2015-1016 HRHR Symposium fast track survey

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

T ITLE OF INFORMATION COLLECTION:

Participant Feedback on 2016 NIH Common Fund High-Risk, High-Reward Research Symposium

PURPOSE:

The purpose of this voluntary, confidential survey is to obtain feedback from participants on their satisfaction with and perceived usefulness of the science discussed during the symposium. This will aid in improving the delivery of this annual symposium.

DESCRIPTION OF RESPONDENTS:

Participants of the 2016 NIH Common Fund High-Risk, High-Reward Research Symposium include scientists who are current and previous recipients of the NIH Common Fund High-Risk, High-Reward Research program awards, including the NIH Director’s Pioneer, New Innovator, Transformative Research, and Early Independence Awards.

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:_Amanda L Greene_______________________________________________

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
Scientists	185	1	5/60	15
Totals	185	185		15

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Scientists	15.4	39.68	611.73
Totals	15.4	39.58	611.73

*Source per bls.gov Scientific Research and Development Services mean wage, https://www.bls.gov/oes/current/oes191029.htm)

FEDERAL COST: The estimated annual cost to the Federal government is $321.04.

____________

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Personnel from the NIH Office of Strategic Communication	13/4	$101,361	0.1%		$101.36
Personnel from the NIH Office of Strategic Communication	14/5	$123,406	0.05%		$61.70
Personnel from the NIH Office of Strategic Communication	15/8	$157,971	0.1%		$157.97
Contractor Cost					0
Travel					0
Other Cost					0
Total					$321.04

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?

This survey will be sent to all registered participants of the 2016 NIH Common Fund High-Risk, High-Reward Research Symposium, i.e., current and previous recipients of the NIH Common Fund High-Risk, High-Reward Research participating in the symposium.

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

3