SUBMISSION OF INFORMATION COLLECTION UNDER THE
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
DATE OF REQUEST: October 18, 2018
SUB AGENCY (I/C): HHS/AHRQ
TITLE: System Usability Scale (SUS)
GENERIC CLEARANCE UNDER OMB#: 0935-0179 EXP. DATE: 11/30/2020
The SUS is a brief
questionnaire which is considered as the industry standard for
evaluating usability of hardware, software, mobile devices,
websites, and applications. The PRO app will be programmed to
include the prompt requiring the 180 patients to complete the SUS
right after they submit their PROMIS data.
TOTAL ANNUAL BURDEN APPROVED: 3,383 Hours Per year
BURDEN USED TO DATE: 404 hours.
BURDEN THIS REQUEST: 14.4 hours.
FEDERAL COST: The estimated annual cost to the Federal government is $350.50_.
IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?
______YES ______ NO _____x_ N/A
OBLIGATION TO RESPOND:
___x___ VOLUNTARY
______ REQUIRED TO OBTAIN OR RETAIN BENEFITS
______ MANDATORY
HOW WILL THIS SURVEY BE OFFERED?
____ WEB SITE
____ TELEPHONE INTERVIEW
_____ MAIL RESPONSE
__ _ IN PERSON INTERVIEW
___x_ OTHER: Explain: The SUS will be programmed on the app for patients to complete right after they answer the PROMIS questions.
_
CONTACT INFORMATION:
NAME: _Erwin Brown______________________________
TELEPHONE NUMBER: 301.427.1652________________
EMAIL ADDRESS: [email protected]________________
| File Type | application/msword |
| File Title | Generic Clearance Form - 04/28/2008 |
| Subject | Generic Clearance Form - 04/28/2008 |
| Author | OD/USER |
| Last Modified By | SYSTEM |
| File Modified | 2018-10-29 |
| File Created | 2018-10-29 |