sub-study for SSSC Mentor Nomination

Request for Approval under the “Generic Clearance for NIH Citizen

Science and Crowdsourcing Projects”

(OMB#: 0925-0766, Expiration Date: 04/30/2024)

TITLE OF INFORMATION COLLECTION:

Nominations for Center for Cancer Training NCI Staff Scientists and Staff Clinicians Outstanding Mentor Award Programs (NCI)

PURPOSE:

The purpose of the annual award programs are to recognize excellence in mentoring and guiding the careers of trainees in cancer research. These award programs aim to empower trainees by participating in the process from the beginning to the end. This is achieved by fellows/trainees nominating excellence of mentorship by NCI investigators, staff scientists, staff clinicians, contractor scientists, or any other scientists in the role to mentor trainees and the coordination of a fellows/trainees led review committee to select the winner. Winners of these awards are recognized at the CCR and DCEG Staff Scientists and Staff Clinicians Retreat in the spring. The completed form (Attachment 1) is uploaded to a website (Attachment 2).

DESCRIPTION OF RESPONDENTS:

For the SSSC Outstanding Mentor Award, the nominators are post-bachelor trainees and high school students.

TYPE OF COLLECTION: (Check one)

[ ] Data Catalogue [ ] Repository of Tools and Best Practices

[ ] Recommendations of scientific reviewers [ ] Resources

[ X ] Call for Nominations [ ] Other: _____________

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. Information gathered will not be used for the purpose of substantially informing influenctial policy decisions.

5. 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: ___Angela Jones___

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ x ] Yes [ ] No

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

Gifts or Payments:

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

Amount: _________

Explanation for incentive: (include number of visits, etc.)

ESTIMATED BURDEN HOURS and COSTS

Form Name	Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
NCI Staff Scientist and Staff Clinician (SSSC) Award Form (Att 1)	Individuals	10	1	10/60	2
NCI SSSC Website Upload (Att 2)	Individuals	10	1	5/60	1
Totals			10		3

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals	3	$46.95	$139
Total			$139

*Source of the mean Hourly Wage Rate is provided by the Bureau of Labor Statistics, Occupation title “Medical Scientists” 19-1040, https://www.bls.gov/oes/2019/May/oes_nat.htm#00-0000.

FEDERAL COST: The estimated annual cost to the Federal government is $1129.30.

Staff	Grade/Step	Salary**	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Program Analyst	13/4	$112,930	1%		$1129.30
Contractor Cost					$0
Travel					$0
Other Cost					$0
Total					$1129.30

**The salary in the table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/20Tables/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

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?

Nominations for these are awards are requested from NCI current, recent or former postdoctoral fellows, research fellows, clinical fellows, postbaccalaureate fellows, graduate students, and other trainees.

Administration of the Instrument

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

[ ] Web-based or other forms on Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Survey Form

[ ] Chart Abstraction

[X] Other, Explain: The SSSC Award is a form that once completed is uploaded, in its entirety to a website.

Will interviewers, facilitators, or research coordinators be used? [ ] Yes [ X ] No

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

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