Appendix Y2 Addendum A to State Agency Letter

OMB Approval No. 0584-0580

Approval Expires: XX/XX/20XX

APPENDIX Y2

Addendum A to State Agency letter

ATTACHMENT A: ADDENDUM FOR STUDY EXTENSION TO AGE FIVE YEARS

SITE NAME: [Local Agency Name - Site Name]

During the extension period for the Feeding My Baby Study, WIC sites will be asked to conduct weight and height measurements for children who are enrolled in the study even if they are no longer participating in the WIC Program. These measurements will be taken near the time of the fourth and fifth birthdays, beginning in April 2017 when the children in the study start to reach age four. Details for this activity are provided below.

Westat Roles and Responsibilities

1. Westat Study Liaisons will advise the parent/caregiver that weight and height measurements are needed for the child and that these will be conducted at no cost to the parent/caregiver at the WIC site. They will also advise parents/caregivers of other options for obtaining the measurements. The Study Liaison will give the parent/caregiver the timeframe during which the measurements need to be taken and will provide them with a Feeding My Baby Study Measurement Card and instructions for completing it and returning it to Westat.

2. For children who are participating in WIC at the time of their fourth birthday, the Study Liaison will recommend that the parent/caregiver take the measurement card to the child’s next WIC appointment and ask the WIC staff to fill in the information. For children who are not participating in WIC at age four, and for all children at age five years, the Study Liaison will provide them with the WIC site name, address, and phone number and instructions for obtaining the measurements from the WIC site. Westat will communicate with the WIC site Study Contact during January 2017 and January 2018 to confirm the site information and instructions to give to the parents/caregivers.

3. In January 2017 and January 2018, Westat will provide the WIC site Study Contact with a list of children recruited from the site that are participating in the study, including children still receiving WIC and those that are no longer participating in WIC. The list will include the child’s birthdate and the time period around the birthdays when the measurements are needed. WIC staff can use this list to confirm that a parent/caregiver requesting to have their child weighed and measured is enrolled in the study and to determine when the measurements should be conducted.

4. Westat will provide a $50 incentive plus $10 transportation cost reimbursement to the parent/caregiver upon completion of the measurements and return of the measurement card for children at age four years, and a $60 incentive plus $10 transportation cost reimbursement at age five years.

5. [Insert if applicable: Westat will provide a [grant or gift card] in the amount of [insert $ amount] to the WIC site for conducting measurements for children who are not enrolled in WIC. The grant will be sent to [insert name and address].

WIC Site Roles and Responsibilities

• Conduct weight and height measurements for children who are in the study around the time of the child’s fourth and fifth birthdays, and record the measurements on a Feeding My Baby Study Measurement Card. For the children who are participating in WIC, the measurements taken for the WIC recertification will be sufficient if they are taken near the time of the fourth birthday.

Contacting Parents/Caregivers of Children in the Study

Westat Study Liaisons handle all communication with parents/caregivers regarding the study and they will use multiple strategies to keep in contact with them. When other strategies are unsuccessful, the Study Liaison will request assistance from WIC if the information available to the Study Liaison indicates the child is a WIC participant.

[If State agency chooses to have the site contacted: The WIC site may be asked to assist by:

• Comparing the phone number, mailing address and/or email address that Westat has for the parent/caregiver with the information in the WIC record to determine if the WIC site’s information is more recent.

• Providing Westat with the parent/caregiver contact information in the WIC record.

• Contacting the parent/caregiver, or making a notation in their WIC record, to ask them to contact the Study Liaison.

• Sending a letter provided by Westat to the parent/caregiver.]

OR [If State agency chooses to be contacted: The Westat Study Liaison will contact the State Agency to request assistance with contacting parents/caregivers of children in the study.]

Study Points-of-Contact

The Westat Deputy Operations Director is: Bibi Gollapudi at (240) 314-7558 or [email protected].

The Westat Study Liaison is [Insert name, phone #, and email address].

The WIC site Study Contact is [Insert name, phone #, and email address].

Westat will inform the Site Study Contact if there is a change in the Study Liaison. The WIC site will inform Bibi Gollapudi and/or the Study Liaison if there is a change in the Site Study Contact.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number.  The valid OMB control number for this information collection is 0584-0580.  The time required to complete this information collection is estimated to average 3 minutes (0.05 hours) per request, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.