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Dec 8 -- The Census Bureau invites comments by February 6, 2023 on the proposed revision of the National Survey of Children's Health for 2023.

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), the United States Department of Health and Human Services' Centers for Disease Control and Prevention (CDC), the National Center on Birth Defects and Developmental Disabilities (CDC-NCBDDD), and the Division of Nutrition, Physical Activity, and Obesity (CDC-DNPAO) sponsor supplemental content on the NSCH. Additionally, the upcoming cycle of the NSCH plans to include fifteen (15) age, state, or regional oversamples. 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 California, the State of Colorado, the State of Illinois, the State of Kansas, the State of Louisiana, the State of Minnesota, the State of Nebraska, the State of New Mexico, the State of Ohio, the State of Pennsylvania, the State of Tennessee, the State of Wisconsin, and the State of Wyoming.

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 2023 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 MCHB sponsored NSCH sample plus the separately sponsored age-, state-, or region-based oversamples will be approximately 385,000 addresses for the 2023 NSCH, compared with 360,000 in 2022. 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 are currently undergoing two rounds of cognitive testing. This testing request was submitted under the generic clearance package and approved by OMB. Based on the results, a final set of proposed new and modified content will be included in the full OMB ICR for the 2023 NSCH.

Oversamples —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 thirteen (13) states and one region contributing to an oversample as part of the 2023 NSCH. Nine (9) states (California, Colorado, Louisiana, Nebraska, Ohio, Pennsylvania, Tennessee, Wisconsin, and Wyoming) and the Atlanta, GA Metro Area, were initially oversampled in 2020, 2021, or 2022 and are continuing with the option as part of the 2023 NSCH. Four (4) additional states (Kansas, Illinois, New Mexico, and Minnesota) will be oversampled for the first time in 2023. CDC-NCCDPHP is supporting an oversample of households with young children. Additionally, MCHB is requesting oversamples within the states of California, Illinois, Kansas, Louisiana, Nebraska, New Mexico, Ohio, Pennsylvania, Wisconsin, and Wyoming.

Besides the proposed changes listed above, the 2023 NSCH will proceed with the current design outlined in the previous OMB ICR package, including the use of incentives. Response rates for the unconditional monetary incentive group continues to show a statistically significant difference over the control group that did not receive an unconditional monetary incentive. As part of the initial screener mailing, 90% will include $5 and 10% will not receive an incentive. The incentive assignment to each sampled address would still be random as was done in prior cycles and approved by OMB. Additionally, the use of a $5 or $10 incentive with the initial paper topical mailing will be used. Additional incentives and mailing strategies may be used to both reduce nonresponse bias and improve response rates per request of the sponsor and as funding allows. 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.

From prior cycles of the NSCH, using American Association for Public Opinion Research definitions of response, we can expect for the 2023 NSCH an overall screener completion rate to be about 44.4% and an overall topical completion rate to be about 31.3%. This is different from the overall response rate, which we expect to be about 39.3%.

The 2023 NSCH plan for the web push data collection design includes approximately 70% of the 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 will receive an additional topical questionnaire incentive. This group will receive two web survey invitation letters requesting their participation in the survey prior to receiving up to two additional paper screener questionnaires in the second and third follow-up mailings.

The 2023 NSCH plan for the mixed-mode data collection design includes up to 30% of the production addresses receiving a paper screener questionnaire in either the initial or the first nonresponse follow-up 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 will receive an additional topical questionnaire incentive. This group will receive both a web survey invitation letter along with a mailed paper screener questionnaire with either the initial invitation or the first follow-up and each additional nonresponse follow-up mailing.

NSCH-Census: https://www.census.gov/nsch
NSCH-HRSA: https://mchb.hrsa.gov/data-research/national-survey-childrens-health
Draft survey instrument and technical documentation: https://www.dropbox.com/scl/fo/wwq8wlma7kdkm4d3dilur/h?dl=0&rlkey=7nlt02w0o665chcktlnolhjes
FRN: https://www.federalregister.gov/d/2022-26701

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