Fast Track Request End of Course Summer Curriculum

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0642 Exp Date: 05/2020)

TITLE OF INFORMATION COLLECTION:

NCI CPFP End of Course Summer Curriculum Survey

PURPOSE: The purpose of the Division of Cancer Prevention’s Cancer Prevention Fellowship Program (CPFP) End of Course Survey is to assess the overall outcome of the course on the participants to better inform the design of the following year’s NCI Summer Curriculum. All Cancer Prevention Fellows are required to attend the National Cancer Institute (NCI) Summer Curriculum during their first full summer at NCI. The Summer Curriculum is also open to the general scientific community worldwide. The Summer Curriculum includes two courses: The Principles and Practice of Cancer Prevention and Control course (the Principles Course) and the Molecular Prevention course (the Molecular Course). Additional details about the program can be found at: https://cpfp.cancer.gov/

DESCRIPTION OF RESPONDENTS:

The respondents to the survey will include general scientific community worldwide as well as Cancer Prevention Fellows (postdoctoral fellows).

TYPE OF COLLECTION: (Check one)

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

[ ] Usability Testing (e.g., Website or Software [ ] 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:_____Hala Azzam___________________________________________

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 [] N/A

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No [] N/A

Gifts or Payments:

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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individuals	150	1	5/60	13
Totals		150		13

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Individuals	13	$40.01	$520.13
Totals	13		$520.13

*Median hourly wage for Social Scientists and Related Workers, All Others (19-3099); https://www.bls.gov/oes/current/oes_nat.htm#19-0000

FEDERAL COST: The estimated annual cost to the Federal government is $1,260.62.

Staff	Grade/Step	Salary**	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Program Lead	13/10	$126,062	1%		$1,260.62
Contractor Cost					$0
Travel					$0
Other Cost					$0
Total					$1,260.62

**https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/18Tables/html/DCB.aspx

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?

The respondent list will be participants who attended and completed the CPFP Summer Curriculum in 2019.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[X] Other, Explain. The surveys are paper-and-pencil surveys.

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

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