2017 NHANES Health Behaviors Cognitive Interviewing Study/Spanish

NCHS Questionnaire Design Research Laboratory

OMB: 0920-0222

IC ID: 218756

Information Collection (IC) Details

View Information Collection (IC)

2017 NHANES Health Behaviors Cognitive Interviewing Study/Spanish 16CC
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0222 Appendix 1 Questionnaire Spanish NHANES 100215 Appendix 1 Questionnaire Spanish NHANES 100215.docx Yes Yes Fillable Printable
Form and Instruction 0920-0222 Appendix 2a&b Ad&Flyer Spanish NHANES Appendix 2a&b Ad&Flyer Spanish NHANES.docx Yes Yes Fillable Printable
Form and Instruction 0920-0222 Appendix 3 Telephone Screener Spanish NHANES 100215 Appendix 3 Telephone Screener Spanish NHANES 100215.docx Yes Yes Fillable Printable
Form and Instruction 0920-0222 Appendix 5 Resp Data Collection Sheet Spanish NHANES Appendix 5 Resp Data Collection Sheet Spanish NHANES.docx Yes Yes Fillable Printable
Instruction ALQ1 Flashcard Spanish.pdf Yes Yes Fillable Printable
Instruction Appendix 6 Thank You letter Spanish NHANES.docx Yes Yes Fillable Printable

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the U. S. Population 09-20-0164   49 FR 37693

68 0
   
Individuals or Households
 
   100 %

  Approved 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 68 0 68 0 0 0
Annual IC Time Burden (Hours) 24 0 24 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
10-day OMB Spanish NHANES final 0911 2015 10-day OMB Spanish NHANES final 0911 2015.docx 10/28/2015
Appendix 4 Informed Consent Spanish NHANES Appendix 4 Informed Consent Spanish NHANES.docx 10/28/2015
Appendix 7 Special Consent Spanish 092315 Appendix 7 Special Consent Spanish 092315.docx 10/28/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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