National Health Interview Survey

ICR 200811-0920-004

OMB: 0920-0214

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form
Modified
Form
Modified
Supplementary Document
2008-12-24
Supplementary Document
2008-12-24
Supplementary Document
2008-11-20
Supplementary Document
2008-11-20
Justification for No Material/Nonsubstantive Change
2008-11-20
Supplementary Document
2008-08-07
Supplementary Document
2008-08-07
ICR Details
0920-0214 200811-0920-004
Historical Active 200808-0920-005
HHS/CDC
National Health Interview Survey
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 12/29/2008
Retrieve Notice of Action (NOA) 11/28/2008
Prior terms continue. Health IT questions are approved for one administration only as further development is needed to determine the most useful questions to be asking.
  Inventory as of this Action Requested Previously Approved
12/31/2009 12/31/2009 12/31/2009
119,600 0 119,600
28,017 0 28,017
0 0 0

The National Health Interview Survey collections demographic and health-related infromation. This change seeks approval to cycle out questions on asthma, oral health, vision, heart disease, cancer screening, immunization, and dizziness, balance problems and falls fielded in 2008, and to cycle in and update questions on carbon monoxide detectors, stroke, arthritis, health care workers, and the use of the internet to learn about health information or to communicate with health care providers for 2009. We also seek approval for revised questions in the reinterview questionnaire used to monitor survey protocols.

US Code: 42 USC 242 Name of Law: Public Health Service Act
   PL: Pub.L. 101 - 445 301 Name of Law: The National Nutrition Monitoring and Related Research Act of 1990
   PL: Pub.L. 104 - 170 136 Name of Law: The Food Quality Protection Act of 1996
  
None

Not associated with rulemaking

  71 FR 36096 06/23/2006
71 FR 55476 09/22/2006
No

9
IC Title Form No. Form Name
NHIS 2007 Reinterview Survey Not Assigned Reinterview Survey
NHIS 2007 Adult Core Questionnaire Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned Adult Identification ,   Adult Health Behaviors ,   Adult Health Status and Limitations ,   Adult Socio-Demographic ,   Adult Conditions ,   Adult Access to Health Care and Utilization ,   Adult AIDS Knowledge and Attitudes
NHIS 2007 Screener Questionnaire None Assigned, None Assigned Screener Survey ,   Screener Questionnaire
NHIS 2007 Family Core Questionnaire Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned Family Identification ,   Family Health Status and Limitations ,   Family Injury and Poisoning ,   Family Access to Health Care and Utilization ,   Family Health Insurance ,   Family Socio-Demographic ,   Family Income ,   Recontact
NHIS 2007 Adult Topical Module
NHIS 2007 Child Core Questionnaire Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned, Not Assigned Child Health Status and Limitations ,   Child Access to Health Care and Utilization ,   Child Identification ,   Child Mental Health Brief Questionnaire ,   Child Mental Health Services ,   Child Influenza Immunization
NHIS 2007 Child Topical Module Not Assigned Child Topical Module
NIS 2008 Child Immunization Questionnaire CDC 64.122 National Immunization Survey
NIS 2008 Teen Immunization Questionnaire CDC 64.122 National Immunization Survey - Teen

  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 119,600 119,600 0 0 0 0
Annual Time Burden (Hours) 28,017 28,017 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$28,000,000
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Maryam Daneshvar 4046394604

  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.
11/28/2008


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