T ITLE OF INFORMATION COLLECTION: Application and registration information collection for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on June 10-12, 2020 at the Lister Hill Auditorium (National Library of Medicine)
PURPOSE:
The Office of Dietary Supplements (ODS) at the National Institutes of Health (NIH) is offering a two and a half day educational opportunity to provide fundamental knowledge of dietary supplements to faculty, students, and practitioners with a serious interest in this subject. This intensive practicum will provide a thorough overview and grounding about issues, concepts, unknowns, and controversies about dietary supplements and supplement ingredients. It will also emphasize the importance of scientific investigations to evaluate the efficacy, safety, and value of these products for health promotion and disease prevention as well as how to carry out this type of research.
DESCRIPTION OF RESPONDENTS:
This practicum is open to university faculty, graduate students, and research practitioners in health-related disciplines such as nutrition, food science, pharmacy, pharmacology and pharmacognosy, exercise science and kinesiology, medicine, dentistry, nursing, and complementary and alternative medicine (CAM). Primary candidates are full-time academic faculty, research practitioners, doctoral students, postdocs, and fellows. Applications will also be accepted from health care providers and scientists with a master's degree or higher whose work involves research with dietary supplements, masters-level students, and students in allied health schools. The practicum is limited to approximately 100 attendees and we estimate that we will receive about 125 applications.
TYPE OF COLLECTION: (Check one)
[ ] Abstract [ ] Application
[X] Registration Form [ ] Other: ______________________
CERTIFICATION:
I certify the following to be true:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
Name: Jaime Gahche______________________________________________
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [X ] Yes [ ] No
If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [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
Amount: ___________
Explanation for incentive: (include number of visits, etc.)
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 (not-for-profit) |
77 |
1 |
5/60 |
6 |
Private Sector (for profit) |
7 |
1 |
5/60 |
1 |
Totals |
|
84 |
|
7 |
Category of Respondent
|
Total Burden Hours |
Wage Rate* |
Total Burden Cost |
Private Sector (not-for-profit) |
6 |
$ 35.76/hr |
$214.56 |
Private Sector (for profit) |
1 |
$ 38.83/hr |
$38.83 |
Totals |
|
|
$253.39 |
FEDERAL COST: The estimated annual cost to the Federal government is _$764.81
Staff |
Grade/Step |
Salary |
% of Effort |
Fringe (if applicable) |
Total Cost to Gov’t |
Federal Oversight |
|
|
|
|
|
Epidemiologist |
13/7 |
119,004 |
0.1% |
|
$119.00 |
|
|
|
|
|
|
|
|
|
|
|
|
Contractor Cost |
|
|
|
|
|
Website Developer |
|
$215.27/hr |
3 hours |
|
$645.81 |
Travel |
|
|
|
|
|
Other Cost |
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
|
|
$764.81 |
The selection of 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?
Identifying potential groups
ODS has compiled emails of specific individuals and groups that will be sent an email that includes information about the DSRP, the website link, an invitation to apply and an invitation to pass along the email to others that may be interested.
These lists include:
University Deans, Department Heads and Professors that have programs in nutrition, food science, pharmacy, pharmacology and pharmacognosy, exercise science and kinesiology, medicine, dentistry, nursing, and complementary and alternative medicine.
ODS collaborating offices and individuals at NIH and other federal government agencies
Nutrition groups both within and outside the federal government
Clinician and pharmacy professional associations.
The DSRP is also promoted on the ODS website, ODS listserv and ODS Twitter and Facebook.
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
[ ] Survey form
[ ] Chart Abstraction
[ ] Other, Explain
Will interviewers, facilitators, or research coordinators be used? [ ] Yes [ X ] No
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Generic Clearance Submission Template |
Subject | Generic Clearance Submission Template |
Author | OD/USER |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |