Stakeholder Measures and Advocate Forms at the National Cancer Institute (NCI)

Forms and Documents

Document Name	Status
Form 1 Survey - Requester Form	New
Form 1 Survey - Advocate Form	Modified
Form 1 Profile Completion Form	Modified
Attachment 5 Privacy Act Memo.pdf Supplementary Document	2024-09-17
Attachment 4 PIA.pdf Supplementary Document	2024-09-17
NCI 30day.pdf Supplementary Document	2024-09-17
SSA OAR Stakeholder Measures 9.4.2024_FINAL.docx Supporting Statement A	2024-09-17

IC Document Collections

IC ID	Document Title	Status
270808	Survey - Requester Form	New
249202	Survey - Advocate Form	Modified
249201	Profile Completion Form	Modified

ICR Details

OMB Control No: 0925-0774	ICR Reference No: 202409-0925-003
Status: Received in OIRA	Previous ICR Reference No: 202109-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Stakeholder Measures and Advocate Forms at the National Cancer Institute (NCI)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/19/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2024
Responses	42	45
Time Burden (Hours)	17	16
Cost Burden (Dollars)	0	0

---

Abstract: This is a request for OMB to approve the revised information collection Stakeholder Measures and Advocate Forms at NCI for an additional three years. This revision adds one new survey form. The Office of Advocacy Relations (OAR) disseminates cancer-related information to various stakeholders, seeks input and feedback, and facilitates collaboration to advance NCI’s authorized programs. It is beneficial for NCI, through the OAR, to recruit and manage research advocates, which includes collecting demographic information and areas of experience, skill, and interest. Since OAR is responsible for matching advocates to NCI programs and initiatives across the cancer continuum, it is also necessary to measure the satisfaction of both internal and external stakeholders with this collaboration.

---

Authorizing Statute(s): US Code: 42 USC sect 410 and sect 285 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 46894	05/30/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 76124	09/17/2024
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Profile Completion	1	Questionnaire
Survey - Advocate	1	Survey
Survey - Requester	1	Survey

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	42	45	0	-3	0	0
Annual Time Burden (Hours)	17	16	0	1	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: We added one new survey by splitting up our precious survey into two. We now have one for the Requestor (Attachment 3) and one for the Advocate (Attachment 2). Changes to the burden are for the following reasons: The number of respondents was reduced from 15 to 6; we added a staff assistant, which increased the Federal cost; other changes were annual updates to BLS and Federal wage figures.

---

Annual Cost to Federal Government: $6,580

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/19/2024

---