SS Attachment 2_ NLM Survey Instrument

SAMPLE OF PREVIOUSLY APPROVED SURVEY INSTRUMENT
OMB #: 0925-0476
Exp. Date: 07/31/2009

Assessment of user experience with Asian American Health web portal as
a professional resource:
Are you a professional working with American Asian populations? Does
your work involve sharing health-related information?
If so, we need your help to make improvements to the Asian Americans Health portal
developed by the Specialized Information Services, US National Library of Medicine.
Please consider participating in our brief survey about professional’s' experience with the
portal.
The survey is anonymous - we will not ask your name or collect any identifying
information. Depending on your answers, the survey will consist of up to 14 questions;
completing the survey takes approximately 15 minutes.
We appreciate your time and assistance to our project!
Public reporting burden for this collection of information is estimated to
average 15 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 208927974, ATTN: PRA (0925-0476). Do not return the completed form to this
address.

Survey questions
1. My professional role is best described as (select one):
Health care provider working with Asian Americans
Medical librarian or information specialist
Public health professional
Social work professionals

Other (please specify): (Fill in the blank)

2. Which Asian languages do you speak (select all that apply):
Burmese
Cambodian/Khmer
Chinese
Filipino/Tagalog
Gujarati
Hindi
Hmong
Indonesian
Japanese
Karen
Korean
Laotian
Malaysian
Thai
Turkish
Vietnamese
Other (Fill in the blank)

3. How familiar were you with this Web site prior to the survey (select one)?
Never heard of it
Heard of it, but never used it
Used it occasionally
Used it frequently

4. How useful do you think Asian American Health will be to the following groups
(Select one answer per group)?
Very
useful
Health care providers working with
Asian Americans
Asian Americans consumers
Medical librarians and information
specialists
Public health professionals
Social work professionals
Other (please specify): (Fill in the
blank)

Useful

Somewhat
Useful

Not at
all

>For “Somewhat useful” and “Not at all” answer>
5a. Help us improve this site for health care providers working with Asian Americans.
Check all that apply.
Topics included not useful for this group
Types of documents and links included not useful for this group
Content is too technical for this group
Content is too basic for this group
Too many gaps in the coverage for this group
Information organization not appropriate for this group
No English descriptions for materials in Asian languages
Any other comments specific to this group? (free text field)
5b. Help us improve this site for Asian Americans consumers.
Check all that apply.
Topics included not useful for this group
Types of documents and links included not useful for this group
Content is too technical for this group
Content is too basic for this group
Too many gaps in the coverage for this group
Information organization not appropriate for this group
Any other comments specific to this group? (free text field)

5c. Help us improve this site for Medical librarians and information specialists.
Check all that apply.
Topics included not useful for this group
Types of documents and links included not useful for this group
Content is too technical for this group
Content is too basic for this group
Too many gaps in the coverage for this group
Information organization not appropriate for this group
No English description for materials in Asian languages
Any other comments specific to this group? (free text field)

5e. Help us improve this site for Public health professionals.
Check all that apply.
Topics included not useful for this group
Types of documents and links included not useful for this group
Content is too technical for this group
Content is too basic for this group

Too many gaps in the coverage for this group
Information organization not appropriate for this group
No English descriptions for materials in Asian languages
Any other comments specific to this group? (free text field)

5f. Help us improve this site for Social work professionals.
Check all that apply.
Topics included not useful for this group
Types of documents and links included not useful for this group
Content is too technical for this group
Content is too basic for this group
Too many gaps in the coverage for this group
Information organization not appropriate for this group
No English descriptions for materials in Asian languages
Any other comments specific to this group? (free text field)
>End For “Somewhat useful” and “Not at all” questions >
6. What health topics are missing that you feel should be included (please specify)?: (Fill
in the blank)
7. Currently we have the following Asian Languages on our site :
Burmese
Cambodian/Khmer
Chinese
Filipino/Tagalog
Gujarati
Hindi
Hmong
Indonesian
Japanese
Karen
Korean
Laotian
Malaysian
Thai
Turkish
Vietnamese
What others do you think we should add? (please specify)? (Fill in the blank)
8. Six languages are under the heading “South Asian (Asian Indian)” in the Materials in
Asian Languages section: Burmese, Gujarati, Hindi, Indonesian, Karen, Malaysian,
Turkish.. How appropriate do you think this “South Asian (Asian Indian)” heading is?

Very
appropriate

Appropriate

Somewhat
appropriate

Not at all
appropriate

Not sure

Please explain your answer: (Fill in the blank)
9. Tell us what you think about this site’s look-and-feel
Like

It is Ok

Dislike

Color scheme
Graphics
Page layout
Font style
Font size
Overall
appearance
10. Please share with us any additional comments or suggestions you have for Asian
American Health. (Fill in the blank)