Fast-Track Request_#27_CGH_5-6-2013

Request for Approval under the

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

(OMB Control Number: 0925-0642-27, Expiration Date 9/30/2014)

T ITLE OF INFORMATION COLLECTION: Satisfaction with Cancer Research Programs in Underserved Communities (CGH)

PURPOSE:

Center for Global Health (CGH) is a new entity of the National Cancer Institute (NCI) that is focused on promoting research programs in low and middle income countries. As such the customers of the Center are investigators based in the US as well as in foreign institutions who conduct research amongst underserved populations. The purpose of this data collection effort is to garner investigators’ and stakeholders’ needs for cancer research so that CGH can receive feedback as it plans future programs. We will be using a short survey to assess research needs. Survey participants will include investigators and stakeholders who will partner with CGH. Results of this survey will provide feedback that will help craft new global health programs at NCI.

DESCRIPTION OF RESPONDENTS:

• Cancer researchers - both in the US and in foreign institutions

• Investigators - both in the US and in foreign institutions

• Cancer Program Implementers - representatives of organizations that work with patients and families affected by cancer including advocacy group, health educators.

• Stakeholders - representatives of organizations that support as well as implement cancer research in low and middle income countries and include: non-government and government organizations.

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: Sudha Sivaram

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 (in hours)	Total Burden
Individuals	150	20/60	50

Total Burden Hours used for IC’s to date: 1549

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

Total Burden Hours currently requested: 50

FEDERAL COST: The estimated annual cost to the Federal government is $500.00.

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 potential sample of respondents will be identified by a purposive sampling approach. Current partners from organizations working in low and middle income countries, investigators and researchers who partner with NCI such as academic partners will be identified by CGH staff. Based on this, individuals identified will be contacted by telephone for an interview. If there is an opportunity to meet the individual face to face, for example in an upcoming conference, then in person interviews will be conducted.

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

[X] In-person

[ ] Mail

[ ] Other, Explain

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

Attachment 1: Center for Global Health Cancer Research Satisfaction Survey

Page 3 5/6/2013