[Federal Register Volume 89, Number 93 (Monday, May 13, 2024)]
[Notices]
[Pages 41438-41440]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-10357]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-24-0950; Docket No. CDC-2024-0037]


Proposed Data Collection Submitted for Public Comment and 
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), as part 
of its continuing effort to reduce public burden and maximize the 
utility of government information, invites the general public and other 
Federal agencies the opportunity to comment on a continuing information 
collection, as required by the Paperwork Reduction Act of 1995. This 
notice invites comment on a proposed information collection project 
titled National Health and Nutrition Examination Survey (NHANES). 
NHANES produces descriptive statistics, which measure the health and 
nutrition status of the general United States population.

DATES: CDC must receive written comments on or before July 12, 2024.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2024-
0037 by either of the following methods:

[[Page 41439]]

     Federal eRulemaking Portal: www.regulations.gov. Follow 
the instructions for submitting comments.
     Mail: Jeffrey M. Zirger, Information Collection Review 
Office, Centers for Disease Control and Prevention, 1600 Clifton Road 
NE, MS H21-8, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. CDC will post, without change, all relevant comments 
to www.regulations.gov.
    Please note: Submit all comments through the Federal eRulemaking 
portal (www.regulations.gov) or by U.S. mail to the address listed 
above.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the information collection plan 
and instruments, contact Jeffrey M. Zirger, Information Collection 
Review Office, Centers for Disease Control and Prevention, 1600 Clifton 
Road NE, MS H21-8, Atlanta, Georgia 30329; Telephone: 404-639-7570; 
Email: [email protected].

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), Federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. In addition, the PRA also requires 
Federal agencies to provide a 60-day notice in the Federal Register 
concerning each proposed collection of information, including each new 
proposed collection, each proposed extension of existing collection of 
information, and each reinstatement of previously approved information 
collection before submitting the collection to the OMB for approval. To 
comply with this requirement, we are publishing this notice of a 
proposed data collection as described below.
    The OMB is particularly interested in comments that will help:
    1. 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;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected;
    4. 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 
submissions of responses; and
    5. Assess information collection costs.

Proposed Project

    The National Health and Nutrition Examination Survey (NHANES), (OMB 
No. 0920-0950, Exp. 04/30/2025)--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 nutrition 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 substantial 
changes to NHANES content or procedures. As in previous years, the base 
sample will remain at approximately 5,000 interviewed and examined 
individuals 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 sample person 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 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

[[Page 41440]]

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, test 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 sample persons 18 and older. 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 request.

                                        Estimated Annualized Burden Hours
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                                                                     Number of    Average burden
      Type of respondents           Form name        Number of     responses per   per response    Total burden
                                                    respondents     respondent      (in hours)      (in hours)
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Individuals in households.....  Screener........           6,398               1            7/60             747
Individuals in households.....  Home Interview..           5,882               1               1           5,882
Individuals in households.....  MEC Interview &            5,000               1               2          10,000
                                 Examination.
Individuals in households.....  Day 1 Telephone            5,882               1               1           5,882
                                 Dietary Recall,
                                 Dietary
                                 Supplements, &
                                 Flexible
                                 Consumer
                                 Behavior Survey
                                 Phone Follow-up.
Individuals in households.....  Day 2 Telephone            5,882               1           36/60           3,529
                                 Dietary Recall
                                 & Dietary
                                 Supplements.
Individuals in households.....  Developmental              3,500               1               3          10,500
                                 Projects &
                                 Special Studies.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............          36,540
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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. 2024-10357 Filed 5-10-24; 8:45 am]
BILLING CODE 4163-18-P