NHANES I EPIDEMIOLOGIC FOLLOWUP SURVEY

ICR 198112-0925-001

OMB: 0925-0161

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
111395
Migrated
ICR Details
0925-0161 198112-0925-001
Historical Active
HHS/NIH
NHANES I EPIDEMIOLOGIC FOLLOWUP SURVEY
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/05/1982
Retrieve Notice of Action (NOA) 12/09/1981
CLEARANCE IS APPROVED UNDER THE FOLLOWING CONDITIONS 1) ANY CHANGES MADE TO THE QUESTIONNAIRE PRIOR TO FULL FIELD WORK SHALL BE FORWARDED TO OMB. 2) CHANGES - A) CARD P - ADD THE CATEGORY, "BLACK" B) SELF ADMINISTRATION SUBJECT INTERVIEW BOOKLET, PAGE 3, CHANGE INSTRUCTIONS TO BE CONSISTENT WITH THE DIAGRAM.
  Inventory as of this Action Requested Previously Approved
12/31/1983 12/31/1983
14,365 0 0
15,105 0 0
0 0 0

THE NHANES I EPIDEMIOLOGIC FOLLOWUP SURVEY WILL REINTERVIEW ADULT EXAMINEES FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY CONDUCTED 1971-75. RESPONDENTS WILL BE ASKED ABOU THEIR HEALTH STATUS HEALTH HABITS, AND HELTH CONDITIONS THAT HAVE DEVELOPED SINCE THE EARLIER SURVEY. BLOOD PRESSURE AND WEIGHT WILL BE MEASURED IN THE HOUSEHOLD. ILLNESS OUTCOMES WILL BE VERIFIED USING HOSPITAL RECORDS AND DEATH CERTIFICATES.

None
None


No

1
IC Title Form No. Form Name
NHANES I EPIDEMIOLOGIC FOLLOWUP SURVEY

  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 14,365 0 0 14,365 0 0
Annual Time Burden (Hours) 15,105 0 0 15,105 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
12/09/1981


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