Fast Track CPFP Daily Summer Curriculum

Fast Track_CPFP Daily Summer Curriculum Survey-REV2.docx

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

Fast Track CPFP Daily Summer Curriculum

OMB: 0925-0642

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0642, Expiration Date:05/31/2020)

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TITLE OF INFORMATION COLLECTION:


PURPOSE: The purpose of the Division of Cancer Prevention’s Cancer Prevention Fellowship Program (CPFP) Daily Summer Curriculum Survey confirms the course objectives are being met and utilize participants’ feedback to better inform the design of the following year’s NCI Summer Curriculum. All Cancer Prevention Fellows are required to attend the National Cancer Institute (NCI) Summer Curriculum during their first full summer at NCI. The Daily Summer Curriculum consists of 3 different lectures or group activities per day, over the course of 5 weeks (i.e., the length of the Summer Curriculum). Feedback based on these surveys are used to determine the activity and speaker list for the following summer, which is subsequently reviewed by administration. Additional details about the program can be found at: https://cpfp.cancer.gov/


DESCRIPTION OF RESPONDENTS:

The respondents to the survey will include general scientific community worldwide as well as Cancer Prevention Fellows (postdoctoral fellows).




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:______Hala Azzam__________________________________________


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 [ ] N/A

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


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

75

25*

5/60

156






Totals

75

1,875


156

*This same form will be used over 25 separate training/speaker days.


Category of Respondent


Total Burden Hours

Wage Rate***

Total Burden Cost

Individuals

156

$40.01

$6,241.56





Totals

156


$6,241.56


***Median hourly wage for Social Scientists and Related Workers, All Others (19-3099); https://www.bls.gov/oes/current/oes_nat.htm#19-0000


FEDERAL COST: The estimated annual cost to the Federal government is $2,260.62.

Staff

Grade/Step

Salary****

% of Effort

Fringe

(if applicable)

Total Cost to Gov’t

Federal Oversight






Program Lead

13/10

$126,062

1%


$1,260.62













Contractor Cost





$0







Travel





$0

Other Cost (Summer Intern)





$1,000







Total





$2,260.62


****https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2018/DCB.pdf



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


The respondent list will be participants who attended and completed the CPFP Summer Curriculum in 2018 and 2019.



Administration of the Instrument

  1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[X] Other, Explain. The surveys are paper-and-pencil surveys.


  1. 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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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified0000-00-00
File Created2021-01-20

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