FastTrack Submission Form - SRAE Grantee Feedback

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION:

Sexual Risk Avoidance Education (SRAE) Grantee Training and Technical Assistance Satisfaction Survey

PURPOSE:

The purpose of the planned activity is to collect feedback from grantees on training and technical assistance (T&TA) on how training events and technical assistance opportunities to date have met their needs and building from that information to ascertain any gaps and unmet needs to help increase satisfaction for future T&TA. Although T&TA is an on-going activity, it is critical to obtain an assessment of their satisfaction with what they have received and to identify any gaps or unmet needs to be addressed. The feedback we receive from grantees will provide essential information that is critical for improving future trainings, technical assistance, and other resources and planning the type and topics for up-coming training sessions and materials that we will offer to the grantees. The information collected will help ensure that future T&TA is effective and efficient and new content and resources to are appropriately tailored to grantees’ needs to improve overall satisfaction.

We believe that a survey is the most expeditious format to capture a range of needs of the diverse organizations who have received SRAE funding. The survey will be web-based (developed in Survey Gizmo) and sent to the grantee points of contact for response. The survey will include mostly multiple choice, with a limited number of open-ended questions. We do not anticipate it will take longer than 25 minutes to complete.

DESCRIPTION OF RESPONDENTS:

Respondents are SRAE grantees of the Adolescent Pregnancy Prevention program.

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: Needs Assessment Survey

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: __Jacqueline Proctor, Program Specialist, COR _____________

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, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [] Yes [ ] No Not applicable

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No Not applicable

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No

Incentives will not be provided as the respondents are all grantees and this falls within their programming expectations; in addition, the burden of responding to the survey is low.

BURDEN HOURS

Estimated Annual Reporting Burden
Type of Collection	No. of Expected Respondents	Annual Frequency per Response	Hours per Response	Total Hours
Online questionnaire	108	1	25 min (0.42 hours)	45

FEDERAL COST: The estimated cost to the Federal government is $__5,000______

Item/Activity	Details	$ Amount
FYSB oversight of contractor and project	1% of FTE: GS-13 Program Specialist	$1,000
Deployment of survey instrument, reminders to grantees for completion, analysis of results (Contractor)	Labor hours (1.5% of FTE for contractor staff)	$4,000
Total		$__5,000______

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?

All SRAE grantee contacts are eligible to respond to the survey. This amounts to roughly 114 contacts. We estimate a 95 percent response rate, which would amount to 108 SRAE grantee contacts responding to the survey.

Administration of the Instrument

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

[X] Web-based

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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

The survey instrument is attached along with this form as Attachment A.

The e-blast and reminder e-blast announcements are in Attachment B.

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