0720-dcvq - Ss-b_6.15.2021

Supporting Statement Outline – Sample

NOTE: Complete Part B for Survey ICR Requests

SUPPORTING STATEMENT – PART B

B.  COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL METHODS

If the collection of information employs statistical methods, the following information should be provided in this Supporting Statement:

1.  Description of the Activity

Sampling will not apply for this questionnaire. The questionnaire will be sent to all DoD COVID-19 Vaccine beneficiaries who do not, at the time of the questionnaire distribution, have documented COVID-19 vaccination receipt, in any MHS electronic record source.

2.  Procedures for the Collection of Information

Describe any of the following if they are used in the collection of information:

1. Statistical methodologies for stratification and sample selection;

As stated above, this is a Census of all beneficiaries who do not have documentation of a COVID-19 vaccination in any MHS electronic record.

2. Estimation procedures;

c.  Degree of accuracy needed for the Purpose discussed in the justification;

d.  Unusual problems requiring specialized sampling procedures; and

e.  Use of periodic or cyclical data collections to reduce respondent burden.

All data collection efforts will take place within a one-time specified window (depending on when approval is granted).

3.  Maximization of Response Rates, Non-response, and Reliability

Response rates will be maximized by using a mixed-method approach to surveying: an e-mail will initially be sent, followed by an automated phone call.

Non-Response analysis will not be conducted; there is not reason to believe there is a systematic difference between those who respond and those who do not respond.

4.  Tests of Procedures

This questionnaire initially will be sent to personnel associated with the EIDS PMO, including active duty, civilian and contractor support staff to test system load.

5.  Statistical Consultation and Information Analysis

Brian Zutter (bzutter@spinsys) will assist with the data and updating the Population Risk Assessment Tool (PRAT).

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