TITLE OF INFORMATION COLLECTION: NIH Scientific Workshop on Expanding the Evidence Base in Gender-Affirming Care for Transgender and Gender-Diverse Populations – Customer Feedback (SGMRO/OD)
PURPOSE:
The National Institutes of Health (NIH) is holding a virtual NIH Scientific Workshop on Expanding the Evidence Base in Gender-Affirming Care for Transgender and Gender-Diverse Populations. The purpose of the workshop is to advance our understanding of transgender health. The Sexual & Gender Minority Research Office wishes to collect feedback from participants of the scientific Workshop. Responses will be used to enhance the planning of future workshops at NIH.
DESCRIPTION OF RESPONDENTS:
The workshop participants are invited researchers, advocates, and members of the community with expertise in transgender health, measurement, behavioral and social sciences, and other disciplines related to the NIH mission. The workshop assessment is limited to the co-chairs, panelists, and NIH staff, which is approximately 60.
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: ______________________
FREQUENCY OF REPORTING: (Check one)
[X] Once [ ] Quarterly
[ ] Monthly [ ] On Occasion
[ ] Annually [ ] Other ___________________
CERTIFICATION:
I certify the following to be true:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
The results are not intended to be disseminated to the public.
Information gathered will not be used for the purpose of substantially informing influential policy decisions.
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:_ Irene Avila, PhD ([email protected]; 301-594-9701)
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [ ] Yes [X] No
If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] 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 |
Time per Response (in hours) |
Total Burden Hours |
Individuals |
60 |
1 |
5/60 |
5 |
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Totals |
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60 |
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5 |
COST TO RESPONDENT
Category of Respondent
|
Total Burden Hours |
Hourly Wage Rate* |
Total Burden Cost |
Individuals |
5 |
$51 |
$255 |
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Totals |
5 |
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$255 |
* https://www.bls.gov/oes/current/oes_47900.htm#19-0000
FEDERAL COST: The estimated annual cost to the Federal government is ___$241
Staff |
Grade/Step |
Salary* |
% of Effort |
Fringe (if applicable) |
Total Cost to Gov’t |
Federal Oversight |
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Assistant Director |
GS-15-2 |
$ 160,889 |
0.15% |
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241 |
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Contractor Cost |
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Travel |
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Other Cost |
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Total |
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$241 |
*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2023/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
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?
The SGMRO will send an email to ask workshop participants to complete the electronic feedback form (https://survey.alchemer.coms/s3/7220761/) at the end of the meeting.
Administration of the Instrument
How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ ] Other, Explain
Will interviewers or facilitators be used? [ ] Yes [X] No
Please make sure that all instruments, instructions, and scripts are submitted with the request.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Generic Clearance Submission Template |
Subject | Generic Clearance Submission Template |
Author | OD/USER |
File Modified | 0000-00-00 |
File Created | 2023-08-26 |