Fast track template for HRHR 2018 Symposium Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Exp., date: 05/31/2021)

TITLE OF INFORMATION COLLECTION:

Feedback on NIH Common Fund’s High-Risk, High-Reward Research Symposium

PURPOSE:

The purpose of this voluntary survey is to obtain feedback from invited High-Risk, High-Reward Research awardees on their satisfaction with the High-Risk, High-Reward Research Symposium. Responses will be used to improve future symposiums.

DESCRIPTION OF RESPONDENTS:

Respondents are scientists and FY2012-2017 award recipients of the High-Risk, High-Reward Research program, who were all invited to attend the 2018 NIH Common Fund’s High-Risk, High-Reward Research Symposium.

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 hours)	Total Burden Hours
Scientists (non-NIH participants)	537	1	7/60	63
Totals	537	537		63

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Scientists	63	39.68	2499.84
Totals	63	39.68	2499.84

* Source: Scientific Research and Development Services mean wage, https://www.bls.gov/oes/2017/May/oes191029.htm)

FEDERAL COST: The estimated annual cost to the Federal government is $232.72

____________

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Personnel from the NIH Office of Strategic Communication	13	106,668	0.1%		106.67
Personnel from the NIH Office of Strategic Communication	14	126,049	0.1%		126.05
Contractor Cost					0
Travel					0
Other Cost					0
Total					232.72

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

1. 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?

The survey will be sent to FY2012-2017 award recipients of the High-Risk, High-Reward Research program, who were all invited to the NIH Common Fund’s 2018 High-Risk, High-Reward Research Symposium.

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