Information Collection Request

Generic Clearance to Support the Safe to Sleep Campaign at the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD)

ICR 201710-0925-003 · OMB 0925-0701 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Nurses CE follow up survey Form and Instruction New Available
Form 4 Nurses CE Follow-Up survey Form New Available
Form 3 Nurses CE Satisfaction Evaluation Form New Available
Form 2 Nurses CE Post Test Form New Available
Form 1 Nurses CE Pre-Test Form New Available
Form 3 Kappa Before After Activity Knowledge Check Form and Instruction New Available
Form 2 KAPPA Mini-Grant Applicaiton Form and Instruction New Available
Form 1 KAPPA Activity Tracker Form and Instruction New Available
Form 3 Alabama Outreach BeforeAndAfter Activity Knowledge Check Form and Instruction New Available
Form 2 Alabama Outreach Activity Tracking Form and Instruction New Available
Form 1 Alabama Outreach Standard applicaiton Form and Instruction New Available
30day FRN2017-24399.pdf Supplementary Document Uploaded 2017-11-09 Available
0925-0701_Safe to Sleep Generic_NICHD_Information Collection Instruments.pdf Supplementary Document Uploaded 2017-11-01 Available
0925-0701_NICHD_Safe to Sleep_SSA.rev 10.24.17_OMB - FINAL submission 2.2.18.docx Supporting Statement A Uploaded 2018-02-02 Available
0925-0701_NICHD_Safe to Sleep_Attach 1_Sub-study Memo Template.doc Supplementary Document Uploaded 2017-10-31 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
244246 Risk Reduction for Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death: Continuing Education Activity for Nurses (NICHD) Form and Instruction NewNurses CE follow up survey
233726 Risk Reduction for Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death: Continuing Education Activity for Nurses (NICHD) Form NewNurses CE Follow-Up survey
233726 Risk Reduction for Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death: Continuing Education Activity for Nurses (NICHD) Form NewNurses CE Satisfaction Evaluation
233726 Risk Reduction for Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death: Continuing Education Activity for Nurses (NICHD) Form NewNurses CE Post Test
233726 Risk Reduction for Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death: Continuing Education Activity for Nurses (NICHD) Form NewNurses CE Pre-Test
231956 Kappa Safe Infant Sleep Community Engagement Project (NICHD) Form and Instruction NewKappa Before After Activity Knowledge Check
231956 Kappa Safe Infant Sleep Community Engagement Project (NICHD) Form and Instruction NewKAPPA Mini-Grant Applicaiton
231956 Kappa Safe Infant Sleep Community Engagement Project (NICHD) Form and Instruction NewKAPPA Activity Tracker
230667 Sub-Study Alabama Outreach (NICHD) Form and Instruction NewAlabama Outreach BeforeAndAfter Activity Knowledge Check
230667 Sub-Study Alabama Outreach (NICHD) Form and Instruction NewAlabama Outreach Activity Tracking
230667 Sub-Study Alabama Outreach (NICHD) Form and Instruction NewAlabama Outreach Standard applicaiton

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2021 36 Months From Approved
49,170 0 0
12,920 0 0
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Kappa Safe Infant Sleep Community Engagement Project (NICHD) 2, 3, 1 ,   ,  
Risk Reduction for Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death: Continuing Education Activity for Nurses (NICHD) 1
Risk Reduction for Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death: Continuing Education Activity for Nurses (NICHD) 1, 3, 2, 4 ,   ,   ,  
Sub-Study Alabama Outreach (NICHD) 1, 3, 2 ,   ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 49,170 0 0 49,170 0 0
Annual Time Burden (Hours) 12,920 0 0 12,920 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No