Request for Approval (0920-0974- 18ASY

01_request for approval form_webinars_08-08-2018.docx

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Request for Approval (0920-0974- 18ASY

OMB: 0920-0974

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-0974)

Shape1 TITLE OF INFORMATION COLLECTION:

2018 Public Health and Preparedness Webinar Learner Feedback Survey


PURPOSE:


The fourteen basic-intermediate level webinars produced by the Centers for Disease Control and Prevention, Division of Laboratory Systems during October 1, 2017 – September 30, 2018 provide educational content relevant to laboratory scientists working in hospitals, reference laboratories, universities and public health laboratory settings. These one-hour long programs are free of charge, hosted on CDC TRAIN, offer 1.0 contact hour of ASCLS P.A.C.E.® credit, and are available in two formats: as a live broadcast and then in an archived (recorded) format available for one year after the broadcast date. Multiple webinar topics provide relevant information to the same audience; consequently, many laboratory scientists complete more than one webinar annually. Webinar topics are grouped into two broad categories:


Preparedness Topics:

  • Human Brucellosis associated with Brucella abortus RB51 shedding in milk

  • Interface of Biology and Chemistry: How Advanced Analytical Techniques Benefit the Diagnosis, Assessment, of Treatment Efficacy, and Prevention of Toxin-Mediated Diseases

  • Laboratories, Emergencies, and the Law: How Our Legal System Impacts Labs During Emergency Response

  • Overview of CDC’s Nuclear / Radiation Training and Exercise Program

  • Overview of the Rapid Tox Screen and Laboratory Response Network for Chemical Threats (LRN-C)

Public Health Topics:

  • Candida auris: Emerging Multi-drug Resistant Yeast

  • Diagnostic Features of Intestinal Nematodes

  • Hepatitis C Diagnostics

  • Molecular Techniques in Mycology

  • Morphological Diagnosis of Human Entamoeba species

  • Morphological Identification of the Commensal Protozoa of the Human Intestinal Tract

  • New HIV Testing Technologies: Implications for Your Laboratory

  • Trichomoniasis: Diagnosis, Treatment, and Drug Resistance

  • Why, When and How to Create a 508 Compliant Document



An email invitation to complete the Public Health and Preparedness Webinars Learner Feedback voluntary survey will be sent to learners designated by CDC TRAIN as having completed all components of one or more of the 14 webinars during October 1, 2017 through September 30, 2018 (FY2018). The email invitation will include clickable links to either proceed to the survey or unsubscribe (opt out). Learners may also opt out by not responding to the email. If learners click the link to begin the survey in the email, they will link to a Survey Monkey webpage housing the survey.


The information to be collected aims to understand to what extent the learners are able to use the content of the webinars in their work settings. The survey questions will take approximately five minutes to complete. Responses will be anonymous and no unique identifying information will be sought or kept. The feedback we receive will be used by our program in aggregate only. The learner feedback will help the continuous quality assurance of our instructional design process and inform updates to these courses in alignment with learner’ needs. Learner feedback will provide valuable insight on the instructional design of these webinar courses, which includes relevance and applicability of content.



DESCRIPTION OF RESPONDENTS:


This is a voluntary survey to collect information from learners who have completed one or more of the 14 microbiology-oriented eLearning courses from October 2017 through September 2018, and may include laboratory professionals working in clinical, reference, university, and public health laboratories.


TYPE OF COLLECTION: (Check one)


[ ] Customer Comment Card/Complaint Form [ x ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] 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.

  4. The results are not intended to be disseminated to the public.

  5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

  6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.


Name:____Collette Leaumont Fitzgerald ____________________________________


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


Personally Identifiable Information:

  1. Is personally identifiable information (PII) collected? [ ] Yes [ x] 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

  3. If Applicable, has a System or Records Notice been published? [ ] Yes [X ] No (Not Applicable)

Gifts or Payments:

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


BURDEN HOURS


Category of Respondent

No. of Respondents

Participation Time

Burden

Individuals and households

0



Private sector

1,500

5/60

125

State, local, tribal government




Federal government




Totals

1500

5/60

125

FEDERAL COST: The estimated annual cost to the Federal government is $1,000_____


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

  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?

[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?


  • This is a voluntary follow-up user feedback survey sent to learners who have completed all required components for one or more of the 14 webinar courses during FY2018. Completion status is assigned by CDC TRAIN when all components have been accomplished. We anticipate that these learners include laboratory professionals from clinical, reference, university and public health settings. These learners will voluntarily participate in the survey administered through Survey Monkey.


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

[ ] Other, Explain

  1. Will interviewers or facilitators be used? [ ] Yes [ x ] No






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

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”


Shape2

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g., Comment card for soliciting feedback on xxxx)


PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.


DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.


TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.


CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.


Personally Identifiable Information: Provide answers to the questions.


Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.


BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.


FEDERAL COST: Provide an estimate of the annual cost to the Federal government.


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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.


Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.


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

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File TitleDOCUMENTATION FOR THE GENERIC CLEARANCE
Author558022
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