fast track for MYR webinar survey

Fast Track Template for OMB_MYR Webinar_Final_PCB.docx

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

fast track for MYR webinar survey

OMB: 0925-0648

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


Shape1 TITLE OF INFORMATION COLLECTION: Mind Your Risks Webinar Feedback (NINDS)


PURPOSE: This information collection will gather feedback from individuals who attend one of a series of webinars based on the Mind Your Risks® public health campaign, supported by the National Institute of Neurological Disorders and Stroke (NINDS) to increase knowledge about preventable risk factors for stroke and dementia. These webinars will be held by NINDS and historically Black colleges and universities (HBCUs), and their purpose will be to raise awareness of the connection between high blood pressure, stroke, and dementia. After each webinar, participants will be asked questions about their satisfaction with various aspects of the webinar. The responses will be used internally by NINDS Staff and NINDS public health campaign contractors to improve the effectiveness of future webinars. NINDS anticipates holding up to 4 webinars over 2 years.


DESCRIPTION OF RESPONDENTS: Respondents will be alumni, staff, and older adults associated with HBCUs and HBCU Medical Schools who participate in one of a series of webinars based on the Mind Your Risks public health campaign.



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: Barbara I. McMakin, Media Relations Branch Chief, NINDS Office of Neuroscience Communications and Engagement.


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

Individual

400

1

10/60

67











Totals


400


67



Category of Respondent


Total Burden

Hours

Hourly Wage Rate*

Total Burden Cost

General Occupation

67

$22.00

$1,474

Totals




*Hourly wage rates for 00-0000 All Occupations is $22.00 (based on https://www.bls.gov/oes/current/oes_nat.htm).



FEDERAL COST: The estimated annual cost to the Federal government is $__$2793.15__.

Staff


Grade/Step

Salary

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight:












Public Health Analyst

GS-13/2

110,384

.4%


$441.54

Supervisory Technical Writer-Editor

GS-14/5

143,064.00

.4%


$687.81

Contractor Cost





$1,663.80













Travel (optional)





0

Other Cost (optional)





0

Total





$2793.15


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? [ 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 will have a complete list of registrations to each webinar, each of which is anticipated to reach up to 100 participants. We will send a link to the online survey by email to all who register for the webinar.


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

[ ] 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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