fast track study Return to Work Poll

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Exp., date: 06/30/2024)

TITLE OF INFORMATION COLLECTION: Return to Work Poll (NLM)

PURPOSE:

The National Library of Medicine (NLM) wishes to collect feedback from staff, including Federal employees and contractor staff, regarding whether they have returned to the physical workspace and, if so, what their experience has been. This information will inform NLM leadership’s communications and messages regarding the return to the physical workspace.

DESCRIPTION OF RESPONDENTS:

Respondents will be NLM staff who choose to respond to the survey link contained in the monthly NLM Insider employee newsletter.

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: Quick poll

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: Alison Lemon

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

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
NLM Staff	1,800	1	1/60	30
Totals		1,800		30

COST TO RESPONDENT

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals or Households	30	$28.01	$841
Totals			$841

* The General Public wage rate (Median wage for “All Occupations”) was obtained from May 2021 National Occupational Employment and Wage Estimates (bls.gov)

FEDERAL COST: The estimated annual cost to the Federal government is $941.83

Staff	Grade/Step	Salary*	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Writer/Editor	14/8	$188,366	0.5%		$941.83
Contractor Cost
Travel					N/A
Other Cost					N/A
Total					$941.83

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

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?

Survey respondents will be NLM staff, including Federal employees and contractor staff, who choose to respond to a survey invitation contained in an anonymous URL link in NLM’s monthly NLM Insider electronic newsletter.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[X] Other, (Email)

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

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