Part B - NSCH 2016 Production OMB_4_27_2016

2016 National Survey of Children's Health:

Request for OMB Review

Supporting Statement B

OMB Control No. 0607-XXXX

B. Description of Statistical Methodology

1. Statistical Design and Estimation

Sponsored by the U.S. Department of Health and Human Services’ (HHS’) Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB), the National Survey of Children’s Health (NSCH) is designed to produce data on the physical and emotional health of American children under 18 years of age. Since its beginning, the NSCH has been a critical component in the estimation of the national and state-level prevalence for a variety of physical, emotional, and behavioral child health indicators in combination with information on the child’s family context and neighborhood environment. The National Survey of Children with Special Health Care Needs (NS-CSHCN) was a complementary survey designed to estimate the prevalence and impact of children with special health care needs (CSHCN) at both the state and national levels and to estimate the percent of households with children having one or more CSHCN aged 17 or younger. Recently, decreasing response rates required the HRSA MCHB to initiate a redesign of the NSCH and NS-CSHCN. This redesign includes combining the original NSCH and NS-CSHCN into a single annual survey that will be known solely as the NSCH. In addition to combining content, the redesign also involves changing the sampling frame from a list-assisted Random Digit Dial (RDD) to an Address-Based Sample (ABS) frame. Based on the results of a pretest in 2015, the multimode design for the 2016 NSCH was developed. The two new modes of data collection are an initial attempt to collect information by Web (self-administered) followed by non-response follow-up with a paper instrument sent by mail (self-administered). Both modes are accompanied by a Telephone Questionnaire Assistance (TQA) line. This multi-mode design differs significantly from the telephone, interviewer-administered mode that was originally used.

The NSCH will use an address-based sample derived from the Census Master Address File (MAF)¹ covering the 50 states and the District of Columbia. The 2016 NSCH will be conducted from June 2016 through January 2017. Households will be randomly sampled as described in section B.1.1 and an invitation to participate in the NSCH with login information for the online survey instrument will be sent to each sampled household. The first section of the online instrument, as well as the first paper follow-up instrument, are screening instruments. Information on the presence of children within the household, child demographic information, as well as basic questions about each child’s health provided in these screeners will be used to determine whether the household is eligible for one of the three age-based surveys: 0 to 5 year old children, 6 to 11 year old children, or 12 to 17 year old children. This screener information is also used for the subsampling selection of a specific child within the household based on an oversampling of CSHCN at 80%. In order to limit respondent burden, regardless of the number of eligible children, no more than one child per household will be sampled for the age-based topical surveys, which means that no more than one topical survey will be administered in any given household. In the online instrument, subsampling is automatic and the respondent can continue seamlessly from the screener items to the topical section. In the paper instrument, the screener is returned to Census by mail, and the topical instrument is sent back to the household for the subsampled child. The target population for the NSCH survey consists of children aged 17 or younger.

1. Sampling Households

For the 2016 NSCH, a sample frame of 364,153 household addresses will be used. The sample file was selected from the Census Master Address File (MAF) and supplemented with an administrative records based flag identifying households with children. The Census Bureau’s Center for Administrative Records Research and Applications (CARRA) has developed an indicator based on multiple sources of administrative data which is being used for the first time to identify households with children to improve sampling efficiency in the NSCH. As background, CARRA is an interdisciplinary group in the Research and Methodology Directorate and is charged with the strategic re-use of administrative data from federal, state, and commercial providers. Information is combined from multiple sources to create new data products that would be impossible to produce using single data sets.

Through combining data sources with the MAF, four flags will be available to be used during sampling and survey data collection management. The four flags below are described in detail in Appendix A:

• Flag1: presence of children; no presence of children

• Flag2: child recipient of Supplemental Security Income (SSI) benefits; no child recipients of SSI benefits

• Flag3: poverty; non-poverty (block, block-group, or tract level geographic definition)

• Flag4: ‘high’ internet access; ‘low’ internet access block group identifier.

Flag1 will be used in the sampling processes; Flags 2 and 3 will be used for sort and stratification; Flag4 is used to tailor data collection mode switching based on characteristics of the sample geography.

The Flag 1 based sampling strata are mutually exclusive. See Table B.1.1.A. The sample sizes were allocated based on the relative sizes of stratum 1 (households flagged as having children under 18 present) and stratum 2 (households expected to have no children under 18 present) and the number of records per state for each group. State-level samples will be allocated to produce equally sized samples in each state and the District of Columbia. The sampling is designed for an initial sample size of 364,153 households nationwide to yield at least 1500 households with children per state and will include approximately 300 children with special health care needs in that state (see Appendix B for a table of estimated sample sizes per state). Approximately 61 percent of the sample is expected to be drawn from Stratum 1. This represents an average oversample ratio of about 5.2:1 for Stratum 1 versus Stratum 2.

A single sampling rate for the screener will be produced and used in both Stratum 1 and Stratum 2 for each state. Within these strata, characteristics from Flags 2 and 3 will be identified for use in the sort and stratification processes.

o Stratum 1: Households with the ‘child present’ flag

• Receipt of SSI benefits

• Poverty (geographic) and non-recipient of SSI benefits

• Remaining households with children

o Stratum 2: Households without the ‘child present’ flag

• Poverty (geographic)

- Non-poverty

Table B.1.1.A: Addressed-Based Sample by Stratum for the 2016 NSCH

Estimated Households with Children by Strata	Stratum 1 Households Flagged as with Children	Stratum 2 Households Flagged as without Children	Total
Total	222,751	141,402	364,153
Estimated Number of Households with Children	171,696	14,404	186,100
Estimated Number of Screener Only (no children) Households	51,055	126,998	178,053

As in the NSCH 2015 Pretest, the 2016 NSCH will employ subsampling once data are collected for the screening items (Child Roster with Age, and CSHCN Screener Items 6-10). In the web instrument (Centurion) this will happen dynamically as that section is completed. In the paper instrument, the screener interview is completed by the respondent, sent to Census and subsampled based on the reported data, and the paper questionnaire with the appropriate topical questions is mailed back to the respondent. With one exception, the subsampling selection of one sample child per household will remain the same process as was done for the pretest. First, to achieve the necessary state level representation of CSHCN, in multi-child households an 80 percent oversampling procedure is used for CSHCN following screener completion. Following this subsampling procedure, an additional subsampling is being used to increase the representation of children aged 0-5.

The 2016 NSCH will include three experiments to evaluate opportunities to incorporate efficiencies in the data collection process. The treatment groups will be assigned within the

sampling processes. The initial invitation to participate by web will be divided into three treatment groups to evaluate the use of an unconditional cash incentive to improve response and reduce follow-up costs. The screener incentive treatment groups divide the sample into three equal groups, a control treatment receiving no incentive, and two treatment groups receiving either a single $2 or $5 cash incentive in their initial web invitation mailing, see Table B.1.1.B. Second, to test whether an alternative HRSA MCHB branding improves response for the NSCH over the Census Bureau’s standard branding, the second follow-up web-invitation mailing will be divided among two different reminder letters, see Table B.1.1.C.

Table B.1.1.B: Incentive Experiment

Incentive Treatment Group	Screener Sample Size
Control - $0	121,385
Incentive1 - $2	121,384
Incentive2 - $5	121,384
Total	364,153

Table B.1.1.C: Mailing Experiment

Mailing Treatment Group	Screener Sample Size	Reminder
Control	182,077	Census Bureau
Treatment	182,076	MCHB-HHS
Total	364,153

The third, experiment is a modification to data collection procedures based on the tract level internet response likelihood (Flag 4). Based on evaluation of information from the American Community Survey (ACS) paradata, we developed a tract level picture of internet response mode choices in ACS. Since 2012, ACS respondents have been able to submit survey forms over the internet. ACS paradata record whether a respondent chose the online option. The ACS paradata has been summarized at the tract level. Our internet-accessible household measure is equal to a weighted proportion of the respondents that chose to submit the ACS survey over the internet if given the option to do so. Figure B.1.1.D shows the distribution of tract-level internet response for the 2013–2014 ACS survey years. Based on the tract level identification of internet response rates, sample households will be ranked by tract. The lowest 30% of households by tract level identification of internet response will be assigned as ‘low internet’ and non-responders to the initial web invitation and first reminder web invitations will be sent paper screener questionnaires earlier than the households in the remaining tracts.

Figure B.1.1.D: Kernel-smoothed probability distribution function of tract-level

ACS Internet response rate, ACS paradata, 2013–2014 survey years

The following Table B.1.1.E is a summary of the comparisons that will be performed on for the incentive and mailing treatment groups based on the maximum eligible sample. The Fisher Exact Test is used to derive power in Table B.1.1.F. While Table B.1.1.E shows the maximum sample possible in the mailing and internet comparisons based on simply splitting the sample by half for the two mailing treatments and by 30% and 70% for the internet comparisons. The power calculations (Table B.1.1.F) were computed first based on the maximum sample in Table B.1.1.E and also on a conservative 50% response applied to the mail and internet cells, the resulting power estimates were nearly identical and presented in Table B.1.1.F. When comparing sample sizes X and Y, at both alpha=0.5 and alpha=.10, they are sufficiently large to produce a statistically significant result approximately 100 percent of the time. The high statistical power indicates that there is nearly no chance of concluding there is no difference when, in fact, there is one.

Table B.1.1.E: Incentive and Mailing Treatment Group Comparisons

Incentive	Initial Cases	Mailing	Maximum Cases for Mailing Comparison	Internet Likelihood	Maximum Cases for Internet Comparison	Treatment Groups (TG)
Control	121,385	Census	60,693	Low	18,208	1
				Med/High	42,485	2
		MCHB-HHS	60,692	Low	18,208	3
				Med/High	42,484	4
$2	121,384	Census	60,692	Low	18,208	5
				Med/High	42,484	6
		MCHB-HHS	60,692	Low	18,208	7
				Med/High	42,484	8
$5	121,384	Census	60,692	Low	18,208	9
				Med/High	42,484	10
		MCHB-HHS	60,692	Low	18,208	11
				Med/High	42,484	12

Table B.1.1.F: Incentive and Mailing Treatment Group Comparisons

Incentive Comparisons	Mailing Comparisons	Internet Comparisons
Control v. $2 TG(1+2+3+4) v. TG(5+6+7+8)  p=0.05, power≈1 p=0.10, power≈1	Census v. MCHB TG(1+2+5+6+9+10) v. TG(3+4+7+8+11+12) p=0.05, power≈1 p=0.10, power≈1	Low v. M/H TG(1+3+5+7+9+11) v. TG(2+4+6+8+10+12) p=0.05, power≈1 p=0.10, power≈1
		Low v. M/H in C’trl TG(1+3) v. TG(2+4) p=0.05, power≈1 p=0.10, power≈1
	Census v. MCHB in C’trl TG(1+2) v. TG(3+4) p=0.05, power≈1 p=0.10, power≈1
Control v. $5 TG(1+2+3+4) v. TG(9+10+11+12) p=0.05, power≈1 p=0.10, power≈1		Low v. M/H in $2 TG(5+7) v. TG(6+8) p=0.05, power≈1 p=0.10, power≈1
	Census v. MCHB in $2 TG(5+6) v. TG(7+8) p=0.05, power≈1 p=0.10, power≈1	Low v. M/H in $5 TG(9+11) v. TG(10+12) p=0.05, power≈1 p=0.10, power≈1
$2 v. $5 TG(5+6+7+8) v. TG(9+10+11+12) p=0.05, power≈1 p=0.10, power≈1		Low v. M/H in Census TG(1+5+9) v. TG(2+6+10) p=0.05, power≈1 p=0.10, power≈1
	Census v. MCHB in $5 TG(9+10) v. TG(11+12) p=0.05, power≈1 p=0.10, power≈1
		Low v. M/H in MCHB TG(3+7+11) v. TG(4+8+12) p=0.05, power≈1 p=0.10, power≈1

2. Within-Household Sampling

Eligible children within households that have a completed screener will be sampled for one of the three age-based topical surveys: 0 to 5-year-old children, 6 to 11-year-old children, or 12 to 17-year-old children. Only one child per household will be selected for a topical questionnaire in an effort to minimize respondent burden.

In order to select the sample child from a household, it must first be determined whether each eligible child is a Child with Special Health Care Needs (CSHCN) or a Child without Special Health Care Needs (Non-CSHCN). CSHCN are identified by asking respondents if each child rostered in the screening instrument uses more medical care, mental health services, or educational services than is usual for most children of the same age; if the child uses specialized therapies, mental health counseling, or prescription medications; and/or if the child is limited or prevented in any way in his or her ability to do things that most children of the same age can do because of a medical, behavioral, or other health condition that is expected to last at least one year. Children are considered to have special health care needs if the respondent answered

“yes” to at least one question in each of these three categories. These questions are part of the screener questionnaire, which was developed by researchers, practitioners, family advocates, and policy makers to identify CSHCN in household surveys². Each household will fall within a specific Household Type (HHTYP) (See Table B.1.2.A). An 80 percent oversampling is applied for those households having both CSHCN and Non-CSHCN present; i.e., household types 4, 6, and 7. An additional 60 percent oversampling of children aged 0-5 years occurs in household types 3 and 5, and possibly household type 8. Based on internal evaluations approximately 4,433,000 households (weighted) with children aged 0-5 years are being missed with the current sampling frame methodology, while approximately 7,256,000 households are being correctly identified. Although this indicates the number of households with children aged 0-5 years are being missed, it does not tell how many 0-5-year-olds are being missed. The ’presence of children’ flag will perform less well for the very youngest children (ages 0-2 years) since some of the administrative records and linkages used for creating it are 1-2 years old, as is the ACS data used as a benchmark. Every effort will be made to use the most recent data that are available.

Table B.1.2.A: Strategies for Selecting the 2016 NSCH Sample Child

House-hold Type	Number of Eligible Children in Household	Number of Eligible Non-CSHCN,CSHCN	% Probability of Selection for Non-CSHCN		% Probability of Selection for CSHCN		Notes
1	0 or ‘blank’	0,0	0				No eligible children in household.
2	1	1,0 or 0,1	100%				Single child is always selected.
3	2	2,0 or 0,2	If only 1 child is aged 0-5 years, that child’s probability of selection is 62% and the other child’s probability of selection is 38%; otherwise, each child has an equal chance of selection of 50%.				Includes 60% oversampling of children aged 0-5 years.
4	2	1,1	36%			64%	Includes 80% oversampling of CSHCN.
5	3	3,0 or 0,3	If only 1 child is aged 0-5 years, that child’s probability of selection is 44% and each of the other two children have an equal chance of selection of 28%. If 2 children are aged 0-5 years, each has a probability of selection of 38% and the other child has a probability of selection of 24%. If all 3 children are aged 0-5 or aged 6-17 years, then each child has an equal chance of selection of 33%.				Includes 60% oversampling of children aged 0-5 years.
6	3	2,1	53%			47%	Includes 80% oversampling of CSHCN.
7	3	1,2	22%			78%	Includes 80% oversampling of CSHCN.
8	4 or more	Any combination	Before the sort, each of the first 4 children has an equal 25% probability of selection				Simple random selection of 1 of the first 4 (sorted) children, regardless of Non-CSHCN or CSHCN.

Each household will be pre-assigned a value for each of the eight Household Types that corresponds with the oversampling criteria in the Probability of Selection column in the table above. This value denotes the order of the child (0, 1, 2, 3, or 4) that should be selected after the proper sorting of eligible children has occurred. For HHTYP 1 and HHTYP 2, no sorting occurs because there are either no eligible children or one eligible child who will always be selected. For HHTYP 3 through HHTYP 8, children will be sorted by their special needs status (CSHCN children first followed by Non-CSHCN) and then sorted by age (youngest to oldest). Finally, HHTYP 8 children will be sorted by their special needs status (CSHCN children first followed by Non-CSHCN), then sorted by name, and then sorted by age (youngest to oldest).

3. Expected Yield

The respondent universe for the NSCH is adults ages 18 or older who live in the U.S. and who are parents or guardians of at least one child who is age 17 or younger living in the same household. Those households that do not have any infants or children are asked to mark “No” to the first question on the screener which asks, “Are there any youth or children age 17 or younger who usually live or stay at this address?” and would then screen-out of the remaining survey questions.

The initial sample size for the NSCH is 364,153 unique households nationwide. These households are then split by sample stratum (flagged with children or no children) and among three different incentive treatment groups which differ in incentive amount ($0, $2 or $5). With assumed response rates for valid addresses, web and paper screener and topical response, the calculations of the various expected sample sizes for the 2016 NSCH are included in Table B.1.3.A.

Table B.1.3.A: Expected Sample Sizes of 2016 NSCH Incentive Treatment Groups

Initial Sample	Stratum Stratum I: 61.2% Stratum II: 38.8%		Incentive Group $0: 33% $2: 33% $5: 33%		Valid 89%	Screeners Web ($0): 42% Web ($2): 45% Web ($5): 48% Paper: (1-Web)*.25		Households With Kids Stratum I: 77.1% Stratum II: 10.2%		Completed Topicals Web: 95% Paper: 25%
						Web:	Paper:	Web:	Paper:	Web:	Paper:
364,153	I:	222,751	$0	74,251	66,083	27,755	9,582	21,394	7,386	20,324	1,846
			$2	74,250	66,083	29,737	9,086	22,921	7,004	21,775	1,751
			$5	74,250	66,083	31,720	8,591	24,449	6,622	23,227	1,655
	II:	141,402	$0	47,134	41,949	17,619	6,083	1,795	620	1,705	155
			$2	47,134	41,949	18,877	5,768	1,923	588	1,827	147
			$5	47,134	41,949	20,136	5,453	2,051	556	1,949	139
Totals					324,096		190,406		97,307	76,500
per State					6,355		3,733		1,908	1,500

4. Estimation Procedures

There will be written specifications for weighting the data that will have been collected in the 2016 NSCH for people in households selected from the Census Master Address File (MAF). The data from the MAF are supplemented with administrative records based flags to indicate the presence of children in the household. Instructions for computing adjustments (e.g., under coverage and nonresponse) and several final household and person-level weights will be provided.

5. Nonresponse Bias Analysis

Standard 1.3 of the OMB Standards and Guidelines for Statistical Surveys (2006) states that “Agencies must design the survey to achieve the highest practical rates of response, commensurate with the importance of survey uses, respondent burden, and data collection costs, to ensure that survey results are representative of the target population so that they can be used with confidence to inform decisions.” Implicit in this standard is the assumption that the frame variables used at the design stage are sufficiently predictive of the collection variables for this to be feasible. Under this assumption, standard nonresponse bias analyses techniques can and will be applied to frame data variables to study potential areas of nonresponse bias (both item and unit) in the survey estimates.

2. Survey Collection Procedures

This section describes the data collection procedures that will be used in the NSCH. The Census Bureau will request survey participation from 364,153 households via one of two modes: web survey or mail. The primary mode is a letter invitation with the Web URL, username, and password included in the letter. The secondary mode will be a mailed paper screener questionnaire with the Web URL, username, and password included in the questionnaire package. See Appendix C for sample letters.

All respondents will initially receive a letter invitation to complete a self-administered web survey with the Web URL, username, and password included in the invitation letter. The household will be screened to determine if there are any children ages 17 or younger who usually live or stay at that address. Those households that meet the eligibility criteria go on to roster all children living at that address and answer questions to determine the special needs status of each child. Detailed information will be collected for all children living in the household. Those households that are deemed to have eligible children will be directed to complete the survey about one specific child living at that address.

All web non-respondents will receive a two-phase self-administered mail survey. In the first phase, similar to the web, households will be screened to determine if there are any children ages 17 or younger who usually live or stay at that address. Those households that meet the eligibility criteria go on to roster the children living at that address and answer questions to determine the special needs status of each child (up to 4 children). Detailed information will be collected for Child 1 – Child 4, while basic information (name, age, and sex) will be collected for Child 5 – Child 10. In the second phase, households that are deemed to have eligible children will be mailed one of the three age-based topical questionnaires that request more information about one specific child living at that address. See Appendix D for a list of new items for NSCH Production, and copies of the pre-test Screener and Topicals (English and Spanish versions). Currently the production survey forms are being updated and revised copies will be submitted at a later date. Such changes include revisions to the Privacy Act Statement; legal citation; and confidentiality statement that will reflect what is provided within the OMB Supporting Statements A and B.

The topical survey (for both web and mail) will cover the following content areas: child’s health and functional status; the child as an infant; health care services; experience with child’s health care providers; child’s health insurance coverage and experience of uninsured children in low income families; providing for the child’s health; the child’s learning, schooling, and activities; family functioning; parental health; neighborhood and community characteristics; and adult demographics.

The NSCH employs multiple contacts with households to maximize response. These include an initial web response invitation letter, multiple non-response follow-up letters, and up to four questionnaire mailings.

The U.S. Census Bureau is conducting the NSCH on the behalf of the HHS under Title 13, United States Code, Section 8(b), which allows the Census Bureau to conduct surveys on behalf of other agencies. Title 42 U.S.C. Section 701(a)(2) allows HHS to collect information for the purpose of understanding the health and well-being of children in the United States. The data collected under this agreement are confidential under 13 U.S.C. Section 9. All access to Title 13 data from this survey is restricted to Census Bureau employees and those holding Census Bureau Special Sworn Status pursuant to 13 U.S.C. Section 23(c).

3. Methods to Maximize Participation Rates and Deal with Nonresponse

In designing the various modes of the NSCH screener and topical questionnaires, attention will be placed on the following design elements to help increase cooperation by prospective respondents.

• In developing and refining specific questions, the goal will be to create a logical, clear questionnaire with concrete question wording and simple grammar

• The Mail and Web versions of the questionnaire will be attractive with clear and simple instructions on how to complete specific questions

• Questions will be grouped according to subject areas

• Questionnaire formatting will maximize readability, including appropriate question spacing, font type and size, and easy to follow skip instructions

• Questionnaire formatting considerations will also include the use of color and pictures to enhance respondent comprehension

• Respondent contact strategies and letters have been carefully put together to grab the attention of the respondent and pique interest in the subject matter

• In addition to the methods above, we have designed an incentive experiment to evaluate the efficacy of incentives as a means of increasing respondent cooperation with the NSCH. See Section A.9 of the supporting statement for more information on incentives.

Data collection for the NSCH will involve a series of mailings and nonresponse follow-up activities, encouraging questionnaire completion (see Appendix C- Sample letters). Our proposed approach to data collection and nonresponse follow-up is based on previous project experience and recommendations made by Dillman and colleagues (2009)³.

Invitation Letter. An initial invitation letter will be mailed to all potential respondents providing details about the study, a Web URL with the username and password for accessing the Web version of the questionnaire (which combines the screener and topical into a consolidated instrument) and a toll-free number for the individual to call if there are questions or comments. In addition to the invitation letter, two-thirds of the sample will also receive a token of appreciation ($2 or $5). Each household will be contacted up to a potential of five attempts to participate in the survey.

Additional mailings. Subsequent to the first invitation mailing, the Census Bureau will send all remaining non-respondents a second invitation letter. The second mailing is an experiment using two different types of letterhead (Census Bureau and MCHB). After the second mailing, the remaining non respondents will be divided based on an internet usage flag. Those households that are flagged to have low internet usage, will receive their first paper screener questionnaire and those household flagged to have high internet usage will receive a third web invitation letter. The fourth and fifth mailings will be paper screener questionnaires to all non-respondents.

Hardcopy questionnaire mailing. For Mail mode cases, the topical questionnaire and accompanying cover letter will be personalized to fill in the sample child’s name and other identifying information to ensure that the survey is completed for the correct child. This level of personalization in the questionnaire improves data quality by reducing the opportunity for skip logic errors. It also results in a questionnaire that is as short as possible for the selected child. The shorter the questionnaire, the more likely the respondent is to complete it.

3. Individuals Responsible for Study Design and Performance

The Census Bureau will collect the information on behalf of MCHB. Contact information for the Census Bureau’s principal staff on the project is listed below:

Jason Fields

Survey Director

U.S. Census Bureau, ADDP, HQ-7H153

4600 Silver Hill Road

Washington, DC 20233-0001

Phone: (301) 763-2465

Email: [email protected]

Daniel Doyle

Assistant Survey Director

U.S. Census Bureau, ADDP, HQ-7H051

4600 Silver Hill Road

Washington, DC 20233-0001

Phone: (301) 763-5304

Email: [email protected]

Leah Meyer

Survey Team Member

U.S. Census Bureau, ADDP, HQ-7H036A

4600 Silver Hill Road

Washington, DC 20233-0001

Phone: (301) 763-7174

Email: [email protected]

Elizabeth Sinclair

Survey Team Member

U.S. Census Bureau, ADDP, HQ-7H036F

4600 Silver Hill Road

Washington, DC 20233-0001

Phone: (301) 763-3748

Email: [email protected]

List of Attachments:

Appendix A – NSCH sampling flags creation documentation

Appendix B – Table of state sample sizes

Appendix C – Sample letters

Appendix D – List of new survey items to NSCH 2016 production, screener and topicals

1 The MAF is a Title 13 data source, and all data collected are confidential under 13 U.S.C. Section 9. All access to Title 13 data from this survey is restricted to Census Bureau employees and those holding Census Bureau Special Sworn Status pursuant to 13 U.S.C. Section 23(c).

2 Bethell CD, Read D, Stein RE, Blumberg SJ, Wells N, Newacheck PW. Identifying children with special health care needs: Development and evaluation of a short screening instrument. Ambulatory Pediatrics, 2002 Jan-Feb; 2(1):38–48. This came from the 2005-2006 CSHCN Chartbook (pg 10): http://mchb.hrsa.gov/cshcn05/MI/NSCSHCN.pdf

3 Dillman, D.A.; Smyth, J.D.; Christian, L.M. (2009). Internet, mail and mixed-mode surveys: The tailored design method, 3rd edition. Hoboken, NJ: John Wiley & Sons.

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