Sub Study Template HRHR Symposium

Request for Approval under the “Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)”

(OMB#: 0925-0740 Exp Date: 05/2019)

T ITLE OF INFORMATION COLLECTION:

Scientific abstract collection for the 2018 High-Risk, High-Reward Research Symposium

PURPOSE:

Scientific abstracts are being requested for the annual the 2018 High-Risk, High-Reward Research Symposium. Abstracts will be reviewed, and the most scientifically relevant or exciting abstracts will be selected for speaking slots or posters at the symposium. The abstracts will be used to construct the symposium’s agenda.

DESCRIPTION OF RESPONDENTS:

Abstracts are being requested from High-Risk, High-Reward Research awardees (recipients for the NIH Director’s Pioneer, New Innovator, Transformative Research, and Early Independence awards) who will attend the annual symposium.

TYPE OF COLLECTION: (Check one)

[X] 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:__Becky Miller______________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ X] 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 [X ] No

Gifts or Payments:

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

Amount: ___________

Explanation for incentive: (include number of visits, etc.)

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Private sector	120	1	3	360
Totals	120	120		360

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Private sector	360	$35.93	$12,934.80
Totals	360	$35.93	$12,934.80

*Cite source per bls.gov if applicable

The Health Professionals wage rate was obtained from http://www.bls.gov/oes/2013/may/oes290000.htm occupation title “Healthcare Practitioners and Technical Occupations”, occupation code 29-0000

FEDERAL COST: The estimated annual cost to the Federal government is $6,994.70______

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Health Specialist	GS-13/ Step 3	$103,435	2		$2,068.70
Health Science Administrator	GS-15/ Step 8	$164,200	3		$4,926.00
Contractor Cost
Travel
Other Cost
					$6,994.70

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 [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?

All grant awardees from the program over the past six years will be invited to submit an abstract.

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

[ ] Survey form

[ ] Chart Abstraction

[ ] Other, Explain

2. Will interviewers, facilitators, or research coordinators be used? [ ] Yes [X ] No

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

All abstracts will be collected on third-party web application at https://hrhr2018.dryfta.com/en/abstract-submission/abstract/detail (TPWA UID: T-6973961-609767).

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