Fast Track Template for CPFP Speaking about Science Workshop

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0642, Expiration Date:05/31/2020)

TITLE OF INFORMATION COLLECTION:

Cancer Prevention Fellowship Program (CPFP) Speaking About Science Workshop Survey

PURPOSE:

The Speaking about Training Workshop is an opportunity for Cancer Prevention Fellowship Program (CPFP) Fellows to gain training in giving presentations about their scientific research. The purpose of this survey is to have Fellows assess the facilitators of this training and to assess the skills learned from this workshop. The information is collected to identify areas of improvement, determine future planning and to garner feedback of the facilitator.

This workshop occurs annually. This survey will be administered at the 2018 workshop and the 2019 workshop to the attending fellows. The attending fellows will be different participants from year to year.

DESCRIPTION OF RESPONDENTS:

Respondents will be Cancer Prevention Fellows (CPFs) who are postdoctoral research fellows within the Division of Cancer Prevention at the National Cancer Institute.

TYPE OF COLLECTION: (Check one)

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

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

[ ] Focus 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: Annalisa Gnoleba

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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individuals	100	1	20/60	33
Totals	100	100		33

Category of Respondent	Total Burden Hours	Wage Rate**	Total Burden Cost
Individuals	33	$40.01	$1320.33
Totals			$1320.33

**Median hourly wage for Social Scientists and Related Workers, All Others (19-3099); https://www.bls.gov/oes/2017/may/oes_nat.htm#19-0000

FEDERAL COST: The estimated annual cost to the Federal government is $763.80.

Staff	Grade/Step	Salary***	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Program Director	15/5	$152,760	0.5%		$763.80
Contractor Cost					$0
Travel					$0
Other Cost					$0
Total					$763.80

*** https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/18Tables/html/DCB.aspx

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 CPFP office maintains names and email addresses of all current CPFs, and this list provides us with information on all our potential respondents. We plan to sample all of the potential respondents (CPFs).

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

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