Information Collection Request

Feeding My Baby and Me: Infant Feeding Practices Study III

ICR 202310-0920-003 · OMB 0920-1333 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 092-20FO Attachment 4p – Month 24 survey-Revised Form and Instruction Modified Available
Form 092-20FO 24-Month Survey Form and Instruction Modified Available
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 Repair queued
Form 0920-20FO Att.4k-Month 10 Survey-Revised Form and Instruction Modified Available
Form 0920-20FO 10-Month Survey Form and Instruction Modified Repair queued
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 Available
ASA24 Form and Instruction Modified Available
3-Month 24-Hour Dietary Recall (Replicate) Form and Instruction Modified Repair queued
ASA24 Form and Instruction Modified Repair queued
3-Month 24-Hour Dietary Recall Form and Instruction Modified 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 Available
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 Available
Birth Screener Form and Instruction Modified Available
Birth Screener Form and Instruction Modified Repair queued
Request for Notification of Child's Birth Form and Instruction Modified Repair queued
Request for Notification of Child's Birth Form and Instruction Modified Repair queued
ASA24 Form and Instruction Modified Available
Prenatal 24-Hour Dietary Recall (Replicate) Form and Instruction Modified Repair queued
ASA24 Form and Instruction Modified Available
Prenatal 24-Hour Dietary Recall Form and Instruction Modified 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 Modified Repair queued
Study Consent and Contact Information Form and Instruction Modified Repair queued
Screener Form and Instruction Modified Available
Screening Form and Instruction Modified Available
Att.6-Confidentiality Nondisclosure Statement.pdf Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5k-Study removal email and text.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5j-Participant follow up letter.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5i-Missed survey email and text.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5h-Survey thank you email and text.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5g Survey Reminder email and text.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5f-Survey invitation email and text.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5c-Telephone and voicemail script for eligible respondents.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5b-Social media recruitment messages.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.5a-Recruitment Enrollment Flow Chart.pdf Supplementary Document Uploaded 2023-10-13 Repair queued
Att.4r-Common Items across National-level Surveys.docx Supplementary Document Uploaded 2023-10-13 Repair queued
Att.3-Human Subjects Document.pdf Supplementary Document Uploaded 2023-10-13 Repair queued
Att.2-60-day Federal Register Notice and Public Comments.pdf Supplementary Document Uploaded 2023-10-13 Repair queued
Att.1-Public Health Services Act.pdf Supplementary Document Uploaded 2023-10-13 Repair queued
SSB_IFPSIII_extension.docx Supporting Statement B Uploaded 2023-10-18 Available
SSA_IFPSIII_extension.docx Supporting Statement A Uploaded 2023-10-18 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
244224 24-Month Survey Form and Instruction ModifiedAttachment 4p – Month 24 survey-Revised
244224 24-Month Survey Form and Instruction Modified
244223 21-Month Survey Form and Instruction ModifiedAtt.4o-Month 21 Survey-Revised
244223 21-Month Survey Form and Instruction Modified
244222 18-Month Survey Form and Instruction ModifiedAtt.4n-Month 18 Survey-Revised
244222 18-Month Survey Form and Instruction Modified
244221 15-Month Survey Form and Instruction ModifiedAtt.4m-Month 15 Survey-Revised
244221 15-Month Survey Form and Instruction Modified
244220 12-Month Survey Form and Instruction ModifiedAtt.4l-Month12 Survey-Revised
244220 12-Month Survey Form and Instruction Modified
244219 10-Month Survey Form and Instruction ModifiedAtt.4k-Month 10 Survey-Revised
244219 10-Month Survey Form and Instruction Modified
244218 8-Month Survey Form and Instruction ModifiedAtt.4j-Month 8 Survey-Revised
244218 8-Month Survey Form and Instruction Modified
244217 6-Month Survey Form and Instruction ModifiedAtt.4i-Month 6 Survey-Revised
244217 6-Month Survey Form and Instruction Modified
244216 5-Month Survey Form and Instruction ModifiedAtt.4h-Month 5 Survey-Revised
244216 5-Month Survey Form and Instruction Modified
244215 4-Month Survey Form and Instruction ModifiedAtt.4g-Month 4 Survey-Revised
244215 4-Month Survey Form and Instruction Modified
244214 3-Month 24-Hour Dietary Recall (Replicate) Form and Instruction ModifiedASA24
244214 3-Month 24-Hour Dietary Recall (Replicate) Form and Instruction Modified
244213 3-Month 24-Hour Dietary Recall Form and Instruction ModifiedASA24
244213 3-Month 24-Hour Dietary Recall Form and Instruction Modified
244212 3-Month Survey Form and Instruction ModifiedAtt.4f-Month 3 Survey-Revised
244212 3-Month Survey Form and Instruction Modified
244211 2-Month Survey Form and Instruction ModifiedAttachment 4e – Month 2 survey- Revised
244211 2-Month Survey Form and Instruction Modified
244210 1-Month Survey Form and Instruction ModifiedAtt.4d-Month 1 Survey-Revised
244210 1-Month Survey Form and Instruction Modified
244209 Birth Screener Form and Instruction ModifiedBirth Screener
244209 Birth Screener Form and Instruction Modified
244208 Request for Notification of Child's Birth Form and Instruction ModifiedRequest for Notification of Child's Birth
244208 Request for Notification of Child's Birth Form and Instruction Modified
244207 Prenatal 24-Hour Dietary Recall (Replicate) Form and Instruction ModifiedASA24
244207 Prenatal 24-Hour Dietary Recall (Replicate) Form and Instruction Modified
244206 Prenatal 24-Hour Dietary Recall Form and Instruction ModifiedASA24
244206 Prenatal 24-Hour Dietary Recall Form and Instruction Modified
244205 Prenatal Survey Form and Instruction ModifiedAtt.4b-Prenatal Survey-Revised
244205 Prenatal Survey Form and Instruction Modified
244204 Study Consent and Contact Information Form and Instruction ModifiedInformed Consent and Contact Information
244204 Study Consent and Contact Information Form and Instruction Modified
244203 Screening Form and Instruction ModifiedScreener
244203 Screening Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2026 12 Months From Approved 04/30/2024
23,352 0 23,352
5,052 0 5,052
0 0 143,685





Reginfo record details
22
table that charts list of burden
IC Title Form No. Form Name
1-Month Survey 0920-20FO
10-Month Survey 0920-20FO
12-Month Survey 0920-20FO
15-Month Survey 092-20FO
18-Month Survey 0920-20FO
2-Month Survey 0920-20FO
21-Month Survey 0920-20FO
24-Month Survey 092-20FO
3-Month 24-Hour Dietary Recall n/a
3-Month 24-Hour Dietary Recall (Replicate) n/a
3-Month Survey 0920-20FO
4-Month Survey 0920-20FO
5-Month Survey 0920-20FO
6-Month Survey 0920-20FO
8-Month Survey 0920-20FO
Birth Screener n/a
Prenatal 24-Hour Dietary Recall n/a
Prenatal 24-Hour Dietary Recall (Replicate) n/a
Prenatal Survey 0920-20FO
Request for Notification of Child's Birth n/a
Screening n/a
Study Consent and Contact Information 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 23,352 23,352 0 0 0 0
Annual Time Burden (Hours) 5,052 5,052 0 0 0 0
Annual Cost Burden (Dollars) 0 143,685 0 -143,685 0 0


Reginfo record details
  No