Supporting Statement for Review of NSF INCLUDES Technical Assistance—Survey and Focus Groups

Request for Approval Under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB Control Number: 3145-0215)
TITLE OF INFORMATION COLLECTION: Review of NSF INCLUDES Technical
Assistance—Survey and Focus Groups
PURPOSE: The purpose of the evaluation team conducting (1) a brief survey of Design and
Development Launch Pilot (launch pilot) personnel and (2) focus groups with launch pilot
personnel and technical assistance (TA) team personnel as part of its review of the National
Science Foundation (NSF) Inclusion Across the Nation of Communities of Learners of
Underrepresented Discoverers in Engineering and Science (INCLUDES) TA is to improve
implementation of the NSF INCLUDES program. Specifically, NSF would like to know how
launch pilots participate in NSF INCLUDES TA and apply lessons learned during the initial
stages of the program to the development of the next stages. The survey will ask questions about
who participates in TA, how launch pilots learn about TA, what types of support launch pilots
need from TA and the extent to which those needs are met, and how TA could be improved. The
survey will also recruit launch pilot personnel to participate in focus groups about TA
engagement. The focus groups will contribute to NSF’s understanding of the relationship
between TA providers and recipients and will contribute valuable knowledge about TA practices
that help to support program development and improvement.
DESCRIPTION OF RESPONDENTS: Survey respondents are Principal Investigators (PIs)
who were awarded an NSF INCLUDES launch pilot and the lead evaluator for the launch pilot.
If either of those personnel are unavailable, the PI may designate other project staff members
who are knowledgeable about the launch pilot’s engagement with TA to participate in the
survey.
Focus group respondents are launch pilot personnel who agree to speak with us further about
their engagement with TA activities as part of NSF INCLUDES, as well as up to six members of
the independent contractors who provide the TA to launch pilots.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software)
[X] Focus Group

[X] Customer Satisfaction Survey
[ ] Small Discussion 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: Suzanne H. Plimpton, NSF Reports Clearance Officer
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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, will any information that is collected be included in records that are subject to the
Privacy Act of 1974? [ ] Yes [X] No
3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [X] No
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
236
12

Individuals (Survey participants)
Individuals (Launch pilot TA team focus group
participants)
Individuals (Launch pilot focus group participants)
36
Totals
274
*Participation time includes recruitment time and response time.

Participation
Time
10 minutes*
30 minutes

Burden

30 minutes
3,800 minutes

18 hours
63 hours

39 hours
6 hours

FEDERAL COST: This will be incorporated into the plans for running the program.
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.
The survey will be a census of the 70 NSF INCLUDES launch pilots. A total of 70 PIs from
lead institutions, 26 PIs from co-lead institutions, 70 evaluators, and 70 additional project
members will receive requests to complete the survey. Therefore, a total of 236 individuals
will receive requests to complete the survey. The target number of completed surveys is 189
(80 percent). Survey respondents will be recruited from cohort 1 and cohort 2 launch pilot
personnel, including PIs of both lead and co-lead institutions, evaluators, and one additional
project member to be selected based on their participation in NSF INCLUDES TA. If the
project has had no additional project members who have participated in TA events,
respondents will be randomly sampled from the project’s co-PIs. We will follow up by
phone and email with those who do not respond.

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Launch pilot focus group participants will be recruited from those launch pilots that
completed the survey, with emphasis on individuals that are highly engaged in TA activities.
Participants in the launch pilot TA team focus group will include members of the leadership
team, content experts, affinity group liaisons, and communications and support team.
Participants in the focus group will be determined in consultation with the TA team.
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
[X] In person
[ ] Mail
[X] Other: Focus groups may be conducted via Skype.
2. Will interviewers or facilitators be used? [X] Yes [ ] No
Please make sure that all instruments, instructions, and scripts are submitted with the
request.

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Instructions for completing Request for Approval under the “Generic
Clearance for the Collection of Routine Customer Feedback”
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. Note: Agencies should
only collect PII to the extent necessary, and they should only retain PII for the period of time that
is necessary to achieve a specific objective.
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 per row.
No. of Respondents: Provide an estimate of the Number of Respondents.
Participation Time: Provide an estimate of the amount of time (in minutes) 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 Respondents and the
Participation Time then 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.
Submit all instruments, instructions, and scripts with the request

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