OMB
# 0925-0486-1301-06
Exp. 07/31/2010
National Kidney Disease Education Program’s Health Professional Web site User Satisfaction Survey
Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0486). Do not return the completed form to this address.
Thank you for choosing to take part in NKDEP’s survey about the website and patient education videos. This survey will take an average of 5 minutes to complete. Your answers will be used to improve the website including videos. Please be assured that your identity and answers will be kept confidential to the extent permitted by law and will not be shared with anyone outside the study. Once again, thank you for your time.
Have you seen any of the videos on the video library page?
Yes No (If no, terminate and count as incomplete.)
Do you educate patients about diabetes, hypertension, or kidney disease?
Yes
No
(If no, terminate and count as incomplete)
Not
sure (If not sure, terminate and count as incomplete.)
Overall, how useful do you find NKDEP’s Health Professionals section?
Very useful
Somewhat useful
Not very useful
Not at all useful
I have not read or used enough of the Health Professionals section to respond accurately.
Other:
____________________________________
How would you rate the information provided in the videos that you viewed?
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Excellent |
Good |
Fair |
Poor |
Did not view |
What do the kidneys do? |
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What is chronic kidney disease? |
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How can I reduce my risk for kidney disease? |
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Is there a connection between heart disease and kidney disease? |
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What are the symptoms of kidney disease? |
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How do you check for kidney disease? |
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Why did you test me for kidney disease? |
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Can kidney disease get better? |
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What changes do I need to make because I have kidney disease? |
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Are there medications for kidney disease? |
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Will I need dialysis? |
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What is dialysis? |
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Is a kidney transplant an option? |
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Do you have any additional comments on any of the videos? If you have no additional comments, just indicate as “No comment.”
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Comments |
What do the kidneys do? |
|
What is chronic kidney disease? |
|
How can I reduce my risk for kidney disease? |
|
Is there a connection between heart disease and kidney disease? |
|
What are the symptoms of kidney disease? |
|
How do you check for kidney disease? |
|
Why did you test me for kidney disease? |
|
Can kidney disease get better? |
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What changes do I need to make because I have kidney disease? |
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Are there medications for kidney disease? |
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Will I need dialysis? |
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What is dialysis? |
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Is a kidney transplant an option? |
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Overall,
how useful were the videos that you viewed?
Very useful Somewhat useful Not very useful Not at all useful
Other: _________________________________________
How
easy was it to skim
through
the list of video topics/titles?
Very easy Somewhat easy Not very easy Not at all easy
Other: _____________________________________________
If
“Not very easy” or “Not at all easy” is
chosen, respondent will be prompted to respond to the following:
What problems did you experience? _________________________
How easy was it to play the videos?
Very easy Somewhat easy Not very easy Not at all easy
Other: _____________________________________________
If
“Not very easy” or “Not at all easy” is
chosen, respondent will be prompted to respond to the following:
What problems did you experience?__________________
If your patients were to ask questions similar to those in the videos, how likely would you be to model your responses after the videos that you viewed?
Very likely Somewhat likely Not very likely Not at all likely
Other: _____________________________________________
Would you like to see more videos on other kidney disease-related topics?
Yes. If yes, on what topics? ____________________________
No
Maybe/Not sure
Please provide any additional feedback about the videos:____________________________
On average, how often do you use the NKDEP website?
This
is my first time on the site
Daily
A
few times a week
A
few times a month
A
few times a year
Have you ever recommended the NKDEP website to others?
Yes
If
yes, to whom have you recommended the site? Mark all that apply:
Health
care professionals
Clinical Laboratory professionals
Patients
Family members of patients
Other: ________________________
No
Can’t
recall
What
other topics or content would you like to see added to the NKDEP
website?
_________________________________________________________________
Which topics on the NKDEP website need to be covered in more detail? __________________________________________________________________
| File Type | application/msword |
| File Title | God |
| Author | Nancy Accetta |
| Last Modified By | curriem |
| File Modified | 2009-07-07 |
| File Created | 2009-07-07 |