Fast Track Submission Template

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

TITLE OF INFORMATION COLLECTION: Adolescent Pregnancy Prevention Training & Technical Assistance 2023 Conference Feedback Surveys

PURPOSE: The purpose of the planned activities is to collect grantee input on the 2023 Adolescent Pregnancy Prevention (APP) annual grantee conference and to identify additional resources grantees need to support their work in the community. All aspects of the conference will be evaluated, including plenary, networking, and concurrent sessions. We will also evaluate the conference overall. The surveys are necessary to capture a range of perspectives and experiences across all seven funding streams and diverse organizations and geographic regions. We will have two different surveys. The Overall Conference Evaluation survey (Attachment A) will capture the overall conference evaluation along with feedback on the plenary sessions, networking sessions and posters, and the Session Specific Surveys (Attachment B) will capture feedback on each individual concurrent session.

Overall Conference Evaluation Survey (Attachment A)

The Overall Conference Evaluation Survey will be web-based (developed in Alchemer) and the link will be shared during the closing session of the conference. A link will also be sent to all conference participants within 24 hours after the conference to assess the plenary, networking, poster sessions, and conference overall. The survey will include multiple choice and open-ended questions and is estimated to take no longer than 15 minutes to complete.

Session Specific Surveys (Attachment B)

Surveys will be provided to participants of specific concurrent sessions following the session. The session surveys will be available in paper format and through CVENT, the conference platform and through a web-based link (developed in Alchemer). The session specific surveys will include multiple choice and open-ended questions and are estimated to take no longer than 5 minutes to complete.

The contractor (RTI International) will perform analysis of the responses to inform the development of future conference content and T&TA products for the website, distribution and promotion of the technical assistance resources available to grantees, and future training opportunities.

DESCRIPTION OF RESPONDENTS: Respondents are participants in the 2023 Annual Adolescent Pregnancy Prevention Grantee Conference.

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: Corey Palmer, Program Manager, Adolescent Pregnancy Prevention Program

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	Frequency per Response	Hours per Response	Total Hours
Online overall evaluation questionnaire	650	1	15 min (0.25 hours)	162.5
Individual session questionnaire	650	4	5 min (0.08 hours)	208
Total estimated burden hours				370.5

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?

Each conference participant will have to register for the Adolescent Pregnancy Prevention Grantee Conference through the conference platform. The contractor maintains the registration list. Participants will receive individual session evaluations at the end of each concurrent session. The link to the overall conference evaluation will be provided in the closing plenary session, and we will send an email to the conference participants within 24 hours after the conference reminding them to complete the overall evaluation. Session moderators will be responsible for distributing hard copy evaluations and for sharing the link to the concurrent session evaluation. The number of respondents is based on the estimated total conference attendees.

Administration of the Instrument

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

[X] Web-based

[ ] Telephone

[X] 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 overall conference evaluation and session specific instruments are attached along with this form as Attachment A and Attachment B, respectively.

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