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Non-Medically Indicated Induction Prior to 39 Weeks of Gestation Focus Groups
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NICHD)
OMB: 0925-0643
IC ID: 201950
OMB.report
HHS/NIH
OMB 0925-0643
ICR 201110-0925-003
IC 201950
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0643 can be found here:
2017-11-13 - Reinstatement without change of a previously approved collection
2014-10-09 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2
Non-Medically Indicated Induction Prior to 39 Weeks of Gestation Focus Groups
Form and Instruction
2 Focus Group fathers
Pre-term_Birth_Telephone_Focus_Group_Guide_fathers_0925-0643_rev 4-10-12.docx
Form and Instruction
1 Screener
Pre-term_birth_recruitment_screener_0925-0643.docx
Form and Instruction
3 Pregnant Women
Pre-term_Birth_Telephone_Focus_Group_Guide_pregnant_women_0925-0643_rev 4-10-12.docx
Form and Instruction
Generic Template_OMB_preterm_birth_project_0925-0643[1].docx
Generic Template_OMB_preterm_birth_project_0925-0643[1]
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Non-Medically Indicated Induction Prior to 39 Weeks of Gestation Focus Groups
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
2
Focus Group fathers
Pre-term_Birth_Telephone_Focus_Group_Guide_fathers_0925-0643_rev 4-10-12.docx
Yes
Yes
Paper Only
Form and Instruction
1
Screener
Pre-term_birth_recruitment_screener_0925-0643.docx
Yes
Yes
Paper Only
Form and Instruction
3
Pregnant Women
Pre-term_Birth_Telephone_Focus_Group_Guide_pregnant_women_0925-0643_rev 4-10-12.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
45
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
45
0
0
0
0
0
Annual IC Time Burden (Hours)
68
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Generic Template_OMB_preterm_birth_project_0925-0643[1]
Generic Template_OMB_preterm_birth_project_0925-0643[1].docx
04/10/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.