Cover Letter

Cover Page SUB.doc

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

Cover Letter

OMB: 0935-0179

Document [doc]
Download: doc | pdf

SUBMISSION OF INFORMATION COLLECTION UNDER THE

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


DATE OF REQUEST: October 18, 2018


SUB AGENCY (I/C): HHS/AHRQ


TITLE: System Usability Scale (SUS)


GENERIC CLEARANCE UNDER OMB#: 0935-0179 EXP. DATE: 11/30/2020


ABSTRACT:

The SUS is a brief questionnaire which is considered as the industry standard for evaluating usability of hardware, software, mobile devices, websites, and applications. The PRO app will be programmed to include the prompt requiring the 180 patients to complete the SUS right after they submit their PROMIS data.










TOTAL ANNUAL BURDEN APPROVED: 3,383 Hours Per year

BURDEN USED TO DATE: 404 hours.

BURDEN THIS REQUEST: 14.4 hours.


FEDERAL COST: The estimated annual cost to the Federal government is $350.50_.


IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ______ NO _____x_ N/A


OBLIGATION TO RESPOND:

___x___ VOLUNTARY

______ REQUIRED TO OBTAIN OR RETAIN BENEFITS

______ MANDATORY



HOW WILL THIS SURVEY BE OFFERED?

­____ WEB SITE

____ TELEPHONE INTERVIEW

_____ MAIL RESPONSE

__ _ IN PERSON INTERVIEW

___x_ OTHER: Explain: The SUS will be programmed on the app for patients to complete right after they answer the PROMIS questions.

_

CONTACT INFORMATION:

NAME: _Erwin Brown______________________________

TELEPHONE NUMBER: 301.427.1652________________

EMAIL ADDRESS: [email protected]________________

File Typeapplication/msword
File TitleGeneric Clearance Form - 04/28/2008
SubjectGeneric Clearance Form - 04/28/2008
AuthorOD/USER
Last Modified BySYSTEM
File Modified2018-10-29
File Created2018-10-29

© 2024 OMB.report | Privacy Policy