Gen IC Form_GEM-DM

GENERIC SUB-STUDY SUBMISSION – 0925-0589-07

DATE OF REQUEST: 9/4/2013

SUB AGENCY (I/C): NIH/NCI/DCCPS/BRP

TITLE OF SUB-STUDY: “Development of Consensus Measures of Distress for the Grid Enabled Measures-Distress Measurement (GEM-DM) Workspace”

GENERIC CLEARANCE UNDER OMB #0925-0589-07 EXP. DATE: 4/30/2014

TOTAL BURDEN APPROVED: 6,000 hours

BURDEN APPROVED TO DATE: 305 hours

BURDEN FOR THIS REQUEST: 25 hours

ABSTRACT:

To facilitate the development of consensus measures for distress measurement, the BRP developed the Grid Enabled Measurement (GEM) Website (https://www.gem-beta.org/). The website was created to promote quality research measures and support the goals of BRP. The information collected from these surveys will be used by the GEM-Distress Measures (GEM-DM) team to facilitate eventual data harmonization. The data obtained by participants to the survey will be used to drive consensus on the best measures of distress to improve assessment of this construct. The ultimate goal is to enable the use of common measures of distress that will eventually improve negative outcomes like distress in cancer survivors. Respondents will include a maximum of 100 current GEM-DM users and those who have signed up to receive ongoing information regarding GEM initiatives. Current lists include psychosocial expert clinicians and researchers, interested parties from presentation, and professional listserv announcements. Convenience sampling will be used for this formative research project. An invitational email with a link to the survey will be sent to the respondents and information will be collected electronically.

IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED? _____YES __X___NO_______N/A	IS PERSONALLY IDENTIFIABLE INFORMATION (PII) BEING COLLECTED? ___X___YES _____NO_______N/A
OBLIGATION TO RESPOND: __X___ VOLUNTARY ______ REQUIRED TO OBTAIN OR RETAIN BENEFITS ______ MANDATORY	TYPE OF COLLECTION/RESEARCH? _____ CUSTOMER SATISFACTION _____ USABILITY TESTING _____FOCUS GROUPS _____PRETESTING __X___FORMATIVE RESEARCH _____QUESTIONNAIRE DEVELOPMENT _____ OTHER: _________________________
HOW WILL THIS SURVEY BE OFFERED? __X___ WEB SITE _____ TELEPHONE INTERVIEW (screener) _____ MAIL RESPONSE _____ IN PERSON INTERVIEW (cognitive interviewing) _____ OTHER: _________________________
CONTACT INFORMATION: NAME: Richard Moser TELEPHONE NUMBER: 240-276-6915 EMAIL ADDRESS: [email protected]