WIC Nutrition Assessment and Tailoring Study

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SSB - WIC NATS Final.docx	Supporting Statement B	Uploaded 2020-11-23	Repair queued
SSA - WIC NATS Final.docx	Supporting Statement A	Uploaded 2020-11-23	Repair queued
K2_Westat IRB Approval Letter.pdf	Supplementary Document	Uploaded 2020-10-28	Repair queued
K1_Statement of Confidentiality and Nondisclosure.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
J_Pretest_Memorandum.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
I4_FNS Response to NASS Comments.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
H5_Expert Review Panel Comments and Responses.pdf	Supplementary Document	Uploaded 2020-10-28	Repair queued
H4_NASS Comments.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
C5_Clinic Observation Form.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
B_WIC NATS OMB Burden Table.xlsx	Supplementary Document	Uploaded 2020-10-28	Repair queued
A4_WIC NATS Recruitment Summary.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
A3_WIC NATS Objectives and Research Questions.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
A2_Relevant WIC Policy and Guidance Documents.pdf	Supplementary Document	Uploaded 2020-10-28	Repair queued
A1_Authorizing Statutes.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244260	WIC Participants - Individuals and Households (Non-respondents)	Other-Non Respondents Burden Instrument	New
244259	WIC Participants - Individuals and Households	Other-Appendix C6 Nutrition Services Observation Form	New
244258	WIC Local Agency Directors and WIC Clinic Staff - Profit/Non-Profit Businesses (Non-Respondents)	Other-Non Respondents Burden Instrument	New
244257	WIC Local Agency Directors and WIC Clinic Staff - Profit/Non-Profit Businesses	Other-Appendix C2 Local Agency Director Survey	New
244255	State and Local Agency WIC Directors and WIC Clinic Staff - SLT (Non-respondents)	Other-Non Respondents Burden Instrument	New
244254	State and Local Agency WIC Directors and WIC Clinic Staff - SLT	Other-Appendix C1 Call with State Agency Director and Request Do	New

ICR Details

OMB Control No: 0584-0663	ICR Reference No: 202010-0584-009
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: WIC Nutrition Assessment and Tailoring Study
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/13/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/01/2020
Terms of Clearance: We thank the agency for agreeing to submit any additions to the number of respondents through a revision package. The clinic observation form cleared here could be used after submitting a revision package to visit WIC clinics in-person.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2024	36 Months From Approved
Responses	6,496	0	0
Time Burden (Hours)	867	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Following key policy changes, the WIC Nutrition Assessment and Tailoring Study will provide FNS with a comprehensive, detailed description of the WIC nutrition risk assessment process, and explore the ways in which WIC clinics tailor participant benefits to address the results of the assessment. It will also evaluate the relationship between this process and participant program satisfaction.

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Authorizing Statute(s): US Code: 42 USC 1769i (Section 28) Name of Law: Richard B. Russell National School Lunch Act (NSLA)
   PL: Pub.L. 111 - 296 305 Name of Law: Healthy, Hunger-Free Kids Act (HHFKA) of 2010
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 34849	07/19/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 76515	11/30/2020
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
State and Local Agency WIC Directors and WIC Clinic Staff - SLT
State and Local Agency WIC Directors and WIC Clinic Staff - SLT (Non-respondents)
WIC Local Agency Directors and WIC Clinic Staff - Profit/Non-Profit Businesses
WIC Local Agency Directors and WIC Clinic Staff - Profit/Non-Profit Businesses (Non-Respondents)
WIC Participants - Individuals and Households
WIC Participants - Individuals and Households (Non-respondents)

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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	6,496	0	0	6,496	0	0
Annual Time Burden (Hours)	867	0	0	867	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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: No

Burden Reduction Due to:

Short Statement: This is a new information collection request that will provide FNS with a comprehensive, detailed description of the WIC nutrition risk assessment process. FNS estimates that this new information collection will add 6,496 responses and 867 burden hours to OMB's inventory due to a program change.

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Annual Cost to Federal Government: $610,165

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.     No

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? No

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Common Form ICR:  No

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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: 12/01/2020

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