Workshop to Facilitate Cancer Systems Epidemiology Research Registration form

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:

Registration for Workshop to Facilitate Cancer Systems Epidemiology Research

PURPOSE:

The National Cancer Institute’s (NCI) Epidemiology and Genomics Research Program (EGRP) will host the Workshop to Facilitate Cancer Systems Epidemiology Research from February 28 – March 1, 2019. As the first meeting under the banner of systems epidemiology, the objective of this workshop is to facilitate interdisciplinary discussion about the application of systems modeling approaches for population-based cancer epidemiology research between statisticians, mathematicians, computer scientists, bioinformaticians, epidemiologist, and clinicians. In addition, the workshop will identify important research questions and potential barriers and facilitators in applying system modeling approaches to the population sciences.

Attendance of the workshop will be either in-person or by webinar. Workshop will help NCI EGRP identify future research questions and barriers and facilitators to systems epidemiology research, to improve NCI EGRP support of cancer epidemiology research through the development of funding requests and resources for the research community. The purpose of this registration form is to register individuals for the workhop and collect contact information and discussion group preferences.

DESCRIPTION OF RESPONDENTS:

Statisticians, mathematicians, computer scientists, bioinformaticians, epidemiologist, and clinicians interested in registering for a workshop on the application of systems modeling approaches for population-based cancer epidemiology research

TYPE OF COLLECTION: (Check one)

[ ] Abstract [ ] Application

[X] 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: Leah Mechanic

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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individuals	150	1	5/60	13
Totals	150	1		13

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals	13	$45.64	$593.32
Total			$593.32

*Source of the mean Hourly Wage Rate is provided by the Bureau of Labor Statistics, Occupation title “Medical Scientists” 19-1040, https://www.bls.gov/oes/2017/May/oes_nat.htm#00-0000.

FEDERAL COST: The estimated annual cost to the Federal government is $2,356.38.

Staff	Grade/Step	Salary**	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Program Director	14/10	$148, 967	1%		$1489.67
Contractor Cost
Communications Consultant		$46,671	1%		$466.71
Travel					0
Other Cost					0
Cancer Training Research Fellow					$400.00
Total					$2,356.38

**The salary in the table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/18Tables/html/DCB.aspx

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

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?

An invitation to register will be sent to approximately 100 participants. 21 speakers will also be asked to register. We will market the workshop to a targeted audience through selected invitations, listservs, flyers at in-person events, and social media.

Administration of the Instrument

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

Will interviewers or facilitators be used? [ ] Yes [X] No

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

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