NLM Fast Track ICR_AIDSource 2017 Survey

NLM Fast Track ICR_AIDSource 2017 Survey.doc

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

NLM Fast Track ICR_AIDSource 2017 Survey

OMB: 0925-0648

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Exp. Date: 03/31/2018)


TITLE OF INFORMATION COLLECTION: NLM AIDSource 2017 Survey


PURPOSE:

The goal of this National Library of Medicine (NLM) survey is to collect qualitative feedback from AIDSource users. The survey consists of a short list of questions about the AIDSource site to determine what information people coming to the site are looking for, whether users can find what they were looking for and if people have suggestions for improvement. The information from this survey will be used to improve the information architecture, design, navigation and resources linked from the publically accessed AIDSource website.


DESCRIPTION OF RESPONDENTS:

Respondents will be individual users of AIDSource who voluntarily click on an invitation to take a survey that appears on the AIDSource website.


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: Nicole D. Scott, MPH_______________________________________________



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 [X] No

  3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No [X] N/A




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 or Households

200

1

5/60

17






Totals

200

200


17



Category of Respondent


Total Burden

Hours

Wage Rate*

Total Burden Cost

Individuals or Households

17

$23.86

$405.62





Totals



$405.62


*BLS National Occupational Employment and Wage Estimates

https://www.bls.gov/oes/current/oes_nat.htm


FEDERAL COST: The estimated annual cost to the Federal government is $1,833.55


Staff


Grade/Step

Salary

% of Effort


Fringe (if applicable)


Total Cost to Gov’t

Federal Oversight






Technical Information Specialist

13/7

$113,755

1%


$1,137.55













Contractor Cost






Analyst


$69,600

1%


$696.00

Travel






Other Cost












Total





$1,833.55






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? [ ] Yes [X] 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 survey will be available via the AIDSource web site. The respondents will be individual users of AIDSource who voluntarily click on the invitation to take the survey from the web site.



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


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