Sub-study for Rachel Pearline Award Nominations

`Request for Approval under the “Generic Clearance for NIH Citizen Science and Crowdsourcing Projects”

(OMB#: 0925-0766 Exp., date: 04/2023)

TITLE OF INFORMATION COLLECTION: Rachel Pearline Award Nominations (NCI)

PURPOSE:

The 9^th Annual Symposium on Global Cancer Research Steering Committee would like to invite nominations for the 6^th Annual Rachel Pearline Award, to be presented at the virtual Symposium.

The Rachel Pearline Award honors Rachel Pearline, MD, MPH who received the award named in her memory in 2016 following her death at the age of 38, in November 2015, from gastric cancer. As part of the Symposium each year, we recognize one outstanding professional for their excellence in global cancer research and practice. The Steering Committee invites nominations of individuals, at any stage in their career, who have made major contributions to global cancer research and practice. The nominee's work should focus on cancer research and practice in low-and-middle-income countries. The Steering Committee particularly wishes to encourage nominations of individuals currently living and working in a LMIC. The nominee will be recognized at the Annual Symposium on Global Cancer Research where they must give a keynote address that highlights their contributions to global cancer research or practice, and their future perspectives.

DESCRIPTION OF RESPONDENTS:

NIH Scientists, NIH-funded Researchers, PIs, NCI Designated Cancer Centers, academic institutions, students, and researchers from low- and middle-income countries.

TYPE OF COLLECTION: (Check one)

[ ] Data Catalogue [ ] Repository of Tools and Best Practices

[ ] Recommendations of scientific reviewers [ ] Resources

[ X ] Call for Nominations [ ] 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. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

5. 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: Mishka Cira

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [ ] 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 [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ ] 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	20	1	30/60	10
Totals		20		10

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals	10	$46.95	$469.50
Total			$469.50

*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/2019/May/oes_nat.htm#00-0000.

FEDERAL COST: The estimated annual cost to the Federal government is $15,344.70.

Staff	Grade/Step	Salary*	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Program Director	14/4	$133,447	10%		$13,344.70
Contractor Cost					$2,000.00
Travel					$0
Other Cost					$0
Total					$15,344.70

*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2020/general-schedule/

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? [ 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?

This meeting and the award will be advertised through NIH/NCI Center for Global Health listservs, social media, and scientific steering committee members.

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

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

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