FastTrack Generic Submission Form - APP Grantee Conference Feedback Surveys

APP Conference Evaluation OMB submission form Revised for Virtual_Revised 4-28-20.docx

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

FastTrack Generic Submission Form - APP Grantee Conference Feedback Surveys

OMB: 0970-0401

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

Shape1 TITLE OF INFORMATION COLLECTION: Adolescent Pregnancy Prevention Training & Technical Assistance 2020 Conference Feedback Surveys


PURPOSE: The purpose of the planned activities is to collect grantee input on the 2020 Adolescent Pregnancy Prevention (APP) annual grantee conference and to identify additional resources that grantees need to support their work in the community. All aspects of the conference will be evaluated, including plenary, poster, and concurrent sessions. We will also evaluate the conference overall. We will have three different surveys. The surveys are necessary to capture a range of perspectives and experiences across all conference participants and diverse organizations and geographic regions.


Overall Conference Survey (Attachment A)

The Overall Conference survey will capture feedback on the overall conference as well as feedback on the poster session. This survey will be web-based and sent to all conference participants 24 hours after the conference to assess the plenary, workshops, and poster sessions and conference overall. The survey will include multiple choice and open-ended questions and is estimated to take no longer than 10 minutes to complete.


Session Specific Surveys (Attachments B and C)

The Session Specific Survey (Attachment B) will capture feedback on each individual concurrent session, and the Opening and Closing Plenary Session Survey (Attachment C) will capture feedback on each plenary session respectively. These sessions will be evaluated immediately following the session and the survey will be available to participants through the conference app and through a web-based link. The surveys will include multiple choice and open-ended questions and are estimated to take no longer than 5 minutes to complete.


The contractor (RTI International) will perform analysis of the responses to inform the development of new content and products for the website, distribution and promotion of the technical assistance resources available to grantees, and future training opportunities.


DESCRIPTION OF RESPONDENTS: Respondents will include participants in the 2020 Annual Adolescent Pregnancy Prevention Grantee Conference.


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: LeBretia White, Program Manager, Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families


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, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No Not applicable

  3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No Not applicable


Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No


BURDEN HOURS



Estimated Annual Reporting Burden


Type of Collection


No. of Expected Respondents


Frequency per Response


Hours per Response


Total Hours

Online overall evaluation questionnaire

275

1

10 min (0.167 hours)

46

Opening and closing plenary session questionnaire

275

2

5 min (0.08 hours)

44

Individual session questionnaire (mobile app)

275

5

5 min (0.08 hours)

110

Total estimated burden hours

200


FEDERAL COST: The estimated cost to the Federal government is $__5,000______


Item/Activity

Details

$ Amount

FYSB oversight of contractor and project

1% of FTE: GS-13 Program Specialist

$1,000


Deployment of survey instrument, reminders to grantees for completion, analysis of results (Contractor)

Labor hours (1.5% of FTE for contractor staff)

$4,000

Total


$__5,000______


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?


Each participant will register for the Adolescent Pregnancy Prevention Grantee Conference through the conference registration platform. The contractor maintains the registration list. All participants will be invited to sign up for the conference app, which will include the individual session evaluations as well as the overall conference evaluation. In addition, we will send an email to the conference registrants 24 hours after the conference reminding them to complete the overall evaluation. The expected number of respondents was based on the number of attendees who responded to the OMB-approved evaluation forms for the 2019 APP Grantee Conference, which we expect to be similar or the same for the 2020 Conference.


Administration of the Instrument

  1. How will you collect the information? (Check all that apply)

[X] Web-based

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

  1. Will interviewers or facilitators be used? [ ] Yes [ X ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.


The survey instruments are attached along with this form as Attachment A, Attachment B, and Attachment C.

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleFast Track PRA Submission Short Form
AuthorOMB
File Modified0000-00-00
File Created2021-01-13

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