NIH Common Fund SPARC Program Collection for ISAN 2019 Meeting

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: NIH Common Fund SPARC Program Abstract Collection for ISAN 2019 Meeting

PURPOSE:

The NIH Common Fund Stimulating Peripheral Activity to Relieve Conditions (SPARC) program will collect abstract submissions for oral and poster presentations to be given on the final day of the 2019 International Society for Autonomic Neuroscience (ISAN) meeting, which will be hosted by the SPARC program. Abstracts will be reviewed by program staff and ISAN committee members and some will be selected to give a presentation at the ISAN meeting.

DESCRIPTION OF RESPONDENTS:

Respondents will be funded awardees of the NIH Common Fund SPARC program who are attending the ISAN Meeting.

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:__Jill Beaver______________________________________________

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? [ X ] Yes [] 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		360

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

* Cite source per bls.gov if applicable

The Health Professionals wage rate was obtained from http://www.bls.gov/oes/2017/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 _$7,705.91_____

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Health Science Administrator	GS-15/Step 4	$148,267	1		$1,482.67
Health Science Administrator	GS-14/Step 2	$118,410	1		$1,184.10
Health Science Administrator	GS-14/Step 10	$148,967	1		$1,489.67
Health Science Administrator	GS-14/Step 5	$129,869	1		$1,298.69
Health Specialist	GS-14/Step 2	$118,410	1		$1,184.10
Health Specialist	GS-13/Step 4	$106,668	1		$1,066.68
Contractor Cost
Travel
Other Cost
TOTAL					$7,705.91

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?

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 SPARCatISAN2019.dryfta.com

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