Non-Substantive Change to the NSCH ICR

Request for Non-Substantive Change

National Survey of Children's Health

OMB Control No. 0607-0990

The U.S. Census Bureau requests a non-substantive change to the currently approved National Survey of Children’s Health (NSCH) Information Collection Request. The Census Bureau received clearance by OMB for the NSCH data collection on May 19, 2017 (OMB#0607-0990, expires 05/31/2019) for the 2017 survey data collection. Subsequently, we requested a non-substantive change to include an additional incentive in two planned mailings of topical questionnaires in order to help improve paper topical response rates for the 2017 survey for which we received OMB approval on 11/08/2017. This request applies to a non-substantive change needed for the 2018 NSCH data collection. This change reflects 1) a slight net increase in the number of questions in the survey questionnaires, 2) modification to one of the mailing treatment experiments, and 3) the selection of a new set of unduplicated sample addresses the same size as was selected for 2017 from the Master Address File (MAF). The questionnaire revisions are in response to recommendations by the sponsor of the survey, the Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB), along with the U.S. Census Bureau after cognitively testing the 2017 questionnaires. The questions that are to be added and/or removed to this collection (see Attachment A) should yield survey instruments that we expect will provide the best results for the sponsor’s analysis objectives. The request for a modification to the mailing treatment experiment resulted from a lower response rate for the “info-graphic” mailing treatment group compared to the “no info-graphic” group. We are proposing to replace the info-graphic experiment with a certified mailing test. The details for this change can be found below along with the power calculations. The selection of a new, unduplicated sample is required to ensure that a household cannot be selected for this survey more than once every five years. The unduplication period of five years is used to minimize respondent burden and is in line with other demographic household surveys conducted by the Census Bureau.

Estimate of Hour Burden

For the 2017 NSCH, 58,345 respondents are expected to complete the screener and 23,460 respondents are expected to complete one of the three age-based topical questionnaires. This results in an estimated 81,805 responses annually. The total number of annual burden hours for that estimate is 16,573. This includes an average burden per response of 0.083 hours for the screener and 0.5 hours for each of the topical instruments. The estimated total annual respondent cost is $430,898.00. Since the data collection period is still open for 2017 NSCH, we will use these base estimates again for 2018 NSCH planning purposes.

With the questionnaire modifications we request, the expected screener burden per response is unchanged. However, we anticipate that the topical average burden per response will increase by 3 minutes (0.05 hours). This results in a revised burden estimate for the topical interviews of 17,746 hours, an increase of 1,173 hours annually, and an annualized burden cost increase of $30,498. The revised burden and cost estimates for the 2018 cycle of the NSCH are detailed in Table 1 and Table 2.

Table 1: Revised Estimated Annual Burden Hours

Type of Respondent	Questionnaire Name	Expected Number of Respondents0	Number of Responses per Respondent	Current Average Burden per Response (in hours)	Current Total Burden Hours	Revised Average Burden per Response (in hours)	Revised Total Burden Hours
NSCH Production
Adult Parent or Caregiver	Screener	58,345	1	.083	4,843	.083	4,843
Adult Parent or Caregiver	0-5 Topical Instrument	7,820	1	.5	3,910	.55	4,301
Adult Parent or Caregiver	6-11 Topical Instrument	7,820	1	.5	3,910	.55	4,301
Adult Parent or Caregiver	12-17 Topical Instrument	7,820	1	.5	3,910	.55	4,301
Total		81,805			16,573		17,746

Table 2: Revised Estimated Annualized Burden Costs

Type of Respondent	Current Total Burden Hours	Current Hourly Wage Rate	Current Total Respondent Costs	Revised Total Burden Hours	Revised Hourly Wage Rate	Revised Total Respondent Costs
NSCH Production
Adult Parent or Caregiver (Screener)	4,843	$26.00	$125,918.00	4,843	$26.00	$125,918.00
Adult Parent or Caregiver (0-5 Topical Instrument)	3,910	$26.00	$101,660.00	4,301	$26.00	$111,826.00
Adult Parent or Caregiver (6-11 Topical Instrument)	3,910	$26.00	$101,660.00	4,301	$26.00	$111,826.00
Adult Parent or Caregiver (12-17 Topical Instrument)	3,910	$26.00	$101,660.00	4,301	$26.00	$111,826.00
Total	16,573		$430,898.00			$461,396.00

Modification to Mailing Experiment

For the 2017 cycle of the NSCH, it was determined that sending an infographic along with the initial survey mailout package did not increase response, or show surface evidence that it reduces response bias. Instead, the infographic showed a negative correlation with screener returns. Table 3 below displays the web and paper screener returns by infographic as of November 8, 2017.

Table 3: Screener Returns by Infographic - November 8, 2017

As an alternative to sending an infographic with the initial survey invite packages, we would like to revise the mailing experiment to include a certified-mail test. According to research done on increasing response rates to postal questionnaires (Edwards et al. (2002))⁰, the use of recorded delivery more than doubled the odds of response (2.21; 1.51 to 3.25). The certified test would assess the effectiveness of a certified mail sticker placed on the outside of the mail package envelope. Due to budget limitations and the sample size needed for power, the certified mail sticker would give the appearance of mail tracking without providing the actual tracking of the mail piece at less than half of the cost. Table 4 shows the maximum sample sizes for replacement of the certified test as the mailing experiment vs. the infographic, and Table 5 shows the power calculations for the revised certified test treatment group comparisons.

Table 4: Revised Mailing Treatment Group Comparisons – Maximum Sample Sizes

Incentive	Initial Cases	Certified Test Treatment Status	Maximum Sample for Certified Test Comparison	Mode Collection Group	Maximum Sample by Paper	Treatment Groups (TG)
$2	140,450 (43%)	Certified Mail Package	70,224 (43.5%)	Low Paper	49,157 (43.425%)	1
				High Paper	21,067 (43.675%)	2
		Non-certified Mail Package	70,224 (42.5%)	Low Paper	49,157 (42.575%)	3
				High Paper	21,067 (42.325%)	4
Control $0	15,604 (40%)	Certified Mail Package	7,803 (40.5%)	Low Paper	5,462 (40.425%)	5
				High Paper	2,341 (40.675%)	6
		Non-certified Mail Package	7,803 (39.5%)	Low Paper	5,462 (39.575%)	7
				High Paper	2,341 (39.325%)	8

Table 5: Revised Certified Test Treatment Group Comparisons – Power Calculations

Incentive Comparisons	Certified Mail Package Comparisons by Incentive	Certified Mail Package Comparisons by Paper
$2 v. Control TG(1+2+3+4) v. TG(5+6+7+8)  p=0.05, power≈1 p=0.10, power≈1	Certified v. Non-certified TG(1+2+5+6) v. TG(3+4+7+8) p=0.05, power≈0.98 p=0.10, power≈1
	Certified v. Non-certified in $2 TG(1+2) v. TG(3+4) p=0.05, power≈0.97 p=0.10, power≈1	Certified v. Non-certified in Low Paper TG(1+5) v. TG(3+7) p=0.05, power≈0.81 p=0.10, power≈0.88
		Certified v. Non-certified in High Paper TG(2+6) v. TG(4+8) p=0.05, power≈0.84 p=0.10, power≈0.91

Other Considerations

One condition of our current OMB approval was to provide a status update regarding the preschool expulsion question that was removed in between the 2016 and 2017 cycles of the NSCH. OMB requested a status update for this question because of a comment that was received during the Federal Register Notice review period. There are no current plans to include this question again for the 2018 cycle due to funding constraints and the lack of sponsorship for the item from the federal partner that initially requested the item be placed on the NSCH.

Attachment A

Revisions Requested for the 2018 NSCH Survey Instruments⁰

1. Screener Tenure Question

Is this house, apartment, or mobile home:

Mark (X) ONE box.

• Owned by you or someone in this household with a mortgage or loan? Include home equity loans

• Owned by you or someone in this household free and clear (without a mortgage or loan)?

• Rented?

• Occupied without payment of rent?

2. Question A9 (T1, T2, T3) – Additional stem questions

Was this condition identified through a blood test done shortly after birth? These tests are sometimes called newborn screening.

• Yes

• No

If yes, was this child diagnosed with:

Sickle Cell Disease Yes No

Thalassemia Yes No

Hemophilia Yes No

Other Blood Disorders Yes No

3. Questions A12 (T1, T2, T3) and A21 (T1, T2, T3) – Additional stem question

Was this condition identified through a blood test done shortly after birth? These tests are sometimes called newborn screening.

• Yes

• No

4. Questions adapted from A3 (T2, T3) – Response options f & g removed for 2018 to create these new stand-alone questions.

DURING THE PAST 12 MONTHS, how often was this child bullied, picked on, or excluded by other children? If the frequency changed throughout the year, report the highest frequency.

• Never (in the past 12 months)

• 1-2 times (in the past 12 months)

• 1-2 times per month

• 1-2 times per week

• Almost every day

DURING THE PAST 12 MONTHS, how often did this child bully others, pick on them, or exclude them? If the frequency changed throughout the year, report the highest frequency.

• Never (in the past 12 months)

• 1-2 times (in the past 12 months)

• 1-2 times per month

• 1-2 times per week

• Almost every day

5. New Section C questions –

Has a doctor or other health care provider ever told you that this child is overweight?

• Yes

• No

DURING THE PAST 12 MONTHS, was this child admitted to the hospital to stay for at least one night?

• Yes

• No

6. New Section D question –

Did you and this child receive a summary of your child’s medical history (for example, medical conditions, allergies, medications, immunizations)?

• Yes

• No

7. New Section G question –

Is this child able to do the following: Yes No

Say at least 1 word, such as “hi” or “dog”?  

Use 2 words together, such as “car go”?  

Use 3 words together in a sentence, such as “Mommy come now.”?  

Ask questions like “who,” “what” “when” “where”?  

Ask questions like “why” and “how”?  

Tell a story with a beginning, middle, and end?  

Understand the meaning of the word “no”?  

Follow a verbal direction without hand gestures, such as  

“Wash your hands.”?

Point to things in a book when asked?  

Follow 2-step directions, such as “Get your shoes and put  

them in the basket.”?

Understand words such as “in,” “on,” and “under”?  

8. Consolidation of questions H7 and H8 (T1), H6 and H7 (T2 and T3)

The proposed change to these questions is to combine two questions pertaining to time spent watching television, playing video games, on the computer, etc. as a single question to calculate “screen time”. Revised question wording:

DURING THE PAST WEEK, about how much time did this child spend on most weekdays in front of a TV, computer, cellphone or other electronic device watching programs, playing games, accessing the internet or using social media?

• None

• Less than 1 hour

• 1 hour

• 2 hours

• 3 hours

• 4 or more hours

9. Deletion of questions in section D

D15a (T3)

a. Think about and plan for his or her future. For example, by taking time to discuss future plans about education, work, relationships, and development of independent living skills.

• Yes

• No

• Don’t Know

D19 (T3)

Is this plan CURRENTLY up-to-date for this child?

• Yes

• No

0 The expected number of respondents is an estimate of the expected number of completed screener and topical questionnaires, discussed in section B.1.3 of the previously approved OMB package. This is different from the number of respondents that were mailed a screener or topical questionnaire.

0 Edwards, P., Roberts, I., Clarke, M., DiGuiseppi, C., Pratap, S., Wentz, R., and Kwan, I. (2002). Increasing response rates to postal questionnaires: systematic review. British Medical Journal 2002: 324-1183. Stable URL: http://www.bmj.com/content/324/7347/1183?tab=full

01 Question numbering referenced in this section refer to the 2017 paper topical instruments.