Fast-Track Template_NICHD Nurse CEP_0925-0643

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0925-0643)

T ITLE OF INFORMATION COLLECTION: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Nurses’ Continuing Education Program on Sudden Infant Death Syndrome (SIDS)—Customer Satisfaction Survey

PURPOSE: In 1994, the Back to Sleep campaign was launched to raise the public’s awareness of ways to reduce the risk of Sudden Infant Death Syndrome (SIDS) and to help inform all parents and infant care givers about the importance of back sleeping. The launch was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in collaboration with the American Academy of Pediatrics (AAP), the SIDS Alliance (now First Candle/ SIDS Alliance), the Association of SIDS and Infant Mortality Programs (ASIP), and the Maternal and Child Health Bureau of the Health Resources Service Administration (HRSA).

Since the launch of the Back to Sleep campaign, NICHD has conducted the Nurse Continuing Education (CE) Program on SIDS Risk Reduction to educate nurses on safe sleeping and to help reduce the risk of SIDS. The purpose of this data collection is to assess the nurses’ satisfaction with the program and their satisfaction with using the program materials and information in health care delivery settings.

DESCRIPTION OF RESPONDENTS: Nurses who attended an in-person workshop on the NICHD’s nurses’ CE program on SIDS risk reduction or completed the print or online version of the CE program between 2006 and 2011.

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: Jamelle E. Banks

DHHS, NIH, NICHD

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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Private Sector	18,400	15 minutes	4,600 hours
Totals	18,400	15 minutes	4,600 hours

FEDERAL COST: The estimated annual cost to the Federal government is $54,500.

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 universe of potential respondents are nurses who completed the CE program between 2006-2011 and have a valid email address in the nurse CE program database. There are approximately 23,000 nurses in the database and it is expected that at least 80 percent (18,400 respondents) will complete the 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

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