109_GenIC_Request_Webinar Participant Feedback_2017F

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1009)

TITLE OF INFORMATION COLLECTION:

Division of Violence Prevention web-based technical assistance Participant’s Feedback

PURPOSE:

The Division of Violence Prevention (DVP) funds various state and local awardees to implement and evaluate violence prevention programs. As part of various cooperative agreements, CDC provides activities to support awardees with implementation of their initiatives. The Prevention Practice & Translation Branch (PPTB) provides, through a virtual web-based platform, training and technical assistance in a variety of webinar formats including instructional didactic learning, group-based discussions, demonstrations, and virtual office hours.

The purpose of this request is to gather timely feedback from webinar participants on the delivery of web-based technical assistance. Feedback gathered will help improve future webinars and ensure DVP is providing efficient and effective service delivery. The information collected will provide a feedback mechanism to identify areas of improvement and allow for ongoing technical assistance and collaboration with funded awardees. Feedback is vital to ensure the webinars are beneficial for participants. Without such data collection this information would be unknown.

This information collection will allow CDC to assess the effectiveness of the web-based technical assistance in supporting funded state and local awardees with understanding how to implement and evaluate violence prevention programs. These data will enable CDC to improve upon its strategies to provide technical assistance to funded state and local awardees.

Information gathered will be used only internally for general service improvement and is not intended for release outside of the agency. Information gathered will not be used for the purpose of substantially informing influential policy decisions. Without these types of feedback, the Agency will not have timely information to adjust its services to meet customer needs.

DESCRIPTION OF RESPONDENTS:

The collection is targeted to the solicitation of opinions from respondents who have experience with the violence prevention program. Respondents are individuals who attend a webinar delivered by PPTB. Webinar participants include funded awardees from state or local health department responsible for implementing violence prevention programs and strategies.

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:___________Karen Angel_____________________________________

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 [X ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [X ] No

Privacy Act does not apply for this information collection request. Personal Private Information is not collected. All data will be reported in aggregate unlinked form. All procedures have been developed, in accordance with federal, state, and local guidelines, to ensure that the rights and privacy of respondents will be protected and maintained.

Gifts or Payments:

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

BURDEN HOURS

The target respondents will be all participants who attend a PPTB webinar. PPTB will conduct webinars for technical assistance for their funded awardees. PPTB will conduct approximately 40 webinars with an average of 20 participants per webinar. The web-based Webinar Feedback Form (Attachment 1) will be open immediately following the webinar. A link to the web-based Webinar Feedback Form will be emailed directly to all webinar participants following the conclusion of the webinar (Attachment 2) and a reminder will be sent on the day before it closes (Attachment 3). Participation will be voluntary.

The Webinar Feedback Form include 12 questions, 7 of which are required closed-ended questions and 0 are required open-ended questions. Questions ask about the participants’ satisfaction with the webinar content and delivery; no personally identifiable information will be collected. Based on a pilot test with 5 CDC staff, each Webinar Feedback Form takes an average of 3 minutes to complete. There will be no direct costs to the respondents other than their time to respond to the survey.

Category of Respondent	No. of Respondents	Participation Time	Burden
Webinar Participants	800	3/60	40
Totals	800		40

FEDERAL COST: The estimated annual cost to the Federal government is $2,058.34.

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? [ ] 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?

Participants are individuals who voluntarily attend PPTB webinars. Participants are informed of webinars through CDC listerv announcements (Attachment 4), DVP partners’ announcements (Attachment 4), and CDC Program Officers.

No sampling will be conducted in order to gather feedback from any webinar participants who is willing to volunteer to provide feedback. Immediately following the webinar, a link to the online webinar feedback form will be emailed to participants of the webinar.

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

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

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