Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Child Nutrition Formative Research on Administrative Review and Training Grants - SAs and SFAs New 180 120 0 Other-Appendix A State Agency Interview Protocol
Other-Appendix B State Agency Follow-up Interview Protocol
Other-Appendix C School Food Authority Interview Protocol
Consumer Research for Nutrition Educatoin and Promotion Activities (Business IC) New 1200 125 0 Other-Appendix A.4 FNS-816 Level 1 Event Feedback Form
Other-Appendix A.5 FNS-817 Level 3 Event Feedback Form
Other-Appendix A.6 FNS-854 Attendee Evaluation Form
Consumer Research for Nutrition Educatoin and Promotion Activities (SLT) New 13210 3169 0 Other-Appendix A.1 FNS-781 Team Nutrition School Enrollment Web Form
Other-Research and Nutrition SLT\Appendix A.2 FNS-807 Power Panther Costume Request and Agreement Form
Other-Appendix A.3 FNS-808 Power Panther Costume Event Feedback Form
Other-Appendix A.4 FNS-816 Level 1 Event Feedback Form
Other-Appendix A.5 FNS-817 Level 3 Event Feedback Form
Other-Appendix A.6 FNS-854 Attendee Evaluation Form
Other-Appendix A.7 FNS-779 HUSSCSL2014
Digital Nutrition Education Materials for Middle School Students (Individuals/Households) - IC 2 of 2 New 3226 744 0 Other-Attachment B Consent Packge for Parent/Caregivers: Parent/Caregiver Consent Cover Letter, Parent/Caregiver Passive Consent Information
Other-Attachment C Student Focus Group Package for Grade 6: Student Focus Group Guideline, Student Focus Group Questionnaire
Other-Attachment D Student Survey: Grade 6
Other-Attachment E Student Focus Group Package for Grade 7: Student Focus Group Guideline, Student Focus Group Questionnaire
Other-Attachment F Student Survey: Grade 7
Other-Attachment G Student Focus Group Package for Grade 8: Student Focus Group Guideline, Student Focus Group Questionnaire
Other-Attachment H Student Survey: Grade 8
Digital Nutrition Education Materials for Middle School Teachers (SLT) - IC 1 of 2 New 662 375 0 Other-Attachment A Consent Package for Teachers: Teacher Consent Cover Letter, Teacher Informed Consent Form, Questionnaire for Participation in Pilot
Other-Attachment I Teacher Focus Group Guideline
Other-Attachment J Teacher Interview Guideline: Grade 6
Other-Attachment K Teacher Journal: Grade 6
Other-Attachment L Teacher Interview Guideline: Grade 7
Other-Attachment M Teacher Journal: Grade 7
Other-Attachment N Teacher Interview Guideline: Grade 8
Other-Attachment O Teacher Journal: Grade 8
Other-Attachment P Teacher and Principal Communication Documents: Initial Contact Email, Follow Up to Initial Contact Email, and Information about Pilot Opportunity
Other-Attachment Q Principal Letter of Agreement
Other-Attachment B Consent Package for Parent/Caregivers: Parent/Caregiver Consent Cover Letter, Parent/Caregiver Passive Consent Information
Other-Attachment C Student Focus Group Package for Grade 6: Student Focus Group Guideline, Student Focus Group Questionnaire
Other-Attachment D Student Survey: Grade 6
Other-Attachment E Student Focus Group Package for Grade 7: Student Focus Group Guideline, Student Focus Group Questionnaire
Other-Attachment F Student Survey: Grade 7
Other-Attachment G Student Focus Group Package for Grade 8: Student Focus Group Guideline, Student Focus Group Questionnaire
Other-Attachment H Student Survey: Grade 8
FNS-742 Data Study (1 of 2) New 79 11 0 Other- Appendix B - FNS-742
FNS-742 Data Study (2 of 2) New 130 376 0 Other- Appendix A - State Recruitment Letter
Other-Appendix B - FNS-742
Other-Appendix C - Interview guide
Formative Research to Develop Multicultural Nutrition Education for Child Care (Individuals and Households - Children and Parents) New 1620 386 0 Other-Attachment D.1: Questionnaire for Participation in Focus Group Research (Print Version)
Other-Attachment D.2: Questionnaire for Participation in Focus Group Research (Online Version)
Other-Attachment H: Parent/Caregiver Focus Group Guideline
Other-Attachment I: Storybook Interview Form for Children 3-5
Other-Attachment J: Storybook Measure for Children 3-5
Other-Attachment K: Survey for 6-12 Year Old Children
Other-Attachment L: Child Taste Test Ballot: Instructions for Completing the Taste Test Ballots with Children, Taste Test Faces, Taste Test Records Sheet
Other-Attachment D- Recruitment Communications and Consent Document for Parents/Caregivers
Formative Research to Develop Multicultural Nutrition Education for Child Care (SLT - Site Directors and Classroom Providers) New 2088 322 0 Other-Attachment A: Recruitment Communications for Child Care Providers and Directors
Other-Attachment B: Consent for Child Care Providers
Other-Attachment C: Site Confirmation Letter
Other-Attachment E: Research Introduction and Overview for Providers
Other-Attachment F: Child Care Provider Interview Guideline
Other-Attachment G: Child Care Provider Journal
Other-Attachment L: Child Taste Test Ballot: Instructions for Completing the Taste Test Ballots with Children, Taste Test Faces, Taste Test Records Sheet
Other-Attachment M.1: Child Care Director Consent Letter and Survey, Print Version
Other-Attachment M.2: Child Care Director Email, Consent Letter, and Survey - Web Version
Other-Attachment V: Provider Follow Up Interview
Formative Research to Revise Materials for Mothers and Child Care Providers of Infants (Individuals and Households) New 704 358 0 Other-Attachment A: Consent Package for Mothers and Expectant Mothers:Focus Group Flyer,Consent Cover Letter,Informed Consent Form,Questionnaire for Participation,and Focus Group Reminder Phone Call Script
Other-Attachment AA:Consent Package for Mothers and Expectant Mothers:Focus Group Flyer,Consent Cover Letter,Informed Consent Form,Questionnaire for Participation,Focus Group Reminder PhoneCallScript(Span)
Other-Attachment C: Current Breastfeeding Mothers Focus Group Guideline
Other-Attachment CC: Current Breastfeeding Mothers Focus Group Guideline (Spanish)
Other-Attachment D: Expecting Mothers Focus Group Guideline
Other-Attachment DD: Expecting Mothers Focus Group Guideline (Spanish)
Other-Attachment I: Research Stimuli for Parents - English
Other-Attachment K: Research Stimuli for Parents - Spanish
Formative Research to Revise Materials for Mothers and Child Care Providers of Infants (SLT) New 234 94 0 Other-Attachment B: Consent Package for Directors and Providers: Consent Cover Letter, Informed Consent Form, and Questionnaire for Participation
Other-Attachment BB: Consent Package for Directors and Providers: Consent Cover Letter, Informed Consent Form, and Questionnaire for Participation (Spanish)
Other-Attachment E: Director and Provider Interview Guideline
Other-Attachment EE: Director and Provider Interview Guideline (Spanish)
Other-Attachment F:Director and Provider Recruitment Communications:Initial Recruitment Email,Initial Recruitment Phone Call,FollowUp Email to Interested Sites,FollowUp Call with Interested Site Directors
Other-Attachment J: Research Stimuli for Child Care Providers - English
Other-Attachment L: Research Stimuli for Child Care Providers - Spanish
Improving School Meal Program Accuracy through Pre-Ordering and Grab and Go Systems - SA, SFAs, and Schools (SLT) New 192 255 0 Other-Attachment D.1 - SFA/School Follow-up Script
Other-Attachment D.2 - State Follow-up Script
Improving School Meal Program Accuracy through Pre-Ordering and Grab and Go Systems - Students (Individuals/Households) New 36000 360 0 Other-Attachment E.1 - Pre-ordering App Examples - Paper
Other-Attachment E.2 - Pre-ordering App Examples - Electronic
Mealtimes with Toddlers in the Child and Adult Care Food Program (SLT) New 2070 167 0 Other-Attachment F: Follow Up Call to Screened Research Participants
Other-Attachment K: Consent Form for Research Participation
Other-Attachment L: Screener for Research Participation
Other-Attachment N: Guideline for In-Depth Interviews (English)
Other-Attachment O: Guideline for In-Depth Interviews (Spanish)
Other-Screener
Revised - Formative Research to Develop Educational Materials for Parents, Caregivers, and Child Care Providers of Children Ages 2-5 (Individuals/Households) New 195 101 0 Other-Attachment A: Screener: Parent/Caregiver Triad (English)
Other-Attachment B: Parent/Caregiver Triad (Spanish)
Other-Attachment G: Consent Form: Parent/Caregiver Triads (English)
Other-Attachment H: Consent Form: Parent/Caregiver Triads (Spanish)
Other-Attachment L: Triad Moderator's Guide: Parent/Caregiver (English)
Other-Attachment M: Triad Moderator's Guide: Parent/Caregiver (Spanish)
Revised - Formative Research to Develop Educational Materials for Parents, Caregivers, and Child Care Providers of Children Ages 2-5 (SLT) New 108 54 0 Other-Attachment C: Screener: Child Care Provider (English)
Other-Attachment D: Screener: Child Care Provider (Spanish)
Other-Attachment I: Consent Form: Child Care Provider (English)
Other-Attachment J: Consent Form: Child Care Provider (Spanish)
Other-Attachment K: Consent Form: CACFP Site
Other-Attachment N: Interview Facilitator's Guide: Child Care Provider (English)
Other-Attachment O: Interview Facilitator's Guide: Child Care Provider (Spanish)
Other-Attachment U: Screener for CACFP Sites
Other-Attachment V: CACFP Site Screener - Follow-up
Other-Attachment W: CACFP Site Confirmation Email
Team Nutrition Cooks - Individuals and Households New 690 111 0 Other-Attachment A Parent/Caregiver Informed Consent for Child Participation
Other-Attachment C Questionnaaire for Student Pre-/Post-Intervention Survey
Other-Attachment D Lesson Feedback Worksheet for Students
Other-Attachment G Discussion Guide for Focus Groups with Parents/Caregivers
Other-Attachment H Demographics for Parents and Program Operators
Other-Attachment N Parent/Caregiver Informed Consent for Focus Group
Team Nutrition Cooks - State, Local, and Tribal Government New 171 29 0 Other-Attachment B Program Operator Informed Consent
Other-Attachment E Lesson Feedback Worksheet for Program Operators
Other-Attachment F Discussion Guide for In-Depth Interviews with Program Operators
Other-Attachment H Demographics for Parents and Program Operators
Other-Attachment K Lesson Attendance Sheet for Program Operators
Other-Attachment L Confirmation Letter for Administrator/Principal
Other-Attachment P Draft Agenda for Kickoff Meeting with Program Operators
Other-Attachment A Parent/Caregiver Informed Consent for Child Participation
Other-Attachment C Questionnaire for Student Pre-/Post-Intervention Survey
Other-Attachment D Lesson Feedback Worksheet for Students
Other-Attachment G Discussion Guide for Focus Groups with Parents/Caregivers
Other-Attachment N Parent/Caregiver Informed Consent for Focus Group
Team Nutrition Educational Technology Environmental Scan New 2980 501 0 Other-Attachment A_Consent Package for School Focus Groups
Other-Attachment B_Consent Package for SHAPE Conference Focus Groups
Other-Attachment C_Consent Package for Teacher of Health Education Survey
Other-Attachment D_Moderators Guide for Teacher Focus Groups
Other-Attachment E_Teacher of Health Education Survey
Other-Attachment F_Flyer for Focus Group Participation
Other-Attachment G_Introduction Email for School Focus Groups
Other-Attachment H_Scheduling Email for School Focus Groups
Other-Attachment I_Principal Letter of Agreement
Other-Attachment J_Introduction Email for Teacher of Health Education Survey
WIC Breastfeeding Curricula Training SLT Agencies New 1258 82 0 Other-WIC DBE Survey Screen shots
Other-Attachment D_DBE Survey Questions
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 66997 7740 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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