[Federal Register Volume 89, Number 190 (Tuesday, October 1, 2024)]
[Notices]
[Pages 79927-79929]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-22473]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-24-0950]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled ``National Health and Nutrition Examination 
Survey (NHANES)'' to the Office of Management and Budget (OMB) for 
review and approval. CDC previously published a ``Proposed Data 
Collection Submitted for Public Comment and Recommendations'' notice on 
May 13, 2024 to obtain comments from the public and affected agencies. 
CDC did not receive comments related to the previous notice. This 
notice serves to allow an additional 30 days for public and affected 
agency comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) Minimize the burden of the collection of information on those 
who are to respond, including, through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7570. Comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. Direct 
written comments and/or suggestions regarding the items contained in 
this notice to the Attention: CDC Desk Officer, Office of Management 
and Budget, 725 17th Street NW, Washington, DC 20503 or by fax to (202) 
395-5806. Provide written comments within 30 days of notice 
publication.

Proposed Project

    National Health and Nutrition Examination Survey (NHANES) (OMB 
Control No. 0920-0950, Exp. 04/30/

[[Page 79928]]

2025)--Revision -- National Center for Health Statistics (NCHS), 
Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    Section 306 of the Public Health Service (PHS) Act (42 U.S.C. 242k) 
authorizes that the Secretary of Health and Human Services (DHHS), 
acting through NCHS, collect statistics on subjects in the United 
States, such as the extent and nature of illness and disability of the 
population; environment, social, and other health hazards; determinants 
of health; health resources; and utilization of healthcare. The 
National Health and Nutrition Examination Survey (NHANES) has been 
conducted periodically between 1970 and 1994, and continuously since 
1999 by the National Center for Health Statistics, CDC.
    NHANES produces descriptive statistics, which measure the health 
and nutritional status of the general population. With personal 
interviews, physical examinations, and laboratory assessments, NHANES 
studies the relationship between diet, nutrition, and health in a 
representative sample of the United States. NHANES monitors the 
prevalence of chronic conditions and risk factors and is used to 
produce national reference data on height, weight, and nutrient levels 
in the blood. Results from more recent NHANES can be compared to 
findings reported from previous surveys to monitor changes in the 
health of the U.S. population over time. In 2025-2026, the program is 
not considering any substantive changes to NHANES content or 
procedures. As in previous years, the base sample will remain at 
approximately 5,000 individuals interviewed and examined, annually. 
Children 0-17 years of age, persons 65 years of age or older, and non-
Hispanic Black persons will be oversampled in the 2025-2026 survey. 
NCHS collects personally identifiable information (PII). Participant 
level data items will include basic demographic information, name, 
address, social security number, Medicare number and participant health 
information to allow for linkages to other data sources such as the 
National Death Index and data from the Centers for Medicare and 
Medicaid Services.
    A variety of agencies sponsor data collection components on NHANES. 
In the 2025-2026 clearance proposal, the Program modified, added, or 
removed various components that were included in the August 2021-August 
2023 NHANES to update and modernize processes for data collection. 
NHANES staff conducted a thorough review of the survey participant and 
household questionnaire content and made changes to focus on retaining 
questions that are to be used in combination with specific exam or lab 
data collected in the survey, as independent prevalence estimates, or 
as covariates in statistical analyses (e.g., sociodemographic 
characteristics). Further review of all data collection instruments was 
done to update wording, update age restrictions for the respondent 
universe, align wording across instruments, eliminate duplicate 
questions, improve interview flow, and reduce respondent burden.
    With the construction of a new fleet of five mobile examination 
centers (MECs) with updated designs, the 2025-2026 exam components will 
include post consent-questions, anthropometry, oscillometer 
measurements, venipuncture, urine collection, MEC CAPI and ACASI 
questions, body composition, respiratory health, audiometry, visual 
acuity and ophthalmology, oral health, HPV oral rinse and DNA genital 
swab collection, and water fluoride testing. Liver elastography, urine 
testing for several sexually transmitted infections, serology testing 
for HPV and CMV antibodies, and MEC follow-up questionnaires were 
dropped.
    First Dietary Recall interviews, the Flexible Consumer Behavior 
Survey, and the Second Dietary Recall interviews will be conducted via 
telephone either before or after the MEC visit, which is a new approach 
for the 2025-2026 survey. If the participant does not schedule their 
dietary interviews at the end of their household interview, the MEC 
staff will attempt to schedule these appointments at the end of the 
examination. This option provides more flexibility to complete the 
interviews, which may improve completion rates. Program staff will 
monitor response rates closely to assess whether scheduling dietary 
interviews after the household interviews has an impact on response 
rates for dietary interviews and/or MEC exams.
    Although a few laboratory tests are new or have been removed in 
2025-2026, most remain but have been modified. Predominantly, 
modifications are the result of adjustments in age eligibility. Several 
laboratory tests that have not been modified include CBC, hemoglobin 
variants, HIV, cadmium, and lead. RBC folate forms, LDC cholesterol, 
and chlamydia are examples of tests that have been removed for 2025-
2026. New laboratory tests include B vitamins, choline and metabolites, 
and aldosterone. The biospecimens collected for laboratory tests 
include urine and blood. Serum, plasma, DNA, and urine specimens will 
be stored for future testing if the participant provides consent.
    NHANES may conduct developmental projects during NHANES 2025-2026, 
with a focus on planning for NHANES 2027 and beyond. These may include 
activities such as tests of new equipment, crossover studies between 
current and proposed methods, tests of different study modes, settings 
or technology, outreach materials, incentive strategies, sample storage 
and processing or sample designs.
    Burden for individuals in 2025-2026 NHANES will vary based on their 
level of participation. For example, infants and children tend to have 
shorter interviews and exams than adults. This is because young people 
may have fewer health conditions or medications to report so their 
interviews take less time or because certain exams are only conducted 
on survey participants 18 and older, etc. In addition, adults often 
serve as proxy respondents for young people in their families.
    Participation in NHANES is voluntary and confidential. The Program 
is requesting a three-year approval, with 36,540 annualized hours of 
burden in this clearance proposal.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
        Type of respondents                   Form name              Number of     responses per   per response
                                                                    respondents     respondent      (in hours)
----------------------------------------------------------------------------------------------------------------
Individuals in households..........  Household Screener                    6,398               1            7/60
                                      Questionnaire.
Individuals in households..........  Survey Participant                    5,882               1               1
                                      Questionnaire; & Household
                                      Questionnaire.
Individuals in households..........  MEC Examination & Interview           5,000               1               2
                                      Data Collection Forms.

[[Page 79929]]

 
Individuals in households..........  Day1 Dietary Instrument;              5,882               1               1
                                      MEC Dietary Recruitment
                                      Scheduling Instrument;
                                      Dietary Front-End
                                      Instrument; Dietary
                                      Incentives and Scheduling
                                      Instrument; MEC Dietary
                                      Reminder Call-in
                                      Instrument; & Flexible
                                      Consumer Behavior Survey
                                      (FCBS) Instrument.
Individuals in households..........  Day2 Dietary Instrument....           5,882               1           36/60
Individuals in households..........  Developmental Projects &              3,500               1               3
                                      Special Studies.
----------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Public Health 
Ethics and Regulations, Office of Science, Centers for Disease Control 
and Prevention.
[FR Doc. 2024-22473 Filed 9-30-24; 8:45 am]
BILLING CODE 4163-18-P