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

Forms and Documents

Document Name	Status
Form 1 CIS Telephone Customer Service Questions (Appendix 1A_REV) Form and Instruction	Modified
Form 6 CIS Email Intake Form (Appendix 2_REV) Form and Instruction	New
Form 5 CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C_REV) Form and Instruction	Modified
Form 4 CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C_REV) Form and Instruction	Modified
Form 3 CIS LiveHelp Questionnaire (Appendix 1B_REV) Form and Instruction	Modified
Form 2 CIS Telephone Demographic Questions (Appendix 1A_REV) Form and Instruction	Modified
SSB_CIS_6-6-2012.docx Supporting Statement B	2012-10-31
Appendix 6_OHSR_Not Applicable.pdf Supplementary Document	2012-10-31
Appendix 8_CIS Annual Data Report 2011.docx Supplementary Document	2012-10-31
Appendix 7_Confidentiality of CIS Policy 3.docx Supplementary Document	2012-10-31
Appendix 5_Privacy Act Memo_CIS.docx Supplementary Document	2012-10-31
Appendix 4_PIA_CIS.pdf Supplementary Document	2012-10-31
Appendix 3_Facebook and Smartphone screenshots.docx Supplementary Document	2012-10-31
Cover Memo_CIS.doc Supplementary Document	2012-10-31
SSA_CIS_7-18-2012.docx Supporting Statement A	2012-10-31

IC Document Collections

IC ID	Document Title	Status
43626	CIS Telephone Customer Service Questions (Appendix 1A_REV) Form and Instruction	Modified
204675	CIS Email Intake Form (Appendix 2_REV) Form and Instruction	New
189806	CIS Smoking Cessation Proactive Follow-ups (Appendix 1D_REV) Instruction	Modified
189805	CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C_REV) Form and Instruction	Modified
189804	CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C_REV) Form and Instruction	Modified
189803	CIS LiveHelp Questionnaire (Appendix 1B_REV) Form and Instruction	Modified
189802	CIS Telephone Demographic Questions (Appendix 1A_REV) Form and Instruction	Modified

ICR Details

OMB Control No: 0925-0208	ICR Reference No: 201210-0925-004
Status: Historical Active	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
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/21/2012
	Date Received in OIRA: 10/31/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2015	36 Months From Approved	12/31/2012
Responses	110,000	0	100,667
Time Burden (Hours)	2,686	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 410 Name of Law: Public Health Service Act
   US Code: 42 USC 412 (285a-1) 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

IC Title	Form No.	Form Name
CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C_REV)	5	Smoking Cessation Reactive Service Demographic Questions
CIS Smoking Cessation Proactive Follow-ups (Appendix 1D_REV)
CIS Email Intake Form (Appendix 2_REV)	6	Email Intake
CIS Telephone Demographic Questions (Appendix 1A_REV)	2	Telephone Demographic Questions
CIS Telephone Customer Service Questions (Appendix 1A_REV)	1	Telephone Customer Service Questions
CIS LiveHelp Questionnaire (Appendix 1B_REV)	3	LiveHelp Questionnaire
CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C_REV)	4	Smoking Cessation Reactive Service Client Questions

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	110,000	100,667	0	1,000	8,333	0
Annual Time Burden (Hours)	2,686	2,492	0	33	161	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: 10/31/2012

---