Generic Submission Template

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 3045-0137)

TITLE OF INFORMATION COLLECTION:

AmeriCorps VISTA Project Implementation Evaluation Focus Groups

PURPOSE:

To inform CNCS’s implementation of its Transformation and Sustainability Plan, JBS will perform a study about Volunteers in Service to America (VISTA) member recruitment and retention and project development, management, and sustainability.

In preparation for this study, JBS will conduct focus group discussions to collect preliminary information from VISTA sponsors. The primary purpose of the focus groups is to inform the development of survey instruments and interview protocols. The focus group discussions will provide an understanding of the diversity of sponsor conditions and factors that may influence response rates and survey completion. JBS will use information gathered to develop interview questions, a survey, and a survey administration protocol that are relevant to the study and minimize the burden on respondents.

DESCRIPTION OF RESPONDENTS:

Focus groups will be conducted with a broad group of VISTA sponsors of standard, support, and program grant projects and single-site, single-state intermediary, and national and multi-state intermediary projects. We will assemble groups that represent a variety of project sizes, ages, focus areas, and geographic locations.

TYPE OF COLLECTION: (Check one)

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

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

[X] 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: Craig Kinnear, Program and Budget Analyst

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, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] 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
VISTA Sponsors	25	2 hours	50 hours
Totals	25	2 hours	50 hours

FEDERAL COST: The estimated annual cost to the Federal government is $3940.77

Cost	Pay Band	Salary*	% of Effort	Fringe if applicable	Total Cost to Government
Federal Oversight
Kinnear	NY03	90783	2%		1815.66
McNeily	NY03	95,111	1%		951.11
Cox	NY04	117400	1%		1174
Contractor Cost
Total					3940.77

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?

CNCS will provide JBS a list containing information on approximately 800 sponsors from the pool of 2019-2020 VISTA sponsors. JBS will use these lists to select sponsors. In selecting the sponsors, we will consider different project types (standard project, program grant, support grant, national and multi-state intermediary) to obtain in-depth perspectives and understand successes and challenges around the same evaluation themes and exploratory questions.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[X] Telephone

[ ] 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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