Fast Track Template

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0925-0648 exp. 3/2018)

T ITLE OF INFORMATION COLLECTION: Qualitative Research to Explore Barriers and Facilitators for LRP Ambassadors to Promote the NIH Loan Repayment Programs

PURPOSE:

The LRP Ambassadors Program is intended to promote NIH’s Loan Repayment Programs (LRP) by engaging current and past LRP recipients to disseminate information about the availability and usefulness of the LRPs and to support them during the application process. The purpose of the proposed research is to explore the barriers and facilitators of such engagement. The findings will be used to inform the design of the LRP Ambassadors Program to make it an effective mechanism to recruit young biomedical scientists to participate in the LRPs and hence strengthen the nation’s biomedical research workforce.

DESCRIPTION OF RESPONDENTS:

Respondents will be individuals who have previously indicated an interest to the Division of Loan Repayment at NIH in serving as an LRP Ambassador. Generally, these are past and present LRP recipients, as well as faculty at professional health schools.

TYPE OF COLLECTION: (Check one)

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

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

[] Focus Groups [ x] Other: Key Informant 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: Sherry Mills, MD/Seleda M. Perryman

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 [ ] 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

HOUR and COST BURDEN

Category of Respondent	No. of Respondents	Participation Time	Burden Hours
Individuals (current/past LRP recipients)	35	30/60	18
Totals	35	--	18

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals (current/past LRP recipients)	18	$37.01	$666.18
Total			$666.18

*http://www.bls.gov/ooh/life-physical-and-social-science/medical-scientists.htm

FEDERAL COST: The estimated annual cost to the Federal government is $30,000.00.

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Scientific Program Evaluation Specialist	GS 14/5	$122,000	5%		$6,100
Contractor Cost		$23,900	100%	n/a	$23,900
Travel
Other Cost
Total					$30,000

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 Division of Loan Repayment within the Office of Extramural Programs/Office of Extramural Research in the Office of the Director, NIH, maintains a mailing list of approximately 1600 individuals who have indicated an interest in serving as an Ambassador. The list can be searched in several ways, such as whether or not the individual is a current or past LRP recipient, host institution, geographic location, and whether the individual has requested information materials to use in disseminating information about the LRPs to prospective candidates.

The sampling framework consists of randomly selecting approximately equal numbers of respondents from among those who have requested information and those who have not, stratified by type of Ambassador category (i.e., current LRP recipient/past LRP recipient).

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

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

3