.0167 0 0.0334 53.15 1.78
Cognitive testing of QI with Sponsors (b) (1 hour) A.8, D.1 2 2 1 2 1.0000 2.0000 0 1 0 0.0167 0 2.0000 53.15 106.30
Telephone call to recruit Former Sponsors for instrument testing (a) (5 min) A.1 4 3 1 3 0.0835 0.2505 1 1 1 0.0167 0.02 0.2672 53.15 14.20
Email Former Sponsors: schedule for instrument testing (b) (1 min) A.7 3 3 1 3 0.0167 0.0501 0 1 0 0.0167 0 0.0501 53.15 2.66
Cognitive testing of QI with Former Sponsors (b) (30 minutes) B.1, D.1 2 2 1 2 0.5000 1.1250 0 1 0 0.0167 0 1.1250 53.15 59.79
SUBTOTAL OF CN SFSP and SSO SPONSORS 8 6 3 20 0.2844 5.76 2 1 2 0.0167 0.03 5.79 53.15 307.90
CN SSO and SFSP Site Supervisors Telephone call to recruit Site supervisors for instrument testing (b) (5 min) A.1 4 4 1 4 0.0835 0.3340 0 1 0 0.0167 0 0.3340 53.15 17.75
Email data collection instruments and discussion time to Site supervisors (b) (1 min) A.2 3 3 1 3 0.0167 0.0501 0 1 0 0.0167 0 0.0501 53.15 2.66
Conduct cognitive testing and schedule QI interview time (b) (1 hour) C.1, A.4, A.5, A.6, D.1 2 2 1 2 1.0000 2.0000 0 1 0 0.0167 0 2.0042 53.15 106.52
Email thank you letter and QI scheduled time to Site supervisors (b) (1 min) A.7 2 2 1 2 0.0167 0.0334 0 1 0 0.0167 0 0.0334 53.15 1.78
Cognitive testing of QI with Site supervisors (b) (1 hour) C.2, D.1 2 2 1 2 1.0000 2.0000 0 1 0 0.0167 0 2.0000 53.15 106.30

SUBTOTAL OF CN SFSP AND SITE SUPERVISORS 4 4 3 13 0.3398 4.42 0 0 0 0.0000 0 4.42 53.15 235.01
GRAND TOTAL OF STATE/LOCAL GOVERNMENT
12 10 3 33 0.3061 10 2 1 2 0.0188 0 10
542.91
Nonprofit Organizations
Telephone call to recruit Sponsors for instrument testing (a) (5 min) A.1 4 3 1 3 0.0835 0.2505 1 1 1 0.0167 0.02 0.2672 53.15 14.20
Email data collection instruments and discssuion time to Sponsors (b) (1 min) A.2 3 3 1 3 0.0167 0.0501 0 1 0 0.0167 0 0.0501 53.15 2.66
Conduct cognitive testing and schedule QI interview time (b) (1 hour) A.3, A.4, A.5, A.6, D.1 2 2 1 2 1.0000 2.0000 0 1 0 0.0167 0 2.0000 53.15 106.30
Email with QI appointment time (b) (1 min) A.7 2 2 1 2 0.0167 0.0334 0 1 0 0.0167 0 0.0334 53.15 1.78
Cognitive testing of QI with Sponsors (b) (1 hour) A.8, D.1 2 2 1 2 1.0000 2.0000 0 1 0 0.0167 0 2.0000 53.15 106.30
Telephone call to recruit Former Sponsors for instrument testing (a) (5 min) A.1 4 3 1 3 0.0835 0.2505 1 1 1 0.0167 0.02 0.2672 53.15 14.20
Email Former Sponsors: schedule for instrument testing (b) (1 min) A.7 3 3 1 3 0.0167 0.0501 0 1 0 0.0167 0 0.0501 53.15 2.66
Cognitive testing of QI with Former Sponsors (b) (30 minutes) B.1, D.1 3 3 1 3 0.5000 1.5000 0 1 0 0.0167 0 1.5000 53.15 79.73
SUBTOTAL OF CN SFSP AND SSO SPONSORS 8 6 4 21 0.2921 6.13 2 1 2 0.02 0.03 6.17 53.15 327.83
CN SFSP and SSO Site Supervisors Telephone call to recruit Site supervisors for instrument testing (b) (5 min) A.1 4 4 1 4 0.0835 0.3340 0 1 0 0.0167 0 0.3340 53.15 17.75
Email data collection instruments and discussion time to Site supervisors (b) (1 min) A.2 3 3 1 3 0.0167 0.0501 0 1 0 0.0167 0 0.0501 53.15 2.66
Cognitive testing and schedule QI (b) (1 hour) C.1, A.4, A.5, A.6, D.1 2 2 1 2 1.0000 2.0000 0 1 0 0.0167 0 2.0000 53.15 106.30
Email with QI appointment time (b) (1 min) A.7 2 2 1 2 0.0167 0.0334 0 1 0 0.0167 0 0.0334 53.15 1.78
Cognitive testing of QI with Site supervisors (b) (1 hour) C.2, D.1 2 2 1 2 1.0000 2.0000 0 1 0 0.0167 0 2.0000 53.15 106.30

SUBTOTAL OF CN SFSP AND SSO SITE SUPERVISORS 4 4 3 13 0.3398 4.42 0 0 0 0 0 4.42 53.15 234.79
GRAND TOTAL OF BUSINESS NONPROFIT ORGANIZATIONS
12 10 3 34 0.3104 10.55 2 1 2 0.0167 0.03 10.59
562.62
Individuals and households Parents/Caregivers of SFSP/SSO Participants and nonparticipants Study voicemail message for inbound calls from interested caregivers (1 min) E.1 40 40 1 1 0.0167 0.0167 0 1 0 0.0000 0 0.0167 7.25 0.12
Outbound telphone calls to schedule cognitive testing interviews (c) (d) (10 min) E.2 32 26 1 26 0.1670 4.2752 6 1 6 0.0167 0 4.3821 7.25 31.77
Confirmation email for cognitive testing (b) (2 minutes) E.3 23 23 1 23 0.0334 0.7695 0 1 0 0.0167 0 0.7695 7.25 5.58
Cognitive testing of eligibility screener (c)(e) (10 min) E.4 18 18 1 18 0.1670 3.0781 0 1 0 0.0167 0 3.0781 7.25 22.32
Caregiver consent (i) (5 min) E.5 18 18 1 18 0.0835 1.5030 0 1 0 0.0167 0 1.5030 7.25 10.90
Cognitive testing of Caregiver surveys (e) (40 min) E.6, E.7 18 18 1 18 0.6680 12.0240 0 1 0 0.0167 0 12.0240 7.25 87.17
Cognitive testing of caregiver QIs (e) (30 min) E.8, E.9 18 18 1 18 0.5000 9.0000 0 1 0 0.0167 0 9.0000 7.25 65.25
Caregiver consent to interview child/teen (e) (5 min) E.10 18 18 1 18 0.0835 1.5030 0 1 0 0.0167 0 1.5030 7.25 10.90
SUBTOTAL OF PARENTS/CAREGIVERS OF SFSP/SSO PARTICIPANTS AND NONPARTICIPANTS 40 40 4 140 0.2297 32.17 6 1 6 0.02 0 32.28 7.25 234.00
Child and Teen SFSP and SSO participants and nonparticipants Child assent (e) (5 min) E.11 9 9 1 9 0.0835 0.7515 0 1 0 0.0167 0 0.7515 7.25 5.45
Teen assent (e) (5 min) E.12 14 14 1 14 0.0835 1.1690 0 1 0 0.0167 0 1.1690 7.25 8.48
Cognitive testing of child survey (with parent) (e) (20 min) E.13 4 4 1 4 0.5000 2.0000 0 1 0 0.0167 0 2.0000 7.25 14.50
Cognitive testing of teen surveys (20 min) E.14, E.15 14 14 1 14 0.5000 7.0000 0 1 0 0.0167 0 7.0000 7.25 50.75

SUBTOTAL OF CHILD AND TEEN SFSP/SSO PARTICIPANTS AND NONPARTICIPANTS 23 23 2 41 0.2664 10.92 0 0 0 0 0 10.92 7.25 79.17
GRAND TOTAL OF INDIVIDUALS AND HOUSEHOLDS
63 63 3 181 0.2380 43.09 6 1 6 0.02 0.11 43.20
313.18
OVERALL GRAND TOTAL FOR THE BURDEN REQUEST
87 83 3 248 0.2570 63.82 10 1 10 0.02 0.18 64
1,418.71


















(a) 75% of sampled respondents will respond to this data collection activity
















(b) 100% of sampled participants will respond to this data collection activity
















(c) 80% of respondents who agree will participate in this data collection activity
















(d) 80% of respondents who leave a voicemail message on study toll free number will be reached
















(e) 100% of respondents who arrive for cognitive testing will participate in this data collection activity
















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