genIC Application

Request for Approval under the “Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery”

(OMB Control Number: 0920-0919)

TITLE OF INFORMATION COLLECTION: Customer Satisfaction Survey of Preconception Health Adcepts (Concepts/Preliminary Ads).

PURPOSE:

The purpose of the information collection is to conduct a customer satisfaction, Web-based survey to test draft advertising concepts (concepts and messages) to ensure that they are understandable, well-received, and motivate women ages 18-44 to want to learn more about preconception health.

DESCRIPTION OF RESPONDENTS:

Respondents are the two target audiences (or intended customers) of the adcepts:

1. Women aged 18-44 who are planning a pregnancy in the next two years

2. Women aged 18-44 who are not currently planning to become pregnant

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:__________Betsy Mitchell[email protected]___________________________

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? [ X ] Yes [ ] No

As a token of appreciation, we will provide incentives of $6.50 for a full complete and $.50 for those who do not meet screening criteria. We plan to pay consolation incentives to encourage respondents to answer screening questions truthfully, rather than with a ‘must qualify’ mentality. Whether the respondent qualifies or not, we provide them with a token of appreciation (being screened out only takes a few seconds, thus the lower incentive for ‘consolation’).

This excerpt below from the survey vendor on fair-value exchange best explains the incentive methodology. The incentives are standardized by the amount of time it takes to compete the study, which protects against the response bias that might be experienced if each study had a unique incentive amount. They constantly test incentive amounts to ensure we are achieving the best possible response rate without exceeding the point of diminishing returns.

Fair-Value Exchange.

We believe the best way to establish and maintain long-term relationships with our panel members is to truly value their time. Our panel members earn Research Now currency as a token of appreciation for answering market research surveys. They can redeem this currency for valuable rewards from our program sponsors and other participating companies.

An incentive program, such as ours, that supports the accumulation of a currency redeemable at various "bonus thresholds", has been shown by tracking studies to achieve the highest participation rates and retention longevity compared to other incentive approaches.

We value the time that a respondent takes to answer survey questions or respond to e-mail communications. The same reward that is provided for enrolling in the Research Now program — Research Now currency — is given to those who participate in online research surveys.

Other panel providers who have not established a currency often use a sweepstakes methodology and offer an "entry for drawing" to panelists for responding to survey opportunities. Not only does this approach achieve sub-optimal response and retention rates (and potentially introduce non-response bias), we believe that it potentially reinforces a "casino mentality" bias amongst members that are retained in such a panel over time.

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Screener: Female, 18-44, <$50,000, Planner	1200	1/60	20
Screener: Female, 18-44, <$50,000, Non-Planner	510	1/60	9
Screener: Female, 18-44, <$50,000, Non-Planner (Contemplator)	690	1/60	12
Survey: Female, 18-44, <$50,000, Planner	400	25/60	167
Survey: Female, 18-44, <$50,000, Non-Planner	170	25/60	71
Survey: Female, 18-44, <$50,000, Non-Planner (Contemplator)	230	25/60	96
Totals	3200		375 hours

FEDERAL COST: The estimated annual cost to the Federal government is $72,880.00

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

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

The preconception health program will be national on scale, so all of the respondents are potential customers. We will contract with a market research firm to select the sample of potential customers. Within women 18-44 years of age with incomes less than $50,000, the market research contractor will identify 800 target customers: 400 planners, 170 non-planners and 230 non-planner/contemplators using the following screening question.

1. Which of the following statements would best describe you? 

   1. I am currently pregnant (INELIGIBLE)

1. I want to get pregnant in the two years (PLANNERS)

2. I don’t want to get pregnant in the next two years or so but I want to at some time in the future [NON-PLANNERS] 

3. I do not want to get pregnant at any time in the future [NON-PLANNERS]          

4. I cannot get pregnant (surgical sterilization, tubal ligation, hysterectomy, infertility, menopause) [INELIGIBLE]       

Within these two main groups, we plan to oversample African American and Latina women.

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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