View Information Collection (IC)

View Information Collection (IC)

Testing of automated self-response methods for collecting the reduced content version of NCS pregnancy status follow-up contacts
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 survey 3. Appendix A - NCS Formative Research Recruiting Questionnaire - Automated self-response.docx Yes Yes Paper Only
Form and Instruction 2 survey 7. Appendix E - Pregnancy Screener for self-response test.docx Yes Yes Paper Only
Form and Instruction 3 survey 8.Appendix F - Consent Form to Receive Text Messages.docx Yes Yes Paper Only
Form and Instruction 4 survey 9. Appendix G - Interactive Voice Response Phone Follow-up Script.docx Yes Yes Paper Only
Form and Instruction 5 survey 11. Appendix I - Web E-mail Follow-up Script.docx Yes Yes Paper Only
Form and Instruction 6 survey 10. Appendix H - Text Message Follow-up Script.docx Yes Yes Paper Only

Health Health Care Services

 

200 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 200 0 0 0 0 0
Annual IC Time Burden (Hours) 100 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
2 2. Automated Self-response Formative Research Cover Memo.docx 07/16/2009
1 Submission of Information Collection - Automated Self-response (2) 1 Submission of Information Collection - Automated Self-response (2).doc 07/16/2009
4 4. Appendix B - Flowchart for 6-week Contact.pdf 07/16/2009
5 5. Appendix C - Flowchart for 12-week Contact.pdf 07/16/2009
6 6. Appendix D - Consent Form for Westat Formative Research Study.docx 07/16/2009
12 12. Appendix J - Westat IRB Expedited Approval.docx 07/16/2009
Terms of Clearance 0925-0590 Terms of Clearance.doc 09/18/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.