Michele Chiappa

Background-Starting in 1999, the National Health and Nutrition Examination Survey (NHANES) became a continuous, ongoing annual survey of the noninstitutionalized civilian resident population of the United States. A continuous survey allowed content to change to meet emerging needs. Objective-This report describes how NHANES for 1999-2010 was designed and implemented. NHANES is a national survey designed to provide national estimates on various health-related topics. Methods-The survey used in-person face-to-face interviews and physical examinations for data collection. Approximately 5,000 people per year participated in NHANES. The 5,000 people surveyed each year are representative of the entire U.S. population.

BACKGROUND: In October 2008, the federal government issued its first-ever Physical Activity Guidelines for Americans to provide science-based guidance on the types and amounts of physical activity that provide substantial health benefits for Americans (1). Guidelines for children and adolescents recommend 60 minutes or more of aerobic, muscle-strengthening, or bone-strengthening physical activity daily (1). While the number of children in the United States who meet the recommendations in the Physical Activity Guidelines is unknown, the percentage that is physically active in the United States may be declining. No recent national data exist on the fitness levels of children and adolescents. The National Health and Nutrition Examination Survey's (NHANES) National Youth Fitness Survey (NNYFS) was conducted in 2012 and collected data on physical activity and fitness levels for U.S. children and adolescents aged 3-15 years. OBJECTIVES: The objective of NNYFS was to provide national-level estimates of the physical activity and fitness levels of children, based on interview and physical examination data. Results from the survey are intended to contribute to the development of policies and programs to improve youth fitness nationally. The data also may be used in the development of national reference standards for measures of fitness and physical activity. Methods The NNYFS survey design used the design for NHANES, which is a multistage probability sample of the civilian noninstitutionalized resident population of the United States. NNYFS consisted of a household interview and a physical activity and fitness examination in a mobile examination center. A total of 1,640 children and adolescents aged 3-15 were interviewed, and 1,576 were examined.

BACKGROUND: Currently, no national prevalence is available on home blood pressure monitoring (HBPM). METHODS: This report is based on national-level, cross-sectional data for noninstitutionalized US adults aged ≥18 years (n = 6,001 participants) from the National Health and Nutrition Examination Survey (NHANES), 2009-2010. RESULTS: Overall, 21.7% of the population reported HBPM in the past year. Using 2010 Census data as a reference, approximately 33 million (14.5%) individuals engaged in monthly or more frequent HBPM. The frequency of HBPM increased with higher age, higher body mass index, higher family income-to-poverty ratio, and a higher number of health-care visits (all, P < 0.05). Adults with health-care coverage engaged in monthly or more frequent HBPM than adults without coverage (16.1% vs. 8.4%; P < 0.05). Among people with hypertension (blood pressure ≥140/90mm Hg or currently taking medication), 36.6% engaged in monthly or more frequent HBPM. Of those with hypertension whom were aware, treated, and controlled, 41.9%, 43.5%, and 42.1%, respectively, engaged in monthly or more frequent HBPM. Adjusting for covariables, those who were aware of, treated for, and controlled their hypertension were more likely to have a higher frequency of HBPM than the reference: unaware, untreated, and uncontrolled (odds ratio (OR) = 3.59; OR = 3.96; and OR = 1.50, respectively). CONCLUSIONS: Approximately 14.5% of adults engaged in monthly or more frequent HBPM. Being aware of hypertension, being pharmacologically treated, and being controlled were associated with an increased frequency of HBPM. Even among these categories of people with hypertension, <50% were using HBPM.

BACKGROUND: The National Health and Nutrition Examination Survey's 9NHANES) biospecimena program was formed to manage the collection of biospecimena (including serum, plasma, urine, and DNA) from NHANES cycles, the storage of biospecimens in NHANES biospecimens, accessing of biospecimens by researchers and the providing of resulting data to future researchers. Data from biospeceimen research can be combined with existing NHANES data. OBJECTIVE: This report provides background on the development of NHANES biorepositories and describes the collection, processing, and storing of biospecimens; ethical considerations and informed consent; and the proposal process for accessing biospecimens and resulting data. The number and types of biospecimens collected in each survey cycle from NHANES III (1988- 1994) through NHANES 1999-2014 are discussed so that researchers can understand what biospecimens are available if they are considering using NHANES biospecimens in their research.

The continuous National Health and Nutrition Examination Survey began data collection in 1999 and proceeded without interruption until operations were suspended in March 2020 in response to the COVID-19 pandemic. Once the Division of Health and Nutrition Examination Surveys was able to determine and resume safe field operations, the next survey cycle was conducted between August 2021 and August 2023. This report describes the survey content, procedures, and methodologies implemented in the August 2021-August 2023 National Health and Nutrition Examination Survey cycle.