Form NHTSA Form 1272 NHTSA Form 1272 Tween Seat Belt Safety Online Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 2127-0682)

TITLE OF INFORMATION COLLECTION:

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

PURPOSE:

The National Highway Traffic Safety Administration (NHTSA) was authorized by the Highway Safety Act of 1966 to carry out a Congressional mandate to reduce the mounting number of deaths, injuries and economic losses resulting from motor vehicle crashes on our Nation’s highways. In support of this mission, NHTSA is developing a new public service campaign designed to increase the proper use of seat belts among “tweens,” categorized here as children between the ages of 8-14, and to reduce the injuries and deaths in motor vehicle crashes where these tweens were not wearing seat belts. Campaign materials will be placed in donated media.

The results from this survey will in no way be used to make significant policy or resource allocation decisions.

DESCRIPTION OF RESPONDENTS:

The respondents for this survey will be the target audience for the public service campaign: U.S. adults age 25 or older who are parents or caregivers of children ages 8-14. Screening criteria will require that all respondents drive with the children at least three days per week. The campaign will be distributed nationwide, so all respondents participating in the survey have the potential to be exposed to the public service advertising.

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: Online Survey

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: Susan McMeen

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [X] Yes [ ] No

The third party vendor collects information from the survey respondents in order to provide them with the incentive. No PII is reported to NHTSA. No responses will be connected to individual respondents; only aggregate data will be reported.

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? [X] Yes [ ] No

The third-party vendor uses a panel that operates on a points-based incentive and rewards system. The points can be redeemed for cash or other items offered by the vendor when enough points are accrued. It is standard practice to provide a basic incentive in order to avoid bias of receiving responses only from individuals generally predisposed to be helpful.

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Individuals or Households (Survey Respondents)	1,000	14 minutes	234 hours
Individuals or Households (Survey Non-Respondents)	2,900	1 minutes	49 hours
Totals	3,900		283 hours

FEDERAL COST: The estimated annual cost to the Federal government is $17,250.

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?

Convenience samples of test participants are recruited to reflect the target audience. NHTSA plans to work with C+R Research, a third-party vendor, to recruit parents and guardians of children ages 8-14 to participate. Data collection will take place using online panels that respondents have opted to join. Respondents will be recruited through an email invitation with a link to the survey. Recruitment quotas will include gender, age, child age, and race/ethnicity as appropriate. In addition, samples will reflect variety in geographic density (e.g. urban, suburban, rural), and region of the country.

In order to achieve 1,000 completed interviews, it is estimated that there will be about 2,900 non-respondents to the interviews, i.e., parents who are invited to the survey but chose not to participate or do not qualify.

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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