Fast Track Template

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: Scientific Workforce Diversity Seminar Series
(SWDSS): November 17 Seminar Follow-Up Survey
PURPOSE:
The Chief Officer for Scientific Workforce Diversity (COSWD) office hosts a seminar series
called the Scientific Workforce Diversity Seminar Series (SWDSS). The purpose of the series is
to keep scientific workforce diversity issues at the forefront, to share the latest research on these
topics, and to engage with professionals and researchers within and outside of the NIH. The
COSWD office is hosting a virtual seminar on November 17 titled How Do Diversity
Supplements Impact Careers in Biomedical and Behavioral Research? and intends to ask
attendees for feedback on the seminar. The results of the survey will inform future COSWD
office events.
DESCRIPTION OF RESPONDENTS:
Respondents will be NIH staff and the general public from various organizations who attended
the event and who voluntarily choose to participate in the survey. The survey will be accessible
via a web-based survey link provided to attendees.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software
[ ] Focus Group

[X] Customer Satisfaction Survey
[ ] Small Discussion 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: Nicole Lang, Health Program Specialist
Chief Officer for Scientific Workforce Diversity (COSWD) Office
To assist review, please provide answers to the following question:
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? [] Yes [X] No

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

Individuals

150

1

Totals

Time per
Response
(in hours)
5/60

150

Total
Burden
Hours
13
13

COST TO RESPONDENT
Category of Respondent Total Burden
Hours
Individuals
13

Hourly Wage Rate*
$38.15

Totals

Total Burden
Cost
$495.95
$495.95

*Mean hourly wage for Life, Physical, and Social Science Occupations
https://www.bls.gov/oes/2020/may/oes_nat.htm#19-0000
While the event is open to the public, we anticipate that most participants will work in life,
physical, or social science occupations, given the seminar focus on scientific workforce diversity
topics.
FEDERAL COST: The estimated annual cost to the Federal government is $569.72.

Staff
Federal Oversight
Social Science Analyst

Grade/Step

Salary*

% of
Effort

13-03

$113,944

0.5%

Fringe (if
Total Cost to
applicable) Gov’t

$569.72

Contractor Cost
Travel
Other Cost
$569.72

Total
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* the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salarytables/pdf/2022/DCB.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?
All event attendees will be invited to respond to the survey.
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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