[NCHS] RANDS 10 and Accompanying Cognitive Interviews (24CL)

[NCHS] Collaborating Center for Questionnaire Design and Evaluation Research

OMB: 0920-0222

IC ID: 264723

Documents and Forms
Document Name
Document Type
Form
Other-Proposed Questions
Form
Form
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

[NCHS] RANDS 10 and Accompanying Cognitive Interviews (24CL) 0920-0222-24CL
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0222 CCQDER RANDS 10 Questionnaire Attachment 1a Questions for Cognitive Interviews Whole Person Health.docx Yes Yes Fillable Fileable
Other-Proposed Questions Attachment 1b. Proposed RANDS 10 Questionnaire.docx No   Paper Only
Form 0920-022 (24CL) Telephone Screening Script Attachment 4 Screening Script Whole Person Health 1.9.24.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0222 (24CL) Respondent Data Collection Sheet Attachment 9 Data Collection Sheet.docx No   Fillable Fileable

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the US Population 09-20-0164  49 FR 37693

6,720 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,720 0 0 0 0 6,720
Annual IC Time Burden (Hours) 2,290 0 0 0 0 2,290
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA (24CL) Supporting Statement A - Whole Person Health RANDS 10-1.29.24.docx 01/30/2024
Previous use and Development Attachment 2 Previous Use and Development.docx 01/26/2024
Participants Wanted for Research Study (Advertisement/Flyer) Attachment 3 Advertisement Template Whole Person Health.docx 01/26/2024
Adult Informed Consent for Interviews (face-to-face) Attachment 5 Informed Consent Whole Person Health 1.9.24.docx 01/26/2024
NCHS Non-Disclosure Affidavit for NORC Organization Staff working on RANDS Attachment 6 NCHS Non-Disclosure Affidavit for NORC.docx 01/26/2024
CCQDER Data Storage and Access Policy Attachment 7 Data Retention Policy.docx 01/26/2024
Thank You Letter Attachment 8 Thank You Letter.docx 01/26/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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