Sub-study template Curing Epilepsies 2020

Request for Approval under the “Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)”

(OMB#: 0925-0740 Exp Date: 07/2022)

T ITLE OF INFORMATION COLLECTION: “Curing the Epilepsies 2020: Setting Research Priorities” Early Career Investigators Travel Awards Form

PURPOSE: The National Institute of Neurological Disorders and Stroke (NINDS) will hold the “Curing the Epilepsies 2020: Setting Research Priorities” on April 13-15th, 2020. The goal is to gather investigators and individuals interested in finding cures for the epilepsies to participate in a forum and discussion of the progress made in understanding the mechanisms of the epilepsies, as well as the inroads made towards potential cures. A main outcome and priority of the meeting will be the evaluation and updating of the Epilepsy Research Benchmarks. To facilitate participation from early career researchers, NINDS will provide travel support to some early career investigators. Early career investigators will be asked to submit information that will be used to help evaluate who is provided travel support.

DESCRIPTION OF RESPONDENTS: Respondents will include early career attendees of “Curing the Epilepsies 2020: Setting Research Priorities” conference who wish to apply for travel support. Early career attendees will be defined as graduate students, medical students, postdoctoral fellows, research associates, medical residents/fellows, and junior-level faculty within 10 years of their terminal degree or the end of post-graduate clinical training, whichever date is later.

TYPE OF COLLECTION: (Check one)

[ ] Abstract [x] Application

[ ] Registration Form [] 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.

Name: Sophia Jeon, Ph.D. Health Science Policy Analyst, NINDS OSPP

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

Personally Identifiable Information:

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

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

Gifts or Payments:

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

Amount: ___________

Explanation for incentive: (include number of visits, etc.)

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individual: early career epilepsy researchers	100	1	60/60	100
Totals		100		100

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Individual: early career epilepsy researchers	100	$40.19	$4,019
Totals	100		$4,019

* Hourly wage rates for 19-1029 Biologic Scientist in is $40.19 (based on https://www.bls.gov/oes/current/oes191029.htm)

FEDERAL COST: The estimated annual cost to the Federal government is $2,763.63

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
NINDS Division of Neuroscience Staff	GS 13/1	$99,172	1%		$991.72
NINDS Program Director	GS 14/1	$117,191	1%		$1,171.91
Contractor Cost
Web management team		$60,000	1%		$600
Other Cost
Total					$2,763.63

The selection of 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?

Respondents to the Travel Awards application form are undergraduate students, post-bacs, graduate students, post-doc researchers, or early stage investigators working in epilepsy research. Information about the application will be distributed to individuals who hold NIH grants on epilepsy. The application will also be announced at the annual American Epilepsy Society Meeting. We will not sample the respondent population, but an estimated total of 100 researchers who wish to apply for travel funds to the April 3^rd, 2019 workshop will submit the requested information and are expected as a universe of potential respondents.

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

[ ] Survey form

[ ] Chart Abstraction

[ ] Other, Explain

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

3