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Information Collection

[HCHS] Cognitive Evaluation of Questions on Overdose and Substance Use Disorder and RANDS 12

IC 277332 under ICR 202504-0920-019 · OMB 0920-0222.

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Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
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Information Collection (IC) Details

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[HCHS] Cognitive Evaluation of Questions on Overdose and Substance Use Disorder and RANDS 12 0920-25-0169
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Screening Script Attachment 4 - Screening Script.docx Yes Yes Fillable Fileable
Form and Instruction n/a Data Collection Sheet Attachment 9 - Data Collection Sheet.docx Yes Yes Fillable Fileable
Form and Instruction n/a Questions to be Cognitively Tested Attachment 1a - Questions to be cognitively tested.docx Yes Yes Fillable Fileable
Form and Instruction n/a RANDS 12 Questionnaire Attachment 1b - RANDS 12 Instrument - V2.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

11,775 0
   
Individuals or Households
 
   90 %

  Approved 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 11,775 0 11,775 0 0 0
Annual IC Time Burden (Hours) 3,923 0 3,923 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Advertisement 1 Attachment 3a - Advertisement OSUD.docx 08/29/2025
Advertisement 2 Attachment 3b - Advertisement OSUD.docx 08/29/2025
Informed Consent Attachment 5 - Informed Consent.docx 08/29/2025
NCHS Non-Disclosure Affidavit Attachment 6 - NCHS Non-Disclosure Affidavit.docx 08/29/2025
Data Storage and Access Policy Attachment 7 - Data Storage and Access Policy_final.docx 08/29/2025
Thank You Letter Attachment 8 - Thank You Letter.docx 08/29/2025
Research Determination Attachment 10 IRB Determination.pdf 08/29/2025
SSA Supporting Statement A - NHANES OSUD & RANDS 12_8.4.2025.docx 08/29/2025
Previous Use and development Attachment 2 - Previous use and development_V4.docx 12/08/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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