Screener

Study Screener

Welcome to Feeding My Baby and Me! This study is sponsored by the Centers for Disease Control and Prevention (CDC) to help understand the thoughts, experiences, and decisions on baby care and feeding from today’s Moms like you.

CDC has a long history of supporting efforts to improve nutrition for infants. This study will provide important information to guide CDC and others to help improve the health of all of our nation’s children.

We are seeking a select group of pregnant women from across the nation to take part in this online 2-year study. All surveys will be done on the web at a time that is convenient for you.

If you are eligible and decide to join the study, you can receive up to $620 for your participation.

Joining the study means:

• Completing web surveys about baby feeding and care (15 – 20 minutes) online. We will ask you to complete one survey before your baby is born. After your baby’s born, we will ask you to complete surveys periodically from 1-month to age 2 years. You will receive $30 for each survey.

• Complete two web surveys (25 – 30 minutes) about what you eat, one before the baby’s born and one when your baby is 3 months old. You will receive $50 for each.

For more information on the study, click here. To answer a few questions to find out if you are eligible, click here.

Form Approved
OMB No. 0920-xxxx
Exp. Date xx/xx/xxxx

IFPS-3: Screener

The information you are being asked to provide is authorized to be collected under Section 301 of The Public Health Service Act (42 USC 241). Providing this information is voluntary. CDC will use this information in its study, Feeding My Baby and Me (also known as the Infant Feeding Practices Study III), in order to learn more about the choices mothers make in feeding their babies and toddlers in the first 2 years of life. This information will support efforts to improve the health of our nation’s children. This information will be shared with a contractor, Westat, with which CDC has entered into an agreement to assist with carrying out this study.

Public reporting burden of this collection of information varies from 2 to 24 minutes with an average of 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx)

1. Are you currently pregnant?

• Yes

• No [INELIGIBLE]

2. What is your age?

_________ Years [IF AGE < 18 OR >50, INELIIGIBLE]

3. Are you having twins or more than one baby?

• Yes [INELIGIBLE]

• No

• Don’t know [IF SELECT – THEY WILL BE ASKED ON BIRTH SCREENER]

4. When is your baby due?

Month: _______ Day: ________

[IF DUE DATE IS LESS THAN 3 WEEKS, INELIGIBLE]

[IF DUE DATE > 17 WEEKS IN FUTURE]

We can’t enroll you in the study today as you are not far enough along in your pregnancy. Please come back after [DATE] to complete the screener.

5. Are you Latino or Hispanic?

• Yes

• No

6. What is your race?

Select all that apply.

• American Indian or Alaska Native

• Asian

• Black or African American

• Native Hawaiian or Other Pacific Islander

• White

7. What is your zip code? ____________