Fast Track Form

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

T ITLE OF INFORMATION COLLECTION: It’s a Noisy Planet. Protect Their Hearing. Campaign: Customer Satisfaction Survey

PURPOSE:

The National Institute on Deafness and Other Communication Disorders (NIDCD) conducts and supports biomedical and behavioral research and research training in the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language. The Institute also conducts and supports research and research training related to disease prevention and health promotion, as well as manages an integrated communications program to disseminate the goals and findings of NIDCD-funded research to a variety of audiences, including health consumers. A key focus of health promotion activities is to increase awareness about noise-induced hearing loss (NIHL) in youth and adults and to educate target audiences on steps to prevent NIHL. To achieve this, the NIDCD launched in 2008 a national education campaign called It’s a Noisy Planet. Protect Their Hearing. The campaign targets parents of adolescent children aged 8 to 12 and other adults so they can encourage children to adopt healthy hearing practices before and during the time they develop listening, leisure, and work habits. The campaign includes a Web site ((http://www.noisyplanet.nidcd.nih.gov) where people can order and download Noisy Planet materials. The campaign also involves a presentation component in which NIDCD staff give presentations about NIHL at local schools.

The Noisy Planet web site is a primary means of communicating about and distributing educational materials. It is important to obtain feedback about satisfaction with the materials and Web site from customers. Neither the NIDCD materials (available both from the web site and via telephone) nor the order process itself have been the subject of customer feedback previously. Obtaining customer satisfaction feedback would make it possible to incorporate suggestions and directions for changes to the campaign’s web site and other digital tools, the order process, and possibly to the materials to help ensure that the materials and dissemination strategies meet the needs of the target audiences.

The Noisy Planet school campaign presentations are an important means of communicating about and distributing educational materials directly to targeted adolescents, and by extension, their parents. A survey at this time with potential material users and visitors to the Noisy Planet Web site would make it possible to incorporate suggestions and directions for changes to the campaign’s messaging, and possibly to the materials to help ensure that the materials and dissemination strategies meet the needs of the target audiences.

DESCRIPTION OF RESPONDENTS:

1. Parents of adolescents

2. Health professionals

3. Youth- and school-oriented organization representatives

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: Debbie Washington

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 [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 (in hours)	Burden Hours
Individuals or Households (Customer Satisfaction Survey)	500	12/60	100
Individuals or Households (Parent Survey)	50	6 /60	5
Totals	550		105

FEDERAL COST: The estimated annual cost to the Federal government is $20,000.

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? [ ] Yes [X] 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?

For those that order Noisy Planet material, the sample plan consists of a census of all respondents who ordered Noisy Planet materials within the past year. An invitation sent via email will contain a link to the online survey. The survey will be kept “live” for a period of three (3) weeks, or until up to 500 respondents complete the survey.

For parents of adolescents attending a school presentation by NIDCD staff there will be no customer list or sampling plan, teachers who hosted a Noisy Planet school campaign presentation during January - April 2012 will be asked to email survey links to the parents of their students. NIDCD personnel will provide survey invitation language to the teachers and teachers may distribute an invitation electronically along with other classroom communications sent to parents. The email invitation will contain the survey address or a link to the online survey. The survey will be kept “live” for a period of three (3) weeks, or until up to 50 respondents complete the survey.

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

Attachment 1: Customer Satisfaction Survey Email

Attachment 2: Customer Satisfaction Survey Text

Attachment 3: Customer Satisfaction Survey Screen Shots

Attachment 4: Parent Survey Invite Text

Attachment 5: Parent Survey Screen Shots

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