MHSR Conference Registration

Request for Approval under the “Conference, Meeting, Workshop, and Poster

Session Registration Generic Clearance (OD)”

(OMB#: 0925-0740 Exp Date: 05/2019)

TITLE OF INFORMATION COLLECTION:

National Institute of Mental Health (NIMH) Mental Health Services Research Conference Registration

PURPOSE:

Conference participant information is collected electronically via an event registration webpage for registration purposes and for the submission of abstracts of scientific projects to be reviewed and selected for presentation at the meeting. This conference is organized by NIMH to promote areas of high priority for services research and to identify opportunities with potential for significant impact on the health and well-being of people with mental disorders. The conference features state-of-the-art research presented via keynote speakers, thematic panels, discussion groups, papers, and posters.

DESCRIPTION OF RESPONDENTS:

Respondents include the scientific community of mental health services and interventions researchers, representatives of mental health advocacy and professional organizations, and unaffiliated members of the public.

TYPE OF COLLECTION: (Check one)

☒Abstract ☐Application

☒Registration Form ☐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.

Name: Denise Juliano-Bult, Ph.D., NIMH

To assist review, please provide answers to the following questions:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? ☒Yes ☐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

Gifts or Payments:

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

Amount:

Explanation for incentive: (include number of visits, etc.)

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 or households – conference attendees	225	1	5/60	19
Individuals or households – conference presenters	115	1	5/60	10
Totals	340	340		29

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Individuals or households – conference attendees	19	$23.86	$453.34
Individuals or households – conference presenters	10	$35.06	$350.06
Totals			$803.94

* https://www.bls.gov/oes/2016/may/oes_nat.htm#00-0000; https://www.bls.gov/oes/2016/may/oes_nat.htm#19-0000

FEDERAL COST: The estimated annual cost to the Federal government is: $3,989

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Program Chief	GS14/10	$148,967	.1		$1,489
Contractor Cost		$25,000	10		$2,500
Travel
Other Cost
Total					$3,989

The selection of 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 ☐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 include researchers currently or recently funded by the NIMH Division of Services and Intervention Research, and others who have previously attended the conference to include representatives of mental health advocacy and professional organizations, and unaffiliated members of the public.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

☒Web-based or other forms of Social Media

☐Telephone

☐In-person

☐Mail

☐Survey form

☐Chart Abstraction

☐Other, Explain

2. Will interviewers, facilitators, or research coordinators be used? ☐Yes ☒No

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

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