The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form B

LRP Applicant Survey Form B - PCB Fasttrack Template.doc

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

The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form B

OMB: 0925-0648

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

T ITLE OF INFORMATION COLLECTION:


The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form B


PURPOSE:


The NIH Extramural Loan Repayment Programs (LRP) FY2017 application period began on September 1st, 2016 and ended December 1st, 2016. LRP applicants are required to interact with LRP systems in order to learn about the programs, complete an application, upload documents, and provide contact information for their mentors and references/referees.


The purpose of the currently proposed online survey, hosted on SurveyMonkey, is to garner feedback from applicants about the ease and usability of LRP systems, resources, and help desk. The survey will be anonymous, and information garnered from the survey will remain internal to DLR and be used solely to make improvements to our mentor processes for the following year.


DESCRIPTION OF RESPONDENTS:


Respondents will be approximately 594, extramural, doctoral-level researchers who are LRP applicants.


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: Jill I. Mattia, Ph.D.


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

594

1

4/60

40

Totals

594

594


40



Category of Respondent


Total Burden

Hours

Wage Rate*

Total Burden Cost

Individuals

40

$66

$2,640

Totals

40

$66

$2,640


Source is the Chronicle of Higher Education (hyperlink - http://data.chronicle.com/category/sector/1/faculty-salaries/)

The mean annual salary for an assistant professor is $71,130, and the mean hourly wage is $66.


FEDERAL COST: The estimated annual cost to the Federal government is $1,180.


Staff


Grade/Step

Salary

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight






Scientific Prog Eval Spec

14-3

$118,000

1


$1,180













Contractor Cost












Travel





None

Other Cost





None







Total





$1,180




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?


Potential respondents to the survey covered in this form will be individuals who submitted an LRP application. All such individuals will be sent an email with a link to the survey hosted by SurveyMonkey after the LRP application period has closed. Based on last year’s application numbers, DLR anticipates the number of individuals invited to participate in this survey will be n=900. Assuming a 60% response rate obtained in prior research, the final total respondent sample for this survey is anticipated to be n=594.


Context: There will be three different applicant surveys, and as such the entire LRP applicant pool (N=2,700) will be split into thirds (n=900) so that individuals receive an invitation to complete just one survey. Assuming a 60% response rate obtained in prior research, the final total respondent sample for each of the three surveys is anticipated to be n=594. Form A contains questions about using the LRP Online Application system. Form B contains questions about the LRP Information Center (i.e., help desk), and Form C contains questions about the LRP website.


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

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

3

File Typeapplication/msword
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
Last Modified ByFountain, Marisa (NIH/OD) [E]
File Modified2016-12-02
File Created2016-12-02

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