Fast Track Memo

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0990-0379)

TITLE OF INFORMATION COLLECTION:

TPP20 Tier 1 and Tier 2 Grantee Informational Form

PURPOSE:

The Office of Population Affairs (OPA) at the U.S. Department of Health and Human Services (HHS) requests permission to collect information from its currently funded Teen Pregnancy Prevention (TPP) Tier 1 and Tier 2 grantee organizations for the purpose of collecting feedback from grantees about their TPP projects that will be used to help OPA’s contractor prepare for planning implementation evaluation activities. The contractor will collect information from TPP project leads, including basic information about the grantee’s TPP project services and major partner organizations. The feedback collected will inform the planning of implementation evaluation activities and the development of grantee site profiles for the current Teen Pregnancy Prevention Program Tier 1, Optimally Changing the Map for Teen Pregnancy, and Tier 2, Impact and Innovation Network, grantees. The evaluation findings will be used to help shape and improve future strategies for the Teen Pregnancy Prevention Program to ultimately improve adolescent health.

DESCRIPTION OF RESPONDENTS:

Respondents to this collection will be private sector, nonprofit organizations who have Fiscal Year 2020 or 2021 TPP Tier 1 or Tier 2 cooperative agreements. The contractor will contact TPP grantee program directors who work on these cooperative agreements. The universe of organizations to be contacted includes the 62 Fiscal Year 2020 and 2021 TPP Tier 1, Optimally Changing the Map for Teen Pregnancy (Tier 1) Grantees and 13 Fiscal Year 2020 TPP Tier 2 Innovation and Impact Network (Tier 2 IIN) Grantees.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software) [ ] Small Discussion Group

[ ] Focus Group [X] Other: __Customer Feedback 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: ____Alexandra Osberg____________

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 [X] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [X] No

Gifts or Payments:

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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden Hours
Private Sector	75	15/60	19
Totals	75		19

FEDERAL COST: The estimated total and annual cost to the Federal government is $3,795.50.  

 

For cost calculations, we estimate 2 hours of time for a GS-14 (at $68.75/hr) at OPA to review the survey and OMB package. For the contractor, we estimate 24 hours of junior staff time (at $40/hr.) to program and test the survey in Voxco and export the results, and 19 hours of senior staff time (at $142/hr) to review the results of the survey once it is complete.  

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?

OPA will use its administrative records to identify the project directors from each of the 62 TPP Tier 2 and 13 TPP Tier 2 grantee organizations. One individual, the project director, for each grantee would receive the survey. All 75 FY2020 and FY 2021 TPP Tier 1 and Tier 2 grantees organizations will receive surveys.

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

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

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