Formative Research, Pretesting, and Customer Satisfaction of NCI's Communication and Education Resources (NCI)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 9 Spanish Interview Guide - Spanish Consent	Form and Instruction	New	Available
Form 8 English Interview Guide - Spanish Consent	Form and Instruction	New	Available
Form 7 Screener Spanish Consent	Form and Instruction	New	Available
Form 6 Prospective Survey Screenshots Accrual CT	Form and Instruction	New	Available
Form 5 Concept Survey Screenshots Accrual CT	Form and Instruction	New	Available
Form 4 Staff Survey Screenshots Accrual CT	Form and Instruction	New	Available
Form 3 Oncology Survey Screenshots Accrual CT	Form and Instruction	New	Available
Form 2 Survey Screenshots ICD	Form and Instruction	New	Repair queued
Form 1 Screener ICD	Form and Instruction	New	Available
Form 19 #19_Attach 19A_19B_CIRB Addendum	Form and Instruction	New	Available
Form 2 #18 Moderator's Guide and Screener	Form and Instruction	New	Available
Form 1 #17 Email Form and Survey	Form and Instruction	New	Available
Form 16 #16_Attach 16B 16C 16D 16E 16F Survey and Forms	Form and Instruction	New	Available
Form 15 Attach 15A and 15B Oncology Survey & Staff Survey	Form and Instruction	New	Available
Form 14 Attach 14A and 14B (Interview Guide and Screener)	Form and Instruction	New	Available
Form 3 Nightshift and Sleep Qx.	Form and Instruction	New	Available
Form 2 MISC Survey	Form	New	Available
Form 1 Mentee Application and Competancy Assessment	Form and Instruction	New	Available
Form 1 #9_Attach 9B_IRB Policy Survey	Form	New	Available
Form 2 #10_Attach 10C_Camp Survey	Form	New	Available
Form 1 REVISED #7	Form and Instruction	New	Available
Form 1 #7 Attach 7A, 7B, 7F Screener, FG Guide, Questionnaire	Form and Instruction	New	Available
Form 2 #8_Attach 8A_PIO Survey	Form and Instruction	New	Available
Form 2 #6 Web-based Survey	Form and Instruction	New	Available
Form 1 #5 Moderators Guide and Screener	Form and Instruction	New	Available
Form 2 #4_Rev_Attach B2, B3, B4, and B5_Genomics	Form and Instruction	New	Repair queued
Form 1 #3_Nurses Study_Attach A3-5, A7, A9 Discuss Guides	Form and Instruction	New	Available
Form 6 #2_Attach 6_Screener Advocate Triad_Cancer evol	Form and Instruction	Unchanged	Available
Form 4 #2_Attach 4_Screener HCP Triad_Cancer evol	Form and Instruction	Unchanged	Available
Form 3 #2_Attach 3_Screener Patient-Friends-Family_Cancer evol	Form and Instruction	Unchanged	Available
Form 1 #2_Attach 1_Mod Guide Focus Group	Form and Instruction	Unchanged	Available
Form 2 #2_Attach 2_Mod Guide Triad	Form and Instruction	Unchanged	Available
Form 5 #2_Attach 5_Screener Research Triad_Cancer evol	Form and Instruction	Unchanged	Available
Form 1 NCI Cancer Bulletin Survey	Form and Instruction	Unchanged	Available
#2_Change Request to name.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2010-08-23	Available
SSB_Generic Pretesting and Customer_9-30.doc	Supporting Statement B	Uploaded 2009-12-19	Available
ATTACH 5_Memo from NIH OHSR.pdf	Supplementary Document	Uploaded 2009-12-19	Available
ATTACH 4_Privacy Act Memo.pdf	Supplementary Document	Uploaded 2009-12-19	Available
ATTACH 3_Prior sub-study descriptions_9-22.doc	Supplementary Document	Uploaded 2009-12-19	Available
ATTACH 2_Data collection methods_9-22.doc	Supplementary Document	Uploaded 2009-12-19	Available
ATTACH 1_Types of research_9-22.doc	Supplementary Document	Uploaded 2009-12-19	Available
Comments.pdf	Supplementary Document	Uploaded 2009-12-19	Available
SSA_Generic Pretesting and Customer_12 31 REV 1-21.doc	Supporting Statement A	Uploaded 2010-01-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	Spanish Interview Guide - Spanish Consent
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	English Interview Guide - Spanish Consent
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	Screener Spanish Consent
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	Prospective Survey Screenshots Accrual CT
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	Concept Survey Screenshots Accrual CT
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	Staff Survey Screenshots Accrual CT
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	Oncology Survey Screenshots Accrual CT
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	Survey Screenshots ICD
201931	Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	Form and Instruction	New	Screener ICD
199940	Sub-study #19: Addendum to Pilot Study Proposed New Model for the CIRB Participating Institution	Form and Instruction	New	#19_Attach 19A_19B_CIRB Addendum
198803	Bundled sub-studies #17 (CIS) and #18 (Message)	Form and Instruction	New	#18 Moderator's Guide and Screener
198803	Bundled sub-studies #17 (CIS) and #18 (Message)	Form and Instruction	New	#17 Email Form and Survey
197863	Bundled Sub-studies #14, #15, #16 (#14 WYNTK, #15 Accrual CT, #16 CIRB Pilot)	Form and Instruction	New	#16_Attach 16B 16C 16D 16E 16F Survey and Forms
197863	Bundled Sub-studies #14, #15, #16 (#14 WYNTK, #15 Accrual CT, #16 CIRB Pilot)	Form and Instruction	New	Attach 15A and 15B Oncology Survey & Staff Survey
197863	Bundled Sub-studies #14, #15, #16 (#14 WYNTK, #15 Accrual CT, #16 CIRB Pilot)	Form and Instruction	New	Attach 14A and 14B (Interview Guide and Screener)
197264	Bundled Sub-study #11, 12 and #13 (#11 Mentorship Program; #12 Medical Oncologist Practice of Care; #13 Nightshift Work and Sleep in China)	Form and Instruction	New	Nightshift and Sleep Qx.
197264	Bundled Sub-study #11, 12 and #13 (#11 Mentorship Program; #12 Medical Oncologist Practice of Care; #13 Nightshift Work and Sleep in China)	Form	New	MISC Survey
197264	Bundled Sub-study #11, 12 and #13 (#11 Mentorship Program; #12 Medical Oncologist Practice of Care; #13 Nightshift Work and Sleep in China)	Form and Instruction	New	Mentee Application and Competancy Assessment
196948	Bundled Sub-study #9 and #10 (#9 IRB Policy Regarding NCI Action Letters and; #10 NCI Cancer Research Imaging Camp)	Form	New	#9_Attach 9B_IRB Policy Survey
196948	Bundled Sub-study #9 and #10 (#9 IRB Policy Regarding NCI Action Letters and; #10 NCI Cancer Research Imaging Camp)	Form	New	#10_Attach 10C_Camp Survey
195829	Bundled Sub-studies #7 (PSA Decision Making Focus Groups) and #8 (PIO Customer Satisfaction Survey)	Form and Instruction	New	REVISED #7
195829	Bundled Sub-studies #7 (PSA Decision Making Focus Groups) and #8 (PIO Customer Satisfaction Survey)	Form and Instruction	New	#7 Attach 7A, 7B, 7F Screener, FG Guide, Questionnaire
195829	Bundled Sub-studies #7 (PSA Decision Making Focus Groups) and #8 (PIO Customer Satisfaction Survey)	Form and Instruction	New	#8_Attach 8A_PIO Survey
195272	Bundled Sub-studies #5 (Focus Groups) and #6 (Survey) to Test Messages and Raise Public Awareness about NIH Clinical Trials	Form and Instruction	New	#6 Web-based Survey
195272	Bundled Sub-studies #5 (Focus Groups) and #6 (Survey) to Test Messages and Raise Public Awareness about NIH Clinical Trials	Form and Instruction	New	#5 Moderators Guide and Screener
194814	Revised_#3 and #4 Bundled Sub-studies for Interviews-Focus Groups for Nursing Education (#3) and Message testing for Genomics and Genetics (#4)	Form and Instruction	New	#4_Rev_Attach B2, B3, B4, and B5_Genomics
194814	Revised_#3 and #4 Bundled Sub-studies for Interviews-Focus Groups for Nursing Education (#3) and Message testing for Genomics and Genetics (#4)	Form and Instruction	New	#3_Nurses Study_Attach A3-5, A7, A9 Discuss Guides
193546	Sub-Study #3_NCI Cancer.gov Evolution - User Focus Groups and Triads	Form and Instruction	Unchanged	#2_Attach 6_Screener Advocate Triad_Cancer evol
193546	Sub-Study #3_NCI Cancer.gov Evolution - User Focus Groups and Triads	Form and Instruction	Unchanged	#2_Attach 4_Screener HCP Triad_Cancer evol
193546	Sub-Study #3_NCI Cancer.gov Evolution - User Focus Groups and Triads	Form and Instruction	Unchanged	#2_Attach 3_Screener Patient-Friends-Family_Cancer evol
193546	Sub-Study #3_NCI Cancer.gov Evolution - User Focus Groups and Triads	Form and Instruction	Unchanged	#2_Attach 1_Mod Guide Focus Group
193546	Sub-Study #3_NCI Cancer.gov Evolution - User Focus Groups and Triads	Form and Instruction	Unchanged	#2_Attach 2_Mod Guide Triad
193546	Sub-Study #3_NCI Cancer.gov Evolution - User Focus Groups and Triads	Form and Instruction	Unchanged	#2_Attach 5_Screener Research Triad_Cancer evol
192713	2010 NCI Cancer Bulletin Reader Survey (sub-study #1)	Form and Instruction	Unchanged	NCI Cancer Bulletin Survey

ICR Details

OMB Control No: 0925-0046	ICR Reference No: 201008-0925-004
Status: Historical Active	Previous ICR Reference No: 201001-0925-004
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Formative Research, Pretesting, and Customer Satisfaction of NCI's Communication and Education Resources (NCI)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/13/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/23/2010
Terms of Clearance: Prior terms of clearance continue.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2013	02/28/2013	02/28/2013
Responses	33,000	0	33,000
Time Burden (Hours)	7,050	0	7,050
Cost Burden (Dollars)	0	0	0

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Abstract: To help ensure that health messages, materials, strategies, and information services developed by NCI's Office of Communications (OC) have the potential of being received, understood, and accepted by their target audiences, OC will pretest them while they are under development. Respondents include cancer patients and their families, members of the public, health professionals, and organizations/groups that interface with these publics.

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Authorizing Statute(s): US Code: 42 USC 285a-2 Name of Law: NCI's education and information dissemination activities
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 55558	10/28/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 69340	12/31/2009
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 11

table that charts list of burden

IC Title	Form No.	Form Name
2010 NCI Cancer Bulletin Reader Survey (sub-study #1)	1	NCI Cancer Bulletin Survey
Bundled Sub-Studies #20 (Concise ICD), #21 (Accrual CT), and #22 (Spanish Consent)	9, 1, 2, 3, 4, 5, 6, 7, 8	Screener ICD ,   Survey Screenshots ICD ,   Oncology Survey Screenshots Accrual CT ,   Staff Survey Screenshots Accrual CT ,   Concept Survey Screenshots Accrual CT ,   Prospective Survey Screenshots Accrual CT ,   Screener Spanish Consent ,   English Interview Guide - Spanish Consent ,   Spanish Interview Guide - Spanish Consent
Bundled Sub-studies #14, #15, #16 (#14 WYNTK, #15 Accrual CT, #16 CIRB Pilot)	14, 15, 16	Attach 14A and 14B (Interview Guide and Screener) ,   Attach 15A and 15B Oncology Survey & Staff Survey ,   #16_Attach 16B 16C 16D 16E 16F Survey and Forms
Bundled Sub-studies #5 (Focus Groups) and #6 (Survey) to Test Messages and Raise Public Awareness about NIH Clinical Trials	1, 2	#5 Moderators Guide and Screener ,   #6 Web-based Survey
Bundled Sub-studies #7 (PSA Decision Making Focus Groups) and #8 (PIO Customer Satisfaction Survey)	1, 2, 1	#7 Attach 7A, 7B, 7F Screener, FG Guide, Questionnaire ,   #8_Attach 8A_PIO Survey ,   REVISED #7
Bundled Sub-study #11, 12 and #13 (#11 Mentorship Program; #12 Medical Oncologist Practice of Care; #13 Nightshift Work and Sleep in China)	1, 2, 3	Mentee Application and Competancy Assessment ,   MISC Survey ,   Nightshift and Sleep Qx.
Bundled Sub-study #9 and #10 (#9 IRB Policy Regarding NCI Action Letters and; #10 NCI Cancer Research Imaging Camp)	2, 1	#10_Attach 10C_Camp Survey ,   #9_Attach 9B_IRB Policy Survey
Bundled sub-studies #17 (CIS) and #18 (Message)	1, 2	#17 Email Form and Survey ,   #18 Moderator's Guide and Screener
Revised_#3 and #4 Bundled Sub-studies for Interviews-Focus Groups for Nursing Education (#3) and Message testing for Genomics and Genetics (#4)	2, 1	#3_Nurses Study_Attach A3-5, A7, A9 Discuss Guides ,   #4_Rev_Attach B2, B3, B4, and B5_Genomics
Sub-Study #3_NCI Cancer.gov Evolution - User Focus Groups and Triads	2, 1, 3, 4, 5, 6	#2_Attach 2_Mod Guide Triad ,   #2_Attach 1_Mod Guide Focus Group ,   #2_Attach 3_Screener Patient-Friends-Family_Cancer evol ,   #2_Attach 4_Screener HCP Triad_Cancer evol ,   #2_Attach 5_Screener Research Triad_Cancer evol ,   #2_Attach 6_Screener Advocate Triad_Cancer evol
Sub-study #19: Addendum to Pilot Study Proposed New Model for the CIRB Participating Institution	19	#19_Attach 19A_19B_CIRB Addendum

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	33,000	33,000	0	0	0	0
Annual Time Burden (Hours)	7,050	7,050	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $92,740

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/23/2010

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