GenIC Request

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1050)

Instruction: This form should be completed by the primary contact person from the Program sponsoring the collection.

DETERMINE IF YOUR COLLECTION IS APPROPRIATE FOR THIS GENERIC CLEARANCE MECHANISM:

Instruction: Before completing and submitting this form, determine first if the proposed collection is consistent with the scope of the Collection of Routine Customer Feedback generic clearance mechanism. To determine the appropriateness of using the Collection of Routine Customer Feedback generic clearance mechanism, complete the checklist below.

If you select “yes” to all criteria in Column A, the Collection of Routine Customer Feedback generic clearance mechanism can be used. If you select “yes” to any criterion in Column B, the Collection of Routine Customer Feedback generic clearance mechanism cannot be used.

Column A	Column B
The information gathered will only be used internally to CDC. [X] Yes [ ] No	Information gathered will be publicly released or published. [ ] Yes [X] No
Data is qualitative in nature and not generalizable to people from whom data was not collected. [X] Yes [ ] No	Employs quantitative study design (e.g. those that rely on probability design or experimental methods) [ ] Yes [X] No
There are no sensitive questions within this collection (e.g. sexual orientation, gender identity). [X] Yes [ ] No	Sensitive questions will be asked (e.g. sexual orientation, gender identity). [ ] Yes [X] No
Collection does not raise issues of concern to any other Federal agencies. [X] Yes [ ] No	Other Federal agencies may have equities or concerns regarding this collection. [ ] Yes [X] No
Data collection is focused on determining ways to improve delivery of services to customers of a current CDC program. [X] Yes [ ] No	Data will be used to inform programmatic or budgetary decisions, for the purpose of program evaluation, for surveillance, for program needs assessment, or for research. [ ] Yes [X] No
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. [X] Yes [ ] No

Did you select “Yes” to all criteria in Column A?

If yes, the Collection of Routine Customer Feedback generic clearance mechanism may be appropriate for your investigation. You may proceed with this form.

Did you select “Yes” to any criterion in Column B?

If yes, the Collection of Routine Customer Feedback generic clearance mechanism is NOT appropriate for your investigation. Stop completing this form now.

TITLE OF INFORMATION COLLECTION: Strategic Scholars Program Feedback Survey 2024

PURPOSE:

The National Center for State, Tribal, Local and Territorial Public Health Infrastructure and Workforce’s Partnerships and Performance Improvement Branch seeks to obtain program participant feedback on its Strategic Scholars Program. To obtain feedback related to attendees’ satisfaction with and reaction to participation in the Strategic Scholars Program, the Partnerships and Performance Improvement Branch proposes a low-burden, end-of-cohort reaction survey (up to 29 questions). The survey will be administered at the conclusion of the March-July 2024 cohort and will capture respondents’ reactions to overall program structure and to specific program offerings, including web-based training, group learning sessions, team coaching, and applied team projects. Results will be used to refine the program model and improve its delivery for future cohorts of scholars.

DESCRIPTION OF RESPONDENTS:

The respondent universe includes all participants in the March-July 2024 cohort of the CDC-sponsored Strategic Scholars Program (N=28). All current participants in the Strategic Scholars Program will receive an invitation to complete the web-based survey (see Attachment A - SSP Instrument Word Version and Attachment B - SSP Instrument Web Version). The instrument will be used to gather information from program participants regarding their experience in the current cohort of the Strategic Scholars Program.

TYPE OF COLLECTION: (Check one)

Instruction: Please sparingly use the Other category

[ ] 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.

Name: Adrienne Gill _

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 [ ] No

3. If Applicable, has a System or Records Notice 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

If Yes: Please describe the incentive. If amounts are outside of customary incentives, please also provide a justification

BURDEN HOURS

All 28 local and tribal health department staff who are current participants in the Strategic Scholars Program will receive an invitation to complete the survey. The end-of-cohort reaction survey includes up to 29 questions: 23 questions are closed-ended (multiple choice) and six questions are open-ended. The survey includes conditional branching, therefore the actual number of items to which participants respond will vary. Respondents will complete the survey using Qualtrics web-based survey software.

To estimate the burden (hours), CDC’s Strategic Scholars Program implementation partner, the National Network of Public Health Institutes (NNPHI) and NNPHI’s contracted evaluator, Health Resources in Action (HRiA), piloted the survey with internal NNPHI and HRiA staff to calculate the average length of time to complete the survey, including reading the instructions. Based on the results of the pilot, the average time to complete the end-of-training survey is around 10 minutes. The total estimated burden (hours) for 28 respondents is reflected in the table below. There are no other costs to the respondent.

Category of Respondent	No. of Respondents	Participation Time	Burden
Local health department participants	24	10/60	4.0
State health department participants	0	10/60	0.0
Tribal health department participants	4	10/60	0.6
Territory health agency participants	0	10/60	0.0
Totals	28		4.6

FEDERAL COST: The estimated annual cost to the Federal government is $2,488.43. There are no equipment or overhead costs. HRiA staff will lead the development, programming, and pilot testing of the survey instrument. NNPHI staff will manage data cleaning, analysis, and reporting. CDC staff will lead preparation of the OMB package and will collaborate with NNPHI on data cleaning, analysis, and reporting as needed.

Estimated Annualized Cost to the Federal Government

Staff (FTE)	Estimated Hours	Hourly Rate	Total Cost
Health Scientist (GS-14) OMB package development, pilot testing, survey programming support, data management (cleaning, analysis, reporting)	20	$58.48/hour	$1,169.60
Health Scientist (GS-10) Support for data cleaning, analysis, and reporting	40	$29.79/hour	$1,191.60
Public Health Advisor (GS-13) Support for OMB package development	3	$42.41/hour	$127.23

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 Yes: Please provide a description of both below (or attach the sampling plan)

If No: Please provide a description of how you plan to identify your potential group of respondents and how you will select them or ask them to self-select/volunteer

The respondent universe includes all participants in the March-July 2024 cohort of the CDC-sponsored Strategic Scholars Program (N=28). Participants will first receive the link to the survey via Zoom chat (see Attachment C – SSP Survey Communications) during the final required program session. In addition, all participants will receive an invitation to complete the survey (see Attachment C – SSP Survey Communications) at their email address provided in their team’s application to participate.

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

Data will be collected via web-based survey and respondents will be recruited through multiple notifications (see Attachment C – SSP Survey Communications). Each notification will explain:

• The purpose of the data collection, and why their participation is important

• Instructions for participating

• Method to safeguard their responses

• That participation is voluntary

• The expected time to complete the instrument

• Contact information for the project team

Participants will have one week to complete the survey. After the initial email invitation to participate, a reminder email will be sent five days prior to closing the survey (see Attachment C – SSP Survey Communications) and the day before the survey closes (see Attachment C – SSP Survey Communications). Those who do not respond within one week of the initial email invitation will be considered non-responders.

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