#15_SEER RTR_Fast-Track_Request_8_17_2012

Request for Approval under the

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

(OMB Control Number: 0925-0642-15, Expiration Date 9/30/2014)

T ITLE OF INFORMATION COLLECTION:

The Surveillance, Epidemiology, and End Results (SEER) Residual Tissue Repository Program: Survey to Assess Service Delivery and Product Quality

PURPOSE:

The SEER Residual Tissue Repository (RTR) provides population-based biospecimens to the greater scientific community. The number of requests for RTR biospecimens is increasing, with 50 peer-reviewed research articles in print and new research using this resource being published monthly. To optimize the RTR as a research resource, the SEER RTR online survey will collect feedback, comments, and suggestions from members of the NIH intramural and extramural community who are experienced with, or who are interested in utilizing, the SEER cancer biospecimen resource. The purpose of this survey is to obtain information from the scientific community on their past experiences with the SEER RTR program, future applications of this resource, potential limitations of using the RTR biospecimens, and how to maximize the value of the SEER RTR program by improving product quality and future service delivery. This information will be kept secure to the extent provided by law and used by staff members in the National Cancer Institute (NCI) Surveillance Research Program (SRP) and Epidemiology and Genomics Research Program (EGRP) within the Division of Cancer Control and Population Sciences (DCCPS) to improve services provided by the program.

DESCRIPTION OF RESPONDENTS:

To ensure a thorough and comprehensive response to this survey, responses are being sought from members of the NIH intramural and extramural community who are experienced with, or who are interested in utilizing, cancer biospecimen resources.

Such parties include, but are not limited to:

• NIH intramural and extramural researchers with published findings using RTR biospecimens

• NIH intramural and extramural researchers who have requested RTR biospecimens

• The SEER registry community

• Epidemiology & Genomics Research Program (EGRP) grantees and applicants

• The AACR Molecular Epidemiology Work Group

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: __Sean Altekruse (SEER RTR Project Officer)_________________________________

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

3. If Yes, has an up-to-date System of Records Notice (SORN) 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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Individuals	72	5/60	6 hours
Totals	72		6 hours

Total Burden Hours used for IC’s to date: 882

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

Total Burden Hours currently requested: 6

FEDERAL COST: The estimated annual cost to the Federal government is _$10,000________

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

The groups of respondents will be contacted by e-mail and will be selected based on professional networks and privately funding investigators who are currently on distribution lists maintained by the Surveillance Research Program and the Epidemiology & Genomics Research Program.

Administration of the Instrument

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

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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

Attachment 1: Word Document of Survey/Questionnaire

Attachment 2: Email of the Invitation Script

Attachment 3: Screenshots of the Web-based Survey/Questionnaire

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