Formative Research, Pretesting, and Customer Satisfaction of NCI's Communication and Education Resources (NCI)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Interview Guide	Form and Instruction	New	Repair queued
Form 3 reference request	Form and Instruction	New	Available
Form 2 Feedback survey	Form	New	Repair queued
Form 1 Application form	Form and Instruction	New	Available
Form 2 SPORE webpage survey	Form	New	Available
Form 1 SPORE Webpage Instructions	Form and Instruction	New	Available
Form 18 Navigator Interview	Form and Instruction	New	Available
Form 17 Medical Director Interview	Form and Instruction	New	Available
Form 16 Radiation Oncologist Interview	Form and Instruction	New	Available
Form 15 Non-Oncologist Clinician Interview	Form and Instruction	New	Available
Form 14 Oncology Nurse Interview	Form and Instruction	New	Available
Form 13 PCP Interview	Form and Instruction	New	Available
Form 12 Oncologist Interview	Form and Instruction	New	Available
Form 11 Caregiver Interview	Form and Instruction	New	Repair queued
Form 10 Patient Interview	Form and Instruction	New	Repair queued
Form 9 Navigator Screener (screenshot)	Form and Instruction	New	Repair queued
Form 8 Medical Director Screener (screenshot)	Form and Instruction	New	Available
Form 7 Radiation Oncologist Screener (screenshot)	Form and Instruction	New	Available
Form 6 Non-Oncologist Clinician Screener (screenshot)	Form and Instruction	New	Available
Form 5 Oncology Nurse Screener (screenshot)	Form and Instruction	New	Available
Form 4 PCP Screener (screenshot)	Form and Instruction	New	Available
Form 3 Medical Oncologist Screener (screenshot)	Form and Instruction	New	Repair queued
Form 2 Caregiver Screener (screenshot)	Form and Instruction	New	Available
Form 1 Patient Screener (screenshot)	Form and Instruction	New	Available
Form 3 NCF References	Form and Instruction	New	Available
Form 2 NCF Feedback Survey	Form	New	Available
Form 1 NCF Applications	Form	New	Available
Form 2 Interview Guide Personas Project	Form and Instruction	New	Available
Form 1 Screenshot Researcher Personas	Form and Instruction	New	Available
Form 3 ICRC Reference Module	Form	New	Available
Form 2 ICRC Pilot Survey	Form	New	Available
Form 1 ICRC Application	Form and Instruction	New	Available
Form 4 Pilot Feedback Survey	Form and Instruction	New	Available
Form 3 Exit Survey Part 2 - Feedback	Form and Instruction	New	Available
Form 2 Exit Survey Part 1 Alumni	Form and Instruction	New	Available
Form 1 Initial Trainees screenshots	Form and Instruction	New	Available
Form 1 Working Group Progress Report Questions	Form	New	Available
Form 3 Discussion Guide NICHD NCMHEP Maternal Obesity	Form	New	Available
Form 2 Telephone Screener NICHD NCMHEP Maternal Obesity	Form	New	Available
Form 1 Online Prescreener	Form	New	Available
Form 1 Online Survey	Form	New	Repair queued
Form 1 Survey	Form and Instruction	New	Available
Final Revised Formative Testing Generic_SSA Final 7.14.2016-2_OMB NG edits (1).docx	Supporting Statement A	Uploaded 2016-07-15	Available
Published 30-Day FRN.pdf	Supplementary Document	Uploaded 2016-05-27	Available
Attachment 5 Form for NIH Office of Human Subjects Research Protection (OHSRP).doc	Supplementary Document	Uploaded 2016-05-23	Available
Attach4_Privacy Act Memo.pdf	Supplementary Document	Uploaded 2016-05-23	Available
Attach3 PIA.pdf	Supplementary Document	Uploaded 2016-05-23	Available
Attach 2 Approved Sub Studies.docx	Supplementary Document	Uploaded 2016-05-23	Available
Attach1_Types of research_1_13_16 Kb comments.docx	Supplementary Document	Uploaded 2016-05-23	Available
SSB Final 5.20.2016.docx	Supporting Statement B	Uploaded 2016-05-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
236878	Formative assessment to inform the redesign of the Research Tested Intervention Programs (RTIPS) website	Form and Instruction	New	Interview Guide
236488	Pilot Study for The Center for Cancer Research (CCR) Faculty Recruitment Application Website (NCI)	Form and Instruction	New	reference request
236488	Pilot Study for The Center for Cancer Research (CCR) Faculty Recruitment Application Website (NCI)	Form	New	Feedback survey
236488	Pilot Study for The Center for Cancer Research (CCR) Faculty Recruitment Application Website (NCI)	Form and Instruction	New	Application form
236148	Feedback about SPORE Webpage Information and Instructions (NCI)	Form	New	SPORE webpage survey
236148	Feedback about SPORE Webpage Information and Instructions (NCI)	Form and Instruction	New	SPORE Webpage Instructions
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Navigator Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Medical Director Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Radiation Oncologist Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Non-Oncologist Clinician Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Oncology Nurse Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	PCP Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Oncologist Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Caregiver Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Patient Interview
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Navigator Screener (screenshot)
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Medical Director Screener (screenshot)
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Radiation Oncologist Screener (screenshot)
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Non-Oncologist Clinician Screener (screenshot)
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Oncology Nurse Screener (screenshot)
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	PCP Screener (screenshot)
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Medical Oncologist Screener (screenshot)
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Caregiver Screener (screenshot)
235617	Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	Form and Instruction	New	Patient Screener (screenshot)
234704	Pilot Survey Communications Fellowship (NCF) Program Application (NCI)	Form and Instruction	New	NCF References
234704	Pilot Survey Communications Fellowship (NCF) Program Application (NCI)	Form	New	NCF Feedback Survey
234704	Pilot Survey Communications Fellowship (NCF) Program Application (NCI)	Form	New	NCF Applications
233704	Personas and Experience Mapping Project (NCI)	Form and Instruction	New	Interview Guide Personas Project
233704	Personas and Experience Mapping Project (NCI)	Form and Instruction	New	Screenshot Researcher Personas
232748	Pilot Survey Introduction to Cancer Research Careers (ICRC) (NCI)	Form	New	ICRC Reference Module
232748	Pilot Survey Introduction to Cancer Research Careers (ICRC) (NCI)	Form	New	ICRC Pilot Survey
232748	Pilot Survey Introduction to Cancer Research Careers (ICRC) (NCI)	Form and Instruction	New	ICRC Application
232709	Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)	Form and Instruction	New	Pilot Feedback Survey
232709	Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)	Form and Instruction	New	Exit Survey Part 2 - Feedback
232709	Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)	Form and Instruction	New	Exit Survey Part 1 Alumni
232709	Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)	Form and Instruction	New	Initial Trainees screenshots
232127	National Cancer Institute Cohort Consortium Progress Report	Form	New	Working Group Progress Report Questions
230147	Maternal Obesity	Form	New	Discussion Guide NICHD NCMHEP Maternal Obesity
230147	Maternal Obesity	Form	New	Telephone Screener NICHD NCMHEP Maternal Obesity
230147	Maternal Obesity	Form	New	Online Prescreener
226450	Evaluation of the Cancer Control P.L.A.N.E.T.	Form	New	Online Survey
226450	Evaluation of the Cancer Control P.L.A.N.E.T.	Other-Interview	New
224204	Smokefree 60+ Intercept Survey	Form and Instruction	New	Survey

ICR Details

OMB Control No: 0925-0046	ICR Reference No: 201605-0925-007
Status: Historical Active	Previous ICR Reference No: 201304-0925-003
Agency/Subagency: HHS/NIH	Agency Tracking No: 19122
Title: Formative Research, Pretesting, and Customer Satisfaction of NCI's Communication and Education Resources (NCI)
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: 07/25/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/31/2016
Terms of Clearance: Previous terms continue: NIH will submit individual collections under this generic clearance to OMB. OMB will strive to provide feedback on the individual collections within ten working days, whenever possible. Standard incentive amount is remuneration is $40.00; requests for higher levels must be justified (e.g., very difficult recruitments), two-hour focus groups, etc.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2019	36 Months From Approved	07/31/2016
Responses	108,000	0	33,000
Time Burden (Hours)	7,200	0	6,600
Cost Burden (Dollars)	0	0	0

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Abstract: This is a request for OMB to approve a revision for this generic submission for three years. As part of NCI’s mandate from Congress to disseminate information on cancer research, detection, prevention, and treatment, the Institute develops a wide variety of messages and materials. Testing these messages and materials assesses their potential effectiveness in reaching and communicating with their intended audience while they are still in the developmental stage and can be revised.

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Authorizing Statute(s): US Code: 42 USC 285a-2 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:
	81 FR 12054	03/09/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 103	05/27/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 12

table that charts list of burden

IC Title	Form No.	Form Name
Evaluation of the Cancer Control P.L.A.N.E.T.	1	Online Survey
Feedback about SPORE Webpage Information and Instructions (NCI)	1, 2	SPORE Webpage Instructions ,   SPORE webpage survey
Formative assessment to inform the redesign of the Research Tested Intervention Programs (RTIPS) website	1	Interview Guide
Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)	1, 2, 3, 5, 6, 7, 9, 12, 14, 16, 4, 8, 10, 11, 13, 15, 17, 18	Patient Screener (screenshot) ,   Caregiver Screener (screenshot) ,   Medical Oncologist Screener (screenshot) ,   PCP Screener (screenshot) ,   Oncology Nurse Screener (screenshot) ,   Non-Oncologist Clinician Screener (screenshot) ,   Radiation Oncologist Screener (screenshot) ,   Medical Director Screener (screenshot) ,   Navigator Screener (screenshot) ,   Patient Interview ,   Caregiver Interview ,   Oncologist Interview ,   PCP Interview ,   Oncology Nurse Interview ,   Non-Oncologist Clinician Interview ,   Radiation Oncologist Interview ,   Medical Director Interview ,   Navigator Interview
Maternal Obesity	3, 1, 2	Online Prescreener ,   Telephone Screener NICHD NCMHEP Maternal Obesity ,   Discussion Guide NICHD NCMHEP Maternal Obesity
National Cancer Institute Cohort Consortium Progress Report	1	Working Group Progress Report Questions
Personas and Experience Mapping Project (NCI)	1, 2	Screenshot Researcher Personas ,   Interview Guide Personas Project
Pilot Study for The Center for Cancer Research (CCR) Faculty Recruitment Application Website (NCI)	2, 1, 3	Application form ,   Feedback survey ,   reference request
Pilot Survey Communications Fellowship (NCF) Program Application (NCI)	2, 3, 1	NCF Applications ,   NCF Feedback Survey ,   NCF References
Pilot Survey Introduction to Cancer Research Careers (ICRC) (NCI)	3, 1, 2	ICRC Application ,   ICRC Pilot Survey ,   ICRC Reference Module
Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)	1, 2, 3, 4	Initial Trainees screenshots ,   Exit Survey Part 1 Alumni ,   Exit Survey Part 2 - Feedback ,   Pilot Feedback Survey
Smokefree 60+ Intercept Survey	1	Survey

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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	108,000	33,000	0	75,000	0	0
Annual Time Burden (Hours)	7,200	6,600	0	600	0	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: This is a request for OMB to approve a revision for this generic submission. In the previous submission we inadvertently only showed the annualized burden of 33,000, and now we are reflecting the burden for the requested 3 years.

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Annual Cost to Federal Government: $568,534

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: 05/31/2016

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