[NCHS] National Health and Nutrition Examination Survey (NHANES)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0950 Hour Wearable Devices	Form and Instruction	Modified	Available
Form 0920-0950 24 Hour Wearable Devices	Form and Instruction	Modified	Repair queued
Form 0920-0950 NHANES Refuser No Show Questionnaire	Form and Instruction	Modified	Available
Form 0920-0950 NHANES Follow-Up Questionnaire	Form and Instruction	Modified	Available
Form 0920-0950 Introductory Letter for SP Questionnaire	Form and Instruction	Modified	Available
Form 0920-0950 Developmental Projects & Special Studies Testing	Form and Instruction	Modified	Repair queued
Form 0920-0950 FCBS Phone Follow-Up	Form and Instruction	Modified	Repair queued
Form 0920-0950 Flexible Consumer Behavior Survey Phone Follow-Up	Form and Instruction	Modified	Repair queued
Form 0920-0950 Dietary Interview	Form and Instruction	Modified	Available
Form 0920-0950 Day 1 and Day 2 Telephone Dietary Recall & Dietary Supplement	Form and Instruction	Modified	Repair queued
Form 0920-0950 MEC Interview & Examination	Form and Instruction	Modified	Available
Form 0920-0950 Mobile Exam Center (MEC) Interview & Examination	Form and Instruction	Modified	Repair queued
Household Interview (with Covid mods)	Form and Instruction	Modified	Available
Household Interview	Form and Instruction	Modified	Repair queued
Form 0920-0950 Household Screener	Form and Instruction	Modified	Repair queued
Form 0920-0950 Household Screener	Form and Instruction	Modified	Repair queued
Att_2c_NCHS's responses to 60-day FRN comments.docx	Supplementary Document	Uploaded 2023-03-06	Repair queued
0920-0950 Post-COVID_Rx Questions Non-sub 22SEP01.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-09-01	Repair queued
0920-0950 Follow-up survey non-sub 05112022.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-05-18	Repair queued
ATTA~70O.PDF	Supplementary Document	Uploaded 2022-01-25	Repair queued
0920-0950 Incentive Increase Non-sub 22JAN19_final.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-01-25	Repair queued
Attachment 2b COQMEC_revision_211120 (marked copy).docx	Supplementary Document	Uploaded 2022-01-12	Repair queued
Attachment 1b COQ_revision_211120 (marked copy).docx	Supplementary Document	Uploaded 2022-01-12	Repair queued
0920-0950 Covid-related Modifications Non-sub 21DEC15_final submitted.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-01-12	Repair queued
Att_19_Liver_Genetics_FAQ 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_18_NHANES Coming To Your Community 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_13f_NHANES Overview Brochure 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_12_Nonresponse Letter 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_11g_2021 Future Research Consent Form 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_11f_2021 MEC Adult Parental_Child_Consent_Assent Form 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_11e_Adult-Parental-Consent-Assent-Brochure 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_11d_MEC Assent Brochure_7-11 years_2020_v4_2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_11c_Health Measurements List_Dry Run 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_11b_Health Measurements List 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_11a_2021 Home Interview Consent Form 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_10h_Spanish Advance Contact 4_Final Reminder Letter_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_10g_Advance Contact 4_Final Reminder Letter 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_10f_Spanish Advance Contact 3_Reminder Letter 2022OCT13 Span.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_10e_Advance Contact 3_Reminder Letter 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_10d_Spanish Advance Contact 2_Postcard 2022OCT13 Span.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_10c_Advance Contact 2_Postcard 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_10b_Spanish Advance Contact 1_Letter_2022OCT13 Span.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_10a_Advance Contact 1_Letter 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_9_ NHANES History_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_8_Agencies Consulted_21-22_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_7_3-5 Yr Urine Fact Sheet_2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_6b_Lab Assessments_19-20_FINAL_201029.pdf	Supplementary Document	Uploaded 2020-12-28	Repair queued
Att_6a_Lab Assessments_21-22_2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_5b_Sample Design Tables 2019-20_201029.docx	Supplementary Document	Uploaded 2020-12-28	Repair queued
Att_5a_Sample Design Tables 2021-22_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_4_Developmental Project Report-Incentives_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_15 ERB Approval_2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14k_deleted 210323.docx	Supplementary Document	Uploaded 2021-04-06	Repair queued
Att_14j_COVID 19 Safety Flyer_2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14i_Principal Letter_Final_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14h_Community Service Letter_2021_20230106.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14g_Report of Findings 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14f_Environmental Exposures Flyer 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14e_Lab Blood Flyer 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14d_Appt Reminder Call Script_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14c_Appt Reminder Letter_NoFasting_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14b_Appt Reminder Letter_Fasting_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_14a_Appointment Slips-v8_2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_13e_Welcome to NHANES Brochure_2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_13d_Make A Plan_Card-v3 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_13c_Sample Selection Brochure_v5 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_13b_Confidentiality Flyer_2021 2022OCT13.pdf	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_13a_Introductory Letter for SP Questionnaire 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_3h_Dietary Hand Card_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_3j_FCBS PFU Hand Card_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_3k_2019-2020 Instruments_201129.docx	Supplementary Document	Uploaded 2020-12-28	Repair queued
Att_3d_HH Interview HandCard_2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Att_3f_deleted 210323.docx	Supplementary Document	Uploaded 2021-04-06	Repair queued
Att_3a_Question Changes 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-06	Repair queued
Att_2b_Public Comments to the 60-day Federal Register Notice.pdf	Supplementary Document	Uploaded 2023-03-06	Repair queued
Att_2a_Published 60-Day FRN.pdf	Supplementary Document	Uploaded 2023-03-06	Repair queued
Att_1_21-22_Laws 2022OCT13.docx	Supplementary Document	Uploaded 2023-03-08	Repair queued
Sup_Stat_A_02222023.docx	Supporting Statement A	Uploaded 2023-03-06	Repair queued
Sup_Stat_B_02222023.docx	Supporting Statement B	Uploaded 2023-03-06	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
245125	24 Hour Wearable Devices	Form and Instruction	Modified	Hour Wearable Devices
245125	24 Hour Wearable Devices	Form and Instruction	Modified
245124	Developmental Projects & Special Studies Testing	Form and Instruction	Modified	NHANES Refuser No Show Questionnaire
245124	Developmental Projects & Special Studies Testing	Form and Instruction	Modified	NHANES Follow-Up Questionnaire
245124	Developmental Projects & Special Studies Testing	Form and Instruction	Modified	Introductory Letter for SP Questionnaire
245124	Developmental Projects & Special Studies Testing	Form and Instruction	Modified
245124	Developmental Projects & Special Studies Testing	Other-Examples of Potential Special Studies	Modified
245123	Flexible Consumer Behavior Survey Phone Follow-Up	Form and Instruction	Modified	FCBS Phone Follow-Up
245123	Flexible Consumer Behavior Survey Phone Follow-Up	Form and Instruction	Modified
245121	Day 1 and Day 2 Telephone Dietary Recall & Dietary Supplement	Form and Instruction	Modified	Dietary Interview
245121	Day 1 and Day 2 Telephone Dietary Recall & Dietary Supplement	Form and Instruction	Modified
245120	Mobile Exam Center (MEC) Interview & Examination	Form and Instruction	Modified	MEC Interview & Examination
245120	Mobile Exam Center (MEC) Interview & Examination	Form and Instruction	Modified
245119	Household Interview	Form and Instruction	Modified	Household Interview (with Covid mods)
245119	Household Interview	Form and Instruction	Modified
245118	Household Screener	Form and Instruction	Modified	Household Screener
245118	Household Screener	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0950	ICR Reference No: 202302-0920-007
Status: Historical Active	Previous ICR Reference No: 202209-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0950
Title: [NCHS] National Health and Nutrition Examination Survey (NHANES)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/17/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/09/2023
Terms of Clearance: Clearance is provided for completing the current (2021-2022) cycle to perform data collection and processing and public and restricted data release. A Revision (or reinstatement) will be necessary before the next cycle of NHANES (2023/4-2025). NCHS should brief OMB quarterly, beginning in October 2024, as it performs the upcoming redesign of NHANES.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2025	18 Months From Approved	04/30/2023
Responses	35,200	0	35,200
Time Burden (Hours)	65,630	0	65,630
Cost Burden (Dollars)	0	0	0

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Abstract: The National Health and Nutrition Examination Survey (NHANES) is a continuous nationally representative sample of the civilian, non-institutionalized U.S. population. The survey is unique in that it contains interview, laboratory and physical examination segments. The examination component is conducted in mobile examination centers that travel to fifteen survey locations each year. NHANES data have been the cornerstone for numerous national health and nutrition policy and surveillance activities. The Program made changes specific to 2021-22 data collection to adapt the survey due to the COVID-19 disease pandemic and related concerns. These changes impacted a broad range of survey areas, such as sample design, operational procedures (e.g., interview and examination modes and MEC hours), NHANES content (questionnaires, exam components, and laboratory measures), and outreach materials. Covid-related modifications to the Household Interview and the MEC Interview were submitted in January 2022 and additional minor modifications were submitted in May and September of 2022. Due to operational delays, CDC is requesting an additional 18 months (Extension) to complete data collection with the modifications that were previously approved.

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Authorizing Statute(s): US Code: 42 USC 306 Name of Law: PHSA
   PL: Pub.L. 104 - 170 301 Name of Law: Food Quality Protection Act
   PL: Pub.L. 110 - 234 4403 Name of Law: Food, Conservation, and Energy Act of 2008
   US Code: 21 USC 393 Name of Law: Federal Food, Drug and Cosmetic Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 70828	11/21/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 13827	03/06/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
24 Hour Wearable Devices	0920-0950	Hour Wearable Devices
Day 1 and Day 2 Telephone Dietary Recall & Dietary Supplement	0920-0950	Dietary Interview
Developmental Projects & Special Studies Testing	0920-0950, 0920-0950, 0920-0950	Introductory Letter for SP Questionnaire ,   NHANES Follow-Up Questionnaire ,   NHANES Refuser No Show Questionnaire
Flexible Consumer Behavior Survey Phone Follow-Up	0920-0950	FCBS Phone Follow-Up
Household Interview	None	Household Interview (with Covid mods)
Household Screener	0920-0950	Household Screener
Mobile Exam Center (MEC) Interview & Examination	0920-0950	MEC Interview & Examination

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ICR Summary of Burden

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	35,200	35,200	0	0	0	0
Annual Time Burden (Hours)	65,630	65,630	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $46,200,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/09/2023

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