Request for Approval

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-0940)

TITLE OF INFORMATION COLLECTION:

Focus Group Testing of Two Health Hazard Evaluation Program Brochures – One for Employees and One for Employers

PURPOSE:

The proposed activity will allow the Health Hazard Evaluation Program to gather input on two new brochures, one for employees and one for employers. The basis of the customization of each brochure was information collected in 2010 about the motivators and barriers for each audience to utilize the services of the Health Hazard Evaluation Program. Focus group testing of these new brochures will provide information that will allow the Health Hazard Evaluation Program to revise the design, format, and content of each brochure to meet stakeholder needs.

DESCRIPTION OF RESPONDENTS:

Respondents are individuals employed in the private sector; state, local, or tribal governments; or the federal government. The employee and employer groups will represent a mix of industries and will represent a mix of gender, ages, race, years of experience, and company sizes. Participants will be recruited that live in a 20 mile radius of the Seattle focus group facility.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[x] 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: Stefanie M. Brown [email protected]__

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ X ] Yes [] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ X ] 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

Incentives are being given in order to encourage people to take time away from their daily lives to share their opinions in the study. Incentives encourage people to agree to attend, and help ensure attendance. Each testing session will last up to an hour and a half and will be conducted in person. Participants will receive a $75 incentive at the completion of the focus group. This incentive amount is lower than the industry standard for employee focus groups in the Seattle area, and it is also much lower than the standard for employer groups in the Seattle area.

In general, higher incentive amounts are recommended, for example by Human Factors International and the book “Focus Groups: A Practical Guide for Applied Research” (by Richard A. Krueger and Mary Anne Casey). Lower incentives result in higher per person recruitment costs because more people need to be contacted to get the required number of participants to show.

BURDEN HOURS

Type of Respondent	Form Name	Number of Respondents	Number of Responses per Respondent	Average Burden per Response (in hours)	Total Burden Hours
Employees	Appendix A Screener	27	1	10/60	5
	Appendix B: Moderator’s Guide	18	1	1.5	27
Employers	Appendix A Screener	27	1	10/60	5
	Appendix B: Moderator’s Guide	18	1	1.5	27
Total	64

FEDERAL COST: The estimated annual cost to the Federal government is $58,101.

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

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?

Using the participant recruitment screener (Appendix A), the contractor will recruit participants from within approximately a 20 mile radius of the Seattle, Washington area. Respondents will be individuals employed in the private sector; state, local, or tribal governments; or the federal government. A sufficient number of business and home telephone numbers will be purchased from Survey Sample International and/or InfoUSA.

Using the purchased telephone sample lists, we will randomly recruit 12 participants for each employee focus group (expecting 8 to 10 to show) and 14 participants for each employer group (expecting 8 to 10 to show). No more than nine participants will be admitted to each focus group.

Both the employee and employer groups will represent a mix of industries, thought at this time to include manufacturing, services, and health care and social services. The two employee groups will represent a mix of gender, ages, race, years of experience, and company sizes. We will attempt to recruit one union official for each employee group. The two employer groups will also represent a mix of gender, ages, race, years of experience, and business or organization size.

All focus group sessions will be conducted in English.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ ] Telephone

[x] In-person

See Appendix B for Moderator’s Guide

[ ] Mail

[ ] Other, Explain

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

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

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