HHS Brand Awareness Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0990-0379)

TITLE OF INFORMATION COLLECTION:

HHS Brand Awareness Survey

PURPOSE:

The purpose of this survey is to determine general awareness of U.S. Department of Health & Human Services (HHS) and its offerings.

We will do this by using an online survey tool called Survey Monkey. Participants will complete the survey online using their own computer.

DESCRIPTION OF RESPONDENTS:

Survey participation will be optional and voluntary. We will be distributing the URL for the survey via the HHS Gov delivery account, as well as posting it on Amazon’s Mechanical Turk (MTurk) participant board. We would like members of the general public, US residents over the age of 18, to volunteer to participate in this survey.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [X] Other: A Brand Awareness Survey

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: Darryl K. Cunningham

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 [x ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
HHS Gov Delivery email list	187,000	10/60	31,166 hrs
Brand Awareness Survey	1000	10/60	167 hrs
TOTAL			31,333 hrs

FEDERAL COST: The estimated annual cost to the Federal government is none.

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 available to all subscribers of the HHS.gov Gov Delivery email update. The Gov delivery list serves emails to more than 187,000 users. Recipients will be able to access the survey via a link in an email. The URL will also be distributed through Amazon’s Mechanical Turk (MTurk) participant board.

We will not be sampling. Providing feedback through this survey is optional and voluntary. Our goal is a 20% response rate.

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

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

NOTE: Please see attachment (HHS Brand Awareness Survey For OMB Submission 022014 RLM.docx) for instructions and scripts.