Information Collection Request

NATIONAL YOUTH PHYSICAL ACTIVITY AND NUTRITION STUDY

ICR 200907-0920-001 · OMB 0920-0832 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 4 Student Contact Information for Dietary Recall Interview Form and Instruction New Available
Form 3 Student Physical Measurements Form New Available
Form 2 NYPANS Student Questionnaire Form and Instruction New Available
Form 1 Survey Support from Teachers Form New Available
SS_PART_B_11.12.09[1].doc Supporting Statement B Uploaded 2009-11-13 Available
Appendix P - Data Collector Confidentiality Agreement.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix O - List of Previously Fielded Questions.doc Supplementary Document Uploaded 2009-06-16 Repair queued
Appendix N - Sample Table Shells.doc Supplementary Document Uploaded 2009-06-16 Repair queued
Appendix M - IRB Approval.doc Supplementary Document Uploaded 2009-06-16 Repair queued
Appendix L - Sampling and Weighting Plan.pdf Supplementary Document Uploaded 2009-06-16 Available
Appendix_K2_-_Parental_Permission_Form_Distribution_Script_-_NYPANS_and_24-Hour_Recall[1].doc Supplementary Document Uploaded 2009-11-13 Available
Appendix K1 - Parental Permission Form Distribution Script - NYPANS Only.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix B2 - 60 Day FRN Comments.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix F1 - Food Amounts Booklet.pdf Supplementary Document Uploaded 2009-06-16 Repair queued
Appendix C8 - Parental Permission Form Reminnder Notice - Spanish.doc Supplementary Document Uploaded 2009-06-16 Repair queued
Appendix C7 - Parental Permission Form Reminder Notice - English.doc Supplementary Document Uploaded 2009-06-16 Repair queued
Appendix C6 - Parental Permission Form and Fact Sheet - NYPANS and 24-Hour Recall - Spanish.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix_C5_-_Parental_Permission_Form_and_Fact_Sheet_-_NYPANS_and_24-Hour_Recall[1].doc Supplementary Document Uploaded 2009-11-13 Available
Appendix C4 - Parental Permission Form and Fact Sheet - NYPANS Only - Spanish.doc Supplementary Document Uploaded 2009-06-16 Repair queued
Appendix C3 - Parental Permission Form and Fact Sheet - NYPANS Only - English.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix_C2_-_Questionnaire_Administration_Guide_-_NYPANS_and_24-Hour_Recall[1].doc Supplementary Document Uploaded 2009-11-13 Available
Appendix C1 - Questionnaire Administration Guide - NYPANS Only.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix J1 - Letter to Teachers in Particpating Classes.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix_I2_-_School_Fact_Sheet[1].doc Supplementary Document Uploaded 2009-11-13 Available
Appendix I1 - School Letter of Invitation.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix I3 - Letter to Agreeing Schools.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix H1 - District Letter of Invitation.doc Supplementary Document Uploaded 2009-06-16 Available
Appendix G1 - State Letter of Invitation.doc Supplementary Document Uploaded 2009-06-16 Available
SS_PART_A_11.12[1].doc Supporting Statement A Uploaded 2009-11-13 Available
IC Document Collections
IC IDCollectionTypeStatusForm
189801 Student 24-Hour Dietary Recall Instruction New
189800 Student Contact Information for Dietary Recall Interview Form and Instruction New
189799 Student Physical Measurements Form New
189798 NYPANS Student Questionnaire Form and Instruction New
189797 Survey Support from Teachers Form New
189796 Recruitment of Schools Instruction New
189795 Recruitment of States Instruction New
189794 Recruitment of States Instruction New
ICR Details
0920-0832 200907-0920-001
Historical Active
HHS/CDC
NATIONAL YOUTH PHYSICAL ACTIVITY AND NUTRITION STUDY
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 11/16/2009
Retrieve Notice of Action (NOA) 07/02/2009
This package is approved consistent with revised documents and based on a commitment by the Program to collaborate with NCI and ERS researchers working in the area of dietary assessment to develop an approach for cross-walking the results of this survey with their surveys, including the results of the NCI/NHANES survey: http://riskfactor.cancer.gov/studies/nhanes/nhanes_dtq_en.pdf.
  Inventory as of this Action Requested Previously Approved
11/30/2010 12 Months From Approved
20,080 0 0
7,781 0 0
0 0 0

CDC proposes to conduct a study in Spring 2010 involving a nationally representative sample of students attending public and private schools in grades 9-12. The study will provide data on behaviors and behavioral determinants related to physical activity and nutrition, as well as information to help improve questions on the Youth Risk Behavior Survey. Study results will be used to develop more effective interventions for obesity.

US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  74 FR 6164 02/05/2009
74 FR 29215 06/19/2009
Yes

  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 20,080 0 0 20,080 0 0
Annual Time Burden (Hours) 7,781 0 0 7,781 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new request to collect nationally representative information involving a student survey as well as physical measurements of height and weight. The information is not available on the study population from other sources. The present request is for a one-time information collection. A follow-up study may be conducted in approximately 4-5 years.

$584,577
Yes Part B of Supporting Statement
Yes
Uncollected
Uncollected
No
Uncollected
Petunia Gissendaner 4046390164

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
07/02/2009