Generic Submission for Formative Research, Pre-testing, Stakeholder Measures and Advocate Forms at NCI

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
30-day FRN2017-26495.pdf	Supplementary Document	Uploaded 2017-12-08	Available
Attachment 5 Profile Completion Questionairre.pdf	Supplementary Document	Uploaded 2017-12-04	Available
Attachment 4 Interview Guide.docx	Supplementary Document	Uploaded 2017-12-04	Available
Attachment 3 OHSRP Exclusion.pdf	Supplementary Document	Uploaded 2017-12-04	Available
Attachment 2 PIA.xml	Supplementary Document	Uploaded 2017-12-04	Repair queued
Attachment 1 Privacy Act Memo.pdf	Supplementary Document	Uploaded 2017-12-04	Available
SSA OAR Final.docx	Supporting Statement A	Uploaded 2017-12-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form

ICR Details

OMB Control No: 0925-0641	ICR Reference No: 201712-0925-001
Status: Active	Previous ICR Reference No: 201409-0925-008
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Generic Submission for Formative Research, Pre-testing, Stakeholder Measures and Advocate Forms at NCI
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/29/2018
	Date Received in OIRA: 12/08/2017
Terms of Clearance: This generic ICR is approved consistent with NIH agreement to submit individual colletions to OMB as they are implemented, along with all necessary supporting statements (to include information about research design and analysis, incentives, burden estimates, approaches to address non-response bias, etc). OMB will aim to review each IC submission within 14 days; however, OMB approval should not be assumed if not explicitly granted, even if 14 days have elapsed since submission. Approval for this generic ICR should not be construed as approval for this particular IC. **All collections subject to the Privacy Act will include a Privacy Act statement somewhere on the instrument**

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	36 Months From Approved	01/31/2018
Responses	270	0	2,925
Time Burden (Hours)	135	0	3,075
Cost Burden (Dollars)	0	0	0

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Abstract: This is a request for OMB to approve the extension of the generic collection titled, “A Generic Submission for Formative Research, Pre-testing, Stakeholder Measures and Advocate Forms at NCI” for an additional three years of data collection. The Office of Advocacy Relations (OAR) disseminates cancer-related information to a variety of stakeholders, seeks input and feedback, and facilitates collaboration to advance NCI’s authorized programs. It is beneficial for NCI, through the OAR, to pretest strategies, concepts, activities and materials while they are under development.

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Authorizing Statute(s): US Code: 42 USC 285a-1 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 45870	10/02/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 58006	12/08/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 0

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	270	2,925	0	-2,655	0	0
Annual Time Burden (Hours)	135	3,075	0	-2,940	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is an extension. Since the database is fully developed, with only occasional and minor edits to be made, the program is asking for a reduction in burden hours. Annual burden hours for previous submission (2014) were proposed at 1025, annual burden hours for current submission (2017) are proposed at 45, for a 980 annual burden-hour reduction. Previous submission (2014) respondents were 975 and proposed respondents (2017) are now 90, this is a reduction of 885.

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Annual Cost to Federal Government: $25,613

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/08/2017

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