SUPPORTING STATEMENT
TITLE OF INFORMATION COLLECTION: Flight Analog Projects (FAP) Crew Selection
Questionnaire
TYPE OF INFORMATION COLLECTION: New Collection without an OMB Control Number
A. JUSTIFICATION
Explain the circumstances that make the collection of information necessary.
The NASA Human Research Program (HRP) is responsible for understanding and mitigating the highest risks to astronaut health and performance to ensure that crews remain healthy and productive during long-duration missions beyond low Earth orbit. HRP leverages the talents of researchers within NASA and across U.S. academia to implement a detailed plan for risk reduction, with much of this work taking place aboard the ISS and ground based flight analogs such as the Human Exploration Research Analog (HERA). As NASA prepares to conduct crewed missions in cis-lunar space, on the Moon, and eventually at other locations including MARS, HRP biomedical research and technological development are enabling the Agency to safely send humans into deep space for longer durations. This collection will help to select subjects for the Analog missions for these ground studies and provide opportunities to have wide variety of subject pool.
Indicate how, by whom, and for what purpose the information is to be used.
The information in this collection are geared towards getting minimal but enough information for preliminary evaluation of becoming a ground study crew member for Analog missions such as HERA. Further evaluation of the subject occurs downstream after the initial screening is done. Participation is voluntary.
The research managed through NASA Johnson Space Center, is leading to the development and delivery of:
Human health, performance, and habitability standards
Countermeasures and other risk mitigation solutions
Advanced habitability and medical support technologies
A list of additional routine uses is available in our Privacy Act System of Records Notices (SORN), entitled “Human Experimental and Research Data Records.”, as published in the Federal Register on 11/05/2015, at “80 FR 68568”. Additional information, and a full listing of all of our SORNs, is available on our website at https://www.nasa.gov/content/nasa-privacy-act-system-of-records-notices-sorns
Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g. permitting electronic submission of responses, and the basis for the decision for adopting this means of collection.
The voluntary crew application are submitted through secure, electronic methods. The electronic forms are filled on-line through secure transmission. The ability to receive these forms electronically assists in the efficiency of the stages of approval relating to becoming a study subject for ground missions such as HERA.
Describe efforts to identify duplication.
There is no duplication as there will be no other sources available to collect this information once the website with this collection forms are deployed online.
If the collection of information impacts small businesses or other small entities (Item 5 of the OMB Form 83-I), describe the methods used to minimize burden.
There is no impact on small businesses or other small entities
Describe the consequence to federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.
This collection will help to screen new subjects and crew-members for HERA mission/ground studies. Without these questionnaire, consequences may include – 1) Lack of available subjects to perform a mission, 2) Lack of diversified crew to validate/conduct science.
These impacts will not impact federal policy activities, only science activities.
Explain any special circumstances that would cause an information collection to be conducted in a manner: -
There are no special circumstances. The collection of information is conducted in a manner consistent with the guidelines in 5 CFR 1320.6.
Provide the date and page number of publication in the Federal Register for the 60-day and 30-day FNRS, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB.
60-day FRN: Federal Register / Vol. 84, No. 104 / Thursday, May 30, 2019. No comments were received.
30-day FRN: Federal Register / Vol. 84, No. 191 / Wednesday, October 2, 2019.
Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.
No payments or gifts are provided to respondents.
Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation, or agency policy.
The personally identifying information is transferred from the client’s browser to the web server over a secure channel (HTTPS) using an up to date protocol (TLS1.2). The information is then encrypted before being stored. The personally identifying information is only decrypted by users that have been explicitly granted access to the information.
The application page has the following disclaimer in place: ‘Submitting voluntary information constitutes your consent to the use of the information for the stated purpose. By clicking the 'Apply' or 'Submit' buttons on any of the site’s forms, you are providing voluntary consent to use of the information submitted for the purpose stated.’
The following privacy statement is displayed at the top of the questionnaire page:
Pursuant to the Privacy Act of 1974, 5 U.S.C. § 552a, the following statement is furnished to individuals supplying information for participating as a subject for ground study:
AUTHORITY: NASA Institutional Review Board (IRB) is the authority which authorizes the solicitation of the information.
PURPOSE: The information in this form is geared towards collecting minimal but enough participant information for preliminary evaluation to become a ground study subject for Analog missions such as Human Exploration Research Analogs (HERA). Further evaluation of the subject occurs downstream after the initial screening is completed. The requested information is required to perform initial screening though participation to become a ground study subject is voluntary.
EFFECTS OF NOT PROVIDING: Failure to provide the requested information will result in incomplete information to proceed to next phase of evaluation and not be able to be considered for further evaluation to become a ground study subject.
ROUTINE USES: Routine uses of the information for this collection are described below –
Standard Routine Use No. 1 – The information will help to perform initial screening of the participants to become a ground study subject for missions such as HERA. The records and information in this system may be shared with following NASA/Contractor personnel:
1) NASA Institutional Review Board (IRB)
2) Principal Investigators/Study Scientists
3) Test Subject Screening and Recruiting Coordinator
4) Study related personnel
Standard Routine Use No. 2 – This information in conjunction with additional information collected via other downstream processes will be evaluated for approval/disapproval of the applicant to become ground study subject.
Standard Routine Use No. 3 – This information in conjunction with additional information collected via other downstream processes will be used to assess compatibility with research protocol requirements for data collection and ground mission assignments if the applicant is selected to become a ground study subject.
Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.
Questions of sensitive nature are required for initial screening (automated accept/reject) of the applicant. This questionnaire eliminates the need for paper copy and burden on evaluating/processing an application and replaces it with an automated initial accept/reject of the application.
Provide estimates of the hour burden of the collection of information.
Category of Respondent |
Number of Respondents |
Participation Time |
Burden (hours) |
Civil Servants |
0 |
0 |
0 |
Contractor |
0 |
0 |
0 |
General Public |
100 |
10 minutes |
16.67 hours |
Provide
an estimate of the total annual cost burden to respondents or record
keepers resulting from the collection of information.
The estimated cost per individual response is the following (average wage rate - $27.16):
0.167 hours x $27.16 per hour = $4.54
The estimate of annualized total cost to respondents is the following (Average wage rate - $27.16):
16.66 hours x $27.16 per hour = $452.49
This collection will eliminate current manual work performed by the record keepers as it will automatically perform initial screening to accept/reject an applicant. Further evaluation of applicants occur downstream after the initial screening, which is not a part of this collection.
Cost to the Federal Government: Provide estimates of annualized costs to the Federal government.
This collection will eliminate current manual work performed by the record keepers as it will automatically perform initial screening to accept/reject an applicant. Further evaluation of applicants occur downstream after the initial screening, which is not a part of this collection. Minimal amount of work required to evaluate those applicants by Research coordinator is as follows -
Number of Applicants |
Initial Application Evaluation |
Total Hours |
100/year |
10 minutes/respondent |
16.67 hours |
The estimated annualized total cost to the Federal government to process the applicants:
16.67 hours x $30.15 per hour = $502.60
(Clinical Research Coordinator wage rate - $30.15)
Changes in Burden: Explain the reasons for any program changes or adjustments reported in Items 13 or 14 of the OMB Form 83-I, if applicable.
Not applicable. The information collection is requesting OMB approval.
Publication of Results: For collections of information whose results will be published, outline plans for tabulation and publication.
There will be no publication from this collection.
If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.
NASA will display the expiration date on the electronic version of the forms within the required PRA Statement.
Explain each exception to the certification statement identified in Item 19, "Certification for Paperwork Reduction Act Submissions," of OMB Form 83-I.
The NASA office conducting or sponsoring this information collection certifies compliance with all provisions listed above.
Name: Dave Hanson
Title: Human Health & Performance Directorate, Acting Information Systems Group Lead
Email address or Phone number: Dave Hanson ([email protected])
Date: 2/4/2020
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | TEMPLATE/GUIDELINES FOR PREPARING THE SUPPORTING STATEMENT |
Author | IMB, ERO |
File Modified | 0000-00-00 |
File Created | 2021-01-15 |