Feeding My Baby and Me: Infant Feeding Practices Study III

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 092-20FO Attachment 4p – Month 24 survey-Revised	Form and Instruction	Modified	Available
Form 092-20FO 24-Month Survey	Form and Instruction	Modified	Repair queued
Form 0920-20FO Att.4o-Month 21 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 21-Month Survey	Form and Instruction	Modified	Repair queued
Form 0920-20FO Att.4n-Month 18 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 18-Month Survey	Form and Instruction	Modified	Repair queued
Form 092-20FO Att.4m-Month 15 Survey-Revised	Form and Instruction	Modified	Available
Form 092-20FO 15-Month Survey	Form and Instruction	Modified	Repair queued
Form 0920-20FO Att.4l-Month12 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 12-Month Survey	Form and Instruction	Modified	Available
Form 0920-20FO Att.4k-Month 10 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 10-Month Survey	Form and Instruction	Modified	Available
Form 0920-20FO Att.4j-Month 8 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 8-Month Survey	Form and Instruction	Modified	Repair queued
Form 0920-20FO Att.4i-Month 6 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 6-Month Survey	Form and Instruction	Modified	Repair queued
Form 0920-20FO Att.4h-Month 5 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 5-Month Survey	Form and Instruction	Modified	Repair queued
Form 0920-20FO Att.4g-Month 4 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 4-Month Survey	Form and Instruction	Modified	Repair queued
ASA24	Form and Instruction	Unchanged	Available
3-Month 24-Hour Dietary Recall (Replicate)	Form and Instruction	Unchanged	Repair queued
ASA24	Form and Instruction	Unchanged	Available
3-Month 24-Hour Dietary Recall	Form and Instruction	Unchanged	Repair queued
Form 0920-20FO Att.4f-Month 3 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 3-Month Survey	Form and Instruction	Modified	Repair queued
Form 0920-20FO Attachment 4e – Month 2 survey- Revised	Form and Instruction	Modified	Repair queued
Form 0920-20FO 2-Month Survey	Form and Instruction	Modified	Repair queued
Form 0920-20FO Att.4d-Month 1 Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO 1-Month Survey	Form and Instruction	Modified	Repair queued
Birth Screener	Form and Instruction	Unchanged	Repair queued
Birth Screener	Form and Instruction	Unchanged	Repair queued
Request for Notification of Child's Birth	Form and Instruction	Unchanged	Available
Request for Notification of Child's Birth	Form and Instruction	Unchanged	Repair queued
ASA24	Form and Instruction	Unchanged	Available
Prenatal 24-Hour Dietary Recall (Replicate)	Form and Instruction	Unchanged	Available
ASA24	Form and Instruction	Unchanged	Repair queued
Prenatal 24-Hour Dietary Recall	Form and Instruction	Unchanged	Repair queued
Form 0920-20FO Att.4b-Prenatal Survey-Revised	Form and Instruction	Modified	Available
Form 0920-20FO Prenatal Survey	Form and Instruction	Modified	Repair queued
Informed Consent and Contact Information	Form and Instruction	Unchanged	Available
Study Consent and Contact Information	Form and Instruction	Unchanged	Repair queued
Screener	Form and Instruction	Unchanged	Available
Screening	Form and Instruction	Unchanged	Repair queued
Change Request_OMB Control No 0920-1333.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-06-21	Repair queued
IFP3 Att 6 Confidentiality Nondisclose Stmt Final.pdf	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.5k-Study removal email and text.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.5j-Participant follow up letter.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.5i-Missed survey email and text.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.5h-Survey thank you email and text.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.5g Survey Reminder email and text.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.5f-Survey invitation email and text.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.5c-Telephone & VM Script for Elig Resp Final.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.5b-Social Media Recruit Mess Final.docx	Supplementary Document	Uploaded 2020-10-28	Available
Att.5a-Recruit Enroll Flow Cht Final.pdf	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.4r-Common Items across National-level Surveys.docx	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.3-IRB Deter Final.pdf	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.2-60-day FRN published Final.pdf	Supplementary Document	Uploaded 2020-10-28	Repair queued
Att.1-Authorizing Leg Final.pdf	Supplementary Document	Uploaded 2020-10-28	Repair queued
SSB_IFPSIII_Rev1_Clean.docx	Supporting Statement B	Uploaded 2021-04-07	Repair queued
SSA_IFPSIII_10282020.docx	Supporting Statement A	Uploaded 2020-10-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244224	24-Month Survey	Form and Instruction	Modified	Attachment 4p – Month 24 survey-Revised
244224	24-Month Survey	Form and Instruction	Modified
244223	21-Month Survey	Form and Instruction	Modified	Att.4o-Month 21 Survey-Revised
244223	21-Month Survey	Form and Instruction	Modified
244222	18-Month Survey	Form and Instruction	Modified	Att.4n-Month 18 Survey-Revised
244222	18-Month Survey	Form and Instruction	Modified
244221	15-Month Survey	Form and Instruction	Modified	Att.4m-Month 15 Survey-Revised
244221	15-Month Survey	Form and Instruction	Modified
244220	12-Month Survey	Form and Instruction	Modified	Att.4l-Month12 Survey-Revised
244220	12-Month Survey	Form and Instruction	Modified
244219	10-Month Survey	Form and Instruction	Modified	Att.4k-Month 10 Survey-Revised
244219	10-Month Survey	Form and Instruction	Modified
244218	8-Month Survey	Form and Instruction	Modified	Att.4j-Month 8 Survey-Revised
244218	8-Month Survey	Form and Instruction	Modified
244217	6-Month Survey	Form and Instruction	Modified	Att.4i-Month 6 Survey-Revised
244217	6-Month Survey	Form and Instruction	Modified
244216	5-Month Survey	Form and Instruction	Modified	Att.4h-Month 5 Survey-Revised
244216	5-Month Survey	Form and Instruction	Modified
244215	4-Month Survey	Form and Instruction	Modified	Att.4g-Month 4 Survey-Revised
244215	4-Month Survey	Form and Instruction	Modified
244214	3-Month 24-Hour Dietary Recall (Replicate)	Form and Instruction	Unchanged	ASA24
244214	3-Month 24-Hour Dietary Recall (Replicate)	Form and Instruction	Unchanged
244213	3-Month 24-Hour Dietary Recall	Form and Instruction	Unchanged	ASA24
244213	3-Month 24-Hour Dietary Recall	Form and Instruction	Unchanged
244212	3-Month Survey	Form and Instruction	Modified	Att.4f-Month 3 Survey-Revised
244212	3-Month Survey	Form and Instruction	Modified
244211	2-Month Survey	Form and Instruction	Modified	Attachment 4e – Month 2 survey- Revised
244211	2-Month Survey	Form and Instruction	Modified
244210	1-Month Survey	Form and Instruction	Modified	Att.4d-Month 1 Survey-Revised
244210	1-Month Survey	Form and Instruction	Modified
244209	Birth Screener	Form and Instruction	Unchanged	Birth Screener
244209	Birth Screener	Form and Instruction	Unchanged
244208	Request for Notification of Child's Birth	Form and Instruction	Unchanged	Request for Notification of Child's Birth
244208	Request for Notification of Child's Birth	Form and Instruction	Unchanged
244207	Prenatal 24-Hour Dietary Recall (Replicate)	Form and Instruction	Unchanged	ASA24
244207	Prenatal 24-Hour Dietary Recall (Replicate)	Form and Instruction	Unchanged
244206	Prenatal 24-Hour Dietary Recall	Form and Instruction	Unchanged	ASA24
244206	Prenatal 24-Hour Dietary Recall	Form and Instruction	Unchanged
244205	Prenatal Survey	Form and Instruction	Modified	Att.4b-Prenatal Survey-Revised
244205	Prenatal Survey	Form and Instruction	Modified
244204	Study Consent and Contact Information	Form and Instruction	Unchanged	Informed Consent and Contact Information
244204	Study Consent and Contact Information	Form and Instruction	Unchanged
244203	Screening	Form and Instruction	Unchanged	Screener
244203	Screening	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-1333	ICR Reference No: 202106-0920-010
Status: Historical Active	Previous ICR Reference No: 202010-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-20FO
Title: Feeding My Baby and Me: Infant Feeding Practices Study III
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/29/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/24/2021
Terms of Clearance: Previous terms continue: The data collected from this collection is not generalizable beyond the respondents and in all publications and discussions, CDC will characterize these limitations on generalizability due to the sampling approach.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2024	04/30/2024	04/30/2024
Responses	23,352	0	23,352
Time Burden (Hours)	5,052	0	5,052
Cost Burden (Dollars)	143,685	0	143,685

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Abstract: The Feeding My Baby and Me: Infant Feeding Practices Study III (IFPS III) is a longitudinal study that will follow pregnant women and their new baby for two years. This study will assess the current state of mothers' intentions, behaviors, feeding decisions, and practices from pregnancy through their child's first two years of life, assess how these change, and their association with different health outcomes. Data will be used to inform CDC's programmatic work to improve feeding practices.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

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:
	85 FR 29453	05/15/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 80109	12/11/2020
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 22

table that charts list of burden

IC Title	Form No.	Form Name
1-Month Survey	0920-20FO	Att.4d-Month 1 Survey-Revised
10-Month Survey	0920-20FO	Att.4k-Month 10 Survey-Revised
12-Month Survey	0920-20FO	Att.4l-Month12 Survey-Revised
15-Month Survey	092-20FO	Att.4m-Month 15 Survey-Revised
18-Month Survey	0920-20FO	Att.4n-Month 18 Survey-Revised
2-Month Survey	0920-20FO	Attachment 4e – Month 2 survey- Revised
21-Month Survey	0920-20FO	Att.4o-Month 21 Survey-Revised
24-Month Survey	092-20FO	Attachment 4p – Month 24 survey-Revised
3-Month 24-Hour Dietary Recall	n/a	ASA24
3-Month 24-Hour Dietary Recall (Replicate)	n/a	ASA24
3-Month Survey	0920-20FO	Att.4f-Month 3 Survey-Revised
4-Month Survey	0920-20FO	Att.4g-Month 4 Survey-Revised
5-Month Survey	0920-20FO	Att.4h-Month 5 Survey-Revised
6-Month Survey	0920-20FO	Att.4i-Month 6 Survey-Revised
8-Month Survey	0920-20FO	Att.4j-Month 8 Survey-Revised
Birth Screener	n/a	Birth Screener
Prenatal 24-Hour Dietary Recall	n/a	ASA24
Prenatal 24-Hour Dietary Recall (Replicate)	n/a	ASA24
Prenatal Survey	0920-20FO	Att.4b-Prenatal Survey-Revised
Request for Notification of Child's Birth	n/a	Request for Notification of Child's Birth
Screening	n/a	Screener
Study Consent and Contact Information	n/a	Informed Consent and Contact Information

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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	23,352	23,352	0	0	0	0
Annual Time Burden (Hours)	5,052	5,052	0	0	0	0
Annual Cost Burden (Dollars)	143,685	143,685	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $683,294

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? 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: 06/24/2021

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