NIMH Global Mental Health Conference Registration

Request for OMB Clearance - NIMH Global Mental Health Conference Registration_FINAL_v2.pdf

Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)

NIMH Global Mental Health Conference Registration

OMB: 0925-0740

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Request for Approval under the “Conference, Meeting, Workshop, and Poster
Session Registration Generic Clearance (OD)”
(OMB#: 0925-0740 Exp Date: 05/2019)
TITLE OF INFORMATION COLLECTION:
NIMH Global Mental Health Conference Registration

PURPOSE:
To collect registration information from individuals who attend the Global Mental Health
(GMH) annual conference organized by NIMH and Grand Challenges Canada (GCC). The
GMH conference brings together mental health innovators, investigators and other key
stakeholders to discuss new research findings to improve mental health treatments.

DESCRIPTION OF RESPONDENTS:

The respondents are mental health stakeholders, which include students, researchers,
policymakers, mental health advocates, and others.

TYPE OF COLLECTION: (Check one)
Abstract

Application

Registration Form

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.
Name: Ishmael Amarreh, NIMH
To assist review, please provide answers to the following question:
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected?

Yes

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

1

Last Updated: August 2016

Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to
participants?
Yes
No
Amount:
Explanation for incentive: (include number of visits, etc.)
ESTIMATED BURDEN HOURS and COSTS
Category of Respondent

No. of Respondents

Individuals
Private Sector

155
145

1
1

300

1

Totals
Category of Respondent
Individuals
Private Sector

Totals

Total Burden
Hours
13 hours
12 hours

No. of Responses per
Respondent

Time per
Response
(in hours)
5/60
5/60

Total
Burden
Hours
13 hours
12 hours

25 hours

Wage Rate*
$23.30/hour
$34.24/hour

Total Burden
Cost
$302
$411

25 hours

$713

*Cite source per bls.gov if applicable
www.bls.gov/oes/current/oes_nat.htm#00-0000; www.bls.gov/oes/current/oes190000.htm

FEDERAL COST: The estimated annual cost to the Federal government is: $556

Staff
Grade/Step
Federal Oversight
Health Scientist Adm.
14/01

Salary

$111,200

% of
Effort

.5%

Fringe (if
Total Cost to
applicable) Gov’t

$556

Contractor Cost
Travel
Other Cost

2

Last Updated: August 2016

The selection of 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
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 potential respondents are individuals identified from email listservs provided by the NIMH
Office for Research on Disparities and Global Mental Health and GCC.
Administration of the Instrument
1. How will you collect the information? (Check all that apply)
Web-based or other forms of Social Media
Telephone
In-person
Mail
Survey form
Chart Abstraction
Other, Explain
2. Will interviewers, facilitators, or research coordinators be used?

Yes

No

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

3

Last Updated: August 2016


File Typeapplication/pdf
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified2017-03-07
File Created2017-02-28

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