Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Computer Assisted Telephone Interview for Mothers (English)	Form and Instruction	Modified	Available
Introductory Phone Script (Spansih)	Form and Instruction	Modified	Available
Introductory Phone Script (English)	Form and Instruction	Modified	Available
Computer Assisted Telephone Interview for Mothers (Spanish)	Form and Instruction	Modified	Available
Computer Assisted Phone Interview about Stillbirth (Spanish)	Form and Instruction	Modified	Available
Computer Assisted Phone Interview about Stillbirth (English)	Form and Instruction	Modified	Available
Introductory Phone Script for the Interview about Stillborth (Spanish)	Form and Instruction	Modified	Available
Introductory Phone Script for the Interview about Stillborth (English)	Form and Instruction	Modified	Available
Verbal Consent for Release of Reportable Infectious Diseases (Spanish)	Form and Instruction	Modified	Available
Verbal Consent for Release of Reportable Infectious Diseases (English)	Form and Instruction	Modified	Available
Written Consent for Release of Reportable Infectious Diseases (Spanish)	Form and Instruction	Modified	Available
Written Consent for Release of Reportable Infectious Diseases (English)	Form and Instruction	Modified	Available
Teaching_Screenshots_Spanish	Form and Instruction	Modified	Available
Teaching_Screenshots_English	Form and Instruction	Modified	Available
Restaurant Worker_Screenshots_Spanish	Form and Instruction	Modified	Repair queued
Restaurant Worker_Screenshots_English	Form and Instruction	Modified	Available
Office Worker_Screenshots_Spanish	Form and Instruction	Modified	Available
Office Worker_Screenshots_English	Form and Instruction	Modified	Available
Janitorial_Screenshots_Spanish	Form and Instruction	Modified	Available
Healthcare_Screenshots_Spansih	Form and Instruction	Modified	Available
Healthcare_Screenshots_English	Form and Instruction	Modified	Available
Electronic Equipment Operators_Screenshots_Spanish	Form and Instruction	Modified	Available
Electronic Equipment Operators_Screenshots_English	Form and Instruction	Modified	Available
Cosmetology_Screenshots_Spanish	Form and Instruction	Modified	Available
Cosmetology_Screenshots_English	Form and Instruction	Modified	Available
Agriculture_Screenshots_Spanish	Form and Instruction	Modified	Available
Agriculture_Screenshots_English	Form and Instruction	Modified	Available
Janitorial_Screenshots_English	Form and Instruction	Modified	Available
Bloodspot Verbal Consent for Multiples (Spanish)	Form and Instruction	Modified	Available
Bloodspot Consent for Multiples (Spanish)	Form and Instruction	Modified	Available
Bloodspot Verbal Consent (Spanish)	Form and Instruction	Modified	Available
Bloodspot Consent (Spanish)	Form and Instruction	Modified	Available
Bloodspot Verbal Consent for Multiples (English)	Form and Instruction	Modified	Available
Bloodspot Consent for Multiples (English)	Form and Instruction	Modified	Available
Bloodspot Verbal Consent (English)	Form and Instruction	Modified	Available
Bloodspot Consent (English)	Form and Instruction	Modified	Available
AttBB2_IntvThankYou_Infection_BloodspotIntroLtr_MULTI_SPAN.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttBB1_IntvThankYou_Infection_BloodspotIntroLtr_MULTI.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttAA2_IntvThankYou_Infection_Bloodspot_IntroLtr_SPAN.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttAA1_IntvThankYou_Infection_Bloodspot_IntroLtr.docx	Supplementary Document	Uploaded 2019-08-26	Repair queued
AttK_Collaborators List.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttI_Stillbirth_Case_Definition.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttZ_JustificationNewQuestions.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttH_ Birth_Defects_Case_Definition.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttW_CBDRP_ConfidentialityOaths.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttX_PrivacyImpactAssessment.pdf	Supplementary Document	Uploaded 2019-08-26	Available
AttDD1_PrivacyActStatement.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttE_ListofBDSTEPSCenters.pdf	Supplementary Document	Uploaded 2019-08-26	Available
AttCC_NBDPS-Publications.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttD_CDC-IRB_ApprovalLetter.pdf	Supplementary Document	Uploaded 2019-08-26	Available
AttC2_CDC-IRB_AmendmentApproval_92.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttC1_CDC-IRB_AmendmentApproval_89.docx	Supplementary Document	Uploaded 2019-08-26	Available
AttB_60dayFRN.pdf	Supplementary Document	Uploaded 2019-08-26	Available
AttA_BDPreventionActof1998.pdf	Supplementary Document	Uploaded 2019-08-26	Available
BD-STEPS_OMBStatementB_20190813-Final.docx	Supporting Statement B	Uploaded 2019-08-26	Available
BD-STEPS_OMBStatementA_20190813-Final.docx	Supporting Statement A	Uploaded 2019-08-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6608	Mother's Consent Script and Computer Assisted Telephone Interview	Form and Instruction	Modified	Computer Assisted Telephone Interview for Mothers (English)
6608	Mother's Consent Script and Computer Assisted Telephone Interview	Form and Instruction	Modified	Introductory Phone Script (Spansih)
6608	Mother's Consent Script and Computer Assisted Telephone Interview	Form and Instruction	Modified	Introductory Phone Script (English)
6608	Mother's Consent Script and Computer Assisted Telephone Interview	Form and Instruction	Modified	Computer Assisted Telephone Interview for Mothers (Spanish)
222820	Supplemental CATI about Stillbirth	Form and Instruction	Modified	Computer Assisted Phone Interview about Stillbirth (Spanish)
222820	Supplemental CATI about Stillbirth	Form and Instruction	Modified	Computer Assisted Phone Interview about Stillbirth (English)
222820	Supplemental CATI about Stillbirth	Form and Instruction	Modified	Introductory Phone Script for the Interview about Stillborth (Spanish)
222820	Supplemental CATI about Stillbirth	Form and Instruction	Modified	Introductory Phone Script for the Interview about Stillborth (English)
216978	Medical Record Review	Instruction	Removed
216974	Consent for Linkage to Reportable Infectious Diseases Results	Form and Instruction	Modified	Verbal Consent for Release of Reportable Infectious Diseases (Spanish)
216974	Consent for Linkage to Reportable Infectious Diseases Results	Form and Instruction	Modified	Verbal Consent for Release of Reportable Infectious Diseases (English)
216974	Consent for Linkage to Reportable Infectious Diseases Results	Form and Instruction	Modified	Written Consent for Release of Reportable Infectious Diseases (Spanish)
216974	Consent for Linkage to Reportable Infectious Diseases Results	Form and Instruction	Modified	Written Consent for Release of Reportable Infectious Diseases (English)
216968	Occupational Questionnaires	Form and Instruction	Modified	Teaching_Screenshots_Spanish
216968	Occupational Questionnaires	Form and Instruction	Modified	Teaching_Screenshots_English
216968	Occupational Questionnaires	Form and Instruction	Modified	Restaurant Worker_Screenshots_Spanish
216968	Occupational Questionnaires	Form and Instruction	Modified	Restaurant Worker_Screenshots_English
216968	Occupational Questionnaires	Form and Instruction	Modified	Office Worker_Screenshots_Spanish
216968	Occupational Questionnaires	Form and Instruction	Modified	Office Worker_Screenshots_English
216968	Occupational Questionnaires	Form and Instruction	Modified	Janitorial_Screenshots_Spanish
216968	Occupational Questionnaires	Form and Instruction	Modified	Healthcare_Screenshots_Spansih
216968	Occupational Questionnaires	Form and Instruction	Modified	Healthcare_Screenshots_English
216968	Occupational Questionnaires	Form and Instruction	Modified	Electronic Equipment Operators_Screenshots_Spanish
216968	Occupational Questionnaires	Form and Instruction	Modified	Electronic Equipment Operators_Screenshots_English
216968	Occupational Questionnaires	Form and Instruction	Modified	Cosmetology_Screenshots_Spanish
216968	Occupational Questionnaires	Form and Instruction	Modified	Cosmetology_Screenshots_English
216968	Occupational Questionnaires	Form and Instruction	Modified	Agriculture_Screenshots_Spanish
216968	Occupational Questionnaires	Form and Instruction	Modified	Agriculture_Screenshots_English
216968	Occupational Questionnaires	Form and Instruction	Modified	Janitorial_Screenshots_English
187391	Consent for Bloodspot Retrieval	Form and Instruction	Modified	Bloodspot Verbal Consent for Multiples (Spanish)
187391	Consent for Bloodspot Retrieval	Form and Instruction	Modified	Bloodspot Consent for Multiples (Spanish)
187391	Consent for Bloodspot Retrieval	Form and Instruction	Modified	Bloodspot Verbal Consent (Spanish)
187391	Consent for Bloodspot Retrieval	Form and Instruction	Modified	Bloodspot Consent (Spanish)
187391	Consent for Bloodspot Retrieval	Form and Instruction	Modified	Bloodspot Verbal Consent for Multiples (English)
187391	Consent for Bloodspot Retrieval	Form and Instruction	Modified	Bloodspot Consent for Multiples (English)
187391	Consent for Bloodspot Retrieval	Form and Instruction	Modified	Bloodspot Verbal Consent (English)
187391	Consent for Bloodspot Retrieval	Form and Instruction	Modified	Bloodspot Consent (English)

ICR Details

OMB Control No: 0920-0010	ICR Reference No: 201908-0920-005
Status: Historical Active	Previous ICR Reference No: 201608-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0010
Title: Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/07/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/27/2019
Terms of Clearance: Approved consistent with the understanding that CDC will continue to work with SAMHSA on questions related to illicit drug use. The Agency will include the OMB control number and expiration date (as well as the burden statement) on all questionnaires and forms administered to participants in this collection.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2023	36 Months From Approved	02/29/2020
Responses	8,940	0	6,190
Time Burden (Hours)	4,433	0	3,034
Cost Burden (Dollars)	44,307	0	0

---

Abstract: The purpose of BD-STEPS is to evaluate factors associated with the occurrence of birth defects and stillbirths and ultimately to work to prevent major birth defects and stillbirths associated with maternal risk factors.

---

Authorizing Statute(s): PL: Pub.L. 105 - 168 1 Name of Law: Birth Defects Prevention Act
   US Code: 42 USC 247b-4 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 7374	03/04/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 44314	08/23/2019
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Consent for Bloodspot Retrieval	n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a	Bloodspot Consent (English) ,   Bloodspot Verbal Consent (English) ,   Bloodspot Consent for Multiples (English) ,   Bloodspot Verbal Consent for Multiples (English) ,   Bloodspot Consent (Spanish) ,   Bloodspot Verbal Consent (Spanish) ,   Bloodspot Consent for Multiples (Spanish) ,   Bloodspot Verbal Consent for Multiples (Spanish)
Consent for Linkage to Reportable Infectious Diseases Results	n/a, n/a, n/a, n/a	Written Consent for Release of Reportable Infectious Diseases (English) ,   Written Consent for Release of Reportable Infectious Diseases (Spanish) ,   Verbal Consent for Release of Reportable Infectious Diseases (English) ,   Verbal Consent for Release of Reportable Infectious Diseases (Spanish)
Medical Record Review
Mother's Consent Script and Computer Assisted Telephone Interview	n/a, n/a, n/a, n/a	Introductory Phone Script (English) ,   Introductory Phone Script (Spansih) ,   Computer Assisted Telephone Interview for Mothers (English) ,   Computer Assisted Telephone Interview for Mothers (Spanish)
Occupational Questionnaires	n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a, n/a	Agriculture_Screenshots_English ,   Agriculture_Screenshots_Spanish ,   Cosmetology_Screenshots_English ,   Cosmetology_Screenshots_Spanish ,   Electronic Equipment Operators_Screenshots_English ,   Electronic Equipment Operators_Screenshots_Spanish ,   Healthcare_Screenshots_English ,   Healthcare_Screenshots_Spansih ,   Janitorial_Screenshots_English ,   Janitorial_Screenshots_Spanish ,   Office Worker_Screenshots_English ,   Office Worker_Screenshots_Spanish ,   Restaurant Worker_Screenshots_English ,   Restaurant Worker_Screenshots_Spanish ,   Teaching_Screenshots_English ,   Teaching_Screenshots_Spanish
Supplemental CATI about Stillbirth	n/a, n/a, n/a, n/a	Introductory Phone Script for the Interview about Stillborth (English) ,   Introductory Phone Script for the Interview about Stillborth (Spanish) ,   Computer Assisted Phone Interview about Stillbirth (English) ,   Computer Assisted Phone Interview about Stillbirth (Spanish)

---

ICR Summary of Burden

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	8,940	6,190	0	2,750	0	0
Annual Time Burden (Hours)	4,433	3,034	0	1,399	0	0
Annual Cost Burden (Dollars)	44,307	0	0	44,307	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The length of the CATI for Mothers will increase due to an increase in the number of qualifying birth defects. The number of respondents will increase. The number of respondents will increase for the Online Occupational Questionnaires but there is no change to the estimated burden per response. The previously approved Medical Record Review was not implemented and is being removed in this Revision request.

---

Annual Cost to Federal Government: $2,783,726

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/27/2019

---