Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI Cancer Information Service (CIS) Clients (NCI)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 CIS Telephone Customer Service Questions (Appendix 1A)	Form and Instruction	Modified	Available
Form 7 CIS Email Intake Form (Appendix 2)	Form and Instruction	New	Repair queued
Form 6 CIS Smoking Cessation Proactive Follow-up (Appendix 1D)	Form and Instruction	Modified	Available
Form 5 CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C)	Form and Instruction	Modified	Repair queued
Form 4 CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C)	Form and Instruction	Modified	Repair queued
Form 3 CIS LiveHelp Questionnaire (Appendix 1B)	Form and Instruction	Modified	Available
Form 2 CIS Telephone Clients - Demographic Questions (Appendix 1A)	Form and Instruction	Modified	Repair queued
SSB_CIS_6-6-2012.docx	Supporting Statement B	Uploaded 2012-07-24	Available
Appendix 8 CIS Annual Data Report 2011.docx	Supplementary Document	Uploaded 2012-07-24	Available
Appendix 7 Confidentiality of CIS Policy 3.docx	Supplementary Document	Uploaded 2012-07-24	Available
Appendix 6 OHSR Not Applicable.pdf	Supplementary Document	Uploaded 2012-07-24	Available
Appendix 5 Privacy Act Memo_CIS.docx	Supplementary Document	Uploaded 2012-07-24	Available
Appendix 4 PIA_CIS.pdf	Supplementary Document	Uploaded 2012-07-24	Available
Cover Memo_CIS.doc	Supplementary Document	Uploaded 2012-07-24	Available
Appendix 3 Facebook and Smartphone screenshots.docx	Supplementary Document	Uploaded 2012-07-24	Available
SSA_CIS_7-18-2012.docx	Supporting Statement A	Uploaded 2012-08-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43626	CIS Telephone Customer Service Questions (Appendix 1A)	Form and Instruction	Modified
203805	CIS Email Intake Form (Appendix 2)	Form and Instruction	New
189806	CIS Smoking Cessation Proactive Follow-up (Appendix 1D)	Form and Instruction	Modified
189805	CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C)	Form and Instruction	Modified
189804	CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C)	Form and Instruction	Modified
189803	CIS LiveHelp Questionnaire (Appendix 1B)	Form and Instruction	Modified
189802	CIS Telephone Clients - Demographic Questions (Appendix 1A)	Form and Instruction	Modified

ICR Details

OMB Control No: 0925-0208	ICR Reference No: 201208-0925-003
Status: Historical Inactive	Previous ICR Reference No: 200907-0925-001
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI Cancer Information Service (CIS) Clients (NCI)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 10/26/2012
	Date Received in OIRA: 08/20/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2012	36 Months From Approved	12/31/2012
Responses	100,667	0	100,667
Time Burden (Hours)	2,492	0	2,492
Cost Burden (Dollars)	0	0	0

---

Abstract: The Cancer Information Service (CIS) currently collects demographic, customer service and smoking cessation information from clients contacting CIS by telephone and through LiveHelp (an online instant messaging service) for cancer information or smoking cessation assistance). A new service, information requested and provided by e-mail, will be implemented. As well, users can now find information about cancer on Facebook and through smartphones. Information is collected in order to properly plan, implement, and evaluate cancer education efforts and to provide smoking cessation services tailored to the individual client's needs. Since its inception in 1976, the CIS network has handled more than ten million calls from the public. The potential universe of Cancer Information Service (CIS) clients is almost 308 million respondents based on the U.S. Census estimate for 2010 of adults estimated to be 18 years and older.

---

Authorizing Statute(s): US Code: 42 USC 412 (285a-1) Name of Law: Public Health Service Act
   US Code: 42 USC 410 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 31028	05/24/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 50138	08/20/2012
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
CIS Telephone Customer Service Questions (Appendix 1A)	1	Telephone Client-Customer Service Questions
CIS Telephone Clients - Demographic Questions (Appendix 1A)	2	Telephone Clients - Demographic Questions
CIS LiveHelp Questionnaire (Appendix 1B)	3	CIS LiveHelp Form
CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C)	4	Smoking Cessation Reactive Service Client Questions
CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C)	5	Smoking Cessation Reactive Service Demographic Questions
CIS Smoking Cessation Proactive Follow-up (Appendix 1D)	6	Smoking Cessation Proactive Follow-Up
CIS Email Intake Form (Appendix 2)	7	CIS Email Intake Form

---

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This information collection contains both program changes (revision) and adjustments. Program changes to NCI's CIS include: consolidating 15 regional offices to a single contact center, increasing the hours that Cancer Information Specialists are available on the toll-free number and LiveHelp Service, improving the e-mail response intake form so that responses from NCI can be better tailored to the questions, added a Facebook Service, and creating a smartphone user service available in both English and Spanish. The addition of the new e-mail response intake form will increase the burden hours in the form of a program change. There are also a few adjustments to this information collection. Overall, it is estimated there will be an increase in burden primarily due to the changing trends in CIS points of access as a result of the public's increasing reliance on the Internet for health information. Specifically, this would affect the burden on the Telephone Clients and the Proactive Callback Service Clients by increasing the number of respondents from the 2009 submission and therefore the burden hours. However, the burden hours for the LiveHelp and Reactive Service clients are expected to decrease somewhat or remain the same.

---

Annual Cost to Federal Government: $182,297

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/20/2012

---