Fast-Track Template - Office of Global Research (OGR) Georgia and MENA Workshops

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0925-0668)

T ITLE OF INFORMATION COLLECTION: Office of Global Research (OGR) Georgia and MENA Workshops

PURPOSE:

The Office of Global Research (OGR) of the National Institute of Allergy and Infectious Diseases (NIAID) sponsors workshops around the world, and will be sponsoring two workshops, one in Qatar in May 2014 and one in Tbilisi, Georgia in June 2014. NIAID is interested in knowing the participant’s overall satisfaction with what they learned at the workshop as well as if they were able to meet potential collaborators. This survey is part of a customer satisfaction assessment to examine the NIAID’s workshop implementation and grantees’ perceptions to date. The information collected will enable the Office of Global Research to improve future workshops and encourage collaboration.

DESCRIPTION OF RESPONDENTS:

Potential survey respondents are the participants of the Middle East and North Africa (MENA) and the US-Georgia Program-Development Workshops, including both American scientists and scientists from the regions. We are expecting about 90 non-FTE attendees in Qatar and about 110 non-FTE attendees in Georgia.

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: Elizabeth Dillard (DHHS, NIH, NIAID, OD, OGR)

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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Private Sector/ non-USG (Academia, industry, not-for profits, scientists)	200	5 minutes	17h
Totals	200	5 minutes	17h

FEDERAL COST: The estimated annual cost to the Federal government is $920.

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 survey will be provided to all the participants at both the MENA and the Georgia Workshops, in paper form on the final day of the meetings. The survey will also include a question for participants to indicate whether they are government employees or not. Neither workshop registration is complete; therefore, the list of specific participants is not yet available. We anticipate hosting 90 non FTE participants at the MENA Workshop and 110 non FTE participants at the Georgia Workshop. The surveys will be administered and collected by Elizabeth Dillard at the MENA Workshop and Dr. Ranjan Gupta at the Georgia Workshop.

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

[ ] Mail

[ ] Other, Explain

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

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