fast track NIA website survey

NIA Website_generic_clearance_template2.docx

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

fast track NIA website 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: 05/2021)

Shape1 TITLE OF INFORMATION COLLECTION: NIA Website Survey for Website Satisfaction Rating 


PURPOSE: The National Institute on Aging (NIA) would like to add a 5-question customer satisfaction survey to nia.nih.gov to get a better understanding of its users motivations and demographic information. Filling out the survey will take less than a minute, providing little burden to the user while giving them the chance to provide NIA with their thoughts on the site. The information collected from the survey will be used to improve the design and operation of the publicly accessed website.   

 Along with this form, we have submitted:

  • An explanation of how the survey will function on nia.nih.gov and what text will be added to the privacy policy page.

  • Screenshots of how the survey will look like on the site. Please note the persistent display of the OMB approval number and a link to the privacy policy appears under each question .

  • A list of pages the survey will appear on.



DESCRIPTION OF RESPONDENTS: Visitors to NIA website who choose to respond to the survey. 



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:________________________________________________


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 

20,000

1

2/60

667

Totals


20,000


667



Category of Respondent


Total Burden

Hours

Hourly Wage Rate*

Total Burden Cost

Individuals or Households 

      667

$25.72 

$17,155.24 

Totals

      


$17,155.24 

* BLS National Occupational Employment and Wage Estimates Occupational Employment and Wages, May 2019

http://www.bls.gov/oes/current/oes_nat.htm#00-0000


FEDERAL COST: The estimated annual cost to the Federal government is $2,565.66

Staff


Grade/Step

Salary*

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight












Writer/Editor

5/1

$39,291

.5% 

 

$761.76 

Supervisory Public Affairs Specialist

14/2

$125,360

.3%



$1,803.90

Contractor Cost












Travel






Other Cost












Total





$2,565.66

*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2020/DCB.pdf



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?


The universe of potential respondents will be visitors to NIA website, and the sample will consist of those who choose to respond to the survey. 


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

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




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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified0000-00-00
File Created2021-04-06

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