Information Collection Request

Balance After Baby Intervention

ICR 201805-0920-009 · OMB 0920-1115 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-15BEB Block Food Frequency Questionnaire Form and Instruction Modified Repair queued
BABI 24 - Month Questionnaire Form and Instruction Modified Repair queued
BABI 18 - Month Questionnaire Form and Instruction Modified Repair queued
BABI 12 - Month Questionnaire Form and Instruction Modified Available
BABI 6 - Month Questionnaire Form and Instruction Unchanged Available
BABI 6 - Week Questionnaire Form and Instruction Unchanged Available
Form 0920-15BEB BABI Screener Questionnaire Form and Instruction Unchanged Available
BABI (1115) Change Request 05_08_18.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-05-31 Available
BABI (1115) Change Request_10_31_17.docx Justification for No Material/Nonsubstantive Change Uploaded 2017-11-02 Available
Attachment 11_InformedConsentDocumentUCH.pdf Supplementary Document Uploaded 2016-01-21 Available
Attachment 10_InformedConsentDocumentBWH.pdf Supplementary Document Uploaded 2016-01-21 Available
Attachment 8_BABI_Item-LevelCrosswalk.xlsx Supplementary Document Uploaded 2016-01-21 Available
Attachment 1_42 U.S.C. 241.docx Supplementary Document Uploaded 2016-01-21 Available
OMB_SupportingStatementB_01 12 16.docx Supporting Statement B Uploaded 2016-01-21 Available
OMB_SupportingStatementA_01 13 16_clean.docx Supporting Statement A Uploaded 2016-01-21 Available
IC Document Collections
IC IDCollectionTypeStatusForm
219655 Block Food Frequency Questionnaire Form and Instruction Modified
219654 BABI 24 - Month Questionnaire Form and Instruction Modified
219653 BABI 18 - Month Questionnaire Form and Instruction Modified
219649 BABI 12 - Month Questionnaire Form and Instruction Modified
219642 BABI 6 - Month Questionnaire Form and Instruction Unchanged
219641 BABI 6 - Week Questionnaire Form and Instruction Unchanged
219639 BABI Screener Questionnaire Form and Instruction Unchanged
ICR Details
0920-1115 201805-0920-009
Historical Active 201711-0920-001
HHS/CDC 0920-1115-18AJY
Balance After Baby Intervention
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/01/2018
Retrieve Notice of Action (NOA) 05/31/2018
  Inventory as of this Action Requested Previously Approved
06/30/2019 06/30/2019 06/30/2019
635 0 698
169 0 187
0 0 0

Information will be collected from postpartum women with recent gestational diabetes mellitus (GDM). A randomized controlled clinical trial will be conducted to evaluate the effectiveness of a web-based lifestyle intervention program that may promote weight management and reduce risk of developing type 2 diabetes. Changes to the questionnaires are requested to allow for some participants to complete the final survey at 12 or 18 months, instead of 24. This will result in a slight decrease in total burden.

US Code: 24 USC 42 Name of Law: Public Health Service Act, Research and Investigations
  
None

Not associated with rulemaking

  80 FR 52292 08/28/2015
81 FR 3426 01/21/2016
No

  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 635 698 0 -63 0 0
Annual Time Burden (Hours) 169 187 0 -18 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Minor changes are requested to allow for some participants to complete the study at earlier points than previously anticipated. Changes decrease the total burden by 18 hours.

$500,000
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/31/2018