2022 Q3 Changes to Assess Data Quality (Online Panels) and Recruit Sample Households

Nonsubstantive Change Request

NATIONAL HEALTH INTERVIEW SURVEY

OMB No. 0920-0214, Expiration Date 12/31/2023

Contact Information:

Stephen Blumberg, PhD

Division of Health Interview Statistics

National Center for Health Statistics/CDC

3311 Toledo Road

Hyattsville, MD 20782

301.458.4107 (voice)

301.458.4035 (fax)

[email protected]

May 2, 2022

Table of Contents

1. Circumstance Making the Collection of Information Necessary 4

2. Purpose and Use of Information Collection 5

12. Estimates of Annualized Burden Hours and Costs 7

15. Explanation for Program Changes or Adjustments 9

List of Attachments

Att 5b	2022 Q3 NHIS Proposed New Content - Concepts Measured, Duplication, and Proposed Uses of Data
Att 9b	2022 Q3 Additions to Sample Adult Questionnaire
Att 10c	Supplemental Letter

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NCHS National Health Interview Survey

This is a request for approval of a nonsubstantive change to the National Health Interview Survey (NHIS) (OMB No. 0920-0214, Exp. Date 12/31/2023), conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC). This nonsubstantive change request includes two changes: (1) addition of questions to inform NCHS’s ongoing efforts to evaluate the quality of data collected from probability-based online survey panels (Attachments 9b and 5b) (2) the addition of a follow-up sample adult letter to the supplemental recruitment materials (Attachment 10c). The plan is for both of these changes to continue into the 2023 NHIS data collection.

Questions to inform quality of data from probability-based online survey panels

The proposed questions are being added to quarter 3 of the 2022 NHIS, beginning on July 1, to inform NCHS’s ongoing efforts to evaluate the quality of data collected from probability-based online survey panels (see section A.1 for a brief description and Appendix 5b for how the questions will be used).

In total, 9 questions covering three areas are being proposed for inclusion on the NHIS.

Internet Access

• Do you have access to the Internet?  

• Do you have access to the Internet from your home?

Health Information Technology (HIT)

• During the past 12 months, have you used the Internet to look for health or medical information?

• During the past 12 months, have you used the Internet to communicate with a doctor or doctor’s office?

• During the past 12 months, have you used the Internet To look up medical test results?  

Civic Engagement 

• During the past 12 months, did you spend any time volunteering for any organization or association?

• Some people don’t think of activities they do infrequently or for children’s schools or youth organizations as volunteer activities.  During the past 12 months, have you done any of these types of activities?

• During the past 12 months, did you attend a public meeting, such as a zoning or school board meeting, that discussed a local issue? 

• Did you vote in the last local elections, such as for mayor, councilmembers, or school board?

Sample Adult Letter

We are proposing the inclusion of a follow-up sample adult letter to the supplemental mailing materials to aid interviewers with contacting selected sample adults who are not immediately available for an interview.

1. Justification

1. Circumstance Making the Collection of Information Necessary

The NHIS is conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) to collect, on an annual basis, statistically valid data on the amount, distribution, and effects of illness and disability in the population and on the utilization of health care services for such conditions.

Questions to inform quality of data from probability-based online survey panels

In the past decade NCHS began using commercial survey panels for a variety of purposes. Namely, as part of the Center’s Research and Development Survey (RANDS) program, NCHS used commercial survey panels to augment NCHS’ question evaluation and research program with quantitative methodologies for measuring error, and for other statistical research purposes. RANDS has been used for methodological research at the National Center for Health Statistics (NCHS), including the use of close-ended probe questions and split-panel experiments for evaluating question-response patterns and for developing statistical methodology to calibrate survey estimates in a way that leverages the strength of national survey data. Survey results have been used to evaluate estimation approaches for health outcomes from recruited survey panels, including propensity score adjustment and calibration.

The questions in this nonsubstantive OMB clearance package are being added to the NHIS to inform NCHS’s ongoing efforts to evaluate the quality of data collected from probability-based online survey panels. The proposed questions measure topics that are generally known to be associated with lower levels of participation in online survey panels. Bias would occur if these questions are also associated with key indicators in a survey conducted using such panels. By including these measures on the NHIS, we will be able to examine associations between these topics and key NHIS health indicators.

These questions will be included in future rounds of RANDS data collection to continue developing statistical methodology to calibrate survey estimates in a way that leverages the strength of national survey data. Adding these questions to NHIS provides additional national survey data to improve the statistical methods that RANDS is developing. In other words, estimates from NHIS may be useful information for calibrating survey weights from RANDS and other surveys conducted using probability-based online survey panels.

The statistical methods that RANDS develops will be applied in the future in a Rapid Surveys program under development. NCHS plans to collect survey data from existing, commercially available, probability-based online survey panels to supplement its ongoing research and data dissemination efforts. In response to the COVID-19 pandemic, the Center expanded its use of RANDS and collected survey data in order to release timely, experimental estimates on a set of coronavirus and pandemic-related topics. NCHS plans to continue exploring the use of commercial survey panels, not only for methodological research, but also for producing estimates on key health outcomes and emerging topics that the Center will release publicly through a Rapid Surveys program.

Sample Adult Letter

After the household roster is completed, the NHIS interviewer attempts to collect detailed health information from one adult (the “Sample Adult”). The proposed new letter can be left with the household respondent in the case that the Sample Adult is not available to speak with the NHIS interviewer immediately. The proposed letter will assist Census Field Representatives in contacting and recruiting sample households to participate in the NHIS (See Attachment 10c).

2. Purpose and Use of Information Collection

Questions to inform quality of data from probability-based online survey panels

Questions are being added to quarter 3 of the 2022 NHIS for use in calibrating RANDS (and perhaps future Rapid Surveys program) weights. The process will entail raking RANDS weights to weighted distributions of variables based on these questions using NHIS data. For calibration to be effective, the variables (and therefore the questions behind them) need to meet two criteria:

• The variables should be differentially associated with adult participation in probability-based online survey panels and in the RANDS surveys, that is, adults with the associated characteristic should be over- or under-represented in RANDS, and

• The variables should be associated with health outcomes of interest in RANDS (and perhaps future Rapid Surveys program questionnaires).

The 9 questions covering three areas that are being proposed for inclusion on the NHIS are expected to meet both criteria. Including these questions on NHIS will yield data to help NCHS determine if these expectations are met. See attachment 5b for more information on duplication with other surveys, expected prevalences, reliability and more specific use of the data.

12. Estimates of Annualized Burden Hours and Costs

A. Time Estimates

Both of these changes have a neglibile impact on the the OMB revision package that was approved on 12/31/2020 (OMB# 0920-0214, expires 12/31/2023). The Sample Adult Letter is only sent to households that are not immediately available for an interview. The questions used to inform the quality of data from probability-based online survey panels will take roughly 1.5 minutes to administer in the last half of 2022 and the full year of 2023. This amounts to less than 30 seconds of annualized average burden per response for the Sample Adult interview in the revision package. Therefore, we have not made any changes to the burden table last submitted in the previous nonsubstantive OMB change requests approved on 12/3/2021.

Any future modification that might impact the instruments and/or burden estimates will be submitted as a nonsubstantive change request for OMB review, as applicable.

Lines 1-3 of the burden table represent the different sections of the NHIS questionnaire. Line 4 covers the methodological projects such as web and/or mail-based methodological, cognitive testing activities, and pilot studies. Line 5 covers the adolescent follow-back survey. Line 6 covers a follow-up health exam. Small quality control resurveys of participating households are represented on line 7.

Estimated Annualized Burden Hours

Type of Respondent	Form Name	Number of Respondents	Number of Responses per respondent	Average Burden per Response (in hours)	Total Burden Hours
Adult Household Member	Household Roster	36,000	1	4/60	2,400
Sample Adult	Adult Questionnaire	30,000	1	44/60	22,000
Adult Family Member	Child Questionnaire	10,000	1	22/60	3,667
Adult Family Member	Methodological Projects	15,000	1	20/60	5,000
Sample Child	Adolescent follow-back survey	1,200	1	16/60	320
Sample Adult	Health Exam	5,000	1	45/60	3,750
Adult Family Member	Reinterview Survey	5,500	1	5/60	458
Total					37,595

Not all questions apply to each person, and the questionnaire instrument automatically skips over questions that do not apply, based on earlier information given by the respondent. Thus, no respondent is ever asked all of the questions in the questionnaire.

The estimate of response burden above is based on an average length of interview per household. Variations occur in individual household interview times primarily because of differing numbers of persons in the household and variations in the number of health conditions reported in the household.

The burden on any single member of a sample family also varies according to who is designated respondent for each component. In some sample families the same adult could be the respondent for all of the major components: roster, adult, and child. In other families there could be a different respondent for each component. In the first case, the total average burden on the single respondent would be about one hour; in all other cases the burden on a single respondent would be less.

B. Cost to Respondents

At an average wage rate of $21.00 per hour, the estimated annualized cost for the 37,595 burden hours is $789,495. This estimated cost does not represent an out of pocket expense but represents a monetary value attributed to the time spent doing the interview.

Estimated Annualized Burden Costs

Type of Respondent	Form Name	Total Burden Hours	Hourly Wage Rate	Total Respondent Costs
Adult Household Member	Household Roster	2,400	$21.00	$50,400
Sample Adult	Adult Questionnaire	22,000	$21.00	$462,000
Adult Family Member	Child Questionnaire	3,667	$21.00	$77,000
Adult Family Member	Methodological Projects	5,000	$21.00	$105,000
Sample Child	Adolescent follow-back survey	320 267	$21.00	$6,720
Sample Adult	Health Exam	3,750	$21.00	$78,750
Adult Family Member	Reinterview Survey	458	$21.00	$9,625
Total	$789,495

15. Explanation for Program Changes or Adjustments

The questions being added to the NHIS will help NCHS improve statistical methodology to calibrate survey estimates from RANDS and future probability-based online survey panels in a way that leverages the strength of national survey data. The sample adult letter will assist Census Field Representatives in contacting and recruiting sample households to participate in the NHIS.

The questions used to inform the quality of data from probability-based online survey panels will take roughly 1.5 minutes to administer in the last half of 2022 and the full year of 2023. This amounts to less than 30 seconds of estimated annualized burden for Sample Adult interview in the revision package. Therefore, we have not made any changes to the burden table last submitted in the previous nonsubstantive OMB change requests approved on 12/3/2021.

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