Template

FINALFast Track Template BRAIN PI Meeting Feedback Survey 2023.docx

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

Template

OMB: 0925-0648

Document [docx]
Download: docx | pdf

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: 2023 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative Meeting Conference Feedback Survey


PURPOSE: The purpose of this survey is to receive feedback from the attendees of the 2023 BRAIN Initiative meeting regarding their overall satisfaction with the meeting (e.g. topics covered, presentation quality, organization of the meeting, etc.). These survey results will be used to inform planning of future BRAIN Initiative meetings.


DESCRIPTION OF RESPONDENTS: Respondents are meeting registrants including NIH-, NSF-, DARPA-, and IARPA- funded investigators and associated scientific staff (e.g., postdocs) from academic and private institutions around country who attended the NIH sponsored 2023 BRAIN Initiative Meeting on June 12-13, 2023. Respondents also include federal staff (NIH, NSF, DARPA, IARP), BRAIN Initiative related investigators who do not receive federal funding (e.g., Allen Institute, HHMI/Janelia, Human Brain Project), the media, members of congress, patient/advocacy groups, and members of the public.



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: Cara Long, Ph.D. Health Science Policy Analyst, NINDS OSPP


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 [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

Individual: BRAIN Initiative meeting participants

1500

1

10/60

250











Totals


1500


250



Category of Respondent


Total Burden

Hours

Wage Rate*

Total Burden Cost

Individual: BRAIN Initiative meeting participants

250

$46.11

$11528

Totals

250


$11528

*Hourly wage rates for 19-1029 Biologic Scientist is $46.11 (based on http://www.bls.gov/oes/current/oes191029.htm).



FEDERAL COST: The estimated annual cost to the Federal government is $2,500

Staff


Grade/Step

Salary

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight:






Chief of Staff

14/5

$150,016

1%


$1500













Contractor Cost (optional):






Management Analyst


$100,000

1%


$1000







Travel (optional)






Other Cost (optional)






Total





$2,500

*The Salary in table above is cited from OPM’s GS salary & wages (https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2023/general-schedule


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 the complete list of registrants to the 2023 BRAIN Initiative meeting held on June 12-13, which is anticipated to reach 3000. We do not plan to sample this population, but rather email the attendees via Survey Monkey, and we estimate that up to 50% of the attendees will complete the survey, due to attrition.


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.





5

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified0000-00-00
File Created2023-08-26

© 2024 OMB.report | Privacy Policy