RevisedHRSA Bullying Supporting Statement 062315

Health Resources and Services Administration

SUPPORTING STATEMENT

Bullying Prevention Training Modules Feedback Forms

A. Justification

1. Circumstances of Information Collection

The Health Resources and Services Administration (HRSA) currently has approval under the generic clearance, Office of Management and Budget (OMB) Control No. 0915-0212, to conduct customer satisfaction surveys and focus groups. This collection of information helps fulfill the requirements of:

1. Executive Order 12862, “Setting Customer Service Standards,” which directs Agencies to continually reform their management practices and operations to provide service to the public that matches or exceeds the best service available in the private sector.

This is a request for OMB approval of a qualitative voluntary customer satisfaction survey or focus group under HRSA’s generic clearance.

Pending OMB approval, HRSA’s Maternal and Child Health Bureau (MCHB) will obtain feedback from consumers of a resource titled Bullying Prevention Training Modules and Community Action Toolkit utilizing one survey administered immediately after training and another survey administered four months later.

Production of this resource was funded through HRSA’s contract entitled Communications Management Services to Support the HRSA National Bullying Prevention Campaign. The statement of work for this current contract includes both the production and dissemination of the training modules project including Power Point slides and a step-by-step guide for conducting a community event addressing bullying. This contract has been extended through September 22, 2016.

Executive Order 12862 directs agencies that "provide significant services directly to the public" to "survey customers to determine the kind and quality of services they want and their level of satisfaction with existing services."

The objective of surveying the consumers of the Bullying Prevention Training Modules and Community Action Toolkit is to provide insight regarding user opinions, experiences and perceptions of the new resource. This information will inform revision of the product in order to ensure that the public’s needs are being effectively met.

2. Purpose and Use of the Information

As local communities respond to increased awareness about the negative impact of bullying on youth, they actively seek bullying prevention expertise to provide evidence-informed, accurate information to inform prevention efforts. HRSA’s new Bullying Prevention Training Modules and Community Action Toolkit responds to this need by distilling the latest evidence and expert opinion.

The information will be collected for program planning purposes to understand the degree to which the resources are useful to the public, and to inform revisions to the bullying prevention resources.

3. Use of Improved Information Technology

The surveys will employ technology by being accessible via an online survey application (i.e., Survey Monkey). In addition, the forms will be available for download as a Word document to increase user accessibility. The Word document version will be accepted via email to HRSA’s contractor. In both methods of feedback (online survey and Word document), all data will be extracted and compiled into one spreadsheet for analysis. All raw data will be destroyed.

4. Efforts to Avoid Duplication

The proposed surveys are unique to this activity and the information cannot be found elsewhere.

5. Involvement of Small Entities

These surveys will not have a significant impact on small businesses or other small entities.

6. Consequences if Information Collected Less Frequently

Information gathered through these surveys will serve to inform future revisions to the Bullying Prevention Training Module and Community Action Toolkit. If this information is not collected, the Program will be (1) unable to establish and report internally to HRSA a metric of the usefulness of the bullying prevention resources and (2) inhibited in obtaining data that can be analyzed by HRSA/MCHB to inform future revisions to the bullying prevention resources.

7. Consistency With the Guidelines in 5 CFR 1320.5(d) (2)

These surveys will be implemented in a manner fully consistent with 5 CFR 1320.5(d) (2).

8. Consultation Outside the Agency

In accordance with 5 CFR 1320.8(d), on April 24, 2009, a 30 day notice was published in the Federal Register for HRSA’s generic clearance, OMB Control No. 0915-0212 (Vol. 74, Page 18726). No public comments were received.

9. Remuneration of Respondents

Not applicable.

10. Assurance of Confidentiality

On the initial survey, providing name, e-mail address and name/address of organization is fully voluntary and will only be used to contact the respondent for the four month follow-up survey. This information will not be shared with HRSA staff and will be destroyed by HRSA’s contractor upon collection of the four month follow-up data.

11. Questions of a Sensitive Nature

The surveys do not contain questions of a sensitive nature.

12. Estimates of Annualized Hour Burden

Respondents:

The total respondent burden for the customer satisfaction surveys is estimated to be 100 hours. We estimate 500 respondents immediately after training and 250 respondents to the follow-up survey at four months following the initial training.

See the table below for annual burden estimates:

Type of Collection	Number of Respondents	Responses per Respondent	Total Responses	Hours per Respondent	Total Burden Hours	Wage Rate	Total Hour Cost
Form A: Feedback Form for Bullying Prevention Training Module Participants	500	1	500	0.16	80	$44/hr	$3,520
Form B: Feedback Form for Bullying Prevention Training Module Participants (follow-up)	250	1	250	0.08	20	$44/hr	$880
Total	750	--	750	--	100	--	$4400

As the total burden anticipated through collecting this user feedback is approximately 100 hours, this totals $4400 in total hour cost.

Planned frequency of information collection:

This information will be collected in stages: immediately after the initial training, and four months later. Each survey is designed to collect user feedback at a different stage in the implementation of the Bullying Prevention Training Modules and Community Action Toolkit: Form A immediately after receiving the training and Form B four months later to assess the utility of the resource in planning a community event.

13. Estimates of Annualized Cost Burden to Respondents

The only associated cost to respondents is their time to provide the requested information.

14. Estimates of Annualized Cost to the Government

The surveys will be accessible through the online survey application Survey Monkey. Collection and analysis of the data, including the storage and destruction of personally identifiable information, will be performed by HRSA’s bullying prevention contractor. This activity fits within the existing scope of work and award of this contract with an estimated annual cost of $20,000.

15. Change in Burden

Not Applicable. This is an activity under HRSA’s generic clearance and will be included in the total burden currently approved by OMB under OMB Control No. 0915-0212.

16. Plans for Analysis and Timetable of Key Activities

All data will be collected by HRSA’s contractor and will occur in the stages outlined previously. The HRSA contractor will compile information from the online survey database and emailed Word documents destroying personally identifiable information as it is no longer needed for follow up. After 12 months of collection, the contractor will deliver the full data analysis to HRSA. Findings will only be used for internal service improvement by program staff. There are no plans for publication or distribution of any survey results.

17. Exemption for Display of Expiration Date

No exemption is being requested. The expiration date will be displayed.

18. Certifications

This information collection activity will comply with the requirements in 5 CFR 1320.9.

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