sub-study for HRSN 2022

Request for Approval under the “Conference, Meeting, Workshop,
Registration and Challenges Generic Clearance (OD)”
(OMB#: 0925-0740, Exp Date: 09/30/2025)
TITLE OF INFORMATION COLLECTION:
NCI Cancer Care Delivery Research Health-Related Social Needs Clinical Trials Planning Meeting
PURPOSE:
The National Cancer Institute’s Division of Cancer Control and Population Sciences (DCCPS) will
hold a Clinical Trials Planning Meeting (CTPM) on November 17-18, 2022, that focuses on
Addressing Health-Related Social Needs to Improve Cancer Care Delivery and Outcomes
Among Newly Diagnosed Cancer Patients in Community Settings.
The goal of this meeting is to make consensus-based decisions about the design of NCORP
studies around health-related social needs, screening processes, interventions, endpoints, and
study design features.
Attendees will engage in in-depth discussions to identify research concepts that will guide
community-based oncology practice-based efforts to screen for and address health-related
social needs.
DESCRIPTION OF RESPONDENTS:
Oncologists, health service researchers, NCORP representatives, community oncologists,
experts in cancer care, experts in financial hardship in the cancer care community,
scientists, nurses, statisticians, clinical trialists, and advocates.
TYPE OF COLLECTION:
[ ] Abstract
[ ] Challenges and Competition
[X] Registration Form

[ ] Application
[ ] 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.
Name: Ramy Serour

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To assist review, please provide answers to the following question:
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? [X] Yes [ ] No
2. 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: N/A
Explanation for incentive: N/A
ESTIMATED BURDEN HOURS and COSTS
Category of
Respondent

No. of
Respondents

No. of Responses
per Respondent

46

1
46

Individuals
Totals

Category of Respondent
Individuals
Total

Total Burden
Hours
2

Time per
Response
(in hours)
3/60

Total
Burden
Hours
2
2

Hourly Wage Rate*

Total Burden Cost

$49.44

$98.88
$98.88

*Source of the mean Hourly Wage Rate is provided by the Bureau of Labor Statistics, Occupation
title “Medical Scientists” 19-1040, https://www.bls.gov/oes/2021/May/oes_nat.htm#19-1040.

FEDERAL COST: The estimated annual cost to the Federal government is $3,014.08.
Staff
Federal Oversight
Program Director
Contractor Cost
Travel
Other Cost
Total

Grade/Step

Salary**

% of
Effort

15/6

$173,232

1%

Fringe
Total Cost to
(if applicable)
Gov’t
$1,732.32
$1,281.76
$0
$0
$3014.08

**The salary in the table above is cited from https://www.opm.gov/policy-data-oversight/payleave/salaries-wages/salary-tables/22Tables/html/DCB.aspx

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The selection of your targeted respondents
1. Do you have a customer list or something similar that defines the universe of potential
espondents 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?
We have a list of steering committee members, NCORP investigators, and government staff that
will be used to invite respondents to the registration site.

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
[ ] Mail
[ ] Survey Form
[ ] Chart Abstraction
[ ] Other, Explain
Will interviewers, facilitators, or research coordinators be used? [ X ] Yes [ ] No
Please make sure that all instruments, instructions, and scripts are submitted with
the request.

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