Information Collection Request

Changes to 2020 National Health Interview Survey in light of Novel Coronavirus (2019-nCoV)

ICR 202006-0920-009 · OMB 0920-0214 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0214 COVID-Related Questions Sample Adult 2019 Follow-back Form and Instruction New Available
Form 0920-0214 COVID-Related Questions Adult Family Member Form and Instruction New Available
Form 0920-0214 COVID-Related Questions Sample Adult Form and Instruction New Available
Form 0920-0214 Re-Designed Re-Interview Survey Form and Instruction Unchanged Available
Form 0920-0214 Methodological Projects Form and Instruction Unchanged Available
Form 0920-0214 Re-Designed Child Questionnaire Form and Instruction Unchanged Available
Form 0920-0214 Re-Designed Adult Questionnaire Form and Instruction Unchanged Available
Form 0920-0214 Re-Designed Household Roster Form and Instruction Unchanged Available
2020 Q3 Emergency NHIS Letter 06152020.doc.pdf Supplementary Document Uploaded 2020-06-17 Available
2020 Q3 Emergency NHIS Attachment D ICR 0920-0214 SSA.docx Supplementary Document Uploaded 2020-06-17 Available
2020 Q3 Emergency NHIS Attachment C Power Calculations 6022020.xlsx Supplementary Document Uploaded 2020-06-17 Available
2020 Q3 Emergency NHIS Attachment B 06032020.docx Supplementary Document Uploaded 2020-06-17 Available
NHIS Nonsubstantive Change Request 2020 clean_120919PM.docx Justification for No Material/Nonsubstantive Change Uploaded 2019-12-11 Available
Att 4_AdvanceLetterRevised.pdf Supplementary Document Uploaded 2019-12-11 Available
Att 1 Changes to the rotating core and sponsored content.docx Supplementary Document Uploaded 2019-12-11 Available
Att 4 - Adv Letter 071618.pdf Supplementary Document Uploaded 2018-07-23 Available
Att 1 Proposed changes.docx Supplementary Document Uploaded 2018-07-23 Available
NHIS Nonsubstantive Change Request 071618.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-07-23 Available
Att 12 Listing of Proposed Items for 2019 and 2020.docx Supplementary Document Uploaded 2017-12-27 Available
Att 11 - ERB Approval Notice.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 10d - Thank you letter.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 10c - Sup Mailings.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 10b - NHIS Brochure.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 9 - Redesign Consultations.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 8 - Data Collection Proc.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 4f - Main Q Flashcards.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 4e REV - Main Q Sup Descr.pdf Supplementary Document Uploaded 2017-11-28 Repair queued
Att 3d - Need Core Mod Redesigned Q.pdf Supplementary Document Uploaded 2017-11-28 Repair queued
Att 3c - Need Core Mod Main Q.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 3b - Main and Redes Ques Struc.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 3a - Redes Q Modules and Peri.pdf Supplementary Document Uploaded 2017-11-28 Available
Att 2b Public Comments.docx Supplementary Document Uploaded 2017-11-28 Available
Att 2a - 60 Day FRN 102417.pdf Supplementary Document Uploaded 2017-11-28 Available
2020 Q3 Emergency NHIS SSB 06172020.docx Supporting Statement B Uploaded 2020-06-17 Available
2020 Q3 Emergency NHIS SSA 06172020.docx Supporting Statement A Uploaded 2020-06-17 Available
Att 1 - Legislative Mandates.pdf Supplementary Document Uploaded 2016-11-30 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
242299 COVID-Related Questions Sample Adult 2019 Follow-back Form and Instruction New
242298 COVID-Related Questions Adult Family Member Form and Instruction New
242297 COVID-Related Questions Sample Adult Form and Instruction New
229175 Re-Designed Re-Interview Survey Form and Instruction Unchanged
229173 Methodological Projects Form and Instruction Unchanged
229172 Re-Designed Child Questionnaire Form and Instruction Unchanged
229171 Re-Designed Adult Questionnaire Form and Instruction Unchanged
229170 Re-Designed Household Roster Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2020 6 Months From Approved 12/31/2020
122,579 0 88,450
49,893 0 34,371
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 122,579 88,450 0 34,129 0 0
Annual Time Burden (Hours) 49,893 34,371 0 15,522 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No