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Nov 10 -- The Census Bureau indicates it will ask for OMB approval for the conduct of the 2021 National Survey of Children's Health and invites public comment on its proposed design by January 11, 2021.  
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 (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 (USDA) and the United States Department of Health and Human Services' Center for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities (CDC-NCBDDD) sponsor supplemental content on the NSCH.   

Additionally, the upcoming cycle of the NSCH would like to feature four returning state-based oversamples and four new oversamples that are either age-based, state-based, or region-based. The age-based oversample would be funded by the United States Department of Health and Human Services' Center for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC-NCCDPHP). The state- or region-based oversamples would be sponsored by Children's Health Care of Atlanta, the State of Colorado, the State of Nebraska, the Ohio Department of Health, the Oregon Center for Children and Youth with Special Health Care Needs, the Southeast Louisiana Area Health Education Center, 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 2021 NSCH is to provide HRSA MCHB, the supplemental sponsoring agencies, states, regions, and other data users with the necessary data to support the production of national estimates yearly and state- or region-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.

NSCH is seeking clearance to make the following changes:

Increased sample size—The base NSCH sample plus the proposed oversamples may reach up to 300,000 addresses for the 2021 NSCH, compared with 240,000 in 2020. The increased sample will allow individual states and agencies to produce statistically sound child health estimates in a fewer number of pooled years than if the sample were to remain the same annually, thereby resulting in more timely age-, state- and region-based health estimates of children.

Revised questionnaire content—The NSCH questionnaires with newly proposed and revised content from the sponsors at HRSA MCHB and CDC-NCCDPHP are currently undergoing two rounds of cognitive testing. This testing request was submitted under the generic clearance package and approved by OMB.[1] Based on the results, a final set of proposed new and modified content will be included in the full OMB ICR for the 2021 NSCH.
Oversamples [2] —In order to inform various priorities that are otherwise not supported by the NSCH, some stakeholders have shown interest in sponsoring an oversample of particular populations as part of the annual NSCH administration. Currently, there are six states, one region, and one federal partner contributing to an oversample as part of the 2021 NSCH. Four states (Colorado, Nebraska, Oregon and Wisconsin) were initially oversampled in 2020, and are continuing with the option as part of the 2021 NSCH. Two states (Louisiana and Ohio) and the Atlanta, GA Metro Area will be oversampled for the first time in 2021. Finally, CDC-NCCDPHP is supporting an oversample of households with young 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. 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. In the 2020 NSCH, the share of addresses receiving the $5 incentive was increased to 60%, with 30% receiving the $2 incentive; again, 10% did not receive an incentive. The proposal for 2021 NSCH is to remove the $2 incentive group, so 90% 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.

Alternative invitation letter wording—A random selection of addresses will receive an initial invitation letter than uses the traditional letter design but slightly modified wording that may encourage internet response. This test is conditional on ongoing results from the current NSCH 2020 redesigned envelope and letter test.

Besides the proposed changes listed above, the 2021 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.
FR notice inviting comment:  https://www.federalregister.gov/documents/2020/11/10/2020-24920/agency-information-collection-activities-submission-to-the-office-of-management-and-budget-omb-for
NSCH webpages: https://mchb.hrsa.gov/data/national-surveys, https://www.census.gov/programs-surveys/nsch.html, and https://www.childhealthdata.org/learn-about-the-nsch/NSCH
2020 NSCH OMB package -- supporting statement and supplementary documents:  https://www.reginfo.gov/public/do/PRAViewDocument?ref_nbr=202003-0607-001

Point of contact: Carolyn Pickering, NSCH Director 301-763-3873   Carolyn.M.Pickering@census.gov

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