Adult Parental Consent Brochure

Attachment 9p

National Health and Nutrition Examination Survey

Overview
The National Health and Nutrition
Examination Survey (NHANES) is
conducted by the National Center for
Health Statistics (NCHS), which is part
of the Centers for Disease Control and
Prevention. We designed the survey
to learn about the health and diet of
people in the United States.
Our survey is unique. It combines
a home interview with health
measurements that are done in special
mobile exam centers. These centers travel across the country, each with
its own highly trained medical team. The team looks at special health
topics. We use the most up-to-date methods and equipment for medical
and dental exams and other lab tests.
Why is this health survey important?
We use the data gathered in this survey
to find out the number of people with
certain health problems—for example,
diabetes and high blood pressure. We
look at diet and other habits that affect
health, such as smoking and exercise.
NHANES provides health and nutrition
information on people of all ages. It is
also used by those who design health
programs and services, and the survey
expands our knowledge about the
health of people in the United States.
What do I gain by taking part in the exam?
• Free health test results.
• The chance to help learn more about the health of the Nation.
• A token of thanks for your time and effort.
You may choose to be in the survey and you may allow your child to
be in it, too. That is your choice. There is no penalty if you refuse. You
may refuse any part of the exam and you are free to drop out at any
time. Also, during the interviews you may choose not to answer every
question.

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What will I be asked to do at the mobile center?

Upon arriving at the mobile center, you will be asked to
change into a two-piece examination outfit.
Our medical team will then guide you to a private room,
where we will check your:
Height and weight

Blood pressure

Hearing

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National Health and Nutrition Examination Survey

Teeth

Bone density

We will collect blood and urine
samples

and ask you questions about
what you eat

If your appointment is scheduled in the morning, we will ask you not
to eat or drink anything overnight. The health tests may take up to 4
hours. The time spent in the mobile center and the tests you receive will
be based on your age and current medical condition. For a full list of
exams you may receive, see the Health Measurements List.
Are the tests safe?
The tests are safe. Some tests may cause you slight discomfort.
Examples are having a blood sample taken or not eating for 9 hours.
For the blood sample, a person will have a small amount of blood
drawn from a vein in his or her arm with a needle. We will not ask you
to have any test that is wrong for you because of a health problem you
have.
We will give a bone density test involving low-dosage x-rays to persons
aged 8 years and over. Radiation exposure during this test is equal
to a cross-country airline flight or a few days of natural background
radiation. However, because the bone density scan involves x-rays,
those who are pregnant should not have this exam. We will get
information about periods from girls and women, and those who have
started their periods will have a urine pregnancy test. Those with a
positive test will not have the bone density scan.

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Medical errors and injuries are rare. The NHANES program cannot
provide money or other compensation if they occur. However, if you
believe you have been harmed as a result of your participation in
NHANES, we want to know about it. Please call us at
1–800–452–6115. You also have a right to file a claim under the
Federal Tort Claims Act with the Centers for Disease Control and
Prevention. We can provide you with information about this process.
You must file the claim within 2 years after the date you became aware
of the personal injury, loss of property, or other damage.
Will you be asked personal questions?
At the mobile center, you will be asked some
personal questions. A trained interviewer
will ask some of these questions. Other
questions, like those about sexual behaviors
and drug use, will be asked in complete
privacy. The interviewer will leave the room.
The questions will be on a computer screen.
You answer by touching an answer on the
screen.
Like all of the other data we collect, your answers are kept strictly
private. If you are under 18 years of age, we may notify your parents
if we have reason to believe you may harm yourself because of sad
feelings.
Will I get my results?
You will get a report of your results. If the
exam shows urgent health problems, we
will notify you at once and refer you for
treatment. If an urgent problem is found
through your lab tests, we will immediately
send that information in a letter to your
home address. If you wish, we will also mail
routine results to you approximately 3–4
months after the exam. In general, we give
results only to persons examined or to the
parents or guardians of children. Some results, like those for sexually
transmitted diseases (STD) and pregnancy, are not put in writing. We
report positive pregnancy results only to the person tested if she is aged
14 years or over and doesn’t already know that she is pregnant. If a girl
is younger than 14 and has a positive pregnancy test, we will inform
both her and her parent or guardian. The next section describes how
we report STD results.
Some tests are not reported because they will be used only for research
and are not used for medical care. Better ways to look at some of the
tests may be developed in the future. Some of the tests may be read
again. We will not report the results of future tests to you.
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National Health and Nutrition Examination Survey

NHANES does not cover the cost of any health care you may decide
to get after the exam. If you have questions about getting your results,
please call 1–800–452–6115.
Will you test for sexually transmitted diseases (STDs)?
Teenagers (14 years and older) and adults under age 60 will be tested
for STDs. We will not put these results in writing, but you can get STD
test results a few weeks after the exam.
Before you leave the mobile center, you will be given a toll-free number,
a password, and the dates to call for your results. Only you will get
your test results by calling in and telling us your password. Parents will
not be told their child’s STD test results. If your test results show that you
have a current health problem, we will talk with you about the results
and tell you how to get treatment. We will keep all STD test results
completely private, just like all other test results. If you do not want to be
tested, you can tell a staff member. For details on the tests, please see
the Health Measurements List.
Will my information be kept private?
We respect your privacy. Public laws keep all information you give
private.
Assurance of Confidentiality: We take your privacy very seriously.
All information that relates to or describes identifiable characteristics
of individuals, a practice, or an establishment will be used only for
statistical purposes. NCHS staff, contractors, and agents will not
disclose or release responses in identifiable form without the consent
of the individual or establishment in accordance with section 308(d) of
the Public Health Service Act (42 U.S.C. 242m (d)) and the Confidential
Information Protection and Statistical Efficiency Act of 2002 (CIPSEA,
Title 5 of Public Law 107-347). In accordance with CIPSEA, every
NCHS employee, contractor, and agent has taken an oath and is
subject to a jail term of up to five years, a fine of up to $250,000, or
both if he or she willfully discloses ANY identifiable information about
you. In addition, NCHS complies with the Federal Cybersecurity Act
of 2015 (6 U.S.C. §§ 151 & 151 note). This law requires the federal
government to protect federal computer networks by using computer
security programs to identify cybersecurity risks like hacking, internet
attacks, and other security weaknesses. If information sent through
government networks triggers a cyber threat indicator, the information
may be intercepted and reviewed for cyber threats by computer
network experts working for, or on behalf of, the government.
These laws do not allow us to give out data that identifies you or your
family without your permission. However, if we find signs of child abuse
during an exam, we will report it to the local department of social
services or the police.

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We will keep all survey data safe and secure. When we share data
with our partners, to help prepare and process the data, we do so in a
way that protects your privacy as required by law. Our interviewer can
provide a list of our partners if you wish to learn more.
How are NHANES data used?
What you tell us, your exam results, and the samples you give are a
good resource for health science. Many federal agencies, universities,
and other public and private groups use NHANES data. They use it to
help find new cures and treatments for diseases and disabilities. The
aim is to make the health of all people better. Results of this survey may
be reported in journals, at major scientific meetings, or through other
news media. None of these reports will ever name or use data that can
identify any person who took part in the survey.
NHANES has been used in important national reports. One of these
highlights the food we eat. Another tells us about the exposures we
have to chemicals in the environment. The survey has also been used
to track the number of people who are overweight or obese. Research
using NHANES can be found on our website, listed on the back of this
brochure.
Health research using NHANES can be enhanced by combining your
survey records with other data sources. An example is linking your
survey results with vital statistics and Medicare claims. To do this, we
will ask your permission to collect your Social Security and Medicare
numbers. As we told you before, we keep this information safe and
secure.
Also, we may need to contact you in the future. To do this, we will ask
public or private agencies, such as the Post Office, to update us with
changes to your home address. In the past, we have called or revisited
people who took part in this survey. We may contact you in the future
to ask you to be part of other research projects. Your participation in
future studies is voluntary.

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National Health and Nutrition Examination Survey

More questions?
Our survey representatives can discuss other
questions or concerns you might have or give
you printed material that can help you. They
can also give you a phone number in your
area that you can call for more facts about
the survey.
You can call our Senior Medical Officer,
Dr. Duong Nguyen of the U.S. Public Health
Service, to discuss any aspect of the survey.
He can be reached at 1–800–452–6115,
Monday–Friday, 7:30 a.m.–4:30 p.m. EST.
You may also contact him regarding any harm to you resulting from this
survey. You can also get answers to your questions by writing to
Dr. Nguyen at MS P08, 3311 Toledo Rd., Hyattsville, MD 20782–2064.
If you have questions about your rights as a participant in this research
study, please call the Research Ethics Review Board at the National
Center for Health Statistics, toll-free, at 1–800–223–8118. Please leave
a brief message with your name and phone number, and say that you
are calling about Protocol # 2018-01. Your call will be returned as soon
as possible.

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