#13_Fast-Track Request_TCO_5-23-2012

Request for Approval under the

“Generic Clearance for the Collection of Routine Customer Feedback” (NCI)

(OMB Control Number: 0925-0642-13, Expiration Date 9/30/2014)

T ITLE OF INFORMATION COLLECTION: Focus Groups to Assess Implementation of the NCCCP-developed Template for Community Outreach (TCO)

PURPOSE: The purpose of this collection is to understand the process of and experiences with implementing the NCI Community Cancer Centers Program (NCCCP) Template for Community Outreach (TCO). The Template was created for community cancer centers as a resource to assist sites in designing outreach programs to achieve the NCCCP program goals which are to: 1) enhance access to care; 2) improve quality of care; and 3) expand research opportunities in particular for racially and ethnically diverse and other underserved populations. The data obtained will be used to further refine and improve the Template for future use.

DESCRIPTION OF RESPONDENTS: The respondents for this collection will be NCCCP Disparities Site leads who have direct experience with implementing the Template at their sites.

TYPE OF COLLECTION: (Check one)

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

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

[x] 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: Brenda Adjei, MPA, EdD, Program Director, CRCHD

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

Personally Identifiable Information:

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

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

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ x] No

A list of Disparities Lead contact information (name and email address) is maintained for programmatic purposes. It is people from this list who will be respondents for this project. No additional PII will be collected. The NIH Privacy Act Officer was consulted and determined the Privacy Act does not apply to this collection of information.

Gifts or Payments:

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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Private Sector: NCCCP Disparities Site Leads	15	1.5 hours	23
Totals	15		23

Total Burden Hours used for IC’s to date: 726

Total Burden Hours Approved for IC’s under 0925-0642: 8750

Total Burden Hours currently requested: 23

FEDERAL COST: The estimated annual cost to the Federal government is ___$2,700______

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? [ x ] Yes [ ] No

Respondents will be Disparities Project Leads from the 15 NCCCP sites funded to participate in ARRA Project 5 – Improving the Effectiveness of NCCCP Community Outreach Programs in Addressing Healthcare Disparities. Project participation required that sites implement the Template for Community Outreach to guide their community outreach efforts.

These 15 funded sites will be sent an email invitation to participate in either of two focus groups (7-8 participants per group) to assess their implementation experiences with the Template. The email invitation will describe the focus group process and request that each site select which date they are available to take part in the focus groups. Selecting a date will serve as their consent to participate in the study.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ x ] Telephone

[ ] In-person

[ ] Mail

[ x ] Other, Explain Adobe Connect Web Conferencing

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

A focus group moderator/facilitator will conduct the focus group. The focus group will be conducted using Adobe Connect, a web conferencing solution that is used for web meetings. All participants will be required to sign in to Adobe Connect and will be able to view all of the focus group questions via power point slides to be loaded for sharing. In addition, the participants will be asked to phone in to the accompanying teleconference line for the audio participation.

Using Adobe Connect, the moderator/facilitator will be able to manage attendance, share questions and focus group information via screen sharing, and ensure and facilitate a balanced interaction/ discussion among participants. Responses will be audio recorded, transcribed, and analyzed after the focus groups have been completed.

List of instruments, instructions, and scripts submitted with this request:

Attachment #1: Email/Letter Invitation

Attachment #2: Moderator’s Guide

Attachment #3: Survey/Questionnaire Screenshots

Attachment #4: NCCCP Template for Community Outreach (TCO)

Page 4 5/24/2012