Service Deliery Fast Track_SBS Excel Tool for Thematic Analysis Feedback Survey

Service Deliery Fast Track_SBS Excel Tool for Thematic Analysis Feedback Survey.docx

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

Service Deliery Fast Track_SBS Excel Tool for Thematic Analysis Feedback Survey

OMB: 0920-1071

Document [docx]
Download: docx | pdf


Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1071)

Shape1 TITLE OF INFORMATION COLLECTION: SBS Excel Tool for Thematic Analysis Feedback Survey


PURPOSE: The Social and Behavioral Sciences team have developed a free and publicly available Excel tool to guide people in planning, collecting, and analyzing text information from communities (the CDC Excel Tool for Thematic Analysis). This tool will be published on an NCEZID webpage in 2024 and the development team would like to include a short feedback survey about the tool on the website. The goal of collecting feedback from people visiting the Excel tool website is to help the tool’s developers understand who the audience of the tool is and what settings they work in, as well as quickly identify and respond to any technical issues with downloading or using the tool. We will also include questions asking for feedback about possible improvements we could make to the tool to better serve those in public health involved in collecting, synthesizing, and implementing findings from text data.



DESCRIPTION OF RESPONDENTS: Respondents will be members of the public who are interested in using the CDC Excel Tool for Thematic Analysis, have visited the tool’s website and are willing to voluntarily provide anonymous feedback. We anticipate that this group will include public health professionals interested in collecting and analyzing community feedback in text form.


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: Ciara Nestor


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


BURDEN HOURS


Category of Respondent

No. of Respondents

Participation Time

Burden

Federal Government

500

15 minutes

125

State, local, or tribal governments

500

15 minutes

125

Private sector

500

15 minutes

125

Individuals or households

500

15 minutes

125

Totals

2000


500



FEDERAL COST: The estimated annual cost to the Federal government is $2,328.40. GS-13 Health Scientist @ $58.12 x 40 hours.


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?

We do not have a specific list of potential respondents but the universe of respondents will be visitors to the CDC Excel Tool for Thematic Analysis website who are interested in using the tool and opt-in to voluntarily providing anonymous feedback on their intended use of the tool.



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

  1. Will interviewers or facilitators be used? [ ] Yes [ X] No

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


Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”


Shape2

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g., Comment card for soliciting feedback on xxxx)


PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.


DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.


TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.


CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.


Personally Identifiable Information: Provide answers to the questions.


Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.


BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.


FEDERAL COST: Provide an estimate of the annual cost to the Federal government.


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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.


Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.


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


5

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleDOCUMENTATION FOR THE GENERIC CLEARANCE
Author558022
File Modified0000-00-00
File Created2024-07-26

© 2024 OMB.report | Privacy Policy