PHC Digest Newsletter Subscriber Survey

Request for Approval under the “Voluntary Partner Surveys to Implement Executive Order 12862/Questionnaire and Data Collection Testing, Evaluation, and Research for the Health Resources and Services Administration” (OMB Control Number: 0915-0212/0915-0379)

TITLE OF INFORMATION COLLECTION: Primary Health Care Digest Newsletter Subscriber Survey

PURPOSE:

HRSA’s Bureau of Primary Health Care (BPHC) publishes a weekly newsletter, the Primary Health Care Digest (Digest). This survey will solicit feedback on the Digest from its readers.

We will use the feedback to identify potential areas for innovation and change for the Digest newsletter. The data will also illuminate our audience’s communications needs and expectations. It will benefit anyone doing communications – our entire Communications Division and others across BPHC.

DESCRIPTION OF RESPONDENTS:

The survey will be open to anyone who receives the Digest newsletter. The main audience for the Digest is the health center community. Primarily, this means leadership, board members, administrative staff, and providers at nearly 1,400 HRSA-funded health centers and Health Center Program look-alike health centers. Secondarily, it means HRSA-funded organizations that support health centers, like Primary Care Associations and National Training and Technical Assistance Partners, and anyone who is interested in issues impacting health centers.

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: Jeremy Bent

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

3. If yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Gifts or Payments:

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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden Hours Total
Newsletter subscriber	5,000	7 minutes	583
Totals			583

FEDERAL COST:

The estimated annual cost to the federal government is $X, which includes [provide a brief description of the costs to the government, including the number of staff hours and the GS level of those who would be working on it, i.e., “$800 (12 hours at the GS-14 level) in project management and oversight.”]

The estimated annual cost to the federal government is $1,404, which includes 12 hours at the GS-13 and GS-14 levels for data analysis, project management, and oversight. The data will help BPHC identify areas for innovation and change for the Digest newsletter.

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? [] 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?

The universe of potential respondents is the 5,000 people who receive and are actively engaged with the Digest. The survey will be distributed via the Digest by including a link to the survey in the newsletter.

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

[ ] Other, Explain

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

The survey questions are attached to the request. Also, a preview of the web-based survey instrument is located here: Digest Newsletter Survey Preview.