Supporting Document

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-0940)

TITLE OF INFORMATION COLLECTION:

Material Testing of Health Hazard Evaluation Program Investigation Reports

PURPOSE:

The proposed activity will allow the Health Hazard Evaluation Program to gather input from customers about whether the Health Hazard Evaluation final reports released after an Health Hazard Evaluation is conducted at a worksite meets their needs. This information will allow the Health Hazard Evaluation Program to better serve its customers and enhance the impact of its activities.

DESCRIPTION OF RESPONDENTS:

Respondents are individuals employed in the private sector; state, local, or tribal governments; or the federal government. Respondents will be recruited from three worksites in the United States where a health hazard evaluation was completed within the last five years and a Health Hazard Evaluation final report has been issued to employer and employee representatives.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[] Usability Testing (e.g., Website or Software [x] Small Discussion Group

[] Focus Group [ ] 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. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. 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: Stefanie M. Evans gkn9@cdc.gov__

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

Personally Identifiable Information:

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

Incentives serve many purposes. Each testing session will last up to an hour and a half, so incentives function in part to compensate people for the time they spend participating and sharing their opinions. Incentives encourage people to agree to attend and help ensure attendance.

Participants will receive a $75 incentive at the completion of the testing process. This incentive amount is below standard in the industry for employee and employer participants when asked to do extensive pre-group exercises.

In general, higher incentive amounts are recommended, for example by Human Factors International and the book “Focus Groups: A Practical Guide for Applied Research” (by Richard A. Krueger and Mary Anne Casey). Lowering incentives risks increasing the overall costs for the testing session. Lower incentives result in higher per person recruitment costs because more people need to be contacted to get the required number of participants to show.

BURDEN HOURS

Type of Respondent	Form Name	Number of Respondents	No. of Responses per Respondent	Average Burden per Response (in hours)	Total Burden Hours
Facility A	Appendix A: Session Screener	9	1	10/60	2
	Appendix B: Pre-Group Questions	9	1	1.5	14
	Appendix C: Moderator’s Guide	9	1	1.5	14
Facility B	Appendix A: Session Screener	9	1	10/60	2
	Appendix B: Pre-Group Questions	9	1	1.5	14
	Appendix C: Moderator’s Guide	9	1	1.5	14
Facility C	Appendix A: Session Screener	9	1	10/60	2
	Appendix B: Pre-Group Questions	9	1	1.5	14
	Appendix C: Moderator’s Guide	9	1	1.5	14
Total					90

FEDERAL COST: The estimated annual cost to the Federal government is $29,946.

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? [] Yes [x] 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?

The contractor, in conjunction with NIOSH, will select three facilities where a Health Hazard Evaluation has been conducted within the last five years. Selection of facilities will include consideration of the size of the business/number of employees (at least one facility should be a small business); industry sector, with no more than one in each sector; at least one facility with a union and one without a union; and the three facilities should be geographically located in different regions of the United States. The goal will be to recruit between one and three employer representatives and between six and eight employees, depending on the size of the workplace. A minimum of four participants and no more than nine participants will be chosen from each facility.

NIOSH will contact between one and three employer representatives by phone at each facility selected for participation. The project will be explained to each representative in detail and those who wish to participate in the study will be asked to provide their contact information so that NIOSH can send them a copy of the final report they will be asked to review and more information regarding their participation.

NIOSH will also contact the primary employee representative at the facility with whom they previously interacted. The project will be explained to the employee representative. A flyer will be distributed to all employees at the facility. The flyer will explain the project and include a toll-free number to call if an employee is interested in participating. Employees who call the toll-free number will be screened using Appendix A and if selected will be given further directions regarding their participation.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[x] Web-based or other forms of Social Media

Prior to each small group discussion session, participants will read the full report and then complete a brief online survey (or paper survey for those without internet access) in which they will rate various aspects of the Health Hazard Evaluation final report. Participants will also be asked to describe the major strengths and weaknesses of the report and suggest improvements. The pre-session survey is attached in Appendix B. This pre-session work will allow for participants to become familiar with the report design and content before the discussion group and will allow for an in-depth discussion of the Health Hazard Evaluation final report during the testing session.

[ ] Telephone

[x] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [x] Yes [ ] No

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

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