TITLE OF INFORMATION COLLECTION: NIA Website Survey for Website Satisfaction Rating
PURPOSE: The National Institute on Aging (NIA) would like to add a 5-question customer satisfaction survey to nia.nih.gov to get a better understanding of its users motivations and demographic information. Filling out the survey will take less than a minute, providing little burden to the user while giving them the chance to provide NIA with their thoughts on the site. The information collected from the survey will be used to improve the design and operation of the publicly accessed website.
Along with this form, we have submitted:
An explanation of how the survey will function on nia.nih.gov and what text will be added to the privacy policy page.
Screenshots of how the survey will look like on the site. Please note the persistent display of the OMB approval number and a link to the privacy policy appears under each question .
A list of pages the survey will appear on.
DESCRIPTION OF RESPONDENTS: Visitors to NIA website who choose to respond to the survey.
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:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
The results are not intended to be disseminated to the public.
Information gathered will not be used for the purpose of substantially informing influential policy decisions.
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:________________________________________________
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [ ] Yes [X] No
If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No
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 |
Individuals or Households |
20,000 |
1 |
2/60 |
667 |
Totals |
|
20,000 |
|
667 |
Category of Respondent
|
Total Burden Hours |
Hourly Wage Rate* |
Total Burden Cost |
Individuals or Households |
667 |
$25.72 |
$17,155.24 |
Totals |
|
|
$17,155.24 |
* BLS National Occupational Employment and Wage Estimates Occupational Employment and Wages, May 2019
http://www.bls.gov/oes/current/oes_nat.htm#00-0000
FEDERAL COST: The estimated annual cost to the Federal government is $2,565.66
Staff |
Grade/Step |
Salary* |
% of Effort |
Fringe (if applicable) |
Total Cost to Gov’t |
Federal Oversight |
|
|
|
|
|
|
|
|
|
|
|
Writer/Editor |
5/1 |
$39,291 |
.5% |
|
$761.76 |
Supervisory Public Affairs Specialist |
14/2 |
$125,360 |
.3% |
|
$1,803.90 |
Contractor Cost |
|
|
|
|
|
|
|
|
|
|
|
Travel |
|
|
|
|
|
Other Cost |
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
|
|
$2,565.66 |
*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2020/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
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?
The universe of potential respondents will be visitors to NIA website, and the sample will consist of those who choose to respond to the survey.
Administration of the Instrument
How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ ] Other, Explain
Will interviewers or facilitators be used? [ ] Yes [X] No
Please make sure that all instruments, instructions, and scripts are submitted with the request.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Generic Clearance Submission Template |
Subject | Generic Clearance Submission Template |
Author | OD/USER |
File Modified | 0000-00-00 |
File Created | 2021-04-06 |