Request for Approval Application

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-0974)

T ITLE OF INFORMATION COLLECTION: Customer Feedback to Improve the Decision and Implementation Support of The Community Guide Website

PURPOSE: Opinions and feedback sought in this collection will be used to improve the user experience with The Community Guide, an existing website. Specifically, information from this collection will identify improvements in the existing website that are considered fundamental to supporting decision–making related to and implementation of recommendations from the Community Preventive Services Task Force (Task Force). As identified improvements are made, customer satisfaction information will be collected to guide further refinement in service delivery.

DESCRIPTION OF RESPONDENTS:

Respondents were identified as having experience or likely to have experience in the future with The Community Guide website. Respondents are individuals known to Community Guide staff, such as Task Force members or former members, representatives of official Liaison organizations to the Task Force, or others with interest in the work of the Task Force, for example, the American Planning Association.

Although a couple of collections targeting users of The Community Guide have been carried out, their purposes were focused elsewhere, such as awareness or satisfaction with specific materials on the website. In addition, Individuals in the audiences for previous collections do not overlap with this audience. Information about decision and implementation support for use of evidence-based strategies found on The Community Guide website has not been collected previously.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [X] Other: Individual Interviews

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: Katherine M. Wilson

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, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [X] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ]Yes [X] 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	16	60/60	16
Federal government	5	60/60	5
State, tribal, local, or territorial	4	60/60	4
Totals	25		25

FEDERAL COST: The estimated annual cost to the Federal government is $4,500

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?

No list of all users or potential users of The Community Guide website exists. Instead, individuals (25) known as members of user groups or members of groups that may use the website in the near future were identified by Community Guide Branch staff. These individuals include former and current members of the Community Preventive Services Task Force and its official Liaison organizations; program staff of state, tribal, local or territorial government entities; academic and community partners of CDC or other federal agencies; leaders of private sector groups interested in improving use of evidence-based approaches in public health. We intend to send an email to the entire list and interview those that agree to be interviewed. We anticipate a high response rate based on interest in the current website.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[X] Telephone

[X] In-person

[ ] Mail

[ ] Other, Explain

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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