Privacy Act Memo

DATE:

October 5, 2020

TO:

Amy Williams
Office of Advocacy Relations
Office of the Director, National Cancer Institute (NCI)

FROM:

NIH Privacy Act Officer

SUBJECT: Applicability of the Privacy Act: “A Generic Submission for Formative Research,
Pre-testing, Stakeholder Measures and Advocate Forms at NCI”
I have reviewed the NCI submission to OMB entitled, “A Generic Submission for Formative
Research, Pre-testing, Stakeholder Measures and Advocate Forms at NCI” to collect data from
different stakeholder constituencies for the purpose of program development, monitoring and
improvement.
I have determined that the Privacy Act will apply to this data collection which involves the
collection of personally identifiable information such as gender, age, race/ethnicity, address,
telephone number, email address, income, education, medical /health status, years at NCI and
work focus (scientific or communications). Information provided by respondents will be kept
confidential and private, and the presentation of data in reports will be in aggregate form, with no
links to individuals preserved. Data will not be retrieved by personal identifiers unless the
respondent voluntarily agrees to provide the information, so he/she can be contacted for followup.
This data collection is covered by NIH Privacy Act Systems of Record 09-25-0156, “Records of
Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public
Health Service, HHS/PHS/NIH/OD.”
If you have any questions, please contact my office at (301) 402-6201.

Celest Dade-Vinson
cc: Diane Kreinbrink, NCI PRA Liaison