TITLE OF INFORMATION COLLECTION: Advancing NIH Research on the Health of Women: A 2021 Conference
PURPOSE:
In response to a congressional request to address NIH efforts related to women’s health research, the Office of Research on Women’s Health (ORWH), in conjunction with the Advisory Committee on Research on Women’s Health (ACRWH), will be hosting an event titled “Advancing NIH Research on the Health of Women: A 2021 Conference.” The key topics to be discussed, as identified by Congress, are (1) clinical practices related to rising maternal morbidity and mortality rates; (2) increasing rates of chronic debilitating conditions in women; and (3) stagnant cervical cancer survival rates. Learn more about these issues below.
DESCRIPTION OF RESPONDENTS: Researchers, scientists, clinical providers, general public
TYPE OF COLLECTION: (Check all that applies)
[ ] Abstract [ ] Application
[X ] Registration Form [ ] 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.
Name: Lamont Williams
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [ X ] Yes [ ] No
If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ X ] Yes [ ] No
Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No
Amount: ___________
Explanation for incentive: (include number of visits, etc.)
ESTIMATED BURDEN HOURS and COSTS
Category of Respondent |
No. of Respondents |
No. of Responses per Respondent |
Time per Response (in hours) |
Total Burden Hours |
Conference attendees |
500 |
1 |
5/60 |
42 |
|
|
|
|
|
Totals |
500 |
500 |
|
42 |
COST TO RESPONDENT
Category of Respondent
|
Total Burden Hours |
Wage Rate* |
Total Burden Cost |
Conference attendees |
42 |
$27.07 |
$1,137 |
|
|
|
|
Totals |
40 |
|
$1,137 |
*https://www.bls.gov/oes/2020/may/oes_nat.htm#00-0000
FEDERAL COST: The estimated annual cost to the Federal government is $5,269.
Staff |
Grade/Step |
Salary* |
% of Effort |
Fringe (if applicable) |
Total Cost to Gov’t |
Supv. Physician |
15/10 |
$172,500 |
1% |
|
$1,725 |
Communications Director |
13/7 |
$124,428 |
1% |
|
$1,244 |
|
|
|
|
|
|
|
|
|
|
|
|
Contractor Cost |
|
$70,000 |
1% |
|
$700 |
|
|
|
|
|
|
Travel |
|
|
|
|
|
Other Cost |
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
|
|
$5,269 |
*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2021/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 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? [ ] 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?
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
[ ] Survey form
[ ] Chart Abstraction
[ ] Other, Explain
Will interviewers, facilitators, or research coordinators 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 | 2022-02-01 |