Fast track NLM 2018 Public Libraries Association Survey

NIH Fast Track ICR_NLM 2018 Public Libraries Association Survey.doc

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

Fast track NLM 2018 Public Libraries Association Survey

OMB: 0925-0648

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Exp. Date: 03/31/2018)



TITLE OF INFORMATION COLLECTION:

NLM 2018 Public Libraries Association Survey


PURPOSE:

The purpose of this National Library of Medicine (NLM) survey is to collect qualitive customer service feedback from attendees at the 2018 Public Libraries Association meeting. The information from this survey will be used to improve the design and operation of these resources at NLM. The survey form will be made available to those who visit the NLM booth at the conference, and the NLM panel presentation.


DESCRIPTION OF RESPONDENTS:

Public attendees at conference who volunteer to complete paper survey form at the NLM conference booth, and at the NLM panel presentation at the 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: Laura Bartlett


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

  3. If Applicable, has a System or Records Notice been published? [ ] Yes [X] 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

Individuals or Households

200

1

5/60

17






Totals

200

200


17



Category of Respondent


Total Burden

Hours

Wage Rate*

Total Burden Cost

Individuals or Households

17

$23.86

$405.62





Totals

17


$405.62


*BLS National Occupational Employment and Wage Estimates

https://www.bls.gov/oes/current/oes_nat.htm


FEDERAL COST: The estimated annual cost to the Federal government is: $219.80


Staff


Grade/Step

Salary

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight






Technical Information Specialist


13/5

$109,900

0.2%



$219.80













Contractor Cost





N/A







Travel





N/A

Other Cost





N/A







TOTAL





$219.80






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? [ ] Yes [X] 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?


Conference attendees will be offered the opportunity to fill in survey forms at the NLM conference booth. Additionally, those attending the NLM panel presentation will also be offered the opportunity to fill out the survey.


Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ ] Telephone

[X] In-person

[ ] Mail

[ ] Other, Explain

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

3

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File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
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File Modified2018-02-27
File Created2018-02-27

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