Information Collection Request

Assessment & Monitoring of Breastfeeding-Related Maternity Care Practices in Intrapartum Care Facilities in the United States and Territories

ICR 202108-0920-021 · OMB 0920-0743 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0743 CDC mPINC Hospital Survey Form Modified Repair queued
Form 0920-0743 Att 5_Screening Call Script -- Part B (eligibles only) Form Modified Repair queued
Form 0920-0743 Att 4a_Screening Call Script_Part A (all respondents) Form Modified Repair queued
OMB SS PART B_Control No 0920-0743.docx Supporting Statement B Uploaded 2021-09-29 Repair queued
OMB SS PART A_Control No 0920-0743.docx Supporting Statement A Uploaded 2021-09-29 Repair queued
mPINC 2278 PIA_Reauth_PO_approved.pdf Supplementary Document Uploaded 2021-09-29 Repair queued
Attachment 3c Frequently Asked Questions.docx Supplementary Document Uploaded 2021-09-29 Repair queued
Attachment 2a 60 day Federal Register Notice.pdf Supplementary Document Uploaded 2021-09-29 Repair queued
Attachment 1 Public Health Service Act [42 U.S.C. 241].pdf Supplementary Document Uploaded 2021-09-29 Repair queued
Attachment 7 Human Subjects Document.pdf Supplementary Document Uploaded 2021-09-29 Repair queued
Attachment 8 mPINC Scoring Algorithm.pdf Supplementary Document Uploaded 2021-09-29 Repair queued
Attachment 3b 2018 Hospital Report.pdf Supplementary Document Uploaded 2021-09-29 Repair queued
Attachment 3a CDC Survey Website.pdf Supplementary Document Uploaded 2021-08-31 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
239965 CDC mPINC Hospital Survey Form Modified
189526 Att 5_Screening Call Script -- Part B (eligibles only) Form Modified
179024 Att 4a_Screening Call Script_Part A (all respondents) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 10/31/2021
5,241 5,045
805 855
0 0





table that charts list of burden
  Total Request 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 5,241 5,045 0 196 0 0
Annual Time Burden (Hours) 805 855 0 -50 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No