Fast track CT.gov Train-the-Trainer Survey

NLM Fast Track ICR_CT.gov Train the Trainer Survey.doc

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

Fast track CT.gov Train-the-Trainer 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: 05/31/2021)


TITLE OF INFORMATION COLLECTION:

2019 NLM CT.gov Train the-Trainer Workshop Feedback Survey


PURPOSE:

The purpose of this National Library of Medicine (NLM) survey is to obtain customer satisfaction information on the ClinicalTrials.gov “Train-the-Trainer Workshop.” The survey is designed to collect specific and general feedback of participants’ experience with the workshop, what additional questions they may have, and what additional resources would find helpful. This information will improve future Train-the-Trainer Workshops, and the informational content ClinicalTrials.gov offers to users.


DESCRIPTION OF RESPONDENTS:

The respondents will be public attendees of the workshop who provide ClinicalTrials.gov training and support to individuals at their respective institution/company/organization.


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 training program in the future.


Name: Anna Fine, PharmD


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 [ ] 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

180

1

5/60

15

Totals

180


15


Category of Respondent


Total Burden

Hours

Wage Rate*

Total Burden Cost

Individuals or Households

15

$24.98

$374.70





Totals

$374.70


*The General Public wage rate was obtained from https://www.bls.gov/oes/2018/may/oes_nat.htm#00-0000


FEDERAL COST: The estimated annual cost to the Federal government is: $512.39


Staff


Grade/Step

Salary*

% of Effort


Fringe (if applicable)



Total Cost to Gov’t

Federal Oversight






Customer Outreach Service Specialist

    GS13/2

$102,477

0.5%


    $512.39

Contractor Cost





N/A







Travel





N/A

Other Cost





N/A







Total





   $512.39

*The Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/19Tables/html/DCB.aspx


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?


We will provide the survey link to all of the ClinicalTrials.gov Train-the-Trainer Workshop attendees.


Administration of the Instrument

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

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain


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




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File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
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File Modified2019-09-11
File Created2019-09-11

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