Request

Request for Approval under the “Generic Clearance for the

Collection of Routine Customer Feedback”

(OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION: Polling questions to solicit feedback on Child Welfare Information Gateway’s website and special initiatives

PURPOSE: Child Welfare Information Gateway (CWIG) is a service of the Children’s Bureau, a component within the Administration for Children and Families, and is dedicated to the mission of connecting professionals and concerned citizens to information on programs, research, legislation, and statistics regarding the safety, permanency, and well-being of children and families. Child Welfare Information Gateway’s main functions are identifying information needs, locating and acquiring information, creating information, organizing and storing information, disseminating information, and facilitating information exchange among professionals and concerned citizens. A number of vehicles are employed to accomplish these activities, including, but not limited to, website hosting, discussions with customers, and dissemination of publications (both print and electronic).

Each year, Child Welfare Information Gateway helps coordinate three special initiatives: National Child Abuse Prevention Month, National Foster Care Month, and

National Adoption Month and uses social media such as Facebook to promote and broaden the reach of the campaigns. The proposed data collection effort involves administering polls on the CWIG website and through social media. Customers’ responses to polling questions will help CWIG understand more about the information needs of customers and ways to better meet customers’ needs.

DESCRIPTION OF RESPONDENTS: Polling questions may be offered to anyone that uses the CWIG website and social media including: State and local governments, the territories, service providers, Indian Tribes and tribal organizations, grantees, researchers, and the general public.

TYPE OF COLLECTION: (Check one)

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

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

[ ] Focus Group [X] Other: Polling questions

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:________________________________________________

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	Burden
Polling Questions for CWIG Website	Private Sector	1,547.5	0.0167	25.84
	State, Local, or Tribal Governments	1,547.5	0.0167	25.84
	Individuals/Households	1,547.5	0.0167	25.84
Polling Questions for Facebook	Private Sector	2,689.2	0.0167	44.91
	State, Local, or Tribal Governments	2,689.2	0.0167	44.91
	Individuals/Households	2,689.2	0.0167	44.91
Polling Questions for LinkedIn	Private Sector	840	0.0167	14.03
	State, Local, or Tribal Governments	840	0.0167	14.03
	Individuals/Households	840	0.0167	14.03
	Total			254.34

FEDERAL COST: The estimated annual cost to the Federal government is $820 for purchasing an annual licensing agreement with SurveyGizmo. SurveyGizmo software will be used to create polling questions.

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 sampling plan is designed to reach the various types of customers using Child Welfare Information Gateway’s website and social media. Polls will be used on social media websites and the CWIG website to coincide with the following special initiatives: National Adoption Month (November), National Child Abuse Prevention Month (April), and National Foster Care Month (May). Polling questions will be asked on social media websites and the CWIG website during each week of a special initiative:

• CWIG website polls:

  • 4 weeks/special initiative x 3 special initiatives = 12 CWIG website polls/yr.

• Social Media polls:

  • Facebook: 4 weeks/special initiative x 3 special initiatives = 12 Facebook polls/yr.

  • LinkedIn: 4 weeks/special initiative x 3 special initiatives = 12 LinkedIn polls/yr.

TOTAL POLLING QUESTIONS / YEAR = 36

The response rates for polling questions are based on response rates obtained from similar data collection efforts (since CWIG has never conducted polls, an Internet search for results from similar data collection efforts was conducted). Sample size estimates for polls (delivered via CWIG Website, Facebook, and LinkedIn) include the following:

• Polls administered via CWIG website:

  • We plan to administer polling questions on the CWIG website during each week of a special initiative (4 weeks/special initiative x 3 special initiatives = 12 CWIG website polls/yr.). Last year, there were 46,426 visitors to special initiative landing pages and we expected to achieve a response rate of approximately 10%, resulting in roughly 4,642.6 completed CWIG website polls (46,426*.10).

• Polls administered via social media websites:

  • Facebook - During FY 2011, there were 6,723 CWIG Facebook page users and we expect to administer Facebook polls 12 times each year. We expect a response rate of 10%, resulting in 8,067.6 completed Facebook polls (6,723*.10*12).

• LinkedIn – CWIG plans to create a LinkedIn account during FY2013; therefore, there is no data available on LinkedIn annual usage and Facebook data is being used to make response rate estimates. During the first year Facebook was launched, there were 2,100 CWIG Facebook page users (which will serve as the basis for our LinkedIn estimate). We expect to administer LinkedIn polls 12 times each year with a response rate of 10%, resulting in 2,520 completed LinkedIn polls (2,100*.10*12).

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: Live Chat and Email.

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

Required Additional Information

1. Line of Business: (select from lists provided in ROCIS on the edit screen)

2. Subfunction: (select from lists provided in ROCIS on the edit screen)

3. Privacy Act System of Records Notice (SORN): Not applicable.

4. Federal Register citation information: In accordance with 5 CFR 1320.8(d), December 22, 2010, Vol 75, page 80542 a 60-day notice for public comment was published in the Federal Register. No comments were received.

5. Number of respondents for small entities: Small business or other small entities may be involved in this data collection effort but Child Welfare Information Gateway will minimize the burden on them by using short, easy-to-complete polling questions.

6. Percentage of respondents reporting electronically: 100%

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. Note: Agencies

should only collect PII to the extent necessary, and they should only retain PII for the period of

time that is necessary to achieve a specific objective.

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 per row.

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.

Submit all instruments, instructions, and scripts are submitted with the request.

Required Additional Information

1. Line of Business: (select from lists provided in ROCIS on the edit screen)

2. Subfunction: (select from lists provided in ROCIS on the edit screen)

3. Privacy Act System of Records Notice (SORN): Title: ___________

4. Federal Register citation information: Volume _______ Page No. ______

5. Number of respondents for small entities:

6. Percentage of respondents reporting electronically:

6