2015-2016 SPARC Symposium survey Fast track template

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

T ITLE OF INFORMATION COLLECTION:

Participant Feedback on 2017 NIH Common Fund 2017 Stimulating Peripheral Activity to Relieve Conditions (SPARC) Research Program Annual Awardee Meeting

PURPOSE:

The purpose of this voluntary, and secure to the extent permitted by law, survey is to obtain feedback from non-NIH participants on their satisfaction with and perceived usefulness of the science discussed during the meeting. This will aid in improving the delivery of this annual meeting.

DESCRIPTION OF RESPONDENTS:

Participants of the 2017 NIH Common Fund SPARC Annual Awardee Meeting include scientists who are current recipients of SPARC research awards and SPARC program consultants.

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:_Amanda L Greene_______________________________________________

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 minutes)	Total Burden Hours
Scientists (non-NIH participants)	95	1	5/60	8
Totals	95	95		8

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Scientists	8	39.68	317.44
Totals			317.44

* Source: Scientific Research and Development Services mean wage - https://www.bls.gov/oes/current/oes191029.htm

FEDERAL COST: The estimated annual cost to the Federal government is $227.49

____________

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Health Specialist	GS13-4	104,275	0.1%		104.27
Program Manager	GS14-4	123,223	0.1%		123.22
Contractor Cost					0
Travel					0
Other Cost					0
Total					227.49

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?

This survey will be sent to all non-NIH participants of the 2017 NIH Common Fund SPARC Annual Awardee Meeting i.e., current SPARC Research awardees and program consultants participating in the meeting.

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

3