Fast track Template Biorepository

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: DCCPS Biorepository Information Gathering Survey

PURPOSE: To better understand the value of NCI supporting a central Biorepository/biospecimen archive where extramural researchers could store their remaining biospecimens after the main aims of their NCI-funded study have been completed.

DESCRIPTION OF RESPONDENTS: Extramural researchers who possess, or are currently collecting, biospecimens that were collected through a currently- or historically-funded NCI grant.

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: Feasibility 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: Rachel Hanisch

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

Personally Identifiable Information:

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

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ X ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ X ] 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
Private sector (epidemiologists)	340	1	9/60	51
Totals	340	340		51

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Private sector (epidemiologists)	51	$36.65	$1,869.15
Totals	51		$1,869.15

*Source of the mean Hourly Wage Rate is provided by the Bureau of Labor Statistics, Occupation title “Epidemiologists” 19-1041, https://www.bls.gov/oes/2017/May/oes_nat.htm#00-0000.

FEDERAL COST: The estimated annual cost to the Federal government is $12,604.90.

Staff	Grade/Step	Salary**	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Epidemiologist	14/4	$126,049.00	10%		$12,604.90
Contractor Cost					0
Travel					0
Other Cost					0
Total					$12,604.90

**The salary in the table above is cited from 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

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?

Potential respondents will be identified as follows: PI of an active DCCPS grant that involves biospecimens (i.e. coded in PMA as involving biospecimens). All PIs meeting those criteria will be selected to receive the survey.

Administration of the Instrument

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

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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