| Appendix V1 - Burden Table for Nonsubstantive Change |
| Respondent Type |
Respondent Description |
Type of Study Activity |
Appendices |
Sample size (a) |
Number of Respondents |
Frequency of Response (annual) |
Total Annual Responses |
Average Hours per Response |
Sub-Total Annual Burden |
Number of non -respondents |
Frequency of Response (annual) |
Total Annual Responses |
Average Hours per response |
Sub-Total Annual Burden |
Total Burden Hours |
Hourly Rate |
Total Annualized Cost |
| Individuals and Households |
Caregivers of
former WIC children |
Study extension consent age 6 (b) |
A1/A2 |
4,046 |
2,969 |
1 |
2,969 |
0.08 |
247.32 |
1,077 |
1 |
1,077 |
0.02 |
21.54 |
268.86 |
$7.25 |
$1,949.22 |
| Study extension letter (b) |
B1/B2 |
4,046 |
2,969 |
1 |
2,969 |
0.05 |
148.45 |
1,077 |
1 |
1,077 |
0.02 |
21.54 |
169.99 |
$7.25 |
$1,232.43 |
| 72-mo advance letter (c) |
C1/C2 |
2,969 |
2,524 |
1 |
2,524 |
0.05 |
126.20 |
445 |
1 |
445 |
0.02 |
8.91 |
135.11 |
$7.25 |
$979.53 |
| 72-mo telephone interview (d ) |
D1/D2 |
2,969 |
1,901 |
1 |
1,901 |
0.75 |
1,425.75 |
1,068 |
1 |
1,068 |
0.02 |
21.36 |
1,447.11 |
$7.25 |
$10,491.55 |
| 72-mo replicate dietary intake interview (e) |
D3/D4 |
285 |
190 |
1 |
190 |
0.50 |
95.00 |
95 |
1 |
95 |
0.02 |
1.90 |
96.90 |
$7.25 |
$702.55 |
| Reminders for interview from Study Liaison (f) |
E1a/E1b |
1,188 |
1,188 |
1 |
1,188 |
0.03 |
35.64 |
0 |
0 |
0 |
0.00 |
0.00 |
35.64 |
$7.25 |
$258.39 |
| Reminders for non-locatable active interview - English (g) |
E2a/E2b |
148 |
148 |
1 |
148 |
0.02 |
2.47 |
0 |
0 |
0 |
0.00 |
0.00 |
2.47 |
$7.25 |
$17.92 |
| Reminders for study participation refusal conversion (h) |
E3a/E3b |
148 |
148 |
1 |
148 |
0.05 |
7.40 |
0 |
0 |
0 |
0.00 |
0.00 |
7.40 |
$7.25 |
$53.65 |
| Reminders for study participation not answering calls (i) |
E4a/E4b |
297 |
297 |
1 |
297 |
0.05 |
14.85 |
0 |
0 |
0 |
0.00 |
0.00 |
14.85 |
$7.25 |
$107.66 |
| Reminders for Telephone Research Center voicemail, first message (j) |
E5a/E5b |
2,524 |
2,524 |
1 |
2,524 |
0.02 |
42.15 |
0 |
0 |
0 |
0.00 |
0.00 |
42.15 |
$7.25 |
$305.59 |
| Reminders for Telephone Reseach Center voicemail, expiring interview (k) |
E6a/E6b |
445 |
445 |
2 |
890 |
0.02 |
14.86 |
0 |
0 |
0 |
0.00 |
0.00 |
14.86 |
$7.25 |
$107.76 |
| 72- mo H/W measurement (l) |
F1/F2 |
1,901 |
1,331 |
1 |
1,331 |
1.00 |
1,331.00 |
570 |
1 |
570 |
0.02 |
11.40 |
1,342.40 |
$7.25 |
$9,732.40 |
| Height and weight reminders (m) |
G1/G2 |
1,901 |
1,901 |
1 |
1,901 |
0.05 |
95.05 |
0 |
0 |
0 |
0.00 |
0.00 |
95.05 |
$7.25 |
$689.11 |
| 72-mo text or email provider measures (n) |
H1/H2 |
380 |
190 |
1 |
190 |
0.05 |
9.50 |
190 |
1 |
190 |
0.02 |
3.80 |
13.30 |
$7.25 |
$96.45 |
| 72-mo thank you (o) |
I1/I2 |
1,901 |
1,901 |
1 |
1,901 |
0.03 |
57.03 |
0 |
0 |
0 |
0.00 |
0.00 |
57.03 |
$7.25 |
$413.47 |
| Birthday card respondent year 6 (p) |
J1/J2 |
2,969 |
2,969 |
1 |
2,969 |
0.03 |
89.07 |
0 |
0 |
0 |
0.00 |
0.00 |
89.07 |
$7.25 |
$645.76 |
| Birthday card child age 6 (p) |
K1/K2 |
2,969 |
2,969 |
1 |
2,969 |
0.03 |
89.07 |
0 |
0 |
0 |
0.00 |
0.00 |
89.07 |
$7.25 |
$645.76 |
|
|
Contact Information Form (z) |
D5/D6 |
3,072 |
1,229 |
4 |
4,915 |
0.10 |
491.52 |
1,843 |
4 |
7,373 |
0.02 |
147.46 |
638.98 |
|
|
|
|
Birthday card respondent year 9 (aa) |
T1a/T1b |
3,072 |
1,229 |
1 |
1,229 |
0.08 |
101.99 |
1,843 |
1 |
1,843 |
0.08 |
152.99 |
254.98 |
|
|
|
|
Birthday care child year 9 (aa) |
T2a/T2bT3a/T3b |
3,072 |
1,229 |
1 |
1,229 |
0.08 |
101.99 |
1,843 |
1 |
1,843 |
0.08 |
152.99 |
254.98 |
|
|
| Individuals and Households Subtotal (q) |
|
4,046 |
2,969 |
12 |
34,382 |
0.13 |
4,526.31 |
1,077 |
14 |
15,582 |
0.03 |
543.88 |
5,070.20 |
|
$28,429.19 |
| State Government |
State WIC staff point of contact |
Announcement of study extension (r) |
L1 |
27 |
27 |
1 |
27 |
0.08 |
2.25 |
0 |
0 |
0 |
0.00 |
0.00 |
2.25 |
$47.82 |
$107.55 |
| Extension to age 6 webinar (s) |
M |
27 |
27 |
1 |
27 |
1.00 |
27.00 |
0 |
0 |
0 |
0.00 |
0.00 |
27.00 |
$47.82 |
$1,291.14 |
| Conference calls on extension (t) |
N |
27 |
27 |
1 |
27 |
1.00 |
27.00 |
0 |
0 |
0 |
0.00 |
0.00 |
27.00 |
$47.82 |
$1,291.14 |
| Study extension summary and agreement (u) |
O1 |
27 |
27 |
1 |
27 |
0.18 |
4.95 |
0 |
0 |
0 |
0.00 |
0.00 |
4.95 |
$47.82 |
$236.67 |
| Addendum A to study extension summary (u) |
O2 |
27 |
27 |
1 |
27 |
0.08 |
2.25 |
0 |
0 |
0 |
0.00 |
0.00 |
2.25 |
$47.82 |
$107.55 |
| Request for contact information (v) |
P |
14 |
14 |
9 |
126 |
0.08 |
10.50 |
0 |
0 |
0 |
0.00 |
0.00 |
10.50 |
$47.82 |
$501.91 |
| Subtotal |
|
27 |
27 |
10 |
261 |
|
73.94 |
0 |
0 |
0 |
0.00 |
0.00 |
73.94 |
|
$3,535.96 |
| Local Government |
WIC site staff
|
Announcement of study extension (r) |
L2 |
80 |
80 |
1 |
80 |
0.08 |
6.40 |
0 |
0 |
0 |
0.00 |
0.00 |
6.40 |
$47.82 |
$306.05 |
| Extension to age 6 webinar (s) |
M |
80 |
80 |
1 |
80 |
1.00 |
80.00 |
0 |
0 |
0 |
0.00 |
0.00 |
80.00 |
$47.82 |
$3,825.60 |
| Conference call on extension (t) |
N |
80 |
80 |
1 |
80 |
1.00 |
80.00 |
0 |
0 |
0 |
0.00 |
0.00 |
80.00 |
$47.82 |
$3,825.60 |
| Study extension summary and agreement (u) |
O1 |
80 |
80 |
1 |
80 |
0.18 |
14.66 |
0 |
0 |
0 |
0.00 |
0.00 |
14.66 |
$47.82 |
$701.23 |
| Addendum A to study extension summary (u) |
O2 |
80 |
80 |
1 |
80 |
0.08 |
6.66 |
0 |
0 |
0 |
0.00 |
0.00 |
6.66 |
$16.19 |
$107.89 |
| Request for contact information (w) |
P |
40 |
40 |
3 |
120 |
0.08 |
10.00 |
0 |
0 |
0 |
0.00 |
0.00 |
10.00 |
$16.19 |
$161.84 |
| H/W measurement (x) |
F1/F2 |
80 |
80 |
6 |
480 |
0.17 |
80.02 |
0 |
0 |
0 |
0.00 |
0.00 |
80.02 |
$16.19 |
$1,295.46 |
| Subtotal |
|
80 |
80 |
13 |
1,000 |
2 |
277.74 |
0 |
0 |
0 |
0.00 |
0.00 |
277.74 |
|
$10,223.66 |
| State/Local Government Subtotal |
|
107 |
107 |
12 |
1,261 |
0.28 |
351.68 |
0 |
0 |
0 |
0.00 |
0.00 |
351.68 |
|
$13,759.62 |
| Profit/Non-Profit Business |
Health care provider |
H/W measurement (y) |
F1/F2 |
851 |
851 |
1 |
851 |
0.17 |
141.84 |
0 |
0 |
0 |
0.00 |
0.00 |
141.84 |
$32.16 |
$4,561.45 |
| Profit/Non-Profit Business Subtotal |
|
851 |
851 |
1 |
851 |
0.167 |
141.84 |
0 |
0 |
0 |
0 |
0.00 |
141.84 |
|
$4,561.45 |
| GRAND TOTAL |
|
5,004 |
3,927 |
9 |
36,494 |
0.14 |
5,020 |
1,077 |
14 |
15,582 |
0.03 |
543.88 |
5,563.71 |
|
$46,750.27 |
| (a) 4046 = base study total live birth cohort, out of 4367 enrolled initially. |
| (b) 4046 = base study total live birth cohort. Study attrition has been about 6% per per year (e.g., 4046*.94*.94*.94*.94*.94=2,969) so assume 2,969 will be sent study extension letter and consent for age 6 extension. |
| (c) Only those who are still enrolled in the study after the age 5 interview (estimated 2969) will receive the advance letter. Assume 85% will read the advance letter. |
| (d) Of those still enrolled in the study (2,969) -- assume 64% will complete 72-month telephone interview |
| (e) Assume 15% of completes will be sampled for 2nd AMPM and 67% will complete 2nd AMPM |
| (f) Assume 40% of those still enrolled in the study will receive a reminder call |
| (g) Assume 5% of those still enrolled in the study will be non-locatable and will receive a reminder |
| (h) Assume 5% of those still enrolled in the study will refuse and receive a refusal conversion letter |
| (i) Assume 10% of those still enrolled in the study will not answer calls and will receive this reminder. |
| (j) Assume 85% of those still enrolled in the study will receive this reminder. |
| (k) Assume 15% of those still enrolled in the study will receive this reminder. |
| (l) Assume 70% of respondents to the 72-mo interview will go to the WIC site or their provider for H/W measurement. Assume 1 hour for reading letter, travel to/from WIC site or provider, and measuring child. |
| (m) Assume potential respondents for 72-mo HT/WT measures will get an average of 1 reminder to go to WIC or their doctor's office to have their child measured. |
| (n) Assume 20% of those who complete the interview will talk to the study liaison about texting or emailing a copy of their provider measure from a recent visit and 10% will do so. |
| (o) Assume 100% of respondents will have a valid email/text/mail address to receive thank you. |
| (p) Assume 100% of cohort will receive the card. |
| (q) Unique respondents is equal to the largest category of respondents, those who receive the study extension letter and consent form. Total number of nonrespondents is equal to the largest category of nonrespondents, those who do not complete the 72-month interview. |
| (r) Study extension notice sent to all 27 states and 1 point of contact from each of the 80 sites. |
| (s) Assume study extension webinar attended by all 27 states and 1 point of contact from each of the 80 sites. |
| (t) Assumes 1 conf. call with state and 1 conf. call with site with 1 point of contact per site. |
| (u) Assume 1 person in state office and 1 person per site will review the study extension summary agreement and Addendum A. |
| (v) Assume 14 states responsible for 40 sites will agree to be the point-of-contact to look in WIC records for updated contact information on non-located participants and that 9 requests for updated information will be made for each state. |
| (w) Assume 40 sites will agree to be the point-of-contact to look in WIC records for updated contact information on non-located participants and that 3 requests for updated information will be made for each site. |
| (x) Assume 36% of participants will go to WIC to have their child measured with an average of 6 children measured per site ((1,331*.36)/80=6). Assume 10 minutes of staff time for measurements per child. |
| (y) Assume 64% of participants will have their children measured at their health care providers' office. Assume 10 minutes of staff time for measurements per child. |
| (z) Assume 40% of participants from year 6 will respond to the contact information form. |
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| (aa) Assume 40% of participants from year 6 will respond to the birthday cards. |
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