Request for Approval

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-0953)

TITLE OF INFORMATION COLLECTION:

Fatigue Management Training Module for Emergency Responders Evaluation

PURPOSE:

The Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH) seeks to obtain Office of Management and Budget (OMB) approval to collect feedback on customer service delivery and satisfaction with a NIOSH fatigue management training module.

During disasters, emergency responders often suffer from fatigue. During Hurricane Katrina, one in three U.S. Coast Guard personnel who deployed reported getting 5 hours or less of sleep each night. Researchers noted that this gave them three times the risk for depression; slips, trips, and falls; muscle strain; and dehydration.

In response to the 2014 Ebola outbreak in West Africa, NIOSH developed an on-line 30 minute fatigue management training module for emergency responders. The customer service delivery objectives for the training include the following: (1) increase awareness of fatigue and the importance of adequate sleep for health and well-being; (2) improve knowledge of fatigue risk management by introducing relevant and useful fatigue management techniques, and (3) motivate responders to consider how they might better prevent fatigue in the future.

To ensure that this NIOSH fatigue management training product will satisfy our customers’ needs (and previously stated objectives), NIOSH proposes to collect feedback from emergency responders who take the training through a brief web-based survey immediately following the delivery of the NIOSH fatigue management training module. Results will help NIOSH to identify and incorporate any needed improvements; thus, ensuring that the delivery of future versions of our training product meets our stakeholders’ needs and expectations.

DESCRIPTION OF RESPONDENTS:

Respondents will be emergency responders deploying to West Africa for the Ebola response (or potentially to any future disaster). These responders will be at various stages of their careers and lives, both male and female.

BURDEN HOURS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Participation Time	Burden Hours
Emergency Responders	150	1	10/60 hours	25
Total				25

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: Kimberly Brinker

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? [ ] Yes [X] No

FEDERAL COST: The estimated annual cost to the Federal government is $2050.

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?

Respondents will voluntarily take the fatigue management training module on-line. After the training, respondents will be prompted to answer questions about customer service delivery and satisfaction.

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

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