T ITLE OF INFORMATION COLLECTION: Health Disparities Research Institute (HDRI)
PURPOSE: This collection of information is required as part of the application process to the NIMHD’s Health Disparities Research Institute (HDRI) that will take place every summer. Applicants will submit their applications as part of a competitive process to be accepted to attend the HDRI. The information collected will be used during the review of applications in order to select each year’s cohort. This program will support the development of individual research projects by promising scientists early in their careers and will stimulate research in the disciplines supported by science on minority health and health disparities. The program will feature lectures, seminars, and small group discussions on research relevant to minority health and health disparities.
DESCRIPTION OF RESPONDENTS: Postdoctoral students, assistant professors, early career research investigators, and scientists engaged in minority health and health disparities research.
TYPE OF COLLECTION: (Check one)
[ ] Abstract [X] Application:
[ ] Registration Form [ ] Other
CERTIFICATION:
I certify the following to be true:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
Name: Richard C Palmer, DrPH
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [X] Yes [ ] No
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 |
Individuals or Households |
200 |
1
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25/60 |
83 |
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Totals |
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200 |
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83 |
Category of Respondent
|
Total Burden Hours |
Wage Rate*
|
Total Burden Cost |
Individuals or Households |
83 |
$36.62** |
$3039.00 |
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|
Totals |
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$3039.00 |
*Cite source per bls.gov if applicable
**Life, Physical, and Social Science Occupations, Occupation code 19-0000, mean hourly wage: https://www.bls.gov/oes/current/oes_nat.htm#19-0000
FEDERAL COST: The estimated annual cost to the Federal government is $5454.00
Staff |
Grade/Step |
Salary |
% of Effort |
Fringe (if applicable) |
Total Cost to Gov’t |
Federal Oversight |
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|
|
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Ligia Artiles |
13-4 |
$109,088 |
5.0% |
|
$5454.00 |
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Contractor Cost |
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Travel |
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Other Cost |
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Totals |
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$5454.00 |
The selection of targeted respondents
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?
Respondents will be identified by announcing HDRI via the IC’s website, IC’s Listserv, and the IC’s social media pages. Interested respondents will submit a completed HDRI application.
Applications are rated based on the professional experience/educational background, the essay, and the letter of recommendation. Each application will be reviewed independently for its own merit, and is not compared to others.
Reviewers only have access to the applications assigned to them for review. Each application will be assigned three reviewers. In order to maintain the integrity and confidentiality of the review process reviewers do not discuss assigned applications with anyone.
Once a score has been submitted it cannot be modified. The scores for each applicant will be automatically provided through an online system. The second level review team will then rank and conduct the final selection, ensuring diversity and appropriate balance of the final accepted candidates.
Selection criteria will focus on promising candidates with the highest potential for this year’s HDRI and who, with the benefit of this experience, are the most likely to contribute substantially to their academic, organizational or professional fields through teaching, research, professional practice, or policy.
Administration of the Instrument
How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ ] Survey form /
[ ] Chart Abstraction
[ ] Other, Explain:
Will
interviewers, facilitators, or research coordinators be used? [ ]
Yes [X] No
File Type | application/msword |
File Title | Generic Clearance Submission Template |
Subject | Generic Clearance Submission Template |
Author | OD/USER |
Last Modified By | SYSTEM |
File Modified | 2019-12-02 |
File Created | 2019-12-02 |