ODPHP Partnership Engagement Survey

Form Approved

OMB No. 0990-0281

Exp. Date XX/XX/XX12

Partner Engagement Survey

1. How interested is your organization in receiving materials about each of the following?

	Not at all interested	Slightly interested	Moderately interested	Very interested
Physical activity				
Nutrition and healthy eating				
National health objectives and standards				
Using health information technology for health communication				
Prevention and healthy lifestyle information				
Health literacy				

2. During the past 12 months, did you obtain information or materials about each of the following from the government or from a government website?

	Yes	No	Don’t know
a. Physical Activity Guidelines for Americans			
b. Dietary Guidelines for Americans			
c. Healthy People 2020			
d. Healthy People 2020 Health Communication and Health IT Objectives (A set of objectives for promoting health outcomes and quality health care through the use of health communications strategies and health IT)			
e. Quick Guide to Healthy Living (from healthfinder.gov)			
f. Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web Sites			

For each item answered “Yes” in question 2, item 3 will be asked.

If no item in question 2 is answered affirmatively, skip to question 4.

3. IF YES TO 2a, 2b, or 2c, ASK: How useful was the information or materials you obtained about (FILL IN 2a, 2b, or 2c)?

IF YES TO 2d, 2e, or 2f, ASK: How useful was (FILL IN 2d, 2e, or 2f)?

	Not at all useful	Slightly useful	Moderately useful	Very useful
a. Physical Activity Guidelines for Americans				
b. Dietary Guidelines for Americans				
c. Healthy People 2020				
d. Health Communication and Health IT Objectives for Healthy People 2020				
e. Quick Guide to Healthy Living (from healthfinder.gov)				
f. Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web Sites				

4. Which of the following best describes you? Please check all that apply.

 Physician

 Nurse/nurse practitioner

 Other health care provider

 Health plan administrator

 Health care facility administrator

 Health educator

 Public health professional

 Government employee

 Librarian

 Nutritionist or dietitian

 Caretaker

 Other (Please describe) _________________________________

5. Which of the following best describes the type of organization for whom you do health promotion or health education work?

 Private, for-profit

 Non-profit

 Government (local, state, or federal)

 Other (Please describe) __________________________________

6. How old are you?

• 17 years old or under

• 18 to 24 years old

• 25 to 39 years old

• 40 to 49 years old

• 50 to 65 years old

• More than 65 years old

• I prefer not to answer

7. What is the highest level of education you have completed?

• High school or less

• Some college

• College degree

• Advanced degree

• I prefer not to answer

8. What is your gender?

• Male

• Female

9. How useful would each of the following be for you?

	Not at all useful	Slightly useful	Moderately useful	Very useful
PowerPoint slides about health and health policy initiatives (e.g., Healthy People 2020, Dietary Guidelines for Americans, health literacy) that can be downloaded and customized for stakeholder presentations				
Customizable content to be placed in your organization’s newsletters or on your web site				
Customizable materials and templates (toolkits) to help your organization implement public health activities like planning a physical activity program or hosting a World AIDS Day event				
e-Learning/Online continuing education courses for credit				
Downloadable cell phone apps				
Downloadable tablet apps				
Downloadable PDA apps				
Tweets that can be retweeted to your followers				
Facebook updates that can be shared with your Facebook friends				
Viral videos on YouTube				
Personal health tools or widgets (e.g., BMI calculator, health risk calculator) for your computer, cell phone, or PDA				
Health information for people with low health literacy – on a consumer-friendly Web site				
Health information for people with low health literacy – on a mobile device				
Email-an-article function on websites				
“Share” button on websites to allow you to post a link to an article directly to your Twitter feed or Facebook wall				

10. How interested is your organization in receiving and distributing information about the health issues and concerns tailored to each of the following groups of people?

	Not at all interested	Slightly interested	Moderately interested	Very interested
Women				
African Americans				
Latinos/Hispanics				
Asian Americans/Pacific Islanders				
American Indians/Alaska Natives				
Children and teens				
Older Americans				
LGBT Americans				

11. Which, if any, of the following websites have you visited in the last 12 months?

	Yes	No
a. Healthfinder.gov (www.healthfinder.gov)		
b. HealthyPeople.gov (www.healthypeople.gov)		
c. Physical Activity Guidelines page (www.health.gov/paguidelines)		
d. Dietary Guidelines for Americans page (www.health.gov/dietaryguidelines)		
e. Health Communication and eHealth page (www.health.gov/communication)		

For each item answered “Yes” in question 11, items 12 - 16 will be asked about each website.

If no item in question 11 is answered affirmatively, skip to question 17.

12. In which, if any, of the following ways did you hear about [NAME OF WEBSITE]? Please check all that apply.

• Search engine results

• Another web site or blog

• Family member or friend

• Colleague in my organization

• Doctor, nurse, other health professional

• Conference/presentation

• Social networks (Facebook, My Space, Twitter, LinkedIn)

• Email newsletter or listserv

• Television, radio, newspaper or magazine

• Other, please specify ________________________

13. In the last 12 months, why did you visit [NAME OF SITE]? Please check all that apply.

• To learn about government health initiatives and activities such as Healthy People 2020

• To obtain resources for developing programs and initiatives

• To obtain resources for implementing programs and initiatives

• To get information to include in grant applications or proposals

• To obtain information or download products and materials for self or to share with others

• To connect and collaborate with others

• To access credible and reliable health information

• To get materials to include on our organization’s website

• To get hypertext links to include on our website

• To get materials to distribute to our members, colleagues, or other interested professionals

• To get materials to distribute to patients or community members

• To help develop materials for our members, colleagues, or other interested professionals

• To help develop materials for patients or community members

• Other, please specify ___________________________

14. How useful were the information and resources on [NAME OF WEBSITE] for your organization?

• Not at all useful

• Slightly useful

• Moderately useful

• Very useful

15. Which of the following items do you use on [NAME OF WEBSITE]? Check all that apply.

• Blogs

• Video

• e-Cards

• Email updates

• Toolkits

• Materials to download or print

• Widget or online tool

• Related online social network accounts (such as Twitter, Facebook, LinkedIn, etc.)

• Search features

• Other, please specify ________________________

16. What is your overall satisfaction with [NAME OF WEBSITE]?

• Not satisfied

• Slightly satisfied

• Moderately satisfied

• Very satisfied

17. Which of the following would you like to see more of on government websites? Check all that apply.

• Blogs

• Videos

• e-Cards

• Email Updates

• Toolkits

• Podcasts or Audio

• Mobile Alerts

• Email-an-article function

• Website badges (Digital “badges” that can be added to your web site/blog to show support for another website or initiative)

• Webinars

• Executive (brief) summaries of major documents

• Health data sets

• Content syndication (an easy way to incorporate health and prevention information onto your organization’s website that will be automatically updated through a content feed)

• Other, please specify ______________________

18. How likely are you to get health information for your organization in each of the following ways?

	Very unlikely	Unlikely	Likely	Very likely	Not applicable
Social Media
Follow a Twitter account					
Participate in a Twitter chat					
Join a Facebook group					
Join a LinkedIn group					
Participate in a LinkedIn group discussion board					
Learning and Collaboration
Participate in an online webinar or webcast					
Attend local, state, regional, or national conferences					
Attend meetings with other similar organizations to share best practices					
Participate in e-learning for continuing education credits					
Participate in formal partnerships with government initiatives					
Engage with colleagues on a discussion board, forum or through blog comments					
Read information on a government website					
Health Information
Download publications or articles from government websites					
Preview publications online and order those I want in print					
Read regular e-newsletters					
Read information and updates on a blog					
Mobile and Video Technology
Text message updates					
Online video and/or audio clips from government websites					

19. How can the government do a better job of helping your organization prevent disease and promote health? (Open-ended)

A-9