Fast Track DOHS Website Survey

041119-LJohnson-PRA Request-DOHS Website Survey.docx

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

Fast Track DOHS Website Survey

OMB: 0925-0648

Document [docx]
Download: docx | pdf

Shape1 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: Soliciting Feedback About The National Institutes of Health (NIH), Office of the Director (OD), Office of Research Services (ORS), Division of Occupational Health and Safety (DOHS) Website

PURPOSE: The NIH/OD/ORS/DOHS would like to evaluate our customer’s experience with our website located at https://www.ors.od.nih.gov/sr/dohs/Pages/default.aspx. The results of the survey will be used to inform potential strategies to improve the DOHS website including its content, navigation and overall navigation. The information will help develop potential targeted solutions to any identified problems reported. It is our intent to have a link to the electronic survey available on each webpage on the website.


DESCRIPTION OF RESPONDENTS: The respondents include current NIH federal employees and contractors.


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. Shape2 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.


Signature:


Name: Larry Johnson

Chief, OD, ORS, DOHS, Community Health Branch, NIH

9000 Wisconsin Avenue

13 South Drive, Building 13 Room 3K04

Bethesda, MD 20892

(301) 496-2960

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

Individual/households


1,600

1

5/60

133






Totals


1,600


133



Category of Respondent

Total Burden Hours

Hourly Wage Rate*

Total Burden Cost

Individual (Federal Government Employee and Contractor)

133

$28.00

$3,724.00





Totals


$28.00

$3,724.00

*https://www.bls.gov/oes/2017/May/oes_nat.htm#00-0000


FEDERAL COST: The estimated annual cost to the Federal government is $2,243.00.




Staff



Grade/Step



Salary


% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight






Chief, Community Health Branch

GS13/9

$122,830.00

.5%


$614.00







Contractor Cost






Management Consultant in Communications


$108,596.80

1.5%

N/A

$1,629.00

Travel






Other Cost












Total





$2,243.00

*https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2018/general-schedule/


If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions: Not Applicable


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?

[ ] Yes [X] 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?



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


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


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



END OF SURVEY

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified0000-00-00
File Created2021-04-06

© 2024 OMB.report | Privacy Policy