View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View Generic ICR - OIRA Conclusion
OMB Control No:
0920-0222
ICR Reference No:
202504-0920-019
Status:
Active
Previous ICR Reference No:
202212-0920-003
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-25-0099
Title:
[NCHS] Collaborating Center for Questionnaire Design and Evaluation Research
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
07/03/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/01/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2026
01/31/2026
01/31/2026
Responses
215,775
0
215,775
Time Burden (Hours)
65,715
0
65,715
Cost Burden (Dollars)
1,840,677
0
1,840,677
Abstract:
This generic clearance request encompasses general questionnaire development, pre-testing, measurement-error reduction activities to be carried out in 2021-2024 in the Division of Research and Methodology, National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC). The change request is for RANDS 11 to adhere to recent executive orders.
Authorizing Statute(s):
US Code:
42 USC 242k
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
87 FR 59425
09/30/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 76049
12/12/2022
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
14
IC Title
Form No.
Form Name
CCQDER - Questions on Subjective Cognitive Decline
0920-0222, 0920-0222, 0920-0222
Cognitive Decline - Screening Script
,
Questions to be Cognitively Tested
,
Respondent Data Collection Sheet
GenIC for CCQDER's RANDS 9
1
qustionnaire
[NCHS] 2024 NHIS Diabetes
0920-0222 (25BG), 0920-0222 (25BG), 0920-0222 (25BG), 0920-0222 (25BG)
Focus Grouip Protocol
,
Focus Group Telephone Screening Script
,
Respondent Data Collection Sheet
,
Cognitive Interviewing Telephone Screening Script
[NCHS] BMI Focus Groups
0920-24IT, 0920-24IT
Respondent Data Collection
,
Respondent Informed Consent
[NCHS] CCQDER - NISVS
0920-0222, 0920-0222, 0920-0222
NISVS Screener
,
NISVS Questionnaire
,
{NISVS] Respondent Data Collection Sheet (No Form)
[NCHS] CCQDER's Caregiver
n/a, n/a, n/a
Caregiving Questions
,
Caregiving Screening Script
,
Respondent Data Collection Sheet
[NCHS] COLLABORATING CENTER FOR QUESTIONNAIRE DESIGN AND EVALUATION RESEARCH
0920-0222-23EQ, 0920- 0222-23EQ, 0920-0222-23EQ
Attachment 5a-5b Respondent Data Collection Sheet 4.28.23
,
Questions
,
Screening Script
[NCHS] Collaborating Center For Questionnaire Design and Evaluation Research
0920-0222-23EC
RANDS 8 Questionnaire
[NCHS] Collaborating Center for Questionnaire Design and Evaluation Research - RANDS 11
n/a
RANDS 11 Questionnaire-12.10.2024
[NCHS] Evaluation of Revised Questions on Cannabis Use and Experiences
n/a, n/a, n/a
Cannabis Questions to be Cognitively Tested
,
Cannabis Screening Script
,
Cannabis Data Collection Sheet
[NCHS] Point of Care Checklist Subproject 1: Conducting In-depth Interviews Among Those with Intellectual and Developmental Disabilities
n/a, n/a, n/a
Telephone Screening Script
,
Interviewer's Guide
,
Data Collection Sheets
[NCHS] RANDS 10 and Accompanying Cognitive Interviews (24CL)
0920-0222, 0920-022 (24CL), 0920-0222 (24CL)
CCQDER RANDS 10 Questionnaire
,
Telephone Screening Script
,
Respondent Data Collection Sheet
[NCHS] genIC Attention Deficient Hyperactivity Disorder Questions
0920-0222, 0920-0222, 0920-0222
Attachment 6 Respondent Data Collection Sheet
,
ADHD Attachment 1 Questions to be tested
,
Attachment 5 Informed Consent ADHD
[NCHS]CCQDER's NHANES Feeding Practices
0920-24BI, 0920-24BI, 0920-24BI, 0920-24BI, 0920-24BI, 0920-24BI
Attachment 1a-NHANES Question Set 1 11.16.23 CLEAN
,
Attachment 1b-NHANES Question Set 2 11.22.23 CLEAN
,
Attachment 4a - Screening script NHANES 11.16.23 CLEAN
,
Attachment 4b- Screening script NHANES 11.16.23 CLEAN
,
Attachment 5a & 5b - Informed Consent NHANES 11.16.23
,
Attachment 3a- NHANES English Advertisement
ICR Summary of Burden
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
215,775
215,775
0
0
0
0
Annual Time Burden (Hours)
65,715
65,715
0
0
0
0
Annual Cost Burden (Dollars)
1,840,677
1,840,677
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Revision for 0920-0222 requests an increase in burden hours for the next 3-year approval period due to an anticipated increase in the number of RANDS Methodological projects during the approval period.
Annual Cost to Federal Government:
$3,223,325
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Kevin Joyce 404 639-1944 kdj7@cdc.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
05/01/2025
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