WIC Nutrition Assessment and Tailoring Study In-Person Site Visit Data Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SSA - WIC NATS_In-PersonRev Final Revised 2022.03.17.docx	Supporting Statement A	Uploaded 2022-03-17	Repair queued
SSB - WIC NATS_In-PersonRev Final 2022.2.1.docx	Supporting Statement B	Uploaded 2022-02-02	Repair queued
I_FNS Response to NASS Comments.docx	Supplementary Document	Uploaded 2022-02-02	Repair queued
H_NASS Comments.docx	Supplementary Document	Uploaded 2022-02-02	Repair queued
G2_Westat IRB Approval Letter.pdf	Supplementary Document	Uploaded 2022-02-02	Repair queued
G1_Statement of Confidentiality and Non-Disclosure.docx	Supplementary Document	Uploaded 2022-02-02	Repair queued
F_Expert Review Panel Comments and Responses.pdf	Supplementary Document	Uploaded 2022-02-02	Repair queued
E_Pretest_Memorandum.docx	Supplementary Document	Uploaded 2022-02-02	Repair queued
C5_Clinic Observation Form.docx	Supplementary Document	Uploaded 2022-02-02	Available
B_WIC NATS OMB Burden Table_In-PersonRev_2021.06.17.xlsx	Supplementary Document	Uploaded 2022-02-02	Available
A3_WIC NATS Sampling Approach.docx	Supplementary Document	Uploaded 2022-02-02	Repair queued
A2_Relevant WIC Policy and Guidance Documents.pdf	Supplementary Document	Uploaded 2022-02-02	Repair queued
A1_Authorizing Statutes.docx	Supplementary Document	Uploaded 2022-02-02	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	Modified
244259	WIC Participants - Individuals and Households	Other-Appendix C2 Nutrition Services Observation Form	Modified
244258	Local Agency WIC Clinic Staff - Profit/Non-Profit Businesses (Non-Respondents)	Other-Non Respondents Burden Instrument	Modified
244257	Local Agency WIC Clinic Staff - Profit/Non-Profit Businesses	Other-Appendix C1 Site Director Interview Guide	Modified
244255	State and Local Agency WIC Clinic Staff - SLT (Non-respondents)	Other-Non Respondents Burden Instrument	Modified
244254	State and Local Agency WIC Clinic Staff - SLT	Other-Appendix C1 Site Director Interview Guide	Modified

ICR Details

OMB Control No: 0584-0663	ICR Reference No: 202202-0584-001
Status: Received in OIRA	Previous ICR Reference No: 202010-0584-009
Agency/Subagency: USDA/FNS	Agency Tracking No: In-Person Site Visit
Title: WIC Nutrition Assessment and Tailoring Study In-Person Site Visit Data Collection
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/22/2022

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2024
Responses	4,865	6,496
Time Burden (Hours)	510	867
Cost Burden (Dollars)	0	0

---

Abstract: This request is for a revision to the approved collection for the WIC Nutrition Assessment and Tailoring Study (WIC NATS) to add data collection from in-person site visits, where the data collection activities currently approved for remote site visits will be replicated for use with 30 selected WIC clinic sites for in-person site visits once those sites safely resume in-person operations.

---

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

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 41945	08/04/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 16162	03/22/2022
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

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

---

ICR Summary of Burden

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	4,865	6,496	0	-1,792	161	0
Annual Time Burden (Hours)	510	867	0	-358	1	0
Annual Cost Burden (Dollars)	0	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This information collection is currently approved with 867 burden hours and 6,496 responses. FNS estimates that this proposed revision will reduce the total burden by 357 burden hours and 1,631 responses. The overall reduction in the burden hours and responses is due to program changes and adjustments. The WIC State and local agencies were removed from this study since data will not be collected from these entities as part of the in-person site visits. This removed 358 hours and 1,792 responses from the collection. Changes in the number of WIC participants increased the burden by 1 hour and 161 responses due to an adjustment (this increase, however, was offset by the reductions resulting from the program change). With this revision, FNS estimates that this collection will have 510 burden hours and 4,865 responses.

---

Annual Cost to Federal Government: $611,911

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

---

Common Form ICR:  No

---

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: 03/22/2022

---