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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
CNPP MyPlate Focus Groups
Unchanged
2304
380
0
Other-Attachment A-1 Focus Group Screener by Ethnicity (English)
Other-Attachment A-2 Focus Group Screener Spanish-Preferring (English)
Other-Attachment A-3 Focus Group Screener Spanish-Preferring (Spanish)
Other-Attachment A-4 Focus Group Screener by Life Stage (English)
Other-Attachment B-1 Confirmation Form (English)
Other-Attachment B-2 Confirmation Form (Spanish)
Other-Attachment C-1 Consent Form (English)
Other-Attachment C-2 Consent Form (Spanish)
Other-Attachment D-1 Discussion Guide (English)
Other-Attachment D-2 Discussion Guide (Spanish)
FNS WIC: Usertesting.com screener for usability testing model applications with eligible participants
Unchanged
44
1
0
Other-Attachment Instrument for Fast Trace Clearance for WIC User Testing 8 24 23
National Farm to School Network's (NFSN) information collection process for the Racial Equity Learning Lab
Unchanged
352
152
0
Other-
Other-
Other-
Other-
Other-
National Outreach Campaign Needs Assessment for WIC State and Local Agencies
Unchanged
1989
415
0
Other-WIC Needs Assessment
Other-Needs Assessment Email Invitation
Other-Needs Assessment Instrument
Other-Needs Assessment Screenshots
National Outreach Campaign WIC – In-depth Interviews among Healthcare Professionals.
Unchanged
500
103
0
Other-Attachment A-1 WIC HCP IDI Screener
Other-Attachment B-1 Confirmation Form
Other-Attachment C-1 Consent Form
Other-Attachment D-1 WIC HCP IDI Guide
Produce Safety University Nomination Form
Unchanged
218
55
0
Other-Produce Safety University Nomination Form
Product Information Sheet and USDA Foods Database Survey
Unchanged
4800
1600
0
Other-Attachment A - Product Information Sheet and USDA Foods Database Survey Instrument
Other-Attachment D - Product Information Sheet and USDA Foods Database Survey Email
Other-Attachment F - Product Information Sheet and USDA Foods Database Survey - Remind Email
Product Information Sheet and USDA Foods Database Survey
Unchanged
7200
2400
0
Other-Attachment A - Product Information Sheet and USDA Foods Database Survey
Other-Attachment C - Product Information Sheet and USDA Foods Database Survey - Email for States
Other-Attachment D - Product Information Sheet and USDA Foods Database Survey - Email for SFAs
Other-Attachment E - Product Information Sheet and USDA Foods Database Survey - Reminder Email to States
Other-Attachment F - Product Information Sheet and USDA Foods Database Survey - Reminder Email for SFAs
SNAP Call Center and Telephonic Operations (CCTO) State Survey
New
106
106
0
Instruction
Instruction
Supplemental Nutrition Assistance Program Employment & Training (SNAP E&T) Program Marketing/Outreach Support: Participant & Prospective Participant Discussions
Unchanged
20000
459
0
Other-E&T Participant Focus Groups - Attachment A
Other-E&T Participant Focus Groups - Attachment B
Other-E&T Participant Focus Groups - Attachment C
Other-E&T Participant Focus Groups - Attachment D
Survey to Collect Information on the use of MyPlate Materials in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) Clearinghouse
Unchanged
20
5
0
Instruction
Survey to Collect Information on the use of MyPlate Materials in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) Clearinghouse.
Unchanged
110
28
0
Instruction
Survey to Collect Information on the use of MyPlate Materials in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) Clearinghouse.
Unchanged
2
1
0
Instruction
The Evaluation of Equity in The Supplemental Nutrition Assistance Program Nutrition Education (SNAP-Ed) Service Delivery Project State and Implementing Agencies' Listening Sessions (Businesses)
Unchanged
6
12
0
Other-Appendix A. SNAP-Ed Equity Project Listening Sessions Protocols_final
The Evaluation of Equity in The Supplemental Nutrition Assistance Program Nutrition Education (SNAP-Ed) Service Delivery Project State and Implementing Agencies' Listening Sessions (S,L,T))
Unchanged
88
88
0
Other-Appendix A. SNAP-Ed Equity Project Listening Sessions Protocols_final
Other-Appendix C. SNAP-Ed Listening Session Email to State Agencies (003)
Other-Attachment D. SNAP-Ed Equity Project State Agencies Listening Sessions Flyer_final
USFA School Food Procurement Needs Assessment - SLT
New
796
72
0
Other-Attachment B: USFA Survey
Virtual Services Human-Centered Discovery with State and Local Agencies
New
1988
669
0
Other-Attachment 1 – WIC VS-Email Communications
Other-• Attachment 2 – WIC VS-Focus Group Descriptions
Other-Attachment 3 – WIC VS-Focus Group Facilitation Guide_Local Agency_TEMPLATE
Other-Attachment 4 – WIC VS-Focus Group Facilitation Guide_State Agency_TEMPLATE
Other-Attachment 5 – WIC VS-Survey_Local Agencies
Other-Attachment 6 – WIC VS-Survey_State Agencies 01
Other-Attachment 7 – WIC VS-Survey_State Agencies 02
WIC Customer Experience Landscape Assessment
Unchanged
178
34
0
Other-Appendix C Email invitation to WIC SAs_2023
Other-Attachment A_WIC CX Landscape Analysis Survey_2023 11 21
WIC Eligibility Customer Experience Survey
Unchanged
22500
1875
0
Other-WIC Eligibility Customer Experience Survey
WIC National Outreach Campaign Formative Focus Groups
Unchanged
3200
414
0
Other-Attachment A-1 WIC Par Screener (English) UPDATED
Other-Attachment A-2 WIC Non-Par Screener (English) UPDATED
Other-Attachment A-3 WIC Par Screener (Spanish) UPDATED
Other-Attachment A-4 WIC Non-Par Screener (Spanish) UPDATED
Other-Attachment B-1 Confirmation Form (English) UPDATED
Other-Attachment B-2 Confirmation Form (Spanish) UPDATED
Other-Attachment C-1 Consent Form (English) UPDATED
Other-Attachment C-2 Consent Form (Spanish) UPDATED
Other-Attachment D-1 WIC FG Guide Participants (English) UPDATED
Other-Attachment D-2 WIC FG Guide NonParticipants (English) UPDATED
Other-Attachment D-3 WIC FG Guide Participants (Spanish) UPDATED
Other-Attachment D-4 WIC FG Guide NonParticipants (Spanish) UPDATED
WIC National Outreach Campaign – In-depth Interviews (IDIs) among Employees of Food Shopping Vendors
New
1440
167
0
Other-Attachment A-1 WIC Vendor Store Manager -Cashier IDI Screener
Other-Attachment B-2 Confirmation Form - Store Managers
Other-Attachment C-1 Consent Form - Store Managers
Other-Attachment C-@ Consent Form - Cashiers
Other-Attachment D-1 Vendor Reasearch IDI Guide -Store Managers
Other-Attachment D-2 Vendor Reasearch IDI Guide Cashiers
WIC National Outreach Campaign – In-depth Interviews (IDIs) among Employees of Food Shopping Vendors
Unchanged
1440
167
0
Other-Attachment A-1 Vendor Corporate Employee IDI Screener
Other-Attachment B-1 Confirmation Form - Store Managers
Other-Attachment B-2 Confirmation Form - Cashiers
Other-Attachment C-1 Consent Form - Store Managers
Other-Attachment C-2 Consent Form - Cashiers
Other-Attachment D-1 Vendor Research IDI Guide - Store Managers
Other-Attachment D-2 Vendor Research IDI Guide - Cashiers
WIC National Outreach Campaign – In-depth Interviews (IDIs) among Healthcare Professionals
Unchanged
500
103
0
Other-Attachment B-1 Confirmation Form
Other-Attachment C-1 Consent Form
Other-Attachment D-1 WIC HCP IDI Guide
Other-Attachment A-1 WIC HCP IDI Screener
WIC Outreach Campaign Texting Usage Focus Groups
Unchanged
480
202
0
Other-Attachment A-1 WIC Texting FG Screener - English
Other-Attachment A-2 WIC Texting FG Screener
Other-Attachment B-1 WIC Texting Confirmation Form - English
Other-Attachment B-2 WIC Texting Confirmation Form - Spanish
Other-Attachment C-1 WIC Texting Consent Form -English
Other-Attachment C-2 WIC Texting Consent Form - Spanish
Other-Attachment D-1 WIC FG Guide Participants - English
Other-Attachment D-2 WIC FG Guide Participants - Spanish
Other-Attachment D-3 WIC FG Guide Nonparticipants - English
Other-Attachment D-4 WIC FG Guide Non-Participants - Spanish
WIC Outreach Campaign – Campaign Logo and Platform Concept Focus Groups
Unchanged
360
186
0
Other-Attachment A-1 WIC Screener - English
Other-Attachment A-2 WIC Eligible Screener - English
Other-Attachment A-3 WIC Screener - Spanish
Other-Attachment A-4 WIC Eligibility Screener - Spanish
Other-Attachment C-1 Consent Form - English
Other-Attachment C-2 Consent Form - Spanish
Other-Attachment D-1 WIC Focus Group Guide -English
Other-Attachment D-2 WIC Platform Logo FG Guide Spanish
Other-F-1 Stimuli for Focus Groups
Other-B-1 Confirmation Form (English)
Other-B-2 Confirmation Form (Spanish)
WIC PC Longitudinal Feasibility Survey
Unchanged
356
59
0
Other-Recruitment materials - A. email to regional offices
Other-Recruitment materials - B. initial email to state agencies
Other-Recruitment materials - C. follow up email to state agencies
Other-Recruitment Materials D. follow up call to state agencies
Other-Task 5.5 Final State Agency Survey clean
WIC Participant Diaries and IDIs
Unchanged
720
225
0
Other-A-1 WIC Participant Screener (English)
Other-A-2 WIC Participant Screener (Spanish)
Other-B-1 Diary Confirmation Form (English)
Other-B-2 Diary Confirmation Form (Spanish)
Other-C-1 Diary Consent Form (English)
Other-C-2 Diary Consent Form (Spanish)
Other-D-1 WIC Participant Diary Activity List (English)
Other-D-2 WIC Participant Diary Activity List (Spanish)
Other-E-1 IDI Confirmation Form (English
Other-E-2 IDI Confirmation Form (Spanish)
Other-F-1 IDI Consent Form (English)
Other-F-2 IDI Consent Form (Spanish)
Other-G-1 WIC Participant In-Depth Interview (IDI) Moderator’s Guide (English)
Other-G-2 WIC Participant In-Depth Interview (IDI) Moderator’s Guide (Spanish)
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
71697
9978
0
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
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