Fast-track template NLM AIDS Portal Survey

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

TITLE OF INFORMATION COLLECTION:

NLM AIDS Portal Survey

PURPOSE:

The purpose of the survey is to identify the target audiences and their satisfaction with NLM’s HIV/AIDS Portal an online website containing links to HIV/AIDS information covering a variety of topics including general information, treatment, prevention, coping and content for specific population groups. We also want to measure the level of customer satisfaction with the HIV/AIDS Portal and solicit the customers’ feedback regarding the various types of content available and also to assist in identifying content gaps. Participants’ suggestions will assist in our acquisitions process.

DESCRIPTION OF RESPONDENTS:

Overall the respondents will be individuals who are using the HIV/AIDS Portal to find information about HIV/AIDS related issues. They will include the general public, health professionals, AIDS service professionals, librarians, persons affected by HIV/AIDS and their families, students and teachers.

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: Andrew Plumer_

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
Private sector (not for profit)	100	5/60	8 hrs
Totals			8 hrs

FEDERAL COST: The estimated annual cost to the Federal government is $1000

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?

The survey will be placed on the home page and major topic subsequent pages of the HIV/AIDS Portal. Anyone that uses visits the HIV/AIDS Portal pages will be given the opportunity to complete the survey. We want a broad section of potential responders as we have a large and varied user population.

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

Additional Documents:
Attachment 1_NLM AIDS Portal Survey. Instrument

Attachment 2_NLM AIDS Portal Survey 2014_Screen shots

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