Information Collection

NCHS National Health and Nutrition Examination Survey (NHANES) Line 7, Follow-up and Special Studies (Methodological and Pilot tests)

IC 183180 under ICR 200712-0920-010 · OMB 0920-0237.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0237 can be found here:

Documents and Forms

Document Name Document Type
Form No Number NCHS National Health and Nutrition Examination Survey (NHANES) Line 7, Follow-up and Special Studies (Methodological and Pilot tests) Form
No Number Reactions to Race Module Cognitive Test Attachment 1 Reactions to Race questions.doc Form
Attachment 2 Dietary Screener.doc Attachment 2 Dietary Screener Module IC Document
Attachment 3 Consumer Behavior.doc Attachment 3 Consumer Behavior Questionnaire IC Document
Attachment 4 Arthritis Questionnaire.doc Attachment 4 Inflammatory Arthritis - ARQ IC Document
Attachment 5 Reactions to Race pilot test.doc Attachment 5 Reactions to Race Questionnaire IC Document
Attachment 6 Dietary Screener Qx Pilot.doc Attachment 6 Dietary Screener Questionnaire IC Document
Attachment 7 Inflammatory Arthritis Pilot.doc Attachment 7 Inflammatory Arthritis Pilot IC Document
Attachment 8 Dietary Screener HH field test.doc Attachment 8 Dietary Screener Household Field Test IC Document
Attachment 9 Consumer Behavior.doc Attachment 9 Consumer Behavior Questionnaire IC Document
Attachment 10 Arthritis Questionnaire.doc Attachment 10 Inflammatory Arthritis 20-69 IC Document
Attachment 11 Oral Health Questionnaire.doc Attachment 11 Oral Health Questionnaire IC Document
Attachment 12 Methodological Comparison with CHMS.doc Attachment 12 Methodological Comparison IC Document
Attachment 13 Validation of Pubertal Maturation Module.doc Attachment 13b Pubertal Maturation Questionnaire IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NCHS National Health and Nutrition Examination Survey (NHANES) Line 7, Follow-up and Special Studies (Methodological and Pilot tests)	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	No Number	Reactions to Race Module Cognitive Test	Attachment 1 Reactions to Race questions.doc		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Health and Demographic Surveys Conducted in Probability Samples of the US Population	FR Citation: 49 FR 37693

Number of Respondents: 3,363	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 70 %

	Requested	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	3,363	0	0	0	0	0
Annual IC Time Burden (Hours)	673	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 2 Dietary Screener Module	Attachment 2 Dietary Screener.doc	12/03/2007
Attachment 3 Consumer Behavior Questionnaire	Attachment 3 Consumer Behavior.doc	12/03/2007
Attachment 4 Inflammatory Arthritis - ARQ	Attachment 4 Arthritis Questionnaire.doc	12/03/2007
Attachment 5 Reactions to Race Questionnaire	Attachment 5 Reactions to Race pilot test.doc	12/03/2007
Attachment 6 Dietary Screener Questionnaire	Attachment 6 Dietary Screener Qx Pilot.doc	12/03/2007
Attachment 7 Inflammatory Arthritis Pilot	Attachment 7 Inflammatory Arthritis Pilot.doc	12/03/2007
Attachment 8 Dietary Screener Household Field Test	Attachment 8 Dietary Screener HH field test.doc	12/03/2007
Attachment 9 Consumer Behavior Questionnaire	Attachment 9 Consumer Behavior.doc	12/03/2007
Attachment 10 Inflammatory Arthritis 20-69	Attachment 10 Arthritis Questionnaire.doc	12/03/2007
Attachment 11 Oral Health Questionnaire	Attachment 11 Oral Health Questionnaire.doc	12/03/2007
Attachment 12 Methodological Comparison	Attachment 12 Methodological Comparison with CHMS.doc	12/03/2007
Attachment 13b Pubertal Maturation Questionnaire	Attachment 13 Validation of Pubertal Maturation Module.doc	12/03/2007

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