Information Collection Request

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

ICR 201908-0920-005 · OMB 0920-0010 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction Modified Available
Supplemental CATI about Stillbirth Form and Instruction Modified Available
Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction Modified Available
Occupational Questionnaires Form and Instruction Modified Available
Consent for Bloodspot Retrieval Form and Instruction Modified Repair queued
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 Repair queued
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 IDCollectionTypeStatusForm
6608 Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction Modified
222820 Supplemental CATI about Stillbirth Form and Instruction Modified
216978 Medical Record Review Instruction Removed
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction Modified
216968 Occupational Questionnaires Form and Instruction Modified
187391 Consent for Bloodspot Retrieval Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2023 36 Months From Approved 02/29/2020
8,940 0 6,190
4,433 0 3,034
44,307 0 0





Reginfo record details
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)
Mother's Consent Script and Computer Assisted Telephone Interview n/a, n/a, n/a, n/a Computer Assisted Telephone Interview for Mothers (Spanish) ,   Computer Assisted Telephone Interview for Mothers (English) ,   Introductory Phone Script (English) ,   Introductory Phone Script (Spansih)
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)
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 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 ,   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
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)
Medical Record Review

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


Reginfo record details
  No