Information Collection Request

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

ICR 202101-0920-008 · OMB 0920-0010 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
BDSTEPS_CATI_V8.0_SPAN Form and Instruction Modified Available
BDSTEPS_CATI_V8.0 Form and Instruction Modified Available
Introductory Phone Script (Spansih) Form and Instruction Modified Available
Introductory Phone Script (English) Form and Instruction Modified Available
Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction Modified Repair queued
Computer Assisted Phone Interview about Stillbirth (Spanish) Form and Instruction Modified Repair queued
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
Supplemental CATI about Stillbirth Form and Instruction Modified Repair queued
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 Unchanged Available
Verbal Consent for Release of Reportable Infectious Diseases (English) Form and Instruction Unchanged Available
Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction Unchanged Missing upstream
Written Consent for Release of Reportable Infectious Diseases (Spanish) Form and Instruction Unchanged Available
Written Consent for Release of Reportable Infectious Diseases (English) Form and Instruction Unchanged Available
Teaching_Screenshots_Spanish Form and Instruction Unchanged Available
Teaching_Screenshots_English Form and Instruction Unchanged Available
Restaurant Worker_Screenshots_Spanish Form and Instruction Unchanged Available
Restaurant Worker_Screenshots_English Form and Instruction Unchanged Available
Office Worker_Screenshots_Spanish Form and Instruction Unchanged Repair queued
Office Worker_Screenshots_English Form and Instruction Unchanged Available
Janitorial_Screenshots_Spanish Form and Instruction Unchanged Available
Janitorial_Screenshots_English Form and Instruction Unchanged Available
Occupational Questionnaires Form and Instruction Unchanged Repair queued
Healthcare_Screenshots_Spansih Form and Instruction Unchanged Repair queued
Healthcare_Screenshots_English Form and Instruction Unchanged Available
Electronic Equipment Operators_Screenshots_Spanish Form and Instruction Unchanged Repair queued
Electronic Equipment Operators_Screenshots_English Form and Instruction Unchanged Repair queued
Cosmetology_Screenshots_Spanish Form and Instruction Unchanged Available
Cosmetology_Screenshots_English Form and Instruction Unchanged Available
Agriculture_Screenshots_Spanish Form and Instruction Unchanged Available
Agriculture_Screenshots_English Form and Instruction Unchanged Available
Bloodspot Verbal Consent for Multiples (Spanish) Form and Instruction Unchanged Available
Bloodspot Consent for Multiples (Spanish) Form and Instruction Unchanged Available
Bloodspot Verbal Consent (Spanish) Form and Instruction Unchanged Available
Bloodspot Consent (Spanish) Form and Instruction Unchanged Available
Bloodspot Verbal Consent for Multiples (English) Form and Instruction Unchanged Available
Bloodspot Consent for Multiples (English) Form and Instruction Unchanged Available
Consent for Bloodspot Retrieval Form and Instruction Unchanged Repair queued
Bloodspot Verbal Consent (English) Form and Instruction Unchanged Available
Bloodspot Consent (English) Form and Instruction Unchanged Available
Att35_BDSTEPS_Stillbirth_SOP_Protocol_two_part_intvw_CLEAN_v2.docx Supplementary Document Uploaded 2021-01-21 Repair queued
ICR Non-substantive Change Request_BD-STEPS_20201221 final.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-01-21 Repair queued
OMB0920-0010_BD-STEPS_NonSubstantive Change request .docx Justification for No Material/Nonsubstantive Change Uploaded 2020-03-26 Repair queued
Att44A_BD2_SBSupp_Combined_ThankYou_Letter_Combo_InfectiousBSIntroLtr_SPAN_083120_Clean.docx Supplementary Document Uploaded 2021-01-21 Repair queued
Att44A_BD2_SBSupp_Combined_ThankYou_Letter_InterviewsCompletedTogether_InfectiousBloodIntroLtr_English_08_31_2020_Clean.docx Supplementary Document Uploaded 2021-01-21 Repair queued
Att44B_44C_BD2_SBSupp_IntvThankYou_Reminder_BS4Cont_SING_MULTI_SPAN_083020_v2_Clean1.7.2021.docx Supplementary Document Uploaded 2021-01-21 Missing upstream
Att44B_44C_BD2_SBSupp_IntvThankYou_Reminder_BloodIntroLtr_SINGLE_MULTIPLE_08_30_2020_Clean_v3.docx Supplementary Document Uploaded 2021-01-21 Repair queued
AttK_Collaborators List.docx Supplementary Document Uploaded 2019-08-26 Repair queued
AttI_Stillbirth_Case_Definition.docx Supplementary Document Uploaded 2019-08-26 Repair queued
AttZ_JustificationNewQuestions.docx Supplementary Document Uploaded 2019-08-26 Repair queued
AttH_ Birth_Defects_Case_Definition.docx Supplementary Document Uploaded 2019-08-26 Repair queued
AttW_CBDRP_ConfidentialityOaths.docx Supplementary Document Uploaded 2019-08-26 Repair queued
AttX_PrivacyImpactAssessment.pdf Supplementary Document Uploaded 2019-08-26 Repair queued
AttDD1_PrivacyActStatement.docx Supplementary Document Uploaded 2019-08-26 Repair queued
AttE_ListofBDSTEPSCenters.pdf Supplementary Document Uploaded 2019-08-26 Repair queued
AttCC_NBDPS-Publications.docx Supplementary Document Uploaded 2019-08-26 Repair queued
AttD_CDC-IRB_ApprovalLetter.pdf Supplementary Document Uploaded 2019-08-26 Repair queued
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 Repair queued
AttB_60dayFRN.pdf Supplementary Document Uploaded 2019-08-26 Repair queued
AttA_BDPreventionActof1998.pdf Supplementary Document Uploaded 2019-08-26 Repair queued
BD-STEPS_OMBStatementB_20190813-Final.docx Supporting Statement B Uploaded 2019-08-26 Repair queued
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 ModifiedBDSTEPS_CATI_V8.0_SPAN
6608 Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction ModifiedBDSTEPS_CATI_V8.0
6608 Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction ModifiedIntroductory Phone Script (Spansih)
6608 Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction ModifiedIntroductory Phone Script (English)
6608 Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction Modified
222820 Supplemental CATI about Stillbirth Form and Instruction ModifiedComputer Assisted Phone Interview about Stillbirth (Spanish)
222820 Supplemental CATI about Stillbirth Form and Instruction ModifiedComputer Assisted Phone Interview about Stillbirth (English)
222820 Supplemental CATI about Stillbirth Form and Instruction ModifiedIntroductory Phone Script for the Interview about Stillborth (Spanish)
222820 Supplemental CATI about Stillbirth Form and Instruction Modified
222820 Supplemental CATI about Stillbirth Form and Instruction ModifiedIntroductory Phone Script for the Interview about Stillborth (English)
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction UnchangedVerbal Consent for Release of Reportable Infectious Diseases (Spanish)
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction UnchangedVerbal Consent for Release of Reportable Infectious Diseases (English)
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction Unchanged
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction UnchangedWritten Consent for Release of Reportable Infectious Diseases (Spanish)
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction UnchangedWritten Consent for Release of Reportable Infectious Diseases (English)
216968 Occupational Questionnaires Form and Instruction UnchangedTeaching_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction UnchangedTeaching_Screenshots_English
216968 Occupational Questionnaires Form and Instruction UnchangedRestaurant Worker_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction UnchangedRestaurant Worker_Screenshots_English
216968 Occupational Questionnaires Form and Instruction UnchangedOffice Worker_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction UnchangedOffice Worker_Screenshots_English
216968 Occupational Questionnaires Form and Instruction UnchangedJanitorial_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction UnchangedJanitorial_Screenshots_English
216968 Occupational Questionnaires Form and Instruction Unchanged
216968 Occupational Questionnaires Form and Instruction UnchangedHealthcare_Screenshots_Spansih
216968 Occupational Questionnaires Form and Instruction UnchangedHealthcare_Screenshots_English
216968 Occupational Questionnaires Form and Instruction UnchangedElectronic Equipment Operators_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction UnchangedElectronic Equipment Operators_Screenshots_English
216968 Occupational Questionnaires Form and Instruction UnchangedCosmetology_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction UnchangedCosmetology_Screenshots_English
216968 Occupational Questionnaires Form and Instruction UnchangedAgriculture_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction UnchangedAgriculture_Screenshots_English
187391 Consent for Bloodspot Retrieval Form and Instruction UnchangedBloodspot Verbal Consent for Multiples (Spanish)
187391 Consent for Bloodspot Retrieval Form and Instruction UnchangedBloodspot Consent for Multiples (Spanish)
187391 Consent for Bloodspot Retrieval Form and Instruction UnchangedBloodspot Verbal Consent (Spanish)
187391 Consent for Bloodspot Retrieval Form and Instruction UnchangedBloodspot Consent (Spanish)
187391 Consent for Bloodspot Retrieval Form and Instruction UnchangedBloodspot Verbal Consent for Multiples (English)
187391 Consent for Bloodspot Retrieval Form and Instruction UnchangedBloodspot Consent for Multiples (English)
187391 Consent for Bloodspot Retrieval Form and Instruction Unchanged
187391 Consent for Bloodspot Retrieval Form and Instruction UnchangedBloodspot Verbal Consent (English)
187391 Consent for Bloodspot Retrieval Form and Instruction UnchangedBloodspot Consent (English)

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2023 02/28/2023 02/28/2023
8,940 0 8,940
4,433 0 4,433
44,307 0 44,307





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 ,   ,   ,   ,   ,   ,   ,  
Consent for Linkage to Reportable Infectious Diseases Results n/a, n/a, n/a, n/a ,   ,   ,  
Mother's Consent Script and Computer Assisted Telephone Interview n/a, n/a, n/a, n/a ,   ,   ,  
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 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Supplemental CATI about Stillbirth n/a, n/a, n/a, n/a ,   ,   ,  

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 8,940 0 0 0 0
Annual Time Burden (Hours) 4,433 4,433 0 0 0 0
Annual Cost Burden (Dollars) 44,307 44,307 0 0 0 0


Reginfo record details
  No