Fast Track Submission Template

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION: Interview for soliciting feedback on teaching materials based on OPRE’s research and evaluation

PURPOSE: The purpose of the proposed information collection is to gather feedback on the usability of the teaching materials developed as a part of the Develop Teaching Materials Based on OPRE’s Research and Evaluation project.

The information collected in the interviews will focus on the usability of four teaching materials: Behavioral Science, Self-Regulation, Head Start, and Child Care and Development Fund (CCDF). Usability refers to how useful, fitting, and valuable these teaching materials are to instructors in relevant disciplines. The information gathered will inform revisions to the teaching materials. Some of the information gathered may be used in public documents about the teaching materials, if appropriate.

DESCRIPTION OF RESPONDENTS: The targeted group for this collection of information is undergraduate- and graduate-level instructors across various disciplines.

TYPE OF COLLECTION:

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [X] 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 primary purpose of the results is not for public dissemination.

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 and affiliation: Alysia Blandon, Senior Social Science Research Analyst, ACF OPRE

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

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? [ X ] Yes [ ] No

The respondents will receive a $75 honorarium for their time reviewing the materials and discussing their feedback with the project team.

BURDEN HOURS

Information Collection	Category of Respondent	No. of Respondents	No. of Responses per Respondent	Estimated Time per Response	Burden Hours
Interview protocol for feedback on instructional materials	Individuals	12	1	2.5 hours	30 hours
Totals		12	1	2.5 hours	30 hours

FEDERAL COST: The estimated annual cost to the Federal government is: $6,000

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 [ ] 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?

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[X] Other, Explain: Video conference.

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

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

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