NIH Single Cell Analysis Mtg Survey Fast Track

NIH Single Cell Analysis Mtg Survey Fast Track Template 2015 - 3.25.2015.doc

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

NIH Single Cell Analysis Mtg Survey Fast Track

OMB: 0925-0648

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2015 Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Expiration Date: 03/2018)

T ITLE OF INFORMATION COLLECTION:

2015 NIH Single Cell Analysis Investigators Meeting Survey


PURPOSE:


To collect customer satisfaction information from participants of the 2015 NIH Single Cell Analysis (SCA) Investigators Meeting in order to improve the 2016 meeting


DESCRIPTION OF RESPONDENTS:


Expected respondents are participants at the 2015 NIH SCA Investigators Meeting. This includes the funded grantees of the SCA Common Fund Program, interested members from multidisciplinary scientific communities, and NIH extramural and intramural staff.


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: Keisha Shropshire, Project Clearance Liaison


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 [X] N/A

  3. If Applicable, has a System or Records Notice 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



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

20

1

20/60

7






Totals







Category of Respondent


Total Burden

Hours

Wage Rate*

Total Burden Cost

Conference Participant

20/60

0

0





Totals



0


*Cite source per bls.gov if applicable


FEDERAL COST: The estimated annual cost to the Federal government is $153.

Staff


Grade/Step

Salary

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Employee






Scientific Program

Analyst


12/1

76,378

1/500



152.76













Contractor (N/A)


0

0

0

0







Travel






Other Cost



















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?


A link to the online survey will be shared electronically to all meeting participants who registered for the Single Cell Analysis Program meeting on April 20-21, 2015. We expect 10% response rate (20 individuals out of maximum of 200 participants). It is not mandatory to complete this survey.


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

  1. Will interviewers or facilitators be used? [ ] Yes [X] No


3

File Typeapplication/msword
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
Last Modified ByAbdelmouti, Tawanda (NIH/NCI) [E]
File Modified2015-04-15
File Created2015-04-15

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