[Federal Register Volume 81, Number 249 (Wednesday, December 28, 2016)]
[Notices]
[Pages 95562-95565]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-31414]


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DEPARTMENT OF COMMERCE

U.S. Census Bureau


Proposed Information Collection; Comment Request; 2017 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 the 
proposed 2017 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 February 27, 2017.

ADDRESSES: Direct all written comments to Jennifer Jessup, Departmental 
Paperwork Clearance Officer, Department of Commerce, Room 6616,

[[Page 95563]]

14th and Constitution Avenue NW., Washington, DC 20230 (or via the 
Internet at [email protected]).

FOR FURTHER INFORMATION CONTACT: Requests for additional information or 
copies of the information collection instrument(s) and instructions 
should be directed to Jason Fields, U.S. Census Bureau, ADDP, HQ-7H153, 
4600 Silver Hill Road, Washington, DC 20233-0001 (301-763-2465 or via 
the Internet at [email protected]).

SUPPLEMENTARY INFORMATION

I. Abstract

    Sponsored by the U.S. Department of Health and Human Services' 
(HHS') Health Resources Services Administration's Maternal and Child 
Health Bureau (HRSA MCHB), the National Survey of Children's Health 
(NSCH) is designed to produce data on the physical and emotional health 
of American children under 18 years of age. 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. In 2011-2012, the NSCH also collected information to 
assess parents' awareness of, experience with, and interest in 
enrolling in Medicaid and the State Children's Health Insurance Program 
(CHIP).
    The 2017 NSCH project includes plans to test incentive efficacy 
(the relative benefit for reducing survey non-response by providing $0 
or a $2 incentive as a token of appreciation), contact materials, and 
modifications to data collection strategies based on modeled 
information about Internet access. Preliminary results from the 2016 
NSCH production cycle (administered from June 2016-February 2017) were 
used to inform the decisions made regarding this second year 2017 NSCH 
production survey project. First, based on the results from the 2016 
NSCH and available funds, a $2 incentive will be administered with the 
initial mailing. For initial incentives, the evaluation of results from 
the 2016 NSCH showed that there was a statistically significant 
difference in the response rates when respondents were provided an 
incentive compared to those who were part of the control group that did 
not receive an incentive. The cost of incentives is balanced against 
the reduction in follow-up effort and cost required to collect the 
required data. There was a slightly larger increase in response for 
households mailed a $5 incentive compared to those mailed a $2 
incentive with their initial survey invite, but due to budget 
limitations that amount is not being considered for the 2017 NSCH. A 
small group (10% or less) receiving no incentive will be included to 
monitor the effectiveness of the incentive in the initial mailing. 
Second, for respondents who answer a paper screener interview and are 
mailed their first paper topical questionnaire, incentives will be 
tested for their ability to reduce bias and gain cooperation for this 
critical second stage of paper questionnaire data collection.
    In addition to testing incentives and developing materials, the 
2017 NSCH will continue to serve as a platform to evaluate different 
non-response follow-up mailing strategies based on a household's 
likelihood to respond over the Internet. For the 2016 NSCH, every 
household within the sample was assigned an American Community Survey 
(ACS) tract level Internet response likelihood flag (from 2013-2014 ACS 
survey years) of either medium/high (approximately 70% of the sample) 
or low (approximately 30% of the sample). The results from the 2015 
NSCH pretest showed that Internet was the mode of choice (>70% response 
rate); therefore, the 2016 NSCH planned solely for a web push mode of 
data collection. The web push mode included a combined screener and 
topical web instrument invite first, followed by a paper screener 
questionnaire in either their second or third non-response follow-up 
mailing. Households assigned to the low Internet likelihood group 
received their first paper screener questionnaire with their second 
non-response follow-up mailing and households assigned to the medium/
high Internet likelihood group received their first paper screener 
invite with their third non-response follow-up mailing. For those 
households with children that responded to the screener questionnaire 
by paper, a follow-up topical paper questionnaire was mailed to that 
address.
    In the 2016 NSCH, we observed response rates which were lower than 
the pretest and lower than our conservative estimates. While sample 
composition is still being evaluated, it is much closer to the expected 
nationally representative sample than the pretest was. We were able to 
learn considerably more about the production use of flags identifying 
the likelihood of responding by Internet and their usability to target 
mailed paper non-response follow-up. Since the 2016 NSCH sample was 
more representative of the general U.S. population than the prior 
year's pretest, we learned that response rates were actually lower 
across all characteristics of the sample than originally anticipated. 
The indicator that we developed for differentiating households likely 
to respond by Internet versus paper was more successful at indicating 
the likelihood of overall survey response than the preference for 
Internet over paper (medium/high Internet group were more likely to 
respond in general than the low Internet group). Since there continues 
to be a significant potential for cost savings for web data collection 
over paper data collection, we are working to refine and retest an 
Internet response indicator for the 2017 NSCH based on the results from 
the 2016 data collection. The first mailing strategy is a web push. 
This treatment is structured to reduce cost and respondent burden, 
focused so that all households in this group will first be invited to 
complete the NSCH online, and only non-respondents or those who call in 
to request a hard copy will be mailed a paper questionnaire. The second 
mailing strategy is mixed-mode, where web invitations and paper 
questionnaires are mailed with their initial survey invitation. The web 
push data collection strategy will be applied to approximately 70% of 
the sample using the medium/high Internet group flag that was improved 
based on the results of the 2016 NSCH and updated input data, while the 
remaining 30% low Internet group sample cases will be included in the 
mixed-mode data collection plan. Based on final results of the 2016 
NSCH and the finalized sampling plan for the 2017 NSCH, we expect to 
differentiate this mix of web push and mixed-mode mailings by sampling 
strata and the expected presence of children.
    The second new data collection strategy being tested is a pressure-
sealed reminder postcard scheduled to be mailed approximately one week 
after the initial survey invite mailing. This strategy is being 
implemented because the time gap used during the 2016 NSCH proved too 
long, and a significant dip in response flow was observed between 
mailings. The ability to send reminders enclosed with pressure-seal 
system allow them to contain username and password login information 
for the Centurion web instrument as well as specific information about 
the survey. The postcard will also allow for a paragraph in Spanish 
that will direct the respondent to the Spanish web survey or the 
Telephone Questionnaire Assistance (TQA) line for Spanish assistance.
    Third, we will test for response improvements using different 
envelopes to deliver the survey materials, and the impact of adding 
supplemental fact

[[Page 95564]]

sheets with important statistics from prior NSCH administrations. The 
initial mailing and first follow-up mailing will utilize the standard 
BC-1328 or BC-1776 flat mail envelopes both of which are white. During 
the initial and first follow-up mailing, inserts with important NSCH 
facts will be tested. During the second follow-up mailing when all 
respondents are receiving the BC-1776 flat mail envelopes containing a 
paper questionnaire, we will test if there is a difference in color 
preference and wording on the outside of the envelope.
    Finally, for respondents who experience technical problems with the 
web instrument, have questions about the survey, or need other forms of 
assistance, the 2017 NSCH will continue to have a TQA line available 
similar to what was used for 2016 NSCH. TQA staff will not only be able 
to answer respondent questions and concerns, but also they will have 
the ability to collect survey responses over the phone if the 
respondent calls in and would like to have interviewer assistance in 
completing the interview.
    In both Internet and paper collection modes, the survey design for 
the 2017 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 of the original 190,000 selected households, our target 
screener return rate of 40.5 percent will yield approximately 76,950 
responses to the screener. We then estimate that 60 percent of 
households from the first phase of the screener will be eligible to 
receive a topical questionnaire (households with children), and 70 
percent of these households with children will return the topical 
questionnaire, resulting in approximately 32,319 completed topical 
interviews.\1\ 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.
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    \1\ The topical return rate was calculated using an average of 
the web topical return rate (95%) and the paper topical return rate 
(45%). The return rate includes fully complete topicals and 
sufficient partial topicals out of all completed screeners. The 
completion rate (31% for topicals) and response rate (40.4%) 
calculations on the following page additionally includes households 
in the denominator that are estimated to have eligible children, but 
who did not complete screeners.
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    Census staff have developed a plan to select a production sample of 
approximately 190,000 households (addresses) from a Master Address File 
(MAF) 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 2016 
incentive experiments and the availability of funds, we plan to use a 
$2 initial incentive 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 incentive is expected for that 
mailing. The recommendation for the amount of this secondary incentive 
will be based on the results of the 2016 NSCH and available funding. 
From the 2016 NSCH, using AAPOR definitions of response, we can expect 
an overall screener completion rate for the 2017 NSCH to be about 45% 
percent and a 31% percent overall topical completion rate.\2\ This is 
different from the total overall response rate, which is expected to be 
about 40.4%.\3\
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    \2\ 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).
    \3\ 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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    The goal of the 2017 NSCH is to provide HRSA MCHB 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.

II. Methods of Collection

Web Push

    The production 2017 NSCH plan for the web push data collection 
design includes 70% of the 190,000 households receiving an initial 
invite with instructions on how to complete an English or Spanish-
language screening questionnaire via the web. Those households who 
decide to complete the web-based survey will be taken through the 
screening questionnaire to determine if they screen into one of the 
three topical instruments. If a household lists at least one child who 
is 0 to 17 years old in the screener, they are directed into a topical 
questionnaire immediately after the last screener question. The web 
push production sample of 133,000 is broken out into two incentive 
groups the majority, 119,700 households, receiving a $2 incentive, and 
a small group, 13,300 households, receiving no incentive so that the 
effectiveness of the incentive can be monitored. No additional 
incentives are planned for subsequent screener follow-up reminders or 
screener paper questionnaire mailings. If a household in the web push 
treatment group decides to complete the paper screener, they may have a 
chance to receive an additional topical questionnaire incentive.

Mixed-Mode

    The production 2017 NSCH plan for the mixed-mode data collection 
design includes approximately 30% of the 190,000 households receiving 
both an initial invite with a paper screening questionnaire and 
instructions on how to complete an English or Spanish language 
screening questionnaire via the web. Those households who decide to 
complete the web-based survey will follow the same screening and 
topical selection path as the web push. For households that choose to 
complete the paper screener questionnaire rather than completing the 
survey on the Internet, upon receipt of their completed paper screener 
at the Census processing center, households with eligible children will 
be mailed a paper topical questionnaire. The mixed-mode production 
sample of 57,000 will also receive incentives. Approximately 51,300 
households will receive a $2 incentive with the initial mailing. As in 
the web push group, a small sample of approximately 5,700 households 
will receive no incentive so that the incentive effectiveness may be 
monitored. No additional incentives are planned for subsequent screener 
follow-up reminders or screener paper questionnaire mailings. If a 
household in the mixed-mode group chooses to complete the paper 
screener instead of completing by Internet, they may receive an 
additional topical questionnaire incentive.

[[Page 95565]]

Follow-Up Reminder Design

    The NSCH historically was conducted in a partnership between the 
Health Services Resources Administration's Maternal and Child Health 
Bureau and the National Center for Health Statistics. As such, the 
survey information was sent to respondents under letterhead from the 
Department of Health and Human Services and the Centers for Disease 
Control and Prevention, with the Director of NCHS signing the letters 
to the respondent.
    In the 2016 NSCH, we tested both standard contact branding utilized 
for Census Bureau surveys, which included Census Bureau letterhead and 
the Census Director's signature, and an alternative sent with HRSA MCHB 
branding. The first follow-up mailing, sent to non-responding 
households approximately three-weeks after their initial invitation to 
respond to the survey by web, was split into two groups. The first 
group was sent a reminder to participate with their web login and 
password under standard Census Bureau letterhead. The second group was 
sent their reminder under a HRSA MCHB letterhead. The differential 
success of these reminder treatments continues to be evaluated. 
However, initial results lean toward the majority of respondents 
preferring Census Bureau letterhead. These results have aided in our 
decision to go with Census Bureau branding on all mailed materials.

Non-Response Follow-Up for the High-Internet Group and Low-Internet 
Group

    The high-Internet group will receive two additional web survey 
invitation letters requesting their participation in the survey prior 
to receiving their first paper screener questionnaire in the third 
follow-up mailing. The low-Internet group will receive both a web 
survey invitation letter along with a mailed paper screener 
questionnaire with each follow-up mailing. Once a household in the 
high-Internet group receives a paper screener questionnaire, they will 
then have the option to either complete the web-based survey or 
complete the mailed paper screener similar to the low-Internet group. 
If the household chooses to complete the mailed paper questionnaire, 
then they would then be considered part of the mailout/mailback paper-
and-pencil interviewing treatment group and would receive a paper 
topical questionnaire if there is at least one eligible child who is 0 
to 17 years old listed on the screener. Non-response follow-up for the 
topical questionnaire will include three more mailings, each including 
the paper topical questionnaire.

III. Data

    OMB Control Number: 0607-0990.
    Form Number(s): NSCH-P-S1 (English Screener), NSCH-P-T1 (English 
Topical for 0- to 5-year-old children), NSCH-P-T2 (English Topical for 
6- to 11-year-old children), NSCH-P-T3 (English Topical for 12- to 17-
year-old children), NSCH-PS-S1 (Spanish Screener), NSCH-PS-T1 (Spanish 
Topical for 0- to 5-year-old children), NSCH-PS-T2 (Spanish Topical for 
6- to 11-year-old children), and NSCH-PS-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: 76,950 for the Screener and 32,319 
for the Topical.
    Estimated Time per Response: 5 minutes per screener response and 30 
minutes per topical response.
    Estimated Total Annual Burden Hours: 22,572 hours.
    Estimated Total Annual Cost to Public: $585,067.
    Respondent's Obligation: Voluntary.
    Legal Authority: Census Authority: 13 U.S.C. Section 8(b).
    HRSA MCHB Authority: Section 501(a)(2) of the Social Security Act 
(42 U.S.C. 701).
    USDA Authority: The Healthy, Hunger-Free Kids Act of 2010, Public 
Law 111-296. In particular, 42 U.S.C. 1769d(a) authorizes USDA to 
conduct research on the causes and consequences of childhood hunger 
included in 1769d(a)(4)(B), the geographic dispersion of childhood 
hunger and food insecurity.
    CDC/NCBDDD Authority: Public Health Service Act, Section 301, 42 
U.S.C. 241.
    EPA Authority: FIFRA: Section 20(a); Toxic Substances Control Act: 
Section 10; 15 U.S.C. 2609.
    Confidentiality: The data collected under this agreement are 
confidential under 13 U.S.C. Section 9. All access to Title 13 data 
from this survey is restricted to those holding Census Bureau Special 
Sworn Status pursuant to 13 U.S.C. Section 23(c).

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,
PRA Departmental Lead, Office of the Chief Information Officer.
[FR Doc. 2016-31414 Filed 12-27-16; 8:45 am]
BILLING CODE 3510-07-P