NINDS Public Site Widget fast track

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 ExpDate: 03/2018)

T ITLE OF INFORMATION COLLECTION: The NINDS Public site widget

PURPOSE:

The mission of NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.

To support this mission, NINDS:

• Supports and performs basic, translational, and clinical neuroscience research through grants-in-aid, contracts, scientific meetings, and through research in its own laboratories, and clinics.

• Funds and conducts research training and career development programs to increase basic, translational and clinical neuroscience expertise and ensure a vibrant, talented, and diverse work force.

• Promotes the timely dissemination of scientific discoveries and their implications for neurological health to the public, health professionals, researchers, and policy-makers.

DESCRIPTION OF RESPONDENTS: The survey will be open to all users. The users are the general public.

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: Nadia Douaji

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 [x] NA

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No [x] NA

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
General public	30	1	3/60	2
Totals	30	30		2

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
General public	2	$40/hour	$80
Totals	2		$80

*Cite source per bls.gov if applicable: all occupations rate.

Bls.gov Occupational Employment and Wages, http://www.bls.gov/oes/current/oes_dc.htm

FEDERAL COST: The estimated annual cost to the Federal government is $306

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
PM	13/5	103,000	0.1		$103
Web M	13/5	103,000	0.1		$103
Contractor Cost
Web Developer	NA	100,000	0.1		$100
Travel
Other Cost
Total					$306

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? [] 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

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

3