Practicum Feedback Survey fast track

0925-0648_Practicum_Feedback_Survey_Clearance.doc

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

Practicum Feedback Survey fast track

OMB: 0925-0648

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Exp., date: 05/2021)

T ITLE OF INFORMATION COLLECTION: Participant Feedback for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (National Library of Medicine)


Purpose: The Office of Dietary Supplements (ODS) at the National Institutes of Health (NIH) is offering a two-and-a-half-day educational opportunity to provide fundamental knowledge of dietary supplements to faculty, students, and practitioners with a serious interest in this subject. This intensive practicum will provide a thorough overview and grounding about issues, concepts, unknowns, and controversies about dietary supplements and supplement ingredients. It will also emphasize the importance of scientific investigations to evaluate the efficacy, safety, and value of these products for health promotion and disease prevention as well as how to carry out this type of research. To best inform future Practicum planning (selection of topics and speakers), ODS plans to ask attendees for their feedback on the clarity and value of each session, as well as the value and quality of the whole practicum experience.


Description of Respondents: The respondents to the feedback survey will only include attendees of the practicum. The practicum is open to university faculty, graduate students, and research practitioners in health-related disciplines such as nutrition, food science, pharmacy, pharmacology and pharmacognosy, exercise science and kinesiology, medicine, dentistry, nursing, and complementary and alternative medicine (CAM). The 145 practicum attendees enrolled include full-time academic faculty, research practitioners, doctoral students, postdocs, research fellows, health care providers and scientists with a master's degree or higher whose work involves research with dietary supplements, masters-level students, and students in allied health schools. Among the attendees there are 106 with private sector not-for-profit affiliations, 19 with private sector for-profit affiliations and 20 government employees. This OMB submission focuses only on the non-government attendees.


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: Jaime Gahche .


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



ESTIMATED BURDEN HOURS and COSTS


Category of Respondent

No. of Respondents

No. of Responses per Respondent

Time per

Response

(in hours)

Total Burden

Hours

Private Sector (not-for-profit)1

106

3

35/60

186

Private Sector (for profit)2

19

3

35/60

33

Totals

125

375


219




Category of Respondent


Total Burden

Hours

Hourly Wage Rate*

Total Burden Cost

Private Sector (not-for-profit)1

186

$ 36.62/hr

$6,811.32

Private Sector (for profit)1

33

$ 36.62/hr

$1,208.46

Totals

219


$8,019.78

1 https://www.bls.gov/oes/current/oes190000.htm |


FEDERAL COST: The estimated annual cost to the Federal government is __$1,141.50________

Staff


Grade/Step

Salary*

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight






Epidemiologist

13/7

116,365

0.3%


$349.10













Contractor Cost






Materials Manager


$79.24/hr

10 hours


$792.40

Travel






Other Cost












Total





$1,141.50

*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2018/DCB.pdf



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?


Universe of Respondents

All participants will be asked to provide feedback on each session/speaker and on the overall practicum workshop as well. Thus, there is no sampling involved.



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

[ x ] Other, Explain – – Paper copy will also be provided for participants who prefer that mode instead of web-based. We want to give people the option of hard copy because they may not have a computer/laptop/tablet/smart phone OR they may prefer to fill them out by hand. We decided this because there has been a lot of research on evaluations particularly in educational settings and how the response rates have really gone down – and one of the reasons is moving to online surveys. One of the suggestions is to provide an option for people to fill them out by hand.


  1. Will interviewers or facilitators be used? [ ] Yes [ x ] No


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File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
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File Modified2019-04-26
File Created2019-04-26

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