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Research and Development Survey (RANDS) Cognitive Interviewing Sub-Study
NCHS Questionnaire Design Research Laboratory
OMB: 0920-0222
IC ID: 229901
OMB.report
HHS/CDC
OMB 0920-0222
ICR 201506-0920-003
IC 229901
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:
2022-12-21 - Revision of a currently approved collection
2021-08-16 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Attach 2 - Questionnaire 012418.docx
Other-WORD
Attach 4 - Telephone Screener.docx
Other-WORD
Attach 3 - Advertisement.docx
Att 3_Recruitment Advertisement
IC Document
Attach 5 - Informed Consent.docx
Att 5_ Adult Informed Consent
IC Document
Attach 6 - Resp Data Collect.docx
Att 6 Respondent Data Collection Sheet
IC Document
Attach 7 - Thank You Letter.docx
Att 7_Thank You Letter
IC Document
Attach 8 - Special Consent.docx
Att 8_Special Consent
IC Document
Attach 9 - Analysis Plan.docx
Att 9_Analysis Plan
IC Document
Rands 10-day Letter 012418.docx
RANDS 10-Day Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Research and Development Survey (RANDS) Cognitive Interviewing Sub-Study
Agency IC Tracking Number:
0920-0222 18ML
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
Other-WORD
Attach 2 - Questionnaire 012418.docx
No
Paper Only
Other-WORD
Attach 4 - Telephone Screener.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population
FR Citation:
49 FR 37693
Number of Respondents:
200
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
200
0
200
0
0
0
Annual IC Time Burden (Hours)
90
0
90
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 3_Recruitment Advertisement
Attach 3 - Advertisement.docx
01/30/2018
Att 5_ Adult Informed Consent
Attach 5 - Informed Consent.docx
01/30/2018
Att 6 Respondent Data Collection Sheet
Attach 6 - Resp Data Collect.docx
01/30/2018
Att 7_Thank You Letter
Attach 7 - Thank You Letter.docx
01/30/2018
Att 8_Special Consent
Attach 8 - Special Consent.docx
01/30/2018
Att 9_Analysis Plan
Attach 9 - Analysis Plan.docx
01/30/2018
RANDS 10-Day Letter
Rands 10-day Letter 012418.docx
01/30/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.