OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

National Health Interview Survey

ICR 201611-0920-011 · OMB 0920-0214 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Reinterview Survey Form and Instruction Modified Repair queued
New Supplements and Core Changes Form and Instruction Modified Repair queued
Sample Child Core Questionnaire Form and Instruction Modified Repair queued
Sample Adult Core Questionnaire Form and Instruction Modified Repair queued
Family Core Questionnaire Form and Instruction Modified Repair queued
Att 6 rev - Detailed Methodological Projects Description.pdf Supplementary Document Uploaded 2016-12-28 Available
Att 10 - Adaptive Design Experiment.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 9 rev - ERB Approval.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 8f - University Thank You Letter.pdf Supplementary Document Uploaded 2016-11-30 Repair queued
Att 8e - University Advance Letter.pdf Supplementary Document Uploaded 2016-11-30 Repair queued
Att 8d - Supplementary Mailings.pdf Supplementary Document Uploaded 2016-11-30 Repair queued
Att 8c rev - Thank you letter.pdf Supplementary Document Uploaded 2016-11-30 Repair queued
Att 8b - NHIS Brochure.pdf Supplementary Document Uploaded 2016-11-30 Repair queued
Att 8a rev2 - Advance Letter.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 7b rev - Public Comments.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 7a - 60 Day FRN.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 4 - Flashcards.pdf Supplementary Document Uploaded 2016-11-30 Repair queued
Att 3c - Core and Supplement Changes Summary Table.pdf Supplementary Document Uploaded 2016-11-30 Repair queued
Att 3b rev - Description of Supplements.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 2f - Additions to Core NHIS.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 2e rev - OMB Statement and HH Comp.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 2d - Need for Core Modules.pdf Supplementary Document Uploaded 2016-11-30 Available
Att 1 - Legislative Mandates.pdf Supplementary Document Uploaded 2016-11-30 Repair queued
2017 NHIS SSB 111416.doc Supporting Statement B Uploaded 2016-11-30 Available
2017 NHIS SSA 111416.docx Supporting Statement A Uploaded 2016-11-30 Available
IC Document Collections
IC IDCollectionTypeStatusForm
214142 Methodological Projects - Adult Family Member Other-Overview Description of Methodological and Testing Activit Modified
214116 Reinterview Survey Form and Instruction Modified
214115 New Supplements and Core Changes Form and Instruction Modified
214114 Sample Child Core Questionnaire Form and Instruction Modified
214113 Sample Adult Core Questionnaire Form and Instruction Modified
214112 Family Core Questionnaire Form and Instruction Modified
ICR Details
0920-0214 201611-0920-011
Historical Active 201606-0920-006
HHS/CDC 16AQB
National Health Interview Survey
Revision of a currently approved collection   No
Regular
Approved without change 12/29/2016
Retrieve Notice of Action (NOA) 12/01/2016
CDC/NCHS may use the non-substantive change mechanism to modify existing questions, including those designed to add depth/additional detail and cycle in and out methodological modules that have been used in the past years (with modest updates). If new supplemental modules, new questionnaire instruments, or modifications to the sample are anticipated, a full revision of the ICR package must be submitted to OMB.
  Inventory as of this Action Requested Previously Approved
12/31/2019 36 Months From Approved 01/31/2019
160,000 0 160,000
49,000 0 49,000
0 0 0
This revision request is to conduct the National Health Interview Survey for 2017-2019; to modify selected sections of the 2017-2019 surveys; and to conduct special projects to inform the 2018 questionnaire redesign.
US Code: 42 USC 242 Name of Law: Public Health Service Act
   PL: Pub.L. 107 - 347 511 Name of Law: Confidential Information Protection and Statistical Efficiency Act
  
None
Not associated with rulemaking
  81 FR 48802 07/26/2016
81 FR 85963 11/29/2016
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 160,000 160,000 0 0 0 0
Annual Time Burden (Hours) 49,000 49,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$42,000,000
Yes Part B of Supporting Statement
No
Yes
No
No
Uncollected
Renita Macaluso 770 488-6458 [email protected]
  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.
12/01/2016