National Survey of Family Growth

Forms and Documents

Document Name	Status
Form 3 Household Screener Form and Instruction	Modified
Form K Verification form Form and Instruction	Modified
National Survey of Family Growth--Male Interview Form	Modified
PartB-March-6-2012.docx Supporting Statement B	2012-03-23
Attach N-nonresponse bias 2011-final.doc Supplementary Document	2012-03-23
Att J--C8 Int Observ Form-Oct-2011.doc Supplementary Document	2012-03-23
ATTACH_G123.pdf Supplementary Document	2012-03-23
ATTACH F1235.doc Supplementary Document	2012-03-23
Attach D--NSFG Pubs.doc Supplementary Document	2012-03-23
Attach D--NSFG Pubs.doc Supplementary Document	2012-03-23
Attach C-Incentives-D3-FEB3.doc Supplementary Document	2012-03-23
B2-ACASI_Justification_Fall2011.docx Supplementary Document	2012-03-23
B1-Feb 3-Questionnaire-Cuts.xlsx Supplementary Document	2012-03-23
A1-A8-NSFG.doc Supplementary Document	2012-03-23
NSFG 2009 G2b-Confidentiality.pdf Supplementary Document	2009-03-31
NSFG 2009 G2a -QA Brochure.pdf Supplementary Document	2009-03-31
NSFG 2009 ATT G3-ConsentForms.doc Supplementary Document	2009-03-31
NSFG 2011 change pkg Att 3.docx Supplementary Document	2011-06-22
Attach B2-Male-Jan09.doc Supplementary Document	2009-03-30
NSFG 2011 change pkg Att 3.docx Supplementary Document	2011-06-22
Attach B1-Female-Jan09.doc Supplementary Document	2009-03-30
PartA-March-6-2012.doc Supporting Statement A	2012-03-23

IC Document Collections

IC ID	Document Title	Status
188705	Household Screener Form and Instruction	Modified
188704	Male and Female Testing New Questions Instruction	Removed
188703	Verification form Form and Instruction	Modified
188702	National Survey of Family Growth--Male Interview Form	Modified
184020	Female Interview Questionnaire Other-Computer assisted Interview	Modified

ICR Details

OMB Control No: 0920-0314	ICR Reference No: 201203-0920-009
Status: Historical Active	Previous ICR Reference No: 201106-0920-013
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Survey of Family Growth
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/26/2012
	Date Received in OIRA: 03/27/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2015	36 Months From Approved	05/31/2012
Responses	20,400	0	20,650
Time Burden (Hours)	7,192	0	7,442
Cost Burden (Dollars)	0	0	0

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Abstract: The National Survey of Family Growth NSFG) is a nationally-representative sample survey conducted by personal interview among a sample of approximately 5,000 men and women annually. Data will be collected on pregnancy, contraception, parenting, and related attitudes. This request covers the survey from 2012-2015.

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Authorizing Statute(s): US Code: 42 USC 306 Name of Law: Public Health Service Act 242k
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 55392	09/07/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 17064	03/23/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Female Interview Questionnaire	H-1, none, H-2	2011-2015 National Survey of Family Growth Female Questionnaire (Clean Copy) ,   New questions for 2011-12 ,   2011-2015 National Survey of Family Growth Female Questionnaire (with corrections)
National Survey of Family Growth--Male Interview	none, I-1, I-2	New questions for 2011-12 ,   2011-2015 National Survey of Family Growth Male Questionnaire (Clean Copy) ,   2011-2015 National Survey of Family Growth Female Questionnaire (with corrrections)
Verification form	K	National Survey of Family Growth, Verification Questionnaires
Household Screener	3	Household Screening Questionnaire
Male and Female Testing New Questions

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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	20,400	20,650	0	-250	0	0
Annual Time Burden (Hours)	7,192	7,442	0	-250	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: burden change due to program discretion.

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Annual Cost to Federal Government: $5,500,000

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 03/27/2012

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