Template Foundational (25AB)

Request for genIC Approval

CDC/ATSDR Formative Research and Tool Development

0920-1154

CIO: OPHDST

PROJECT TITLE: Foundational User Interviews with the Public

PURPOSE AND USE OF COLLECTION:

To ensure that Data Channel and SAPHIRE (Sharing Actionable Public Health Information) content is useful, actionable, and accessible to the public, the design team within the CDC Office of Public Health Data, Surveillance, and Technology, Inform and Disseminate Division will conduct foundational user interviews with the public to understand the full-spectrum experience of accessing, reviewing, and interpreting public health content with a focus on discovering the components of trust and experiences that lead to action.

DESCRIPTION OF RESPONDENTS:
Interview participants will fall into the following categories: Data enthusiasts/appreciators (individuals with positive beliefs in the role of data and seek data to inform decision making), Data ambivalent (individuals who do not have strong beliefs around the role of data and rarely seek data to inform decision making), Caretakers/adult children of older adults, Caretakers/Parents of young children, People with physical and/or cognitive disabilities such as visual impairments, Dyslexia, etc. who may encounter challenges accessing, reviewing, and understanding data channel content.

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. Information gathered will not be used to substantially inform influential policy decisions.

5. The study is not intended to produce results that can be generalized beyond its scope.

Name: ____Alanté Fields______

To assist review, please answer the following questions:

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 [ X ] 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? [X ] Yes [ ] No
To incentivize participation, interview participants will be offered a $100 incentive for their time, in line with market research recruitment standards for this audience.

BURDEN HOURS

The total estimated burden is 65 hours. Table 1 below describes the burden associated with the information collection.

The burden table assumes screening will take 5 minutes per person for those 60 individuals who are successfully recruited. Interviews last 60 minutes.

Table 1. Annualized Burden (total burden hours rounded)

Form Name	Type of Respondent	No. of Respondents	No. of Responses per Respondent	Average Burden Per Response (hours)	Total Burden Hours
Screener for Foundational Interviews (Attachment 1)	General Public	60	1	5/60	5
Interview Script Foundational Interviews (Attachment 3)	General Public	60	1	1	60
Total					65

FEDERAL COST: The estimated annual cost to the Federal government is $1,502.15

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?

Potential participants are drawn from a national panel of individuals who have opted in to participate in interviews on various topics. The contractor Kaptivate will direct a vendor panel provider to distribute an invitation to screen for the interviews to members of its panel, starting with those individuals whose panel profiles suggest they are most likely to qualify (Data enthusiasts/ appreciators, Data ambivalent, Caretakers/adult children of older adults, Caretakers/Parents of young children, People with physical and/or cognitive disabilities). When an individual receives the invitation to screen, they will complete a screening questionnaire online (Attachment 1). Individuals must pass the screening questionnaire without being disqualified based on their answers or due to quotas reached on certain characteristics. Sixty participants will be purposively selected from this pool of eligible participants for a total of 60 interviews.

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? [ X ] Yes [ ] No

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

Instructions for completing genIC Request for Approval for

CDC/ATSDR Formative Research and Tool Development

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is requested.

PURPOSE and USE: 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: Briefly describe the targeted group/groups for this collection.

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.

Form: Provide the title of the information collection form.

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 in Minutes: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Estimate the annual cost to the Federal government for this collection.

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.

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