AHRQ AI Survey Submission Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0935-0179)

TITLE OF INFORMATION COLLECTION: Agency for Health Research and Quality (AHRQ) Articles of Interest (AI) Survey.

PURPOSE: An important part of AHRQ’s mission is to disseminate our research findings and tools and to make sure that clinicians know how to use this evidence to improve care. Toward that end, we have published AHRQ-supported research in the monthly newsletter, Research Activities, which is no longer published. We continue to publish a listing of AHRQ-supported and AHRQ-related studies in our Articles of Interest (AI) that our librarian sends out to 44,000 online subscribers. The goal of the present survey is to obtain feedback from the AI subscribers about what they value most in the AI, so that we can use that feedback to inform development of a new AHRQ Research Studies Web page, which will take the place of the AI.

DESCRIPTION OF RESPONDENTS:

Subscribers to AHRQ’s online Articles of Interest. They include clinicians, health care administrators, policymakers, and researchers.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ x] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:______Gail Makulowich__________________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [x ] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [x ] No

Category of Respondent: (the options here are Public Sector or Private Sector, or both)

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Individuals: Clinicians/Researchers/Policymakers/ Health Care Administrators	4,000 to RA survey	1 minute	67 hours
Totals	4,000	1 minute	67 hours

FEDERAL COST: The estimated annual cost to the Federal government is for a GS 13 to prepare and analyze results of the short survey, about 12 hours and $660.00

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [ x] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

The survey will be sent to our listserve of AI subscribers, who will be invited to take the 1-minute online survey that we will link to the email. We will also send a few email reminders to the listserve so that we get a maximum response.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ x ] Web-based or other forms of Social Media We will use Survey Monkey.

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ x ] No