[Federal Register Volume 84, Number 223 (Tuesday, November 19, 2019)]
[Notices]
[Pages 63839-63842]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-24962]


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DEPARTMENT OF COMMERCE

Census Bureau


Proposed Information Collection; Comment Request; National Survey 
of Children's Health

AGENCY: U.S. Census Bureau, Commerce.

ACTION: Notice.

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SUMMARY: The Department of Commerce, as part of its continuing effort 
to reduce paperwork and respondent burden, invites the general public 
and other Federal agencies to take this opportunity to comment on a 
proposed revision of the National Survey of Children's Health, as 
required by the Paperwork Reduction Act of 1995.

DATES: To ensure consideration, written comments must be submitted on 
or before January 21, 2020.

ADDRESSES: Direct all written comments to Carolyn Pickering, Survey 
Director, U.S. Census Bureau, 4600 Silver Hill Road, HQ-7H153, 
Washington, DC 20233 (or via the internet at [email protected]). You 
may also submit comments, identified by Docket Number USBC-2019-0016 to 
the Federal e-Rulemaking Portal: http://www.regulations.gov. All 
comments received are part of the public record. No comments will be 
posted to http://www.regulations.gov for public viewing until after the 
comment period has closed. Comments will generally be posted without 
change. All Personally Identifiable Information (for example, name and 
address) voluntarily submitted by the commenter may be publicly 
accessible. Do not submit Confidential Business Information or 
otherwise sensitive or protected information. You may submit 
attachments to electronic comments in Microsoft Word, Excel, or Adobe 
PDF file formats.

FOR FURTHER INFORMATION CONTACT: Requests for additional information or 
copies of the information collection instrument(s) and instructions 
should be directed to Carolyn Pickering, U.S. Census Bureau, ADDP, HQ-
7H153, 4600 Silver Hill Road, Washington, DC 20233-0001 (301-763-3873 
or via email at [email protected]).

SUPPLEMENTARY INFORMATION: 

I. Abstract

    Sponsored primarily by the U.S. Department of Health and Human 
Services' Health Resources Services Administration's Maternal and Child 
Health Bureau (HRSA MCHB), the National Survey of Children's Health

[[Page 63840]]

(NSCH) is designed to produce data on the physical and emotional health 
of children under 18 years of age who live in the United States. The 
United States Department of Agriculture and the United States 
Department of Health and Human Services' Center for Disease Control and 
Prevention, National Center on Birth Defects and Developmental 
Disabilities sponsor supplemental content on the NSCH. Additionally, 
the upcoming cycle of the NSCH would like to feature four individual 
state oversamples that include the selection of a pre-determined number 
of sample cases above the current production base sample in those 
states. The state oversamples would be sponsored by the State of 
Colorado, the State of Nebraska, the Oregon Center for Children and 
Youth with Special Health Care Needs, and the State of Wisconsin.
    The NSCH collects information on factors related to the well-being 
of children, including access to health care, in-home medical care, 
family interactions, parental health, school and after-school 
experiences, and neighborhood characteristics. The goal of the 2020 
NSCH is to provide HRSA MCHB, the supplemental sponsoring agencies, 
states, and other data users with the necessary data to support the 
production of national estimates yearly and state-based estimates with 
pooled samples on the health and well-being of children, their 
families, and their communities as well as estimates of the prevalence 
and impact of children with special health care needs.

Proposed Changes

    Below is a list of updates we are requesting for the 2020 NSCH. 
These updates will be described in further detail within the full 
Office of Management and Budget (OMB) Information Collection Request 
(ICR) package.
     Increased sample size--With additional sponsor funding and 
realized cost savings from streamlining the survey operations process, 
we are requesting an increase in sample size. The base NSCH sample plus 
the proposed state oversamples may reach up to 240,000 addresses for 
the 2020 NSCH. The additional burden on any one address is not 
increasing as the total estimated time to complete the survey remains 
less than 5 minutes for households without children and, on average, 33 
minutes for households with children. However, because the total number 
of sampled addresses is increasing by approximately 45,000, the total 
overall burden to the public is also increasing by approximately 9,271 
hours. The increased sample will allow individual states to produce 
statistically sound child health estimates in a fewer number of years 
than if the sample were to remain the same annually, thereby resulting 
in more timely state-level health estimates of children.
     Unconditional incentive distribution percentage--We plan 
to continue monitoring the effectiveness of the unconditional monetary 
incentive, but request an increase to the percent of addresses 
receiving a $5 incentive in the initial screener mailing. When 
utilized, an unconditional incentive has proven effective each cycle of 
the NSCH. Response rates for the unconditional monetary incentive 
groups showed a statistically significant difference over the control 
group that did not receive an unconditional monetary incentive. A 
larger increase in response was noted for the households mailed a $5 
compared with the $2 incentive, however both treatment groups have 
proven effective at reducing nonresponse bias by encouraging response. 
For both the 2018 NSCH and 2019 NSCH, the initial screener incentive 
splits were 45% received $2; 45% received $5; and 10% did not receive 
an incentive. The proposal for 2020 NSCH is that 30% receive $2; 60% 
receive $5; and 10% would not receive an incentive with the initial 
mailing. The incentive assignment to each sampled address would still 
be random as was done in prior cycles and approved by OMB. Results from 
the 2018 NSCH indicate that the increased incentive amount proved 
effective at obtaining a higher response in general and particularly so 
from underrepresented population groups.\1\ Therefore, the goal of an 
increased $5 incentive treatment group is aimed at reducing nonresponse 
bias further.
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    \1\ U.S. Census Bureau. (2019). 2018 NSCH methodology report. 
Retrieved from https://www2.census.gov/programs-surveys/nsch/technical-documentation/methodology/2018-NSCH-Methodology-Report.pdf.
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     Redesigned survey contact materials test--Instead of 
testing a redesigned envelope alone in the initial mailing (as was done 
in 2019), the 2020 NSCH plans to assign a 30% experimental treatment 
group to receive a redesigned suite of screener (and topical if 
applicable) survey invitation and follow-up mail packages throughout 
the entire data collection period. Two rounds of cognitive testing were 
approved previously by OMB \2\ and will be used to inform development 
of the redesigned contact materials and envelopes. The goal of the 
redesign is to provide the sampled addresses with a cohesive set of 
items within each survey invitation package. The proposed materials 
include key facts pertaining to survey data usage, relatable images for 
the target population, and colors that match the associated paper 
questionnaires. We plan to evaluate the experimental treatment group 
after data closeout to determine the effectiveness of the redesigned 
package strategy and inform future decision-making.
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    \2\ Generic Clearance Information Collection Request: https://www.reginfo.gov/public/do/PRAViewIC?ref_nbr=201606-0607-003&icID=236843.
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     Revised questionnaire content--The NSCH questionnaires 
with newly proposed and revised content from the sponsors at HRSA MCHB 
are currently undergoing two rounds of cognitive testing. This testing 
request was submitted under the generic clearance package and approved 
by OMB \3\. Based on the results, a final set of proposed modified 
content will be included in the full OMB ICR for the 2020 NSCH.
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    \3\ Generic Clearance Information Collection Request: https://www.reginfo.gov/public/do/PRAViewIC?ref_nbr=201606-0607-003&icID=237067.
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     State oversample \4\--In order to inform state-level 
decision making around various priorities, some stakeholders have shown 
interest in sponsoring an oversample of addresses within their state as 
part of the annual NSCH administration. Currently, four states 
(Colorado, Nebraska, Oregon, and Wisconsin) are moving forward with 
this option for the first time as part of the 2020 NSCH. Oversamples 
will provide states with more robust data for analysis and planning at 
the state level. The oversamples can be classified as either a general 
state-wide oversample or sub-state oversample. The state-wide 
oversample increases the total number of sampled addresses within a 
given state and will be distributed to the geographic areas similarly 
to the production base sample. State-level estimates of rare 
populations or outcomes could be evaluated from this larger sample, but 
sub-state (e.g., county-level) estimates could not. The sub-state 
oversample is aimed at producing smaller than state-level (e.g., county 
or county-level grouping) estimates in combination with the NSCH base 
sample to reach a specific sample size in each targeted group. The 
requirements to meet each sub-state oversample are primarily determined 
by county for the 2020 NSCH.
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    \4\ State Oversampling in the National Survey of Children's 
Health: Feasibility, Cost, and Alternative Approaches https://census.gov/content/dam/Census/programs-surveys/nsch/NSCH_State_Oversample_Summary_Document.pdf.

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[[Page 63841]]

Current Design

    Besides the proposed changes listed above, the 2020 NSCH will 
proceed with the current design outlined in the previous OMB ICR 
package. We will continue to make modifications to data collection 
strategies based on modeled information about paper or internet 
response preference. Results from prior survey cycles will continue to 
be used to inform the decisions made regarding future cycles of the 
NSCH.
    Based on the results from prior survey cycles and available funds, 
an unconditional cash incentive will be included with the initial 
mailing. Survey research indicates that incentives are a necessary and 
cost[hyphen]effective expense for achieving a response rate that 
minimizes nonresponse bias.\5\ Our testing to date is consistent with 
this research. Evaluation of previous NSCH cycles showed a 
statistically significant difference in response rates when respondents 
received an incentive compared to those who were part of the control 
group that did not receive an incentive. The effect of the incentive 
was proportionately larger for household types that were less likely to 
respond in previous years, reducing nonresponse bias. There was a 
larger increase in response for households mailed a $5 incentive 
compared to those mailed a $2 incentive with their initial survey 
invite; both treatments proved effective at encouraging response and 
reducing nonresponse bias in 2019. As noted in the proposed changes 
section, we would like to increase the total number of $5 cash 
incentives sent with the initial mailing to 60% and reduce the total 
number of $2 cash incentives sent with the initial mailing to 30% and 
maintain the control group (receiving no incentive) at 10%. For 
respondents who answer a paper screener interview and are mailed their 
first paper topical questionnaire, a $5 incentive will be used to 
reduce bias and gain cooperation for this critical second stage of 
paper questionnaire data collection.
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    \5\ Brick JM, Williams D, Montaquila JM. 2011. 
``Address[hyphen]Based Sampling for Subpopulation Surveys''. Public 
Opinion Quarterly, 75(3): 409-28; Foster EB, Frasier AM, Morrison 
HM, O'Connor KS, Blumberg SJ. 2010. ``All Things Incentive: 
Exploring the Best Combination of Incentive Conditions''. Paper 
presented at the American Association for Public Opinion Research 
annual conference, Chicago, IL.
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    In addition to the testing of incentives, the 2020 NSCH will 
continue to serve as a platform to evaluate different nonresponse 
follow-up mailing strategies based on a household's likelihood to 
respond using a paper questionnaire. To determine this, we assign a 
paper-preference probability to every address using American Community 
Survey (ACS) response mode choices, previous NSCH response mode 
choices, and small area geographic characteristics. The 30% of 
addresses with the highest paper-preference probability are assigned to 
the ``High Paper'' group and receive a paper questionnaire in each 
mailing, starting with the initial invitation. The other 70% of 
addresses are assigned to the ``High Web'' group and receive their 
first paper questionnaires in the second nonresponse follow-up screener 
invitation.
    Since there continues to be a significant potential for cost 
savings in web data collection over paper data collection, we are 
working to refine and retest an internet response indicator for future 
NSCH production cycles based on the results from prior data collection 
efforts.
    A proven effective contact strategy that will continue to be used 
in the 2020 NSCH is the pressure-sealed reminder postcard. The reminder 
postcard will be mailed approximately one week after the initial 
screener (and topical if applicable) survey invite mailing and the 
first nonresponse follow-up. We originally implemented this strategy 
because the time gap between mailings during the 2016 NSCH proved too 
long, and a significant dip in response flow was observed between 
mailings. Over the past few cycles, these pressure-sealed reminder 
postcards have helped boost response immediately following their 
delivery and reduce the time between other nonresponse follow-up 
mailings. The ability to send reminders enclosed with a pressure-seal 
system allows us to include login information for the Centurion web 
instrument as well as specific information about the survey. This 
mailing also includes a paragraph in Spanish that will direct the 
respondent to the Spanish web survey or the Telephone Questionnaire 
Assistance (TQA) line for assistance.
    As in prior administration of the NSCH, the 2020 NSCH will have a 
TQA line available to respondents who experience technical problems 
with the web instrument, have questions about the survey, or need other 
forms of assistance. TQA staff will be able to answer respondent 
questions and concerns, while having the ability to collect survey 
responses over the phone--if the respondent calls in and would like to 
have interviewer assistance in completing the survey. Also, respondents 
can submit questions by email. Email Questionnaire Assistance agents 
will monitor the email account inbox and respond promptly.
    In both internet and paper collection modes, the survey design for 
the 2020 NSCH focuses on first collecting information about the 
children in the household and basic special health care needs, and then 
selecting a child from the household for follow-up to collect 
additional detailed topical information. If there is more than one 
eligible child in a household, a single child will be selected based on 
a sampling algorithm that considers the age and number of children as 
well as the presence of children with special health care needs. We 
estimate that, from the original 240,000 selected production sample 
addresses, our target screener return rate of 39.3% will yield 
approximately 94,370 responses to the screener. We then estimate that 
54.2% of households from the first phase of the screener will be 
eligible to receive a topical questionnaire (households with children), 
and 77.4% of these households with children will return the topical 
questionnaire, resulting in approximately 39,596 completed topical 
interviews. A household could be selected for one of three age-based 
topical surveys: 0-to-5-year-old children, 6-to-11-year-old children, 
or 12-to-17-year-old children.
    Census Bureau staff have developed a plan to select a production 
sample of approximately 240,000 households (addresses) from a Master 
Address File-based sampling frame, with split panels to test mode of 
administration (i.e., high-web and low-web), and improvements to 
contact materials and strategies. Based on results of the prior NSCH 
incentive experiments, we plan to use small, unconditional cash 
incentives with a control group receiving no incentive to monitor the 
effectiveness of the incentive expenditures. For respondents who answer 
the paper screener and are mailed a paper topical questionnaire, an 
additional $5 incentive is expected for that mailing. From prior cycles 
of the NSCH, using American Association for Public Opinion Research 
definitions of response, we can expect for the 2020 NSCH an overall 
screener completion rate to be about 48.6% and an overall topical 
completion rate to be about 36.9%.\6\ This is different from the total

[[Page 63842]]

overall response rate, which we expect to be about 42.2%.\7\
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    \6\ Screener Completion Rate is the proportion of screener-
eligible households (i.e., occupied residences) that completed a 
screener. It is equal to (S+X)/(S+X+R+e(UR+UO)), where S is the 
count of completed screeners with children, X is completed screeners 
without children, R is screener refusals, and e(UR+UO) is the 
estimated count of screener eligible households among nonresponding 
addresses.
    The Topical Completion Rate is the proportion of topical-
eligible households (i.e., occupied residences with children 
present) that completed a topical questionnaire. It is equal to I/
HCt, where I is the count of completed topicals and HCt is the 
estimated count of households with children in the sample or 
S+R+(S+R)/(S+X+R) * e(UR+UO).
    \7\ Total Response Rate is the proportion of screener-eligible 
households that completed a screener or topical questionnaire. It is 
equal to (X+I+P)/(X+I+P+RS+eUS), where I is the count of completed 
topicals, P is the count of sufficient partial completed topicals, 
RS is screener refusals, and eUS is the estimated count of screener 
eligible households among nonresponding addresses.
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II. Method of Collection

Web Push

    The 2020 NSCH plan for the web push data collection design includes 
70% of the estimated 240,000 production addresses receiving an initial 
invite with instructions on how to complete an English or Spanish-
language screener questionnaire via the web. Households that decide to 
complete the web-based survey will be taken through the screener 
questionnaire to determine if they are eligible for one of three 
topical instruments. Households that list at least one child who is 0 
to 17 years old in the screener are directed into a topical 
questionnaire immediately after the last screener question. If a 
household in the web push treatment group decides to complete the paper 
screener, the household may have a chance to receive an additional 
topical questionnaire incentive.

Mixed-Mode

    The 2020 NSCH plan for the mixed-mode data collection design 
includes approximately 30% of the 240,000 production addresses 
receiving both an initial invite with a paper screener questionnaire 
and instructions on how to complete an English or Spanish language 
screener questionnaire via the web. Households that decide to complete 
the web-based survey will follow the same screener and topical 
selection path as the web push. Households that choose to complete the 
paper screener questionnaire rather than completing the survey on the 
internet and that have eligible children will be mailed a paper topical 
questionnaire upon receipt of their completed paper screener at the 
Census Bureau's National Processing Center. If a household in the 
mixed-mode group chooses to complete the paper screener instead of 
completing the web-based screener via the internet, then the household 
may receive an additional topical questionnaire incentive.

Non-Response Follow-Up for the ``High Web'' Group and ``High Paper'' 
Group

    The ``High Web'' group will receive two web survey invitation 
letters requesting its participation in the survey prior to receiving 
its first paper screener questionnaire in the second follow-up mailing. 
The ``High Paper'' group will receive both a web survey invitation 
letter along with a mailed paper screener questionnaire with the 
initial invitation and each follow-up mailing. Once a household in the 
``High Web'' group receives a paper screener questionnaire, it will 
then have the option to either complete the web-based survey or 
complete the mailed paper screener, similar to the ``High Paper'' 
group. If the household chooses to complete the mailed paper 
questionnaire, then it would be considered part of the mailout/mailback 
paper-and-pencil interviewing treatment group. The paper-and-pencil 
treatment group receives a paper topical questionnaire, if there is at 
least one 0 to 17 year old eligible child reported on the screener. 
Nonresponse follow-up for the topical questionnaire will include up to 
one pressure-sealed postcard and up to three mailings including the 
paper topical questionnaire.

III. Data

    OMB Control Number: 0607-0990.
    Form Number(s): NSCH-S1 (English Screener),
    NSCH-T1 (English Topical for 0- to 5-year-old children),
    NSCH-T2 (English Topical for 6- to 11-year-old children),
    NSCH-T3 (English Topical for 12- to 17-year-old children),
    NSCH-S-S1 (Spanish Screener),
    NSCH-S-T1 (Spanish Topical for 0- to 5-year-old children),
    NSCH-S-T2 (Spanish Topical for 6- to 11-year-old children), and
    NSCH-S-T3 (Spanish Topical for 12- to 17-year-old children).
    Type of Review: Regular submission.
    Affected Public: Parents, researchers, policymakers, and family 
advocates.
    Estimated Number of Respondents: 94,370 for the screener and 39,596 
for the topical.
    Estimated Time per Response: 5 minutes per screener response and 33 
minutes per topical response, which in total is approximately 38 
minutes for households with eligible children.
    Estimated Total Annual Burden Hours: 29,642 hours.
    Estimated Total Annual Cost to Public: $0 (This is not the cost of 
respondents' time, but the indirect costs respondents may incur for 
such things as purchases of specialized software or hardware needed to 
report, or expenditures for accounting or records maintenance services 
required specifically by the collection.)
    Respondent's Obligation: Voluntary.
    Legal Authority: Title 13 U.S.C. Section 8(b); 42 U.S.C. 701; 
1769d(a)(4)(B); and 42 U.S.C. 241.

IV. Request for Comments

    Comments are invited on: (a) Whether the proposed collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden 
(including hours and cost) of the proposed collection of information; 
(c) ways to enhance the quality, utility, and clarity of the 
information to be collected; and (d) ways to minimize the burden of the 
collection of information on respondents, including through the use of 
automated collection techniques or other forms of information 
technology.
    Comments submitted in response to this notice will be summarized 
and/or included in the request for OMB approval of this information 
collection; they also will become a matter of public record.

Sheleen Dumas,
Departmental Lead PRA Officer, Office of the Chief Information Officer, 
Commerce Department.
[FR Doc. 2019-24962 Filed 11-18-19; 8:45 am]
 BILLING CODE 3510-07-P