Approved for
pilot test only. Questionnaire will be approved for inclusion as an
HIS supplement only if response rates can be shown to be high and
if procedures can be designed to ensure these questions will not
interfere with responses or response rates to HIS.
Inventory as of this Action
Requested
Previously Approved
03/31/1982
03/31/1982
600
0
0
117
0
0
0
0
0
THIS TELEPHONE PRETEST IS NEEDED TO
AID IN THE DEVELOPMENT AND TESTING OF A SERIES OF QUESTIONS ON
HEALTH PRACTICES WITH EMPHASIS ON ALCOHOL USE AND RELATED ITEMS FOR
A 1983 NATIONAL HEALTH INTERVIEW SURVEY SUPPLEMENT.
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.