#37_Fast Track Request CGH

Request for Approval under the

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

(OMB Control Number: 0925-0642-37, Expiration Date 9/30/2014)

T ITLE OF INFORMATION COLLECTION: Revised Satisfaction Survey for the Symposium on Global Cancer Research 2014

PURPOSE:

Previously the National Cancer Institute’s Center for Global Health (CGH) held the Global Cancer Research Day 2013. For this meeting, a web-based survey was approved to assess satisfaction (OMB No. 0925-0642-06, Approved 6/7/2013) and the feedback received was very valuable and used to improve plans for this upcoming meeting. Though the meeting title has changed to, “Symposium on Global Cancer Research, 2014,” the purpose of the survey is still the same as previously approved. The feedback provided by participants will determine whether we will organize similar meetings, and if so, what improvements can be made and whether the objectives were met. Minor changes were made to this survey to take into the changes made to the sessions for 2014. These changes include questions on the utility of the action plans created during the meeting (no action plans were written in 2013) and the substitution of “yes/no/unsure” for a likert scale as a response to various questions. The meeting is in intended to facilitate information exchange between global health and cancer research professionals about programs in global cancer research, identify potential geographic and scientific areas for collaboration, and work to develop strategic priorities related to cancer research focused on low- and middle- income countries.

DESCRIPTION OF RESPONDENTS:

• Participants of the Symposium on Global Cancer Research (will include individuals from NCI-designated cancer centers, universities, non-profits and US government agencies working on global health activities).

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: ___________Kalina Duncan____________________

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 Hours
Individuals	300	10/60	50

Total Burden Hours used for IC’s to date: 8,750

Total Burden Hours Approved for IC’s under 0925-0642: 1,993

Total Burden Hours currently requested: 50

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

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? [X] Yes [ ] No

The sample of respondents will be derived from the registration list of participants for the Symposium on Global Cancer Research meeting. All participants who registered will be contacted by email within one week of the Symposium to invite them to complete this survey.

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 Attachments

Attachment 1: Survey Screen Shots

Attachment 2: Email Invitation

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