Request for GenIC Approval 0920-1027

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1027)

TITLE OF INFORMATION COLLECTION: MSM AYA Stakeholder Analysis Survey

PURPOSE:

The goal of these two online surveys are to gather feedback about existing CDC-developed products to determine if the materials meet the needs of the target audience. These materials include messaging, web content, and fact sheets. The target audiences for these surveys are adolescents and young adults as well as men who have sex with men.

DESCRIPTION OF RESPONDENTS:

Males; Gay, bisexual, and/or men who have sex with men.

Young men and women aged 15-24.

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: Rachel Powell

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
Individuals: Gay, bisexual, and/or men who have sex with men (MSM)	75	10 minutes	750 minutes/12.5 hours
Individuals: Young men and women aged 15-24 (Adolescents)	75	10 minutes	750 minutes/12.5 hours
Totals	150	20 minutes	1500 minutes/25 hours

FEDERAL COST: The estimated annual cost to the Federal government is $74,297

The anticipated cost to the Federal Government is approximately $74,297 annually. These costs are comprised of the participation of at least one part-time CDC project officer who will be responsible for the project design, providing project oversight, and analysis of the results.

Expense Type	Expense Explanation	Annual Costs (dollars)
Federal Government Personnel Costs	CDC Project Officer	$12,500
Contract	Cooperative Agreements, Task Orders, or Contracts for implementation	$61,797
Total Cost		$74,297

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 National Prevention Information Network (NPIN) and partners from community based organizations including AID Atlanta, Gay Men's Health Crisis, Black AIDS Institute, and the St. Hope Foundation will reach potential MSM survey respondents.

These groups regularly work with MSM to conduct outreach and therefore have vast email lists and social media reach to attract the appropriate demographic for this survey. The request for participation will be shared with these email lists and social media channels.

Danya has included “screener” questions on the survey, and will monitor the survey mechanism, on an ongoing basis, to ensure that the appropriate number of participants within the range of demographics are represented.

The National Prevention Information Network (NPIN) and Advocates for Youth, an organization which champions youth involvement in sexual and reproductive health, will conduct recruitment for the AYA audience group.

Because Advocates for Youth regularly works with young people to conduct outreach, the organization has extensive email lists and social media reach to attract young adults to participate in this survey. The request for participation will be shared with these email lists and social media channels.

Danya has included “screener” questions on the survey and will monitor the survey mechanism, on an ongoing basis, to ensure that the appropriate number of participants within the range of demographics are represented.

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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