fast track for NINDS Public Site Widgets survey

NINDSPublicSiteWidget (4).docx

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

fast track for NINDS Public Site Widgets 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: The NINDS Public site widget


PURPOSE:

The mission of NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.


To support this mission, NINDS:

  • Supports and performs basic, translational, and clinical neuroscience research through grants-in-aid, contracts, scientific meetings, and through research in its own laboratories, and clinics.

  • Funds and conducts research training and career development programs to increase basic, translational and clinical neuroscience expertise and ensure a vibrant, talented, and diverse work force.

  • Promotes the timely dissemination of scientific discoveries and their implications for neurological health to the public, health professionals, researchers, and policy-makers.



DESCRIPTION OF RESPONDENTS: The survey will be open to all users. The users are the general public.



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: Nadia Douaji


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 [x] NA

  3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No [x] NA


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

Indviduals/households

30

1

3/60

2






Totals

30

30


2



Category of Respondent


Total Burden

Hours

Wage Rate*

Total Burden Cost

General public

2

$40/hour

$80





Totals



$80


*Cite source per bls.gov if applicable: all occupations rate.

Bls.gov Occupational Employment and Wages, http://www.bls.gov/oes/current/oes_dc.htm



FEDERAL COST: The estimated annual cost to the Federal government is $306


Staff


Grade/Step

Salary

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight






PM

13/5

103,000

0.1


$103

Web M

13/5

103,000

0.1


$103







Contractor Cost






Web Developer

NA

100,000

0.1


$100

Travel






Other Cost












Total





$306




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?




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


5


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified0000-00-00
File Created2021-07-30

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