NSCH Crowdsourcing Cognitive Interviews

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Document Name Document Type
Form 3 NSCH Crowdsourcing Cognitive Interviews Form and Instruction
1 Survey Content for Participants with a Child Aged 0-5 OMB letter attachment 1_Survey Content for Participants with a Child Aged 0-5_Updated 06292020.docx Form and Instruction
2 Survey Content for Participants with a Child Age OMB letter attachment 2_Survey Content for Participants with a Child Aged 6 to 17_Updated 06292020.docx Form and Instruction
3 Qualtrics Screenshots OMB letter attachment 3_Qualtrics Survey Screen Shot Examples.docx Form and Instruction
Crowdsourcing Cognitive Interviews OMB letter_FINAL.docx OMB Memo IC Document

Information Collection (IC) Details

IC Title:	NSCH Crowdsourcing Cognitive Interviews	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	3	Qualtrics Screenshots	OMB letter attachment 3_Qualtrics Survey Screen Shot Examples.docx	No	Fillable Fileable
Form and Instruction	1	Survey Content for Participants with a Child Aged 0-5	OMB letter attachment 1_Survey Content for Participants with a Child Aged 0-5_Updated 06292020.docx	No	Fillable Fileable
Form and Instruction	2	Survey Content for Participants with a Child Age	OMB letter attachment 2_Survey Content for Participants with a Child Aged 6 to 17_Updated 06292020.docx	No	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	Crowdsourcing Cognitive Interviews OMB letter_FINAL.docx	05/11/2020

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