A-11 Fast-Track Clearance Request Template_ORMDI Brand Health

A-11 Fast-Track Clearance Request Template_ORMDI Brand Health.pdf

Clearance for A-11 Section 280 Improving Customer Experience Information Collection

A-11 Fast-Track Clearance Request Template_ORMDI Brand Health

OMB: 2900-0876

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Request for Approval under the “Generic Clearance for Improving Customer
Experience (OMB Circular A-11, Section 280 Implementation)” (OMB Control
Number: 2900-0876)
TITLE OF INFORMATION COLLECTION: Office of Resolution Management, Diversity & Inclusion
(ORMDI) Brand Health Survey
PURPOSE
The Office of Resolution Management, Diversity & Inclusion (ORMDI) would like to collect survey
and transactional data to help guide the organization’s branding and communications strategies, adjust
product service offerings, and educate all VA employees on the new office and the services it provides to
help maintain a healthy and professional work environment free from discrimination, harassment,
retaliation, exclusion and hostility.
To achieve this, the Veteran Experience Office (VEO) will leverage VSignals to collect feedback
through a short, low burden brand health survey delivered as a URL for distribution through the ORMDI
website. The survey will consist of four questions revolving around a human-centered design, focusing on
such elements as satisfaction and ease with the service. The survey is completed via a web-based survey
design and will be offered to visitors of the ORMDI website on va.gov. Visitors to the ORMDI website will
be able to click on a “feedback” banner on the webpage that will open a pop-up window for the Vsignals
survey. Participants will choose whether they want to click on the banner, or whether they want to
participate in the survey after clicking on the survey. The participant can choose to exit the survey at any
time before submitting their survey response.
DESCRIPTION OF RESPONDENTS:
Vendors contracted with the Department of Veterans Affairs that interact with the Financial Services
Center.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software
[ ] Focus Group

[X] Customer Satisfaction Survey
[ ] Small Discussion 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. Personally identifiable information (PII) is collected only to the extent necessary and is not retained.
5. Information gathered is intended to be used for general service improvement and program management
purposes.
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.
1

7. All or a subset of information may be released as part of A-11, Section 280 requirements on
performance.gov. Additionally, summaries of the data may be released to the public in communications
to Congress, the media and other releases disseminated by VEO, consistent with the Information Quality
Act.
Name: Evan Albert, Director of Measurement and Data Analytics, Veterans Experience Office
[email protected] (202) 875-478

To assist review, please provide answers to the following question:
Personally Identifiable Information:
1. Will this survey use individualized links, through which VA can identify particular respondents even if
they do not provide their name or other personally identifiable information on the survey? [ ] Yes [X]
No
2. Is personally identifiable information (PII) collected? [ ] Yes [X] No
3. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of
1974? [ ] Yes [ ] No [N/A]
4. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No [N/A]
Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants?
[ ] Yes [ X] No

BURDEN HOURS
Category of Respondent
Web site users
Totals

No. of
Respondents
52,087 Annual
52,087 Annual

Participation
Time
2 minutes
2 minutes

Burden
1,736 hours
1,736 hours

*Q4
Please answer the following questions.
1. Are you conducting a focus group, a survey that does not employ random sampling, user testing
or any data collection method that does not employ statistical methods?
Yes _ X __
No _ _

If Yes, please answer questions 1a-1c, 2 and 3.
If No, please answer or attach supporting documentation that answers questions 2-8.

a. Please provide a description of how you plan to identify your potential group of respondents and
how you will select them.
•

The survey is completed via a web-based survey design and will be offered to visitors of the
ORMDI website on va.gov. Visitors to the ORMDI website will be able to click on a
“feedback” banner on the webpage that will open up a pop-up window for the Vsignals
survey. Participants will choose whether they want to click on the banner, or whether they
want to participate in the survey after clicking on the survey. The participant can choose to
exit the survey at any time before submitting their survey response.

b. How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ ] Mail
[ ] Other- E-mail-based surveys
c. Will interviewers or facilitators be used? [ ] Yes [ X ] No
2. Please provide an estimated annual cost to the Federal government to conduct this data collection:
__$13,000______
3. Please make sure that all instruments, instructions, and scripts are submitted with the request. This
includes questionnaires, interviewer manuals (if using interviewers or facilitators), all response options
for questions that require respondents to select a response from a group of options, invitations given to
potential respondents, instructions for completing the data collection or additional follow-up requests for
the data collection.
•

Done

4. Describe (including a numerical estimate) the potential respondent universe and any sampling or other
respondent selection methods to be used. Data on the number of entities (e.g., establishments, State and
local government units, households, or persons) in the universe covered by the collection and in the
corresponding sample are to be provided in tabular form for the universe as a whole and for each of the
strata in the proposed sample. Indicate expected response rates for the collection as a whole. If the
collection had been conducted previously, include the actual response rate achieved during the last
collection.
•

Category of Respondent

No. of Respondents
3

Web site users
Totals

52,087 Annual
52,087 Annual

5. Describe the procedures for the collection of information, including:
a. Statistical methodology for stratification and sample selection.
b. Estimation procedure.
c. Degree of accuracy needed for the purpose described in the justification.
d. Unusual problems requiring specialized sampling procedures.
e. Any use of periodic (less frequent than annual) data collection cycles to reduce burden.
•

•

Not applicable. The survey is completed via a web-based survey design and will be offered
to visitors of the ORMDI website on va.gov. Visitors to the ORMDI website will be able to
click on a “feedback” banner on the webpage that will open up a pop-up window for the
Vsignals survey. Participants will choose whether they want to click on the banner, or
whether they want to participate in the survey after clicking on the survey. The participant
can choose to exit the survey at any time before submitting their survey response.
The estimation procedure uses the number of visitors the website had from 12/15/201912/15/2020.

6. Describe methods to maximize response rates and to deal with issues of nonresponse. The accuracy and
reliability of information collected must be shown to be adequate for intended uses. For collections
based on sampling, a special justification must be provided for any collection that will not yield
"reliable" data that can be generalized to the universe studied.
•

7. Describe any tests of procedures or methods to be undertaken. Testing is encouraged as an effective
means of refining collections of information to minimize burden and improve utility. Tests must be
approved if they call for answers to identical questions from 10 or more respondents. A proposed test or
set of tests may be submitted for approval separately or in combination with the main collection of
information.
•

8. Provide the name and telephone number of individuals consulted on statistical aspects of the design and
the name of the agency unit, contractors, grantees, or other person(s) who will actually collect or
analyze the information for the agency.

Collection and Analysis:
• Evan Albert, Dir. of Measurement and Data Analytics, Veterans Experience Office, VA (202)
875-9478
• Daniel Malloy, ORMDI Director, [email protected] , (513) 861-3100

File Type	application/pdf
File Modified	2020-12-23
File Created	2020-12-23