MIECHV TARC Fast Track Survey Memo

Request for Approval under the “Voluntary Partner Surveys to Implement Executive Order 12862/Questionnaire and Data Collection Testing, Evaluation, and Research for the Health Resources and Services Administration” (OMB Control Number: 0906-0084/0915-0379)

TITLE OF INFORMATION COLLECTION: Maternal, Infant, and Early Childhood Home Visiting Technical Assistance Resource Center (TARC) Satisfaction Surveys

PURPOSE:

The purpose of this information collection request is to assess participant satisfaction with various training and technical assistance (TA) activities offered through a contracted TA provider, Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Technical Assistance Resource Center (TARC). TARC builds capacity of MIECHV awardees to effectively implement evidence-based home visiting through individualized TA, universal tools, and resources such as webinars, newsletters, communities of practice, and written resources, an adaptive leadership academy, and continuous quality improvement (CQI) practicum. The overall purpose of the TARC satisfaction surveys is to collect immediate awardee feedback on their TA experiences to make continuous improvements to service delivery. The contractor will protect the integrity of the data collected and provide opportunities for honest feedback. Data analysis for each tool will include basic descriptive statistics and qualitative analysis of responses.

The ten instruments under this Information Collection are:

1. Individualized (Targeted) TA Check-In Survey: Customer satisfaction on technical assistance received, taken partway through an individualized TA experience.

2. Individualized (Targeted) TA: Closeout Report Survey: Customer satisfaction on technical assistance received, taken at the completion of an individualized TA experience.

3. Individualized (Targeted) TA: Small Group Survey: Customer satisfaction on technical assistance received, disseminated at the completion of a small group TA experience.

4. Webinar Survey: Customer satisfaction with webinars attended, taken after completing a webinar.

5. Community of Practice Survey: Customer satisfaction with community of practice attended, taken once partway through a community of practice and once after completing a community of practice.

6. Adaptive Leadership Academy Survey: Customer satisfaction with adaptive leadership academy attended, taken after completing their participation in the adaptive leadership academy.

7. CQI Practicum Check-In Survey: Customer satisfaction for CQI Practicum participants, taken partway through their participation in the CQI Practicum.

8. CQI Practicum Completion Survey: Customer satisfaction for CQI Practicum participants, taken after completing participation in the CQI Practicum.

9. CQI Practicum Polls: Customer satisfaction for the CQI Practicum session, taken immediately following every monthly CQI Practicum session.

10. General Meeting Poll: Customer input form, taken before an individualized technical assistance or universal technical assistance offering with MIECHV program awardees, intended to support improvement in awardee experiences with the TA by allowing the TARC team to customize the offering based on information collected from the intended participants.

DESCRIPTION OF RESPONDENTS:

MIECHV Program awardees and participants of webinars provided by TARC and the CQI Practicum (who may or may not be MIECHV Program awardees). MIECHV Program support state and jurisdiction MIECHV awardees, so the affected public would be state or jurisdiction governments.

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: Soohyun Kim, Supervisory Public Health Analyst

Division of Home Visiting and Early Childhood Systems

Maternal and Child Health Bureau

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, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [X] No

3. If yes, has an up-to-date System of Records Notice (SORN) 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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden Hours Total
TA Recipients (MIECHV Program awardees)	150	.37	55.5
Webinar participants	380	.08	30.4
Community of Practice participants	330	.12	39.6
Adaptive Leadership Academy participants	52	.12	6.24
CQI Practicum participants	55	.24	13.2
Totals	967		144.94

FEDERAL COST:

The estimated annual cost to the federal government is $56,777, which includes $1,777 in staff hours (30 hours at the GS 13/Step 4 level) in project management and contract oversight and $55,000 in contract costs (estimated at 1% of total contract costs) for survey administration and data analysis.

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

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?

TARC maintains a list of all MIECHV Program awardees that receive TA and all individuals that attend webinars or participate in the CQI Practicum, Adaptive Leadership Academy, or Community of Practice through pre-registration. There will be no sampling, all the TA recipients will receive the relevant surveys for the TA product or activity they participate in and all webinar participants will receive webinar survey after each event.

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

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