Open Call Usability Testing (NCI)

Formative Research, Pretesting, and Customer Satisfaction of NCI's Communication and Education Resources (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Open Call Usability Testing (NCI) Form and Instruction
1 Attachment 1 Screener Lay Consumers English Attachment 1 Screener Lay Consumers_English.doc Form and Instruction
2 Attachment 3 Screener Lay Consumers Spanish Attachment 3 Screener Lay Consumers_Spanish.doc Form and Instruction
3 Attadchment 2 Screener Healthcare Professionals English Attachment 2 Screener Healthcare Professionals_English.doc Form and Instruction
4 Attachment 4 Screener Healthcare Professionals Spanish Attachment 4 Screener Healthcare Professionals_Spanish.doc Form and Instruction
5 Attachment 7 Informed Consent Form English Attachment 7 Informed Consent Form (English).doc Form and Instruction
6 Attachment 8 Informed Consent Form Spanish Attachment 8 Informed Consent Form (Spanish).doc Form and Instruction
7 Attachment 5 Usability Testing Attachment 5 Moderator Guide_English.doc Form and Instruction
8 Attachment 6 Usability Testing Spanish Attachment 6 Moderator Guide_Spanish.doc Form and Instruction
Attachment 9 IRB Approval.pdf Attachment 9 IRB Approval IC Document
Open Call OMB SSA submission_FINAL 8.13.2015.docx Open Call OMB SSA submission IC Document

Information Collection (IC) Details

IC Title:	Open Call Usability Testing (NCI)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Attachment 1 Screener Lay Consumers English	Attachment 1 Screener Lay Consumers_English.doc	Yes	Yes	Fillable Fileable
Form and Instruction	2	Attachment 3 Screener Lay Consumers Spanish	Attachment 3 Screener Lay Consumers_Spanish.doc	Yes	Yes	Fillable Fileable
Form and Instruction	3	Attadchment 2 Screener Healthcare Professionals English	Attachment 2 Screener Healthcare Professionals_English.doc	Yes	Yes	Fillable Fileable
Form and Instruction	4	Attachment 4 Screener Healthcare Professionals Spanish	Attachment 4 Screener Healthcare Professionals_Spanish.doc	Yes	Yes	Fillable Fileable
Form and Instruction	5	Attachment 7 Informed Consent Form English	Attachment 7 Informed Consent Form (English).doc	Yes	Yes	Fillable Fileable
Form and Instruction	6	Attachment 8 Informed Consent Form Spanish	Attachment 8 Informed Consent Form (Spanish).doc	Yes	Yes	Fillable Fileable
Form and Instruction	7	Attachment 5 Usability Testing	Attachment 5 Moderator Guide_English.doc	Yes	Yes	Fillable Fileable
Form and Instruction	8	Attachment 6 Usability Testing Spanish	Attachment 6 Moderator Guide_Spanish.doc	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 492	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	492	492
Annual IC Time Burden (Hours)	172	172
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 9 IRB Approval	Attachment 9 IRB Approval.pdf	08/13/2015
Open Call OMB SSA submission	Open Call OMB SSA submission_FINAL 8.13.2015.docx	08/17/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.