Request for Approval

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-0974)

TITLE OF INFORMATION COLLECTION: Awareness and Perception Survey for BGT-NBS MMWR CE Ad in Genetics in Medicine

PURPOSE:

The Division of Laboratory Programs, Standards, and Services (DLPSS), Center for Surveillance, Epidemiology, and Laboratory Services (CSELS) awarded a cooperative agreement project to the Association of Public Health Laboratories (APHL) in 2013 to prospectively evaluate the impact of the 2012 CDC guideline “Good Laboratory Practices for Biochemical Genetic Testing and Newborn Screening for Inherited Metabolic Disorders” (http://www.cdc.gov/mmwr/pdf/rr/rr6102.pdf). As part of this cooperative agreement project, APHL and CDC have been making efforts to increase awareness and use of the complementary online continuing education (CE) activity that CDC provides for the guideline. These efforts included featuring the CE information as an advertisement in a major genetics journal Genetics in Medicine. This survey, to be administered via Survey Monkey, is designed to evaluate the effectiveness of this promotional approach in reaching the target audience and increasing participation in the CE activity. This short survey is designed to be easy to use and easy to access. Feedback will be used to inform dissemination strategies for additional training and educational materials that are being developed to facilitate the use and adoption of the CDC recommendations.

DESCRIPTION OF RESPONDENTS:

The respondents will be voluntary subscribers to the listserv of the Society for Inherited Metabolic Disorders. Based on informal preliminary interest, CDC and APHL anticipate about half of the individuals to respond to the survey. We will blast an email message with an embedded link to the survey through an intermediary at the SIMD listserv.

TYPE OF COLLECTION: (Check one)

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

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

[] Focus Group [x ] Other: Online survey________

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:_Bin Chen, PhD________________________________________

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 [X] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Private sector	300	5/60	25
Totals	300		25

FEDERAL COST: The estimated annual cost to the Federal government is $400.

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 respondents will be voluntary subscribers to the listserv of the Society for Inherited Metabolic Disorders (SIMD). We will blast an email message with an embedded link to the survey through an intermediary at the SIMD listserv. In this email, respondents will be informed that their participation is strictly voluntary and no personally identifiable information will be collected. Respondents will also be informed that the feedback they provide is valued and will be used to improve messaging and communication for future training/educational activities.

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.

3