Maternal Obesity

Formative Research, Pretesting, and Customer Satisfaction of NCI's Communication and Education Resources (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Maternal Obesity Form
1 Online Prescreener Attachment 2_Online Prescreener_NICHD_NCMHEP Maternal Obesity_0925-0046.pdf Form
2 Telephone Screener NICHD NCMHEP Maternal Obesity Attachment 3_Telephone Screener_NICHD_NCMHEP Maternal Obesity_0925-0046 rev 2.16.18.docx Form
3 Discussion Guide NICHD NCMHEP Maternal Obesity Attachment 4_Discussion Guide_NICHD_NCMHEP Maternal Obesity_0925-0046.docx Form
Mini SSA_Maternal Obesity_0925-0046 rev 2.16.18.docx Mini SSA Maternal Obesity IC Document
Attachment 5_Messaging and visual testing materials for Discussion Guide_NICHD_NCMHEP Maternal Obesity_0925-0046.docx Messaging and Visual Testing material for Discussion Guide IC Document
Attachment 6_Images for Discussion Guide_NICHD_NCMHEP Maternal Obesity_0925-0046.pdf Images for Discussion Guide IC Document

Information Collection (IC) Details

IC Title:	Maternal Obesity	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Online Prescreener	Attachment 2_Online Prescreener_NICHD_NCMHEP Maternal Obesity_0925-0046.pdf	Yes	Yes	Fillable Fileable
Form	2	Telephone Screener NICHD NCMHEP Maternal Obesity	Attachment 3_Telephone Screener_NICHD_NCMHEP Maternal Obesity_0925-0046 rev 2.16.18.docx	No		Paper Only
Form	3	Discussion Guide NICHD NCMHEP Maternal Obesity	Attachment 4_Discussion Guide_NICHD_NCMHEP Maternal Obesity_0925-0046.docx	No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	68	68
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Mini SSA Maternal Obesity	Mini SSA_Maternal Obesity_0925-0046 rev 2.16.18.docx	02/16/2018
Messaging and Visual Testing material for Discussion Guide	Attachment 5_Messaging and visual testing materials for Discussion Guide_NICHD_NCMHEP Maternal Obesity_0925-0046.docx	02/16/2018
Images for Discussion Guide	Attachment 6_Images for Discussion Guide_NICHD_NCMHEP Maternal Obesity_0925-0046.pdf	02/16/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.