UNICEF/WGSEnviornment Evaluation Study

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

January 12, 2016

Margo Schwab, Ph.D.

Office of Management and Budget

725 17th Street, N.W.

Washington, DC 20503

Dear Dr. Schwab:

The staff of the Center for Questionnaire Design and Evaluation Research Laboratory (CQDER) (OMB No. 0920-0222, exp. 7/31/2018) plans to conduct 15 additional cognitive interviews for the UNICEF/Washington Group School Environment evaluation study.

In a letter dated to you on February 27, 2015, twenty-five cognitive interviews were conducted to test the draft survey questions. As a result questions were revised (Attachment 1) to improve comprehension; there are no content changes. In order to assure that these revised questions are relevant and valid, we would like to conduct another small round of testing. There are no changes to the protocol.

No changes have been made to the 5 minute telephone screener (Attachment 2) approved on April 10. The telephone screener is included in this amendment to account for burden. It is anticipated that as many as 36 individuals may need to be screened in order to recruit 15 participants.

We propose paying participants $40, which is our standard payment. In total, for this project, the maximum respondent burden will be 18 hours. A burden table for this project is shown below:

Form Name	Number of Participants	Number of Responses/ Participant	Average hours per response	Response Burden (in hours)
Questionnaire	15	1	60/60	15
Screener	36	1	5/60	3
Questionnaire	15	1	60/60	15

Attachments (2)

cc:

V. Buie

T. Richardson

DHHS RCO