View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View Generic ICR - OIRA Conclusion
OMB Control No:
0925-0701
ICR Reference No:
201403-0925-009
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/NIH
Agency Tracking No:
Title:
Generic Clearance to Support the Safe to Sleep Campaign at the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD)
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
07/30/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/29/2014
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
07/31/2017
36 Months From Approved
Responses
7,500
0
0
Time Burden (Hours)
3,000
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
This is a request for a new generic clearance that would be used for submissions specific to the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Safe to Sleep (STS) public education campaign. Submissions for the STS campaign will be used to assess the understanding and reach of STS campaign materials and messages, and to monitor and improve campaign activities such as training workshops and overall implementation. The purpose of this information collection is to monitor and modify campaign activities, to plan future campaign activities, to develop messages and materials, and to develop distribution and outreach strategies that are effective at communicating their message to bring about the intended response, awareness, and/or behavioral change for the target audiences. This generic clearance will enable the NICHD to: 1) more efficiently assess the implementation of campaign activities; 2) better understand the target audiences' knowledge, attitudes, and beliefs toward STS messages and materials; 3) better understand how the campaign activities have influenced the target audiences' behaviors and practices; and 4) monitor and improve activities such as trainings, and material/message development. Having a way to gather feedback on the STS campaign activities is critical to assessing the reach and effect of campaign efforts. Data collected for the campaign can inform where future STS campaign resources can produce the most meaningful results.
Authorizing Statute(s):
US Code:
42 USC 285
Name of Law: The Public Health Service Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
78 FR 79472
12/30/2013
30-day Notice:
Federal Register Citation:
Citation Date:
79 FR 30856
05/29/2014
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
9
IC Title
Form No.
Form Name
Alabama Safe Sleep Outreach Project
3, 1, 2, 4
Substudy AlabamaOutreach PaperworkChecklist
,
Substudy AlabamaOutreach PrePostAssessment
,
Substudy AlabamaOutreach Activity/Tracking
,
Substudy AlabamaOutreach Signin
Alabama Safe Sleep Outreach Project
4, 2, 3, 5, 1
Alabama Outreach Activity Tracking form
,
Alabama Outreach Assessment Form
,
Alabama Outreach Photo Video Consent Form
,
Alabama Outreach Required Form
,
Alabama Outreach Sign In Sheet
Healthy Native Babies (HNB) Project Materials Distribution
1
Healthy Native Babies Project Materials Distribution Tracking Form
Healthy Native Babies Project Materials Distribution
1
Tracking Form
Healthy Native Babies Project Train-the-Trainer Follow-Up Assessment
1
Healthy Native Babies Project Train-the-Trainer Follow-Up Assessment Survey
Healthy Native Babies Project Train-the-Trainer Follow-Up Assessment
1
Healthy Native Babies Project Train-the-Trainer Follow-Up Assessment Survey
Safe to Sleep National Champions Tracking and Feedback Form
1
National Champions Tracking and Feedback Screenshots
Safe to Sleep National Champions Tracking and Feedback Form
1
National Champions Tracking and Feedback Screenshots
Safe to Sleep National Champions Tracking and Feedback Form
1
National Champions Tracking and Feedback Screenshots
ICR Summary 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
7,500
0
0
7,500
0
0
Annual Time Burden (Hours)
3,000
0
0
3,000
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
This is a new ICR.
Annual Cost to Federal Government:
$69,267
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Seleda Perryman 202 690-5521
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
05/29/2014
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