Healthy Start Program Survey Instruments

Healthy Start Evaluation and Capacity Building Support

NSC A3_HS Recruitment Email Network Survey_8.28.23

Healthy Start Program Survey Instruments

OMB: 0906-0076

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Expiration Date: 0906-0076

OMB Number: 08/31/2024






Attachment A3



Healthy Start Network Survey

Recruitment Email Invitation



HRSA’s Healthy Start Evaluation and Capacity Building Support Project

October 2022



Healthy Start Network Survey Recruitment Email Invitation


Dear [CAN MEMBER’S NAME],


We are contacting you because [PROJECT DIRECTOR’S NAME] from the [GRANTEE NAME] has identified you as a member of Healthy Start’s Community Action Network (CAN).


You may know your local CAN as the [CAN NAME]. The CAN is made up of a group of people, like you, who come together to collaborate on strategies and activities to develop and achieve goals related to the broader goals of the Healthy Start program.


Healthy Start is a national program of the Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration (HRSA). HRSA is conducting a national evaluation of the Healthy Start program, and Westat is an independent research firm that is helping HRSA with this work.


As part of this evaluation, we are inviting you to participate in the Healthy Start Network Survey, which will help us learn more about your collaborations with other CAN members. The survey is online and should take approximately 20 minutes to complete. Please be sure to save your responses if you need to pause the survey for longer than 20 minutes. For more information about the survey, please take a look at the Frequently Asked Questions (FAQs) attached.


When you are ready to take the Network Survey, please use the following web survey link: [INSERT SURVEY LINK]. Do not share this link with others because it is unique to you. The last day to complete the survey is [INSERT DATE].


Your participation is important to us, and the information you provide will help us better understand the collaborations within your Healthy Start CAN. Your responses will also help us find ways to strengthen programs to improve maternal, infant, and family health outcomes.


If you have any questions or need assistance with completing the survey, please contact our Study Support Team by email at [email protected] or by phone at [INSERT PHONE NUMBER]. You may also contact us if you wish to tell us anything else that you did not feel comfortable putting on the survey.



Kind regards,

[WESTAT STAFF]






Public Burden Statement: The purpose of this information collection is to obtain performance data for the following: HRSA grantees and cooperative agreement recipients, outcomes of HRSA, and evaluations. In addition, these data will facilitate the ability to demonstrate alignment between MCHB discretionary programs and the Healthy Start Program to quantify outcomes across MCHB. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 0906-0075 and it is valid until 08/31/2024.Public reporting burden for this collection of information is estimated to average 0.37 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or [email protected]. 



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