View Information Collection Request (ICR) Package
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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:
201501-0925-004
Status:
Historical Active
Previous ICR Reference No:
201112-0925-001
Agency/Subagency:
HHS/NIH
Agency Tracking No:
Title:
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/04/2015
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/29/2015
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2018
36 Months From Approved
03/31/2015
Responses
759,000
0
759,000
Time Burden (Hours)
148,074
0
148,074
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:
79 FR 69500
11/21/2014
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 4934
01/29/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
168
IC Title
Form No.
Form Name
"The Nuts and Bolts of Group Randomized Trials" Participant Feedback Survey
1
SurveyMonkey SBM Evaluation
2015 NIH Single Cell Analysis Investigators Meeting Survey
1
2015 NIH Single Cell Analysis Investigators Meeting Survey
2016 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators' (PI) Meeting Post-Conference Evaluation Survey
1
2016 BRAIN PI Meeting Survey Screenshots
2016 HHS Learning Portal (LMS) User Survey
1
2016 HHS Learning Portal (LMS)
2017 GSRP Website Survey Applicant
1
2017 GSRP Website Survey
2017 Graduate Student Recruitment Program (GSRP)
1
2107 GSRP Survey
2018 NLM SIS Emerging Adults Health Needs Assessment
2, 1
SIS Emerging Adults Focus Group survey instrument
,
SIS Emerging Adults Web Based Survey instrument
Analytical Methods and Reference Materials Program Stakeholder Interviews (For Profit)
ODS Interview Guide for AMRA Stakeholders
1
Analytical Methods and Reference Materials Program Stakeholder Interviews (Not for Profit)
1
ODS Interview Guide for AMRA Stakeholders
Awardees Feedback Survey on NHLBI PAR-10-005 and PAR-13-002, NHLBI Clinical Trial Pilot Studies (R34)
1
Email Survey
Basic electronic survey to inform development of a nursing research brochure (NINR)
1, 1
NINR Survey instrument
,
NINR Survey screenshots
Benefits & Payroll Liaison Branch (BLPB) Customer Satisfaction Survey
1
Retiree Survey
Brother, You're on My Mind (BYOMM) After Action Report
1
BYOMM After Action
Brother, You're on My Mind (BYOMM) Knowledge Attitudes and Believes Form
1
BYOMM KAB Form
CSR Poll on Grant Award Productivity using the Relative Citation Ratio (RCR)
1
CSR Questions MAG
CSR Website Redesign Novice Applicants & Reviewer Interviews
2, 1
Applicant survey
,
Reviewer questions
CTSU Website Customer Satisfaction Surveys
1, 1
1 NCA Survey
,
2 General CTSU Website Survey
Career Symposium Feedback
1
CAREER SYMPOSIUM FEEDBACK
Chair Survey
1
Chair Fair Survey
Change Readiness Survey
1
Change Readiness Survey
Children's Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey
1
CHEAR Client Satisfaction Survey
Community Health Maps Project User Survey
1
Survey Screenshots
Customer Feedback on NIH's Targeted Guidance for New Investigators
1
Survey Screenshot
Customer Satisfaction with the Contribution of Site Visits to Assess Institutional Training Grant Applications (NIGMS)
1
Sit Visit Survey Questions
DIS Immigration Conference Evaluation Survey
1
DIS Immigration Conference Evaluation Survey
DSSEM Application and Interview Satisfaction Survey
1
DSSEM Application and Interview Survey
DVR Animal Services Needs Assessment
1
DVR Needs Assessment Survey
DVR Customer Service Survey - Animal Procurement
1
Animal Procurement Survey
DVR Customer Service Survey - Animal Transportation Services
1
FY17 Animal Transportation Survey
DVR Cutomer Service Survey - Animal Services
1
Animal Services Survey
Data and Safety Monitoring Meeting Evaluation
1 (Screenshots), 1
KAI Research Questions for NIAMS Customer Survey
,
KAI Research Questions for NIAMS Customer Survey
DrugAbuse.gov Website Feedback Survey
1
NIDA- Website Feedback Survey Screenshots
Drupal Implementation and Content Enhancement (DICE) Focus Groups
1
DICE Focus Group Questions
Educational Game Focus Group
1, 4, 5, 2, 3
Screeners
,
Clinical Professional Consent Form and Script
,
Teacher Consent Form and Script
,
Parent Consent Form and Scriot
,
Child Assent Form
Forecasting Science Survey
1
Outsell NIH Forecasting Science Survey
Future Research Leaders Conference Survey
1, 2
FRLC pre-conference survey screenshot
,
FRLC Post-Conference Survey Screenshot
Future Research Leaders Conference –Communication Survey
1
FRLC Communication Survey Screenshots
HHS SBIR/STTR Showcase Conference Feedback
1
HHS SBIR Showcase Event Feedback Form
HMD 2018 Exhibition Program Web Usability Study
1
HMD 2018 Exhibition Web Usability Study instrument
HR Systems Support (HRSS) Customer Satisfaction Survey
1
HRSS Survey
Health Information Technology Patient Satisfaction Survey (CC)
1
Patient Portal Online Survey Screenshot
Human Resources Classification and Recruitment Documents System (HR CARDS) Survey
1
HRCARD Survey Questions
Influenza Vaccine Survey
1
2016 Flu Survey
Information Management Team (IMT) Web Intercept Survey
1
IMT Intercept survey Form
IntraHR Website Customer Satisfaction Survey
1
IntraHR Customer Satisfaction Survey
KAI Annual Client Satisfaction Survey
1
KAI Annual Client Survey Printscreens
LIS User Survey of NLM Resources
1
NLM LIS User Survey Instrument
LRP Ambassador Feedback
1
LRP Ambassador Feedback
LRP Qualitative Research
1
LRP Qualitative Research
Medical Arts Branch (MAB) Services Survey
1
Medical Arts Branch Survey
Medicine: Mind the Gap NIH Seminar Series Survey-For Profits
1
Customer Satisfaction Survey
Medicine: Mind the Gap NIH Seminar Series Survey-Not-For-Profits
1
Customer Satisfaction Survey
Medicine: NIH Mind the Gap Webinar Series Survey II
1
MtG Customer Satisfaction Survey - survey Monkey Screnshot
NCBI 2017 Sequence Database User Survey
1
NCBI Sequence Database User Survey
NCBI 2017 Website User Survey
1
NCBI 2017 Website User Survey Instrument
NCBI 2018 Genetics and Population Frequency Data Survey (NLM)
1
NCBI 2018 Genetics and Population Frequency Data instrument
NCBI BLAST Web Services 2017 Survey
1
NCBI BLAST Web Services 2017 Survey Instrument
NCBI Medical Genetics and Variation Web Resources 2017 Survey
1
NCBI Medical Genetics 2017 Survey Instrument
NCCIH Customer Service Data Collection
2, 1
Telephone Survey
,
Email Survey
NCI OFSM Relocation Survey - Office
1
NCI OFSM Relocation Survey - Office Moves
NCI OSFM Conference Room Services Survey
1
Survey
NCI OSFM Express Services Survey
1
Express Services Survey
NCI OSFM Fitness Center Survey
1
NCI OSFM Fitness Survey
NCI OSFM Relocation Survey- Lab
1
Lab Relocation
NCI OSFM Shuttle Service Survey
1
NCI OSFM Shuttle Service Survey Instrument
NCI OSFM Small Little Job (SLJ) Survey
1
Survey
NEI Health Focus Groups with New Audiences Ages 25-35
1, 2
NEI Screener
,
NEI Mod Guide
NHLBI's Health Information Center (HIC)
1, 2
Survey Instrument IVR
,
Survey Instrument Web Questions
NIH Events Management – Audio Visual Survey
1
FY 17 EM Audio Visual Survey
NIH Events Management – Post Production Survey
1
FY17 EM Post Production Survey
NIH Events Management – Scheduling Services Survey
1
FY17 EM Scheduling Services Survey
NIH Events Management – Video Production Survey
1
FY17 EM Video Production Survey
NIH Library Customer Satisfaction Survey
1
Desk Survey May 2018
NIH Library Survey on Statistical Class Offerings
1
NIH Stats Survey 2017
NIH Library Survey: Weekend Library Use
1
Weekend Use Nov 2017 Survey
NIH Native American Visit Week Feedback
1
Survey Instrument
NIH Office of Intramural Training & Education (OITE) – Community College Day Feedback
1
OITE-OMBFT- Community College Day- Feedback Collection
NIH Office of Intramural Training & Education (OITE) – General Feedback Form
2, 1
FEEDBACK ON AN OITE EVENT
,
CAREER SERVICES CENTER
NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair Feedback
1
Graduate and Professional School Fair Feedback Collection
NIH Office of Intramural Training & Education (OITE) – Management Boot Camp Feedback
1
MANAGEMENT BOOT CAMP FEEDBACK Form
NIH Research Training Institutes (RTIs) Customer Satisfaction Surveys
1, 2, 3
Applicants Survey
,
Faculty Survey
,
Trainee Survey
NIH Training Center Meeting Facilitation Survey
1
NIHTC Training Evaluation- Meeting Facilitation
NIMH Information Resource Center (IRC) Customer Satisfaction Surveys for Email Information Services, Online Publications Ordering Services and Telephone Services
1, 3, 2
Email services survey
,
Online publications ordering services survey
,
Telephone services survey
NIMH Professional Coalition for Research Progress Meeting Assessment Form
1
Professional Coalition for Research Progress Meeting Assessment form
NIMH Website Survey
1
NIMH Website Survey
NLM 2018 Public Libraries Association Survey
1
NLM 2018 Public Libraries urvey
NLM 4 Caregivers User Survey
1
NLM 4 Caregivers 2016 User Survey Instrument
NLM AIDSource 2017 Survey
1
NLM AIDSource 2017 Survey
NLM ClinVar 2016 User Survey
1
NLM ClinVar 2016 User Survey Instrument
NLM ClinVar 2017 Website User Survey
1
NLM NCBI ClinVar 2017 Survey Instrument
NLM Customer Service Satisfaction Survey
1
Survey Instrument
NLM DOCLINE Customer Service Survey
1
NLM DOCLINE Customer Service Survey Instrument
NLM GHR User Study Screening Survey
1
NLM GHR User Study Screening Survey Instrument
NLM Genetic Home Reference User Study
1
NLM GHR Use Study Interview Instrument
NLM Google Survey for MedlinePlus Page Satisfaction Rating
1
NLM MedlinePlus Google Survey Instrument
NLM Library Operations Customer Satisfaction Survey
1
NLM LO Customer Service Survey Instrument
NLM Main Website Satisfaction Survey
1
NLM Main Website Satisfaction Survey Instrument
NLM MedlinePlus Connect Customer Survey
1
Survey
NLM MedlinePlus Page Google Survey Satisfaction Rating
1
NLM MedlinePlus Google Survey Instrument (screenshots)
NLM MedlinePlus RML User Survey
1
NLM Medline Plus RML User Survey Instrument
NLM MedlinePlus Website Usability Testing
1
NLM MedlinePlus Usability Testing ICR Instrument
NLM NCBI 2018 Literature Resources Survey
1
NCBI 2018 Literature Resources Survey
NLM NCBI 2018 Representative Genomes Survey
1
NCBI 2018 Representative Genomes survey instrument
NLM NCBI CCDS User Survey
1
NLM NCBI CDDS Survey Instrument
NLM NCBI ClinicalTrials.gov Website Usability Survey 2017
1
NLM NCBI CT Usability Survey
NLM NCBI ClinicalTrials.gov Website User Survey
1
NLM NCBI CT.gov Website User Survey Instrument
NLM NCBI GRC Website User Survey
1
NLM NCBI GRC Website User Survey Instrument
NLM NCBI Gene Resources Website Survey
1
NLM NCBI Gene Resources Website User Survey Instrument
NLM NCBI Health Resources Survey
1
NLM NCBI Health Resource Survey screenshots
NLM NCBI Microbe Conference Survey
1
NLM NCBI Microbe Conference Survey Instrument
NLM Project SHARE website assessment
1
Focus Group Questions
NLM Reading Rooms Satisfaction Survey
2, 1
Survey Screenshots
,
Survey (paper version)
NLM Survey for MedlinePlus Page Satisfaction
1
NLM MedlinePlus Survey Instrument
NLM TOXNET 2018 Workshop Survey
1
NLM Toxnet 2018 Workshop Survey Instrument
NLM ToxTutor User Survey
1
NLM ToxTutor User Survey Instrument
NLM Traveling Exhibition Visitor Study
1
NLM Traveling Exhibition Visitor Survey
NLM Website Survey for Website Satisfaction Rating
1
NLM Websites Survey
National Institute of Dental and Craniofacial Research (NIDCR) Website Usability Study
1
Usability Test Questions
National Institute of Dental and Craniofacial Research Focus Group Study
2, 1
NIDCR-FG Moderator Guide
,
NIDCR Focus Group Recruitment Screener
National Institute of Mental Health (NIMH) Employee Engagement Survey
1
NIMH Employee Engangement Survey
National Institute of Mental Health (NIMH) Office of the Director and Extramural Programs Workforce Resource Analysis
1, 1
EX Workforace Analysis Focus Group Discussion Guide
,
EX Workforace Analysis Discussion Guide
ODP Pathways to Prevention Survey -For Profits
1
Survey Screenshot
ODP Pathways to Prevention Survey -Not For Profits
1
Survey Screenshot
ODP Pathways to Prevention Survey II
1
Obesity Methods P2P Survey
OER Intercept survey
1
OER Intercept Survey questions
OHR Website Customer Satisfaction Survey
1
OHR Website survey
OM All Hands Meeting Survey
1
OM All Hands Survey
ORF Workplace Aesthetic Survey (OD)
1
NIH Rockledge Visual Vocabulary Survey
Office of Human Resources (OHR) Climate Survey
1
2017 OHR Climate Survey
Office of Human Resources (OHR) Pulse Survey
1
OHR Pulse Survey
Office of Human Resources (OHR) Training Survey
1
HR Training Survey
Ombudsman Services Feedback Survey
1
NIH OOCCR Feedback Survey
Online Customer Service Survey About The Application Technical Assistance Webinar
1
LRP Webinar Survey
Outcomes of IDeA Core Optimization Administrative Supplements
1
NIGMS CRCB IDeA Core Supplement Follow-up Questions
Participant Feedback on 2016 NIH Common Fund High-Risk, High-Reward Research Symposium
1
Survey 2016 HRHR Symposium screenshot
Participant Feedback on 2017 NIH Common Fund 2017 Stimulating Peripheral Activity to Relieve Conditions (SPARC) Research Program Annual Awardee Meeting
1
Survey screenshot
Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (Federal Government)
1
PEPH Aware-Act-Use
Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (Private Sector)
1
PEPH Aware-Act-Use Survey
Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (State, Local or Tribal)
1
PEP Aware-Act-Use survey
Partnerships for Environmental Public Health Program (PEPH) Aware-Act-Use Survey (Individuals/households)
1
PEPH Aware-Act-Use instrument
Pathways for Teamwork Customer Satisfaction Interviews
1
Needs Analysis Interview Protocol
Patient Perception Survey (CC)
2, 1
NIHAIP Survey Mock-up - NRC Health
,
NIHAOP Survey Mock-up - NRC Health
Pediatric Patient Perception Survey (CC)
1
NRC NIH IP P Survey
Pragmatic & Group-Randomized Trials (GRT) in Public Health & Medicine Participant Feedback Survey: Parts 1-7
1
MOOC Survey
PubMed Search User Survey
1
NLM PubMed Search User Survey
Qualitative Research to Explore Barriers and Facilitators for LRP Ambassadors to Promote the NIH Loan Repayment Programs
1
Key Informant Interview Guide
Shuttle Bus Survey for Fishers Lane
1
OAS Shuttle Survey Screenshots
The Annual NIH Pain Consortium Symposium Feedback (For Profit)
1
Pain Survey
The Annual NIH Pain Consortium Symposium Feedback (Not For Profit)
1
Pain Survey
The NIH Director's Blog Readership Survey
1
NIH Blog Survey
The NIH Director's Blog Readership Survey
1
Survey
The NIH Extramural Loan Repayment Programs: Online Customer Service Survey About the Application Technical Assistance Webinar
1
FY2018 LRP Webinar Survey
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form A
1
LRP Survey for Applicants Form A- Screenshots
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form B
1
LRP Survey for Applicants Form B- Screenshot
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form C
1
LRP Survey for Applicants Form C-Screenshots
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Award Applicants
1
LRP Survey for Mentors-Screenshots 2
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Institutional Business Officials (IBOs)
1
LRP IBO Survey- Screenshots
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Mentors
1
LRP Survey for Mentors- Screenshots
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Recommenders/Referees
1
LRP Referee Survey- Screenshots
Traveling Exhibition Host Survey
1
Host Survey
US-Japan Cooperative Medical Sciences Program (USJCMSP) 50th Anniversay and 18th International Conference on Emerging Infectious Diseases in the Pacific Rim
1, 2
USJCP Meeting screenshots
,
USJCP Meeting feedback form
Usability testing for PHPartners.org website
1
Survey Screenshot
Variation Resources Survey
1
NLM Variation Resources User Survey
WiTS Climate Survey 2015
1
2015 WiTS Climate Survey
Workflow Information Tracking System (WiTS) Focus Groups
1
WiTS Focus Group instrument
Workflow information Tracking System (WiTS) Focus Groups (OD)
1
WiTS Focus Group
Workplace and Organizational Performance Survey
1
Workplace Organizational Performance Survey
Workstyle Survey
1
Qualtrics Print
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
759,000
0
0
0
0
Annual Time Burden (Hours)
148,074
148,074
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$350,000
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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:
01/29/2015
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