sub-study for ALS Stretegic Workshop

ALS Strategic Plan Workshop Request for Approval OMB-rev2.docx

Conference, Meeting, Workshop, Registration and Challenges Generic Clearance (OD)

sub-study for ALS Stretegic Workshop

OMB: 0925-0740

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Request for Approval under theConference, Meeting, Workshop, Registration and Challenges Generic Clearance (OD)”

(OMB#: 0925-0740 Exp Date: 09/2025)

Shape1 TITLE OF INFORMATION COLLECTION: ALS Strategic Plan Workshop Registration (NINDS)


PURPOSE: The purpose of this information collection is to collect general registrant information for individuals who will participate in the ALS Strategic Plan Workshop held by NINDS. The information will be used to provide meeting details and links to attendees and for program planning purposes. NINDS is committed to promoting a diverse research workforce and to including diverse participants at this workshop. To allow staff to determine whether participants at the workshop represent diverse groups and backgrounds, the registration form gives registrants an opportunity to share demographic information, which will be aggregated for internal NINDS use and ongoing program improvement purposes only.


DESCRIPTION OF RESPONDENTS: Respondents are members of the public, media, members of congress, patient/advocacy groups, clinicians, investigators and associated scientific staff from academic and private institutions around the country, as well as federal staff (primarily NIH and FDA).





TYPE OF COLLECTION: (Check one)


[ ] Abstract [ ] Application

[ ] Challenges and Competition

[X] Registration Form [ ] 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.


Name:_Cara Long, Ph.D., NINDS OSPP


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


Category of Respondent

No. of Respondents

No. of Responses per Respondent

Time per

Response

(in hours)

Total Burden

Hours

Individuals

700

1

5/60

58





















Totals


700

5/60

58


COST TO RESPONDENT


Category of Respondent


Total Burden

Hours

Wage Rate*

Total Burden Cost

Individuals

58

43.22

2506.76

















Totals



2506.76

*Hourly wage rates for “Academic or independent investigator” 19-1029 Biological Scientists is $43.22 (based on http://www.bls.gov/oes/current/oes191029.htm).



FEDERAL COST: The estimated annual cost to the Federal government is _$859.68_____


Staff


Grade/Step

Salary

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight












Health Science Policy Analyst

13/1

106,823

2.5%


$267

Contractor Cost








130,250

2.5%


592.68

Travel






Other Cost












Total





$859.68

*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2022/DCB.pdf


The selection of 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?


There is not a comprehensive list of all potential registrants. We aim to reach as many as possible individuals that may be interested and want to engage on this topic, primarily via email, social media, and a meeting website. To do that, we have lists of individuals that have responded previously on this topic, lists of partner organizations that will promote the event through their communications and social media. As this is not a research study, we do not have a detailed sampling plan.



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

[X] Survey form

[ ] Chart Abstraction

[ ] Other, Explain


  1. 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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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified0000-00-00
File Created2023-08-26

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