Office of Population Affairs (OPA) Title X Grantee Needs Assessment Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0990-0379)

TITLE OF INFORMATION COLLECTION:

Office of Population Affairs Title X Grantee Needs Assessment Surveys

PURPOSE:

The Office of Population Affairs (OPA) at the U.S. Department of Health and Human Services (HHS) requests permission to conduct an assessment of grantees’ needs related to recognizing and responding to human trafficking issues among Title X clientele. This needs assessment package includes an instrument for surveying the needs of Health professionals on their contact with and knowledge related to Human Trafficking and health. The survey assesses Title X clinicians’ experiences, knowledge, and opinions about human trafficking.

The results of these surveys will provide OPA with information related to Title X grantees’ needs related to specialized training in recognizing ad responding to Human Trafficking in their clientele. The data will inform the development of a detailed, specialized curriculum and learning plan for both on-line and in-person trainings. These will include but are not limited to: written material, training guides, toolkit, and other materials necessary to implement a sound Technical Assistance program that will aid Title X staff in recognizing and responding to human trafficking.

DESCRIPTION OF RESPONDENTS:

The Office of Population Affairs (OPA) administers the Title X program and serves as the focal point to advise the Secretary and the Assistant Secretary for Health on a wide range of reproductive health topics, including family planning, adolescent pregnancy, sterilization, and other population issues. The contractor will contact Title X grantee program directors The universe of organizations to be contacted includes clinicians servicing clientele for all Title X grantees, to include clinicians at sub-recipient sites.

TYPE OF COLLECTION: (Check one)

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

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

[ ] Focus Group [X ] Other: Needs Assessment

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: ___Tara Rice_

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 [ ] 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	Participation Time	Burden
Private Sector (Web survey) One time survey	1680	15/60	420 hours
Totals	1680		420 hours

FEDERAL COST: The estimated annual cost to the Federal government is $34,375.

For cost calculations, we estimate 50 hours of time for the Subject Matter Expert (SME) to prepare the needs assessment survey for distribution. For the contractor, we estimate 50 hours of an intermediate staff member’s time to program the surveys, distribute the surveys, collect the customer responses, and forward survey results to the sub-contractor. For the sub-contractor we estimate 400 hours to tabulate the results and 50 hours of senior staff time to review the results.

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?

Description of Customer List. OPA’s list of project directors for the grantee organizations, and the sub-recipient data base will be used as the customer list.

There is a survey that would be administered to grantees and sub-recipients through a survey monkey link delivered by email to all Title X project Directors (N=71) and sub-recipients (N=769). We estimate 2 individuals at each site will complete the survey; therefore we estimate 1,680 individuals will complete the needs assessment survey.

Table 1. Number of grantees to which survey will be distributed by program and tier within the TPP program

OPA Title X Grant Program	N
Title X Grantees	71
Title X Sub-recipient	769
TOTAL	840

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

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

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