National Health and Nutrition Examination Survey (NHANES)

Forms and Documents

Document Name	Status
Form No Number NCHS National Health and Nutrition Examination Survey (NHANES) Line 7, Follow-up and Special Studies (Methodological and Pilot tests) Form	New
Justification for No Material_vb.doc Justification for No Material/Nonsubstantive Change	2007-12-06
Attachment 13a Study Protocols and Materials.doc Supplementary Document	2007-12-03
Attachment 13 Validation of Pubertal Maturation Module.doc Supplementary Document	2007-12-03
Attachment 13 Validation of Pubertal Maturation Module.doc Supplementary Document	2007-12-03
Attachment 12 Methodological Comparison with CHMS.doc Supplementary Document	2007-12-03
Attachment 11 Oral Health Questionnaire.doc Supplementary Document	2007-12-03
Attachment 10 Arthritis Questionnaire.doc Supplementary Document	2007-12-03
Attachment 9 Consumer Behavior.doc Supplementary Document	2007-12-03
Attachment 8 Dietary Screener HH field test.doc Supplementary Document	2007-12-03
Attachment 7 Inflammatory Arthritis Pilot.doc Supplementary Document	2007-12-03
Attachment 6 Dietary Screener Qx Pilot.doc Supplementary Document	2007-12-03
Attachment 5 Reactions to Race pilot test.doc Supplementary Document	2007-12-03
Attachment 4 Arthritis Questionnaire.doc Supplementary Document	2007-12-03
Attachment 3 Consumer Behavior.doc Supplementary Document	2007-12-03
Attachment 2 Dietary Screener.doc Supplementary Document	2007-12-03
NHANES sup. st. change 11.07.doc Supporting Statement A	2007-12-03

IC Document Collections

IC ID	Document Title	Status
183180	NCHS National Health and Nutrition Examination Survey (NHANES) Line 7, Follow-up and Special Studies (Methodological and Pilot tests) Form	New

ICR Details

OMB Control No: 0920-0237	ICR Reference No: 200712-0920-010
Status: Historical Active	Previous ICR Reference No: 200703-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Health and Nutrition Examination Survey (NHANES)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/08/2008
	Date Received in OIRA: 12/20/2007
Terms of Clearance: Before congnitive testing for the 'perceptions of race' component begins, please check with the director of EPA's Office of Environmental Justice (Charles Lee) regarding EPA's interest in contributing to the design of this new NHANES component.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2009	11/30/2009	11/30/2009
Responses	30,113	0	30,113
Time Burden (Hours)	59,864	0	59,864
Cost Burden (Dollars)	0	0	0

---

Abstract: The National Health and Nutrition Examination Survey (NHANES) is a continuous nationally representative sample of the civilian, non-institutionalized U.S. population. The survey is unique in that it contains interview, laboratory and physical examination segments. The examination component is conducted in mobile examination centers that travel to fifteen survey locations each year. NHANES data have been the cornerstone for numerous national health and nutrition policy and surveillance activities.

---

Authorizing Statute(s): PL: Pub.L. 104 - 170 301 Name of Law: The Food Quality Protection Act of 1996
   PL: Pub.L. 101 - 445 103 Name of Law: The National Nutrition Monitoring and Related Reseach Act of 1990
   US Code: 42 USC 242k Name of Law: National Center for Health Statistics
  

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

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
NCHS National Health and Nutrition Examination Survey (NHANES) Line 7, Follow-up and Special Studies (Methodological and Pilot tests)	No Number	Reactions to Race Module Cognitive Test

---

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	30,113	30,113	0	0	0	0
Annual Time Burden (Hours)	59,864	59,864	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $40,350,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

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: 12/17/2007

---