Fast track NCTN Customer Feedback

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0642 ExpDate:08/2017)

T ITLE OF INFORMATION COLLECTION: NCTN Satisfaction Survey

PURPOSE: A short survey for scientific and administrative leaders in the NCI’s new National Clinical Trials Network (NCTN) as we are halfway through the first five-year grant cycle for this network. The survey objective is to gather feedback from engaged extramural members of the NCTN about their satisfaction with various aspects of the network and suggestions for possible improvements to improve service delivery.

DESCRIPTION OF RESPONDENTS: Respondents will include leaders from the groups, their member sites, and PIs of active group studies.

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:_Grace Mishkin_______________________________________________

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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individuals	1100	1	5/60	92
Totals	1100	1100		92

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Private Sector - Research Investigator	92	$97.33	$8,954.36
Totals	92		$8,954.36

* The mean hourly wage rate for Research Investigators was based on occupation code #29-1060 at $97.33/hour (based on the May 2015 National Occupational Employment and Wage Estimates in the United States; http://www.bls.gov/oes/current/oes_nat.htm).

FEDERAL COST: The estimated annual cost to the Federal government is $6,937.25

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Program Analyst (Federal Oversight and Survey Analysis)	GS 12-01	$77,490	10% for 3 months		$1,937.25
Contractor Cost (Contracted Survey Programming and Collection)					$4,000.00
Total Cost					$6,937.25

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

We have a list of leadership, key member investigators, and study PIs.

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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