Information Collection Request

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

ICR 202212-0920-015 · OMB 0920-0010 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Core CATI (Spanish) Form and Instruction Modified Available
Core CATI Form and Instruction Modified Available
Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction Modified Repair queued
Stillbirth COVID-19 Sub-Study Form (Non-Interviewed) Spanish Form and Instruction New Available
Stillbirth COVID-19 Sub-Study Form (Interviewed) Spanish Form and Instruction New Available
Stillbirth COVID-19 Sub-Study Form (Non-Interviewed) Form and Instruction New Available
Stillbirth COVID-19 Sub-Study Form (Interviewed) Form and Instruction New Available
Stillbirth COVID-19 Sub-Study Form and Instruction New Repair queued
Computer Assisted Phone Interview about Stillbirth (Spanish) Form and Instruction Modified Available
Computer Assisted Phone Interview about Stillbirth (English) Form and Instruction Modified Available
Supplemental CATI about Stillbirth Form and Instruction Modified Repair queued
Verbal Consent for Release of Reportable Infectious Diseases (Spanish) Form and Instruction Modified Available
Verbal Consent for Release of Reportable Infectious Diseases (English) Form and Instruction Modified Available
Written Consent for Release of Reportable Infectious Diseases (Spanish) Form and Instruction Modified Available
Written Consent for Release of Reportable Infectious Diseases (English) Form and Instruction Modified Available
Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction Modified Repair queued
Teaching_Screenshots_Spanish Form and Instruction Modified Available
Teaching_Screenshots_English Form and Instruction Modified Available
Restaurant Worker_Screenshots_Spanish Form and Instruction Modified Available
Restaurant Worker_Screenshots_English Form and Instruction Modified Available
Office Worker_Screenshots_Spanish Form and Instruction Modified Available
Office Worker_Screenshots_English Form and Instruction Modified Available
Janitorial_Screenshots_Spanish Form and Instruction Modified Available
Janitorial_Screenshots_English Form and Instruction Modified Available
Healthcare_Screenshots_Spansih Form and Instruction Modified Available
Healthcare_Screenshots_English Form and Instruction Modified Available
Electronic Equipment Operators_Screenshots_Spanish Form and Instruction Modified Available
Electronic Equipment Operators_Screenshots_English Form and Instruction Modified Available
Cosmetology_Screenshots_Spanish Form and Instruction Modified Available
Cosmetology_Screenshots_English Form and Instruction Modified Available
Agriculture_Screenshots_Spanish Form and Instruction Modified Available
Agriculture_Screenshots_English Form and Instruction Modified Available
Occupational Questionnaires Form and Instruction Modified Repair queued
Bloodspot Verbal Consent for Multiples (Spanish) Form and Instruction Modified Available
Bloodspot Consent for Multiples (Spanish) Form and Instruction Modified Available
Bloodspot Verbal Consent (Spanish) Form and Instruction Modified Available
Bloodspot Consent (Spanish) Form and Instruction Modified Available
Bloodspot Verbal Consent for Multiples (English) Form and Instruction Modified Available
Bloodspot Consent for Multiples (English) Form and Instruction Modified Repair queued
Bloodspot Verbal Consent (English) Form and Instruction Modified Available
Bloodspot Consent (English) Form and Instruction Modified Available
Consent for Bloodspot Retrieval Form and Instruction Modified Repair queued
AttG5.2b_Stillbirth_COVID_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG5.1b_Stillbirth_COVID_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG4.13b_Stillbirth_Thank_You_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG4.2b_Stillbirth_Thank_You_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG4.1b_Stillbirth_Thank_You_Letter.docx Supplementary Document Uploaded 2022-12-23 Available
AttG3b_Stillbirth_Phone_Script.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG2.2b_Stillbirth_Intro_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG2.1b_Stillbirth_Intro_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttF2b_OOQ_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttE6b_Bloodspot_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttD4b_Infection_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC8.2b_Core_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC8.1b_Core_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC7b_Core_Phone_Scripts.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC6b_Address_Correction.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC5b_Privacy_Act.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC4b_Q_and_A.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttC2b_Study_Intro_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
List of Attachments_BD-STEPS.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttO_NSCR_Core_CATI_09Nov2022.docx Supplementary Document Uploaded 2022-12-23 Available
AttN_Publications.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttM2_PIA_Explanation.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttM1_PIA.pdf Supplementary Document Uploaded 2022-12-23 Available
AttL_Confidentiality.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttK_Stillbirth_Case_Definition.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttJ_ Birth_Defects_Case_Definition.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttI_IRB_Amendment.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttH_IRB_2022Continuation.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttG5.2a_Stillbirth_COVID_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG5.1a_Stillbirth_COVID_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG4.3a_Stillbirth_Thank_You_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG4.2a_Stillbirth_Thank_You_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG4.1a_Stillbirth_Thank_You_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG3a_Stillbirth_Phone_Script.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG2.2a_Stillbirth_Intro_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttG2.1a_Stillbirth_Intro_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttF2a_OOQ_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttE6a_Bloodspot_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttE1_Bloodspot_FAQ.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttD4a_Infection_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttD1_Infection_FAQ.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttC8.2a_Core_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC8.1a_Core_Thank_You.docx Supplementary Document Uploaded 2022-12-23 Available
AttC7a_Core_Phone_Scripts.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC6a_Address_Correction.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC5a_Privacy_Act.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttC4a_Q_and_A.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttC3_Human_Subjects_Fact_Sheet.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttC2a_Study_Intro_Letter.docx Supplementary Document Uploaded 2022-12-23 Repair queued
AttB_60_day_FRN.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
AttA_BDPreventionActof1998.pdf Supplementary Document Uploaded 2022-12-23 Repair queued
SSB_BD-STEPS 20221006.docx Supporting Statement B Uploaded 2022-12-23 Repair queued
SSA_BD-STEPS 20221109_final.docx Supporting Statement A Uploaded 2022-12-23 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
6608 Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction ModifiedCore CATI (Spanish)
6608 Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction ModifiedCore CATI
6608 Mother's Consent Script and Computer Assisted Telephone Interview Form and Instruction Modified
257626 Stillbirth COVID-19 Sub-Study Form and Instruction NewStillbirth COVID-19 Sub-Study Form (Non-Interviewed) Spanish
257626 Stillbirth COVID-19 Sub-Study Form and Instruction NewStillbirth COVID-19 Sub-Study Form (Interviewed) Spanish
257626 Stillbirth COVID-19 Sub-Study Form and Instruction NewStillbirth COVID-19 Sub-Study Form (Non-Interviewed)
257626 Stillbirth COVID-19 Sub-Study Form and Instruction NewStillbirth COVID-19 Sub-Study Form (Interviewed)
257626 Stillbirth COVID-19 Sub-Study Form and Instruction New
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 Modified
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction ModifiedVerbal Consent for Release of Reportable Infectious Diseases (Spanish)
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction ModifiedVerbal Consent for Release of Reportable Infectious Diseases (English)
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction ModifiedWritten Consent for Release of Reportable Infectious Diseases (Spanish)
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction ModifiedWritten Consent for Release of Reportable Infectious Diseases (English)
216974 Consent for Linkage to Reportable Infectious Diseases Results Form and Instruction Modified
216968 Occupational Questionnaires Form and Instruction ModifiedTeaching_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction ModifiedTeaching_Screenshots_English
216968 Occupational Questionnaires Form and Instruction ModifiedRestaurant Worker_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction ModifiedRestaurant Worker_Screenshots_English
216968 Occupational Questionnaires Form and Instruction ModifiedOffice Worker_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction ModifiedOffice Worker_Screenshots_English
216968 Occupational Questionnaires Form and Instruction ModifiedJanitorial_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction ModifiedJanitorial_Screenshots_English
216968 Occupational Questionnaires Form and Instruction ModifiedHealthcare_Screenshots_Spansih
216968 Occupational Questionnaires Form and Instruction ModifiedHealthcare_Screenshots_English
216968 Occupational Questionnaires Form and Instruction ModifiedElectronic Equipment Operators_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction ModifiedElectronic Equipment Operators_Screenshots_English
216968 Occupational Questionnaires Form and Instruction ModifiedCosmetology_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction ModifiedCosmetology_Screenshots_English
216968 Occupational Questionnaires Form and Instruction ModifiedAgriculture_Screenshots_Spanish
216968 Occupational Questionnaires Form and Instruction ModifiedAgriculture_Screenshots_English
216968 Occupational Questionnaires Form and Instruction Modified
187391 Consent for Bloodspot Retrieval Form and Instruction ModifiedBloodspot Verbal Consent for Multiples (Spanish)
187391 Consent for Bloodspot Retrieval Form and Instruction ModifiedBloodspot Consent for Multiples (Spanish)
187391 Consent for Bloodspot Retrieval Form and Instruction ModifiedBloodspot Verbal Consent (Spanish)
187391 Consent for Bloodspot Retrieval Form and Instruction ModifiedBloodspot Consent (Spanish)
187391 Consent for Bloodspot Retrieval Form and Instruction ModifiedBloodspot Verbal Consent for Multiples (English)
187391 Consent for Bloodspot Retrieval Form and Instruction ModifiedBloodspot Consent for Multiples (English)
187391 Consent for Bloodspot Retrieval Form and Instruction ModifiedBloodspot Verbal Consent (English)
187391 Consent for Bloodspot Retrieval Form and Instruction ModifiedBloodspot Consent (English)
187391 Consent for Bloodspot Retrieval Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2026 36 Months From Approved 04/30/2023
9,097 0 8,940
4,473 0 4,433
0 0 44,307





Reginfo record details
6
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 ,  
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 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Stillbirth COVID-19 Sub-Study n/a, n/a, n/a, n/a ,   ,   ,  
Supplemental CATI about Stillbirth 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 9,097 8,940 0 157 0 0
Annual Time Burden (Hours) 4,473 4,433 0 40 0 0
Annual Cost Burden (Dollars) 0 44,307 0 -44,307 0 0


Reginfo record details
  No