0923-0047 GenIC Request Template

OMB Control Number: 0923-0047

Expiration Date: 1/31/2028

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0923-0047)

TITLE OF INFORMATION COLLECTION: CDC/ATSDR Social Vulnerability Index (SVI) User Survey

PURPOSE: The purpose of the SVI User Survey is to gather insight from frequent users about their experience with the Social Vulnerability Index (SVI). This survey aims to understand how effectively the SVI and its resources support users in identifying and addressing areas of interest.

DESCRIPTION OF RESPONDENTS: The survey respondents are frequent users of the Social Vulnerability Index (SVI), which includes a diverse group of professionals and stakeholders such as public health officials, emergency planners, community organizers, policymakers, researchers, and healthcare providers. These individuals utilize the SVI to identify and address vulnerable populations, enhance disaster preparedness and response strategies, allocate resources effectively, and inform public health interventions. Their insights and experiences are critical in understanding the utility and impact of the SVI in various contexts.

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: Elizabeth Pembleton______________________________________________

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

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ X ] 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
Individuals or Households - (Frequent users of the SVI (Those who have communicated with us voluntarily through the SVI coordinator inbox)	250	15 minutes	62.5 hours
Totals	250		62.5 hours

FEDERAL COST: The estimated annual cost to the Federal government is $1967.50___________

The mean hourly earnings across all occupations (as of May 2023) was $31.48 per hour based on the U.S. Bureau of Labor Statistics National Occupational Employment and Wage Estimates. The BLS website for this information is: http://www.bls.gov/oes/current/oes_nat.htm. Consequently, the total estimated cost to respondents is $1967.50.

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? [X ] 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?

We plan to identify potential groups based on those that have engaged with our team via the SVI coordinator inbox. These individuals are likely heavy users of the SVI or have a thorough understanding of the tool and its current capabilities. We have compiled a list of emails from correspondents that we will distribute this voluntary survey.

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.

SVI User Survey 2024_Final Draft

SVI User Survey_Email Draft

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