Supporting Statement - A11 Section 280 Clearance - DEEOIC Webinar Web-based Survey

Request for Approval under the “Generic Clearance for Improving Customer Experience: OMB Circular A-11, Section 280 Implementation”

(OMB Control Number: 1225-0093)

TITLE OF INFORMATION COLLECTION: Web-based Survey for Soliciting Webinar Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)

PURPOSE OF COLLECTION: Web-based survey designed to gather feedback from stakeholders attending outreach webinars held by the Division of Energy Employees Occupational Illness Compensation (DEEOIC). Soliciting feedback on how the stakeholders perceive the webinars and how well the webinars help us serve our stakeholders needs. We will use the information to improve the stakeholder experience and identify potential areas for improvement and/or training. We will report the findings of our survey on the Performance.gov website.

TYPE OF ACTIVITY: (Check one)

[ ] Customer Research (Interview, Focus Groups)

[ X ] Customer Feedback Survey

[ ] User Testing

ACTIVITY DETAILS

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. Who will you collect the information from?

DEEOIC will collect information from stakeholders attending the regularly scheduled outreach webinars. This may include claimants, authorized representatives, family members, etc.

3. How will you ask a respondent to provide this information?

DEEOIC will send surveys via email to registered participants after the webinar has ended. Surveys will be optional.

4. What will the activity look like?

The survey will be sent via email to registered participants. The email will explain the purpose of the collection and a survey with 11 questions. Seven of the questions include a 1-5 scale response based on the A-11 drivers, two questions are open-ended, and two questions allow optional personal information to be submitted.

5. Please provide your question list.

1.     Please rate your overall webinar experience. 

·        Outstanding (5)

·        Above Average(4)

·        Average(3)

·        Below Average(2)

·        Poor (1)

2.     What were the most and least valuable parts of the webinar?

3.     This webinar provided valuable information on this topic.

·        Strongly agree (5)

·        Agree (4)

·        Neutral (3)

·        Disagree (2)

·        Strongly disagree (1)

4.     This interaction increased my trust in DEEOIC. 

·        Strongly agree (5)

·        Agree (4)

·        Neutral (3)

·        Disagree (2)

·        Strongly disagree (1)

5.     It was easy to attend this webinar.

·        Strongly agree (5)

·        Agree (4)

·        Neutral (3)

·        Disagree (2)

·        Strongly disagree (1)

6.   This webinar took a reasonable amount of time.

·        Strongly agree (5)

·        Agree (4)

·        Neutral (3)

·        Disagree (2)

·        Strongly disagree (1)

7.     I understood what I needed to do to participate in this webinar.

·        Strongly agree (5)

·        Agree (4)

·        Neutral (3)

·        Disagree (2)

·        Strongly disagree (1)

8.     The employees presenting this webinar were helpful.

·        Strongly agree (5)

·        Agree (4)

·        Neutral (3)

·        Disagree (2)

·        Strongly disagree (1)

9.     What are some topics that you would like DEEOIC to address in future webinars?

10.     Name (optional)

11.     Email (optional)

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

Script/prompt language attached.

6. When will the activity happen?

DEEOIC will send begin sending surveys to stakeholders upon approval, likely late 2^nd quarter of FY 2022. Surveys will be sent after each outreach webinar.

7. Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants?

[ ] Yes [ X ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden Hours
Claimants/Authorize Representatives	4,000	5 minutes	333
Totals	4,000		333

CERTIFICATION:

I certify the following to be true:

1. The collections are voluntary;

2. The collections are low-burden for respondents (based on considerations of total burden hours or burden-hours per respondent) and are low-cost for both the respondents and the Federal Government;

3. The collections are non-controversial and do not raise issues of concern to other Federal agencies;

4. Any 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 near future;

5. Personally identifiable information (PII) is collected only to the extent necessary and is not retained;

6. Information gathered is intended to be used for general service improvement and program management purposes

7. Upon agreement between OMB and the agency aggregated data may be released as part of A-11, Section 280 requirements only on performance.gov. Summaries of customer research and user testing activities may be included in public-facing customer journey maps.

8. Additional release of data will be coordinated with OMB.

Name: Joshua Novack

All instruments used to collect information must include:

OMB Control No. 1225-0093

Expiration Date: 02/29/2024

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