Fast Track Template

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0925-0648)

T ITLE OF INFORMATION COLLECTION: NCCAM Customer Service Data Collection

PURPOSE: NCCAM provides the public, patients, families, health care providers, complementary health practitioners, and others with the latest scientifically based information on complementary health approaches and information about NCCAM's programs through a variety of channels, including its toll-free telephone information service. NCCAM wishes to continue to measure customer satisfaction with NCCAM telephone interactions and to assess which audiences are being reached through these channels. This effort involves a telephone survey consisting of 10 questions, which 25 percent of all callers are asked to answer, for an annual total of approximately 275 respondents. NCCAM uses the data collected from the survey to help program staff measure the impact of their communication efforts, tailor services to the public and health care providers, measure service use among special populations, and assess the most effective media and messages to reach these audiences.

DESCRIPTION OF RESPONDENTS: Respondents are patients, spouses/family/friends of patients, health care providers, physicians, complementary health practitioners, or other individuals contacting the NCCAM Clearinghouse.

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:__Shawn K. Stout______________________________________________

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, 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? [ ] Yes [ X ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time (average burden hours per response)	Burden
Individuals or households	275	5/60	23

FEDERAL COST: The estimated annual cost to the Federal government is $11,688.

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?

Respondent Universe and Sampling Methods

The population for the telephone survey consists of callers to the NCCAM telephone information service. Based on summary statistics for August 2007 to December 2012, an average of 338 callers per month telephoned the NCCAM telephone information service. The projected annual number of callers is 2,000. NCCAM is interested in continuing to ascertain how callers learned of the NCCAM telephone information service and how satisfied callers are with the information provided. In order to meet the needs of the diverse population of callers, NCCAM would like to assess both of these topics by distinct user types (user types of interest are listed in the table below). These user types are expected to have different needs and expectations regarding information obtained from NCCAM.

Estimated annual population counts for these user types, based on survey results to date, are shown in the table below. It is estimated that nearly 9 of every 10 callers (88 percent) fall into one of three groups: patient, spouse/relative/friend of patient, and general public. Other callers, such as complementary health practitioners, other health care providers, and researchers, acquire information for professional use.

Table. Population of Callers to NCCAM Telephone Information Service
User type	Annual estimated callers
	Number	Percentage
Patient	540	27%
Spouse/relative/friend of patient	220	11%
General public	580	29%
CAM practitioner	80	4%
Other health care provider	140	7%
Researcher or grant applicant	80	4%
Journalist/media professional	20	1%
Student	80	4%
Other	260	13%
TOTAL	2,000	100

An approximate 25 percent sampling rate (actually 23 percent) of callers is utilized, yielding a starting sample size of 500 callers. Assuming a gross response rate of 55 percent based on survey results to date, the actual number of callers participating in the interview is estimated to be 275.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ X ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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

Attachments:

Appendix A: Survey Instrument

Appendix B: Caller Anonymity

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