Information Collection

NHANES Contact and Message Testing

IC 230189 under ICR 201506-0920-003 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 1 - Focus Group Protocol rev 020218.docx	Other-ord
Attachment 3 - Screener.docx	Other-SCREENER
Attachment 2 - Advertisement.docx Att 2_Advertisement/Flyer	IC Document
Attachment 4 - Consent.docx Att 4_Adult Informed Consent	IC Document
Attachment 5 - Respondent Data Collection Sheet.docx Att 5_Respondent Data CollectionSheet	IC Document
Attachment 6 - Thank You Letter.docx Att 6_Focus Group Thank you Letter	IC Document
Attachment 7 - Current NHANES Contact Material.pdf Att 7_Current Contact Protocol	IC Document
Attachment 8 - Proposed NHANES Contact Material 02 07 2018.pdf Att 8_Proposed NHANES Contact and Materials	IC Document
NHANES Focus Group 10 day letter 021618.docx Focus Group 10-Day Letter (Request for Approval 0920-0222 18QO)	IC Document

IC Title:

NHANES Contact and Message Testing

Agency IC Tracking Number:

0920-0222 (18QO)

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-ord			Attachment 1 - Focus Group Protocol rev 020218.docx		No		Paper Only
Other-SCREENER			Attachment 3 - Screener.docx		No		Paper Only

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: 164

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	164	164
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 2_Advertisement/Flyer	Attachment 2 - Advertisement.docx	02/20/2018
Att 4_Adult Informed Consent	Attachment 4 - Consent.docx	02/20/2018
Att 5_Respondent Data CollectionSheet	Attachment 5 - Respondent Data Collection Sheet.docx	02/20/2018
Att 6_Focus Group Thank you Letter	Attachment 6 - Thank You Letter.docx	02/20/2018
Att 7_Current Contact Protocol	Attachment 7 - Current NHANES Contact Material.pdf	02/20/2018
Att 8_Proposed NHANES Contact and Materials	Attachment 8 - Proposed NHANES Contact Material 02 07 2018.pdf	02/20/2018
Focus Group 10-Day Letter (Request for Approval 0920-0222 18QO)	NHANES Focus Group 10 day letter 021618.docx	02/20/2018

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