60-day Federal Register Notice

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Population-based studies are needed to
describe the frequency and management
of pain and fatigue and their impact on
the lives of individuals with various
types of MD. The purpose of the
proposed study is to describe the
epidemiology of COVID–19 and flu and
the experience with pain, fatigue,
pregnancy, and infertility for adults
living with MD who are identified
through MD STARnet. Information will
be collected at the seven MD STARnet
surveillance sites and will occur
primarily via a survey of adult men and
women with muscular dystrophy. The

survey will primarily be web-based, but
a paper version and phone interview
will be provided to accommodate
participant preferences. The estimated
burden per response for the MD
STARnet Men Living with Muscular
Dystrophy Survey is 15 minutes. The
MD STARnet Women Living with
Muscular Dystrophy Survey includes
additional questions about pregnancy
and infertility, and the estimated burden
per response is 20 minutes.
Results generated from the study will
provide a better understanding of: (1)
the occurrence, testing, treatment and
severity of COVID–19 in relation to MD;

(2) vaccination status and reasons for
not receiving COVID–19 and flu
vaccinations; (3) the frequency,
intensity, and management of pain and
fatigue; and (4) the effect of having MD
on pregnancy and fertility on adults
living with MD. Ultimately, this
information can be used to develop
interventions that improve the lives of
people with MD and their families.
CDC requests OMB approval for two
years. The total estimated annualized
burden is 292 hours. Participation is
voluntary and there are no costs to
respondents other than their time.

ESTIMATED ANNUALIZED BURDEN HOURS
Form name

Adult Males 18 and over .................................

MD STARnet Men Living with Muscular Dystrophy Survey.
MD STARnet Women Living with Muscular
Dystrophy Survey.

Adult Females 18 and over ............................

Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Scientific Integrity, Office of Science,
Centers for Disease Control and Prevention.
[FR Doc. 2023–04492 Filed 3–3–23; 8:45 am]
BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day-23–1204; Docket No. CDC–2023–
0013]

Proposed Data Collection Submitted
for Public Comment and
Recommendations
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice with comment period.
AGENCY:

The Centers for Disease
Control and Prevention (CDC), as part of
its continuing efforts to reduce public
burden and maximize the utility of
government information, invites the
general public and other federal
agencies to take this opportunity to
comment on a continuing information
collection, as required by the Paperwork
Reduction Act of 1995. This notice
invites comment on a proposed data
collection titled Behavioral Risk Factor
Surveillance System (BRFSS) Asthma
Call-back Survey (ACBS). The ACBS is
an in-depth asthma survey conducted

SUMMARY:

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Number of
respondents

Type of respondents

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on a subset of BRFSS respondents with
an asthma diagnosis with the goal to
strengthen the existing body of asthma
data and to address critical questions
surrounding the health and experiences
of persons with asthma.
DATES: Written comments must be
received on or before May 5, 2023.
ADDRESSES: You may submit comments,
identified by Docket No. CDC–2023–
0013 by any of the following methods:
• Federal eRulemaking Portal:
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Jeffrey M. Zirger, Information
Collection Review Office, Centers for
Disease Control and Prevention, 1600
Clifton Road, NE, MS H21–8, Atlanta,
Georgia 30329.
Instructions: All submissions received
must include the agency name and
Docket Number. CDC will post, without
change, all relevant comments to
www.regulations.gov.
Please note: Submit all comments
through the Federal eRulemaking portal
(www.regulations.gov) or by U.S. mail to
the address listed above.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
proposed project or to obtain a copy of
the information collection plan and
instruments, contact Jeffrey M. Zirger,
Information Collection Review Office,
Centers for Disease Control and
Prevention, 1600 Clifton Road, NE, MS
H21–8, Atlanta, Georgia 30329;
Telephone: 404–639–7118; Email: omb@
cdc.gov.

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Number of
responses per
respondent

Average
burden per
response
(in hours)

538

1

15/60

472

1

20/60

Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. In addition, the PRA also
requires federal agencies to provide a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each new
proposed collection, each proposed
extension of existing collection of
information, and each reinstatement of
previously approved information
collection before submitting the
collection to the OMB for approval. To
comply with this requirement, we are
publishing this notice of a proposed
data collection as described below.
The OMB is particularly interested in
comments that will help:
1. Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
2. Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and
clarity of the information to be
collected;
4. Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,

SUPPLEMENTARY INFORMATION:

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Federal Register / Vol. 88, No. 43 / Monday, March 6, 2023 / Notices

electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submissions
of responses; and
5. Assess information collection costs.

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Proposed Project
Behavioral Risk Factor Surveillance
System (BRFSS) Asthma Call-back
Survey (ACBS) (OMB Control No. 0920–
1204, Exp. 11/30/2023)—Revision—
National Center for Environmental
Health (NCEH), Centers for Disease
Control and Prevention (CDC).
Background and Brief Description
The CDC’s National Center for
Environmental Health (NCEH) is
requesting a three-year Paperwork
Reduction Act (PRA) clearance to revise
and continue to collect information
under the Behavioral Risk Factor
Surveillance System (BRFSS) Asthma
Call-back Survey (ACBS) (OMB Control
No. 0920–1204, Exp. 11/30/2023). The
ACBS is funded by the NCEH National
Asthma Control Program (NACP) in the
Asthma and Community Health Branch
(ACHB).
The ACBS is a follow-up survey on
asthma and is administered on behalf of
NCEH by the CDC’s National Center for
Chronic Disease Prevention and Health
Promotion (NCCDPHP) BRFSS Program.
The BRFSS (OMB Control No. 0920–
1061, Exp. 12/31/2024) is a nationwide
system of customized, cross-sectional
telephone health surveys. The BRFSS
information collection is conducted in a
continuous, three-part telephone
interview process: (1) screening; (2)
participation in a common BRFSS core
survey, and (3) participation in optional
question modules that states use to
customize survey content. BRFSS
coordinators in the health departments
in U.S. states, territories, and the
District of Columbia (collectively
referred to as ‘‘states’’ and
‘‘jurisdictions’’) are responsible for both
the BRFSS and the ACBS
administration. The ACBS is conducted
within two days after the BRFSS survey.
The purpose of ACBS is to gather
state-level asthma data and to make
them available to track the burden of the
disease, to monitor adherence to asthma
guidelines, and to direct and evaluate
interventions undertaken by asthma
control programs located in state health
departments. Beyond asthma prevalence
estimates, for most states, the ACBS
provides the only source of adult and
child asthma data on the state and local
level.

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Data collection for ACBS involves
screening, obtaining permission,
consenting, and telephone interviewing
on a subset of the BRFSS respondents
from participating states. The ACBS
eligible respondents are BRFSS adults,
18 years and older, who report ever
being diagnosed with asthma. In
addition, some states include children,
below 18 years of age, who are
randomly selected subjects in the
BRFSS household. Parents or guardians
serve as ACBS proxy respondents for
their children ever diagnosed with
asthma. If both the BRFSS adult
respondent and the selected child in the
household have asthma, then only one
or the other is eligible for the ACBS.
State BRFSS Coordinators submit deidentified data files to CDC on a
monthly or quarterly basis for cleaning
and weighting. The CDC BRFSS ACBS
operation team returns clean, weighted
data files to the state of origin for its use.
The ACBS adds considerable state-level
depth to the existing body of asthma
data. It addresses critical questions
surrounding the health and experiences
of persons with asthma. Health data
include symptoms, environmental
factors, and medication use among
persons with asthma. Data on their
experiences include activity limitation,
health system use, and self-management
education. These asthma data are
needed to direct and evaluate
interventions undertaken by asthma
control programs located in state health
departments. Federal agencies and other
entities also rely on this critical
information for planning and evaluating
efforts and to reduce the burden from
this disease. The CDC makes annual
ACBS datasets available for public use
and provides guidance on statistically
appropriate uses of the data.
Over the past three years, in response
to the 2020 Terms of Clearance, the
annual joint response rates from BRFSS
and ACBS were reported with ACBS
annual datasets. To communicate the
caveats of state-to-state comparisons, the
ACBS nonresponse bias and impact on
prevalence estimation were analyzed
and reported as appendix tables in the
annual data quality report released with
the public use dataset for adult and
child participants (https://www.cdc.gov/
brfss/acbs/2020/pdf/sdq_report_acbs_
20-508.pdf). The first table reports
unweighted and weighted demographic
distribution percentages for each
participating state based on BRFSSeligible asthma respondents, nonresponding to the ACBS, and ACBS
final completes. The second table

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reports estimated current asthma
percentage among individuals who have
ever been diagnosed with asthma. These
two tables will help communicate the
potential impact of nonresponse bias on
the ACBS published dataset.
Furthermore, we revised the tables of
prevalence estimates for asthma risk
factors based on ACBS, reduced the
number of risk factors prevalence tables
from 20 to 13, and deleted the tables on
active asthma related risk factors, which
did not provide enough information to
make state-to-state comparisons. A
hyperlink to the nonresponse report
have been included in the footnote for
annual ACBS risk factors prevalence
tables. The updated tables are available
at: (https://www.cdc.gov/brfss/acbs/
2020_tables_LLCP.html).
The NACP undertook efforts to
streamline the ACBS, to reduce
unnecessary burden, and to ensure that
the question wording is synchronized
with more recent studies. The
questionnaires were re-evaluated by
ACBS questionnaire working groups
and the ACBS recipients. Question
changes and additions to the 2024 ACBS
questionnaire are as follows. A
proposed total of six questions will be
deleted from the adult’s questionnaire
and 17 questions will be deleted from
the child’s questionnaire. With the
addition of nine new questions to the
adult’s questionnaire and 10 questions
to the child’s questionnaire, the
estimated time burden for the interview
will remain unchanged from that of the
2021 questionnaire (10 minutes per
response).
The total BRFSS sample size was
reduced from 476,217 in 2016 to
393,474 in 2020. As the result of
decreasing BRFSS sample size, the
number of eligible ACBS’s BRFSS
respondents changed from 46,100 to
41,444 from 2016 to 2020. Although no
revisions to the number of responses per
respondent nor to the average time
burden per response are requested, the
NACP proposes the following changes
to the burden estimation from 2021
(based on 2016 ACBS response data) to
2024 (based on 2020 response data). The
total number of respondents is 58,292,
which is a decrease of 10,554 from the
previously approved 68,846. The total
estimated annualized time burden is
6,073 hours, which is a decrease of 542
hours from the previously approved
6,615 hours. Participation in the ACBS
is voluntary and there are no costs to
respondents other than their time.

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ESTIMATED ANNUALIZED BURDEN TO RESPONDENTS

Total burden
hours

Form name

BRFSS Adults ...................................

ACBS Landline Screener—Adult .....
ACBS Cell Phone Screener—Adult
ACBS Landline Screener—Child .....

8,170
20,780
834

1
1
1

1/60
1/60
2/60

136
346
28

ACBS Cell Phone Screener—Child
ACBS Adult Consent and Survey ....
ACBS Child Consent and Survey ....

4,109
20,155
3,764

1
1
1

2/60
10/60
10/60

137
3,359
627

ACBS Data Submission Layout .......

40

12

3

1,440

...........................................................

........................

........................

........................

6,073

BRFSS Parents or Guardians of
Children.
ACBS Adults .....................................
ACBS Parents or Guardians of Children.
State BRFSS Coordinators ...............
Total ...........................................

Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Scientific Integrity, Office of Science,
Centers for Disease Control and Prevention.
[FR Doc. 2023–04491 Filed 3–3–23; 8:45 am]
BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[30Day–23–0950]

Agency Forms Undergoing Paperwork
Reduction Act Review

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Average
burden per
response
(in hrs.)

Number of
responses per
respondent

Number of
respondents

Type of respondents

In accordance with the Paperwork
Reduction Act of 1995, the Centers for
Disease Control and Prevention (CDC) is
submitting the information collection
request titled ‘‘The National Health and
Nutrition Examination Survey
(NHANES)’’ to the Office of
Management and Budget (OMB) for
review and approval. CDC previously
published a ‘‘Proposed Data Collection
Submitted for Public Comment and
Recommendations’’ notice on November
21, 2022 to obtain comments from the
public and affected agencies. CDC
received two comments related to the
previous notice. This notice serves to
allow an additional 30 days for public
and affected agency comments.
CDC will accept all comments for this
proposed information collection project.
The Office of Management and Budget
is particularly interested in comments
that:
(a) Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
(b) Evaluate the accuracy of the
agencies estimate of the burden of the
proposed collection of information,

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including the validity of the
methodology and assumptions used;
(c) Enhance the quality, utility, and
clarity of the information to be
collected;
(d) Minimize the burden of the
collection of information on those who
are to respond, including, through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submission of
responses; and
(e) Assess information collection
costs.
To request additional information on
the proposed project or to obtain a copy
of the information collection plan and
instruments, call (404) 639–7570.
Comments and recommendations for the
proposed information collection should
be sent within 30 days of publication of
this notice to www.reginfo.gov/public/
do/PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function. Direct written
comments and/or suggestions regarding
the items contained in this notice to the
Attention: CDC Desk Officer, Office of
Management and Budget, 725 17th
Street NW, Washington, DC 20503 or by
fax to (202) 395–5806. Provide written
comments within 30 days of notice
publication.
Proposed Project
The National Health and Nutrition
Examination Survey (NHANES), (OMB
Control No. 0920–0950, Exp. 04/30/
2023)—Extension—National Center for
Health Statistics (NCHS), Centers for
Disease Control and Prevention (CDC).
Background and Brief Description
Section 306 of the Public Health
Service (PHS) Act (42 U.S.C. 242k), as
amended, authorizes that the Secretary

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of Health and Human Services (DHHS),
acting through NCHS, shall collect
statistics on the extent and nature of
illness and disability; environmental,
social and other health hazards; and
determinants of health of the population
of the United States.
The National Health and Nutrition
Examination Survey (NHANES) is
designed to study the relationship
between diet, nutrition, and health in a
representative sample of the civilian,
non-institutionalized population of the
United States. Information collection
involves a variety of modes and sources
including physical examinations,
laboratory tests, and interviews.
Findings are used to produce
descriptive statistics that measure the
health and nutrition status of the
general population, generate national
reference data on height, weight, and
nutrient levels in the blood, and
monitor the prevalence of chronic
conditions and risk factors for those
conditions.
The NHANES was conducted
periodically between 1970 and 1994 and
has been conducted continuously since
1999 by the NCHS, CDC, in
collaboration with a variety of agencies
that sponsor specific components of
NHANES. To manage participant
burden and respond to changing public
health research needs, NCHS cycles in
and out various components, however,
the study design generally allows results
from more recent NHANES to be
compared to findings reported from
previous surveys. NCHS collects
personally identifiable information (PII)
to allow for linkages to other data
sources such as the National Death
Index and data from the Centers for
Medicare and Medicaid Services.
Participant-level data items include
basic demographic information, name,
address, Social Security Number,
Medicare number and participant health
information.

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