BRIM Investigator Post-Meeting Survey (NCCIH)

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: BRIM Investigator Post-Meeting Survey (NCCIH)

PURPOSE: To gather feedback from attendees of the National Center for Complementary and Integrative Health (NCCIH)’s Behavioral Research to Improve Medication-Based Treatment (BRIM) Investigator Meeting that was held on May 3, 2022. We would like to know if the meeting achieved its intended purpose (e.g., sharing information and group discussion) and was informative for investigators. Information gathered will help structure next year’s BRIM investigator meeting in order for the meeting to be useful for attendees.

DESCRIPTION OF RESPONDENTS: Respondents are current NCCIH grantees who attended the BRIM Investigator meeting on May 3, 2022. There were 19 attendees. They are part of the BRIM program to support research that assesses whether behavioral interventions can improve outcomes of medication-based treatment.

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: __ Melissa Treviño, PhD

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

3. If Applicable, has a System or Records Notice 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

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 or Households	19	1	10/60	3
Totals		19		3

COST TO RESPONDENT

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals or Households	3	$31.31	$93.93
Totals			$93.93

*Cite source per bls.gov if applicable

https://www.bls.gov/news.release/empsit.t19.htm Used “Education and health services” hourly wage rate

FEDERAL COST: The estimated annual cost to the Federal government is $1,068

Staff	Grade/Step	Salary*	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Health Program Specialist	13/1	106,823	1%		$1,068
Contractor Cost
Travel
Other Cost
Total					$1,068

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

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?

We have a list of 19 attendees that we will be our targeted respondents. Respondents are current NCCIH grantees who attended the BRIM Investigator meeting on May 3, 2022. They are part of the BRIM program to support research that assesses whether behavioral interventions can improve outcomes of medication-based treatment.

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

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

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