The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form A

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 ExpDate: 03/2018)

T ITLE OF INFORMATION COLLECTION:

The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form A

PURPOSE:

The NIH Extramural Loan Repayment Programs (LRP) FY2017 application period began on September 1^st, 2016 and ended December 1^st, 2016. LRP applicants are required to interact with LRP systems in order to learn about the programs, complete an application, upload documents, and provide contact information for their mentors and references/referees.

The purpose of the currently proposed online survey, hosted on SurveyMonkey, is to garner feedback from applicants about the ease and usability of LRP systems, resources, and help desk. The survey will be anonymous, and information garnered from the survey will remain internal to DLR and be used solely to make improvements to our mentor processes for the following year.

DESCRIPTION OF RESPONDENTS:

Respondents will be approximately 594, extramural, doctoral-level researchers who are LRP applicants.

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: Jill I. Mattia, Ph.D.

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 [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individuals	594	1	4/60	40
Totals	594	594		40

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Individuals	40	$66	$2,640
Totals	40	$66	$2,640

Source is the Chronicle of Higher Education (hyperlink - http://data.chronicle.com/category/sector/1/faculty-salaries/)

The mean annual salary for an assistant professor is $71,130, and the mean hourly wage is $66.

FEDERAL COST: The estimated annual cost to the Federal government is $1,180.

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Scientific Prog Eval Spec	14-3	$118,000	1		$1,180
Contractor Cost
Travel					None
Other Cost					None
Total					$1,180

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 respondents to the survey covered in this form will be individuals who submitted an LRP application. All such individuals will be sent an email with a link to the survey hosted by SurveyMonkey after the LRP application period has closed. Based on last year’s application numbers, DLR anticipates the number of individuals invited to participate in this survey will be n=900. Assuming a 60% response rate obtained in prior research, the final total respondent sample for this survey is anticipated to be n=594.

Context: There will be three different applicant surveys, and as such the entire LRP applicant pool (N=2,700) will be split into thirds (n=900) so that individuals receive an invitation to complete just one survey. Assuming a 60% response rate obtained in prior research, the final total respondent sample for each of the three surveys is anticipated to be n=594. Form A contains questions about using the LRP Online Application system. Form B contains questions about the LRP Information Center (i.e., help desk), and Form C contains questions about the LRP website.

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

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

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