Template

Request for Approval under the

“Generic Clearance for NIH Citizen Science and Crowdsourcing Projects”

(OMB#: 0925-0766/Expiration Date: 09/30/2026)

TITLE OF INFORMATION COLLECTION: NCI’s Center for Global Health (CGH) Survey on Cancer Therapeutic Clinical Trials in Low- and Middle-Income Countries

PURPOSE: The NCI Center for Global Health (CGH) is interested in conducting a survey to gain a better understanding of the current landscape of cancer therapeutic clinical trials in low- and middle-income countries (LMICs) and learn about clinicians’ thoughts and opinions regarding concrete steps that might be taken to advance clinical trials in LMICs. They will be reaching out to individuals working in the area of cancer therapeutic trials in LMICs to participate in a survey to help them gain a better understanding of the current landscape and learn about their thoughts and opinions regarding concrete steps that might be taken to advance clinical trials in LMICs.

DESCRIPTION OF RESPONDENTS: Clinicians with experience participating as a member of the research team in at least one cancer therapeutic clinical trials with one or more recruitment sites or facilities in a low- and middle-income country, as defined by the World Bank.

TYPE OF COLLECTION: (Check one)

[ ] Data Catalogue [ ] Repository of Tools and Best Practices

[ ] Recommendations of scientific reviewers [ ] Resources

[ ] Call for Nominations [ x] Other: _____Survey_______________

FREQUENCY OF REPORTING: (Check one)

[x] Once [ ] Quarterly

[ ] Monthly [ ] On Occasion

[ ] Annually [ ] Other ___________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is a low burden for respondents and a low cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. Information gathered will not be used to substantially inform influential policy decisions.

5. The collection is targeted to soliciting opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Nina Goodman

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 subject to the Privacy Act of 1974? [x] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ X ] Yes [ ] No

4. Privacy Act Systems of Records Title: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD. FR Citation 88 FR 49473

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	246	1	15/60	62
Totals		1		62

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals	62	$121.15	$ 7,511.30
Totals			$ 7,511.30

*Source of the mean Hourly Wage Rate is provided by the Bureau of Labor Statistics, Occupation title “Physicians” 29-1210-, https://www.bls.gov/oes/current/oes_nat.htm#29-1210

FEDERAL COST: The estimated annual cost to the Federal government is $1,598.94.

Staff	Grade/Step	Salary*	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Public Health Advisor	14-9	159,894	1%		$1,598.94
Contractor Cost					$0
Travel					$0
Other Cost					$0
Total					$1,598.94

*the Salary in the 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 or 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

2. If yes, please describe both below (or attach the sampling plan). If the answer is no, please explain how you plan to identify your potential respondents and how you will select them.

The survey will be sent to a list of institutions (approximately 180) and individuals (approximately 230) that partner with CGH. Of the 410 invited to participate, we estimate that 60%, or 246 will respond.

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, not for the survey. If we decide to follow up with interviews (undecided now), we will submit for another clearance.

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

5