View Information Collection Request (ICR) Package
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IC List
Burden
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Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View Generic ICR - OIRA Conclusion
OMB Control No:
0925-0648
ICR Reference No:
201112-0925-001
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/NIH
Agency Tracking No:
Title:
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (OD/OER)
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/12/2012
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/06/2011
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2015
36 Months From Approved
Responses
759,000
0
0
Time Burden (Hours)
148,074
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
This collection of information is necessary to enable the National Institutes of Health to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the agency's programs.
Authorizing Statute(s):
None
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 80542
12/22/2010
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 74802
12/01/2011
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
44
IC Title
Form No.
Form Name
Advocacy Organization Interviews
1
Advocate Interview Guide
ClinicalTrials.gov Results Database Train-the-Trainer Workshop Feedback Survey
1
Train-the-Trainer Workshop Feedback Survey
Comment Card for Soliciting Feedback on NEI Public Inquiry Response
1
Comment Card
Focus Groups on Interlibrary Loan/Resource Sharing Needs in the National Network of Libraries of Medicine
1
Focus Groups
Genetic and Rare Diseases Information Center Customer Satisfaction Survey
1, 2
Survey Screenshots
,
Script
Grants Process Satisfaction Survey
1, 2
Researcher Survey
,
Researcher Survey Text Version
It's a Noisy Planet. Protect Their Hearing. Campaign: Customer Satisfaction Survey
1, 2
Customer Satisfaction Survey
,
Parent Survey
It's a Noisy Planet. Protect Their Hearing.® Campaign: Mall Interview Surveys
1, 2, 3, 4
Adolescent Recruitment Screener and Consent Form
,
Parent/Guardian Recruitment Screener and Consent Form
,
Adolescent Interview Survey
,
Parent/Guardian Interview Survey
Loan Repayment Program Survey: Renewal Application Process
1
LRP Screenshots
NCAAM Clearinghouse Telephone Survey
1
NCAAM Clearinghouse Telephone Survey
NCCAM Customer Service Data Collection for the NCCAM Clinical Digest e-Newsletter
1
NCCAM Clinical Digest e-Newsletter Survey
NCI Epidemiology and Genomics Research Program (EGRP) Sequencing Meeting Planning Survey
1
EGRP Meeting
NCI Patient Education Publications Survey
1
NCI Patient Education Publications Survey
NHLBI Health Information Center (HIC) Customer Satisfaction Survey Plan
1, 1
Telephone Survey
,
Online Survey
NIAMS KAI's Client Survey
1
Client Survey
NIAMS KAI's Client Survey
1
Survey
NIH Office of the Ombudsman, Center for Cooperative Resolution, user feedback survey
1
Online Survey
NLM AIDS Portal Survey
1
Attachment 2_NLM AIDS Portal Survey Screenshots
NLM Emergency Access Initiative Satisfaction Survey
1
EAI Satisfaction Survey
NLM IndexCat User Survey
1
NLM Cat Index Cat Survey (Screenshots)
NLM Routine Customeer Feedback Collection
1, 1B
Routine Customer Feedback Form
,
Routine Customer Feedback Form (Screenshots)
NLM SIS Anatomy Physiology Portal Resources Survey
1
Attachment 2_NLM SIS Anatomy Physiology Portal Resources Survey Instrument Screenshots
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Customer Satisfaction Survey
1
Survey
National Multicultural Outreach Initiative (NMOI) Pilot Study
1
Health Planner Survey
OBSSR Online Card Sort
1
Online Card Sort
ONLINE SURVEY FOR NIDCD INSIDE NEWSLETTER
1
Online Survey
Office of Equity, Diversity, and Inclusion (EDI) Customer Service Survey
1
EDI Customer Service Survey
Omnibus Survey of General Satisfaction with NIH Communication Issues
1
Omnibus Survey
Outreach Librarians and Library Directors Competencies Assessment
1
NLM LO Outreach Focus Group Survey Tool
Practicum Participant Survey
1
Practicum Participant Survey
Qualitative Research to Explore Young People's Choices to Pursue a Career as a Physician Scientist
3, 2, 1
Young Faculty Moderator Guide
,
Research Student Modertaor Guide
,
Recruitment and Screening Form
Qualitative Research to Explore Young People's Choices to Pursue a Career as a Physician Scientist
1
Moderator Guide -Young Faculty
Qualitative Research to Explore Young People's Choices to Pursue a Career as a Physician Scientist
1
Interview Guide
Qualitative Research to Explore Young People's Choices to Pursue a Career as a Physician Scientist (Interviews)
1, 2
Research Dean Interview Guide
,
Woman Physician-Scientist -Interview Guide
Qualitative Service Delivery Feedback for National Diabetes Education Program (NDEP) through an Online Survey among Health Professionals
1
Survey Screenshots
Requirements Gathering for Patient-Centered Communication (PCC) Web-based Application for NCI
3, 5, 4, 1, 2
System Usability Scale
,
Patient Protocol
,
Support Person Protocol
,
Group Interviews Moderator's Guide
,
Individual Interviews Moderator's Guide
Semi-structured telephone interview for end users who are stakeholders in PROMIS
1
Survey
Survey on Interlibrary Loan/Resource Sharing Needs in the National Network of Libraries of Medicine, 2013
1
Survey
Traveling Exhibition Host Survey
1
Traveling Exhibition Host Survey
Usability testing of PHPartners.org website
1
PHP Screenshots
User Satisfaction Assessment with MeSH and MeSH Indexing
1
Survey
User Survey for IHM database and website
1
IHM Survey
User Survey for finding aids software/application and website
1
Finding Aid Survey
Web-based Survey of DIRLINE database (NLM)
1
NLM Survey Instument
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
759,000
0
0
759,000
0
0
Annual Time Burden (Hours)
148,074
0
0
148,074
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
This is a new ICR.
Annual Cost to Federal Government:
$350,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Saleda Perryman
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
12/06/2011
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