Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI's Contact Center, Cancer Information Service (CIS) Clients

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Telephone Customer Service Questions	Form and Instruction	Removed	Available
Form 8 Appendix 2 Email Intake Form on Cancer,gov	Form and Instruction	New	Available
Form 7 Appendix 1B LiveHelp Demographic Questions and Sample Transcript	Form and Instruction	New	Available
Form 6 Appendix 9 Customer Satisfaction Survey Questions	Form and Instruction	New	Available
Form 5 Appendix 1D VA Smoking Cessation Callback	Form and Instruction	New	Available
Form 4 Appendix 1C Smoking Cessation Questions	Form and Instruction	New	Available
Form 3 Appendix 1C Smoking Cessation Questions	Form and Instruction	New	Available
Form 2 Appendix 1A Customer Service and Demographic Questions	Form and Instruction	New	Available
Form 1 Appendix 1A Customer Service and Demographic Questions	Form and Instruction	New	Available
Form 6 Email Intake	Form and Instruction	Removed	Available
Form 5 Smoking Cessation Reactive Service Demographic Questions	Form and Instruction	Removed	Available
Form 4 Smoking Cessation Reactive Service Client Questions	Form and Instruction	Removed	Repair queued
Form 3 LiveHelp Questionnaire	Form and Instruction	Removed	Available
Form 2 Telephone Demographic Questions	Form and Instruction	Removed	Available
Appendix 8 CIS Annual Data Report 2014.docx	Supplementary Document	Uploaded 2015-12-23	Repair queued
Appendix 7 Confidentiality of Communications Policy.docx	Supplementary Document	Uploaded 2015-12-23	Available
Appendix 6 Office of Human Subject Research Not Applicable.docx	Supplementary Document	Uploaded 2015-12-23	Available
Appendix 5 Privacy Act Memo.docx	Supplementary Document	Uploaded 2015-12-23	Available
Appendix 4 Privacy Impact Assessment.docx	Supplementary Document	Uploaded 2015-12-23	Available
Appendix 3 Facebook and Mobile Contact Us.docx	Supplementary Document	Uploaded 2015-12-23	Repair queued
30-Day FRN.pdf	Supplementary Document	Uploaded 2015-12-23	Available
SSB_CIS.docx	Supporting Statement B	Uploaded 2015-12-23	Available
SSA CIS Passback 4.4.2016.docx	Supporting Statement A	Uploaded 2016-04-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43626	CIS Telephone Customer Service Questions (Appendix 1A_REV)	Form and Instruction	Removed	Telephone Customer Service Questions
219416	E-mail Clients	Form and Instruction	New	Appendix 2 Email Intake Form on Cancer,gov
219415	LiveHelp Clients	Form and Instruction	New	Appendix 1B LiveHelp Demographic Questions and Sample Transcript
219414	Customer Satisfaction Survey	Form and Instruction	New	Appendix 9 Customer Satisfaction Survey Questions
219413	VA Smoking Cessation Clients Call Backs	Form and Instruction	New	Appendix 1D VA Smoking Cessation Callback
219411	Smoking Cessation Clients Demographic Questions	Form and Instruction	New	Appendix 1C Smoking Cessation Questions
219410	Smoking Cessation Clients Smoking Cessation "Intake" Questions	Form and Instruction	New	Appendix 1C Smoking Cessation Questions
219409	Telephone Clients Demographic Questions	Form and Instruction	New	Appendix 1A Customer Service and Demographic Questions
219408	Telephone Clients Customer Service	Form and Instruction	New	Appendix 1A Customer Service and Demographic Questions
204675	CIS Email Intake Form (Appendix 2_REV)	Form and Instruction	Removed	Email Intake
189806	CIS Smoking Cessation Proactive Follow-ups (Appendix 1D_REV)	Instruction	Removed
189805	CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C_REV)	Form and Instruction	Removed	Smoking Cessation Reactive Service Demographic Questions
189804	CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C_REV)	Form and Instruction	Removed	Smoking Cessation Reactive Service Client Questions
189803	CIS LiveHelp Questionnaire (Appendix 1B_REV)	Form and Instruction	Removed	LiveHelp Questionnaire
189802	CIS Telephone Demographic Questions (Appendix 1A_REV)	Form and Instruction	Removed	Telephone Demographic Questions

ICR Details

OMB Control No: 0925-0208	ICR Reference No: 201512-0925-003
Status: Historical Active	Previous ICR Reference No: 201210-0925-004
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI's Contact Center, Cancer Information Service (CIS) Clients
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/06/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/28/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2019	36 Months From Approved	04/30/2016
Responses	127,726	0	110,000
Time Burden (Hours)	3,387	0	2,686
Cost Burden (Dollars)	0	0	0

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Abstract: This is an information collection request for a revision for three years. NCI’s Contact Center, The Cancer Information Service (CIS), currently collects demographic, customer service and smoking cessation information from clients contacting CIS by telephone, email and through LiveHelp (an online instant messaging service). Information is collected in order to properly plan, implement, and evaluate cancer education efforts and to provide smoking cessation services tailored to the individual client’s needs. Since its inception in 1976, the CIS has handled more than 12 million calls from the public. The potential universe of Cancer Information Service (CIS) clients is almost 319 million respondents based on the U.S. Census estimate for 2014 of adults estimated to be 18 years and older.

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Authorizing Statute(s): US Code: 42 USC 410 Name of Law: Public Health Service Act
   US Code: 42 USC 412 (285a-1) Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 58268	09/28/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 79596	12/22/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
CIS Email Intake Form (Appendix 2_REV)	6	Email Intake
CIS LiveHelp Questionnaire (Appendix 1B_REV)	3	LiveHelp Questionnaire
CIS Smoking Cessation Proactive Follow-ups (Appendix 1D_REV)
CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C_REV)	5	Smoking Cessation Reactive Service Demographic Questions
CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C_REV)	4	Smoking Cessation Reactive Service Client Questions
CIS Telephone Customer Service Questions (Appendix 1A_REV)	1	Telephone Customer Service Questions
CIS Telephone Demographic Questions (Appendix 1A_REV)	2	Telephone Demographic Questions
Customer Satisfaction Survey	6	Appendix 9 Customer Satisfaction Survey Questions
E-mail Clients	8	Appendix 2 Email Intake Form on Cancer,gov
LiveHelp Clients	7	Appendix 1B LiveHelp Demographic Questions and Sample Transcript
Smoking Cessation Clients Demographic Questions	4	Appendix 1C Smoking Cessation Questions
Smoking Cessation Clients Smoking Cessation "Intake" Questions	3	Appendix 1C Smoking Cessation Questions
Telephone Clients Customer Service	1	Appendix 1A Customer Service and Demographic Questions
Telephone Clients Demographic Questions	2	Appendix 1A Customer Service and Demographic Questions
VA Smoking Cessation Clients Call Backs	5	Appendix 1D VA Smoking Cessation Callback

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	127,726	110,000	0	127,726	-110,000	0
Annual Time Burden (Hours)	3,387	2,686	0	3,387	-2,686	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: In this OMB package, we are requesting the addition of three customer service questions aimed at assessing the satisfaction the client have with use of the CIS service. The customer satisfaction survey is to be used in follow up emails after phone calls, cancer.gov emails and at the end of LH sessions.

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Annual Cost to Federal Government: $133,883

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/28/2015

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