Form 1 General Survey

Attachment A. HIC General Survey

OMB No. 0925-XXXX

Exp. Date xx/xx/20xx

NHLBI Health Information Center (HIC)
Customer Survey Questions

Public reporting burden for this collection of information is estimated to average 12 minutes or less 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, 6705Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-xxxx*). Do not return the completed form to this address.

1. During the past 12 months, how many times did you download information or order materials from the National Heart, Lung, and Blood Institute’s (NHLBI’s) Web site?

• 0

• 1

• 2

• 3–5

• 6 or more

Incorporate Skip Logic tool to segment specific questions for specific demographics.
*Professionals highlighted in blue answer will answer all survey questions as well as those highlighted in blue.

2. Which statement below most accurately describes your background? Please check all that apply.

• Physician

• Nurse/nurse practitioner

• Other health care provider

• Health plan administrator

• Health care facility administrator

• Health educator

• Government administrator

• Librarian

• Student

• Patient

• Friend/family member of a patient

• General public

• Other (Please describe)

3. 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

4. What is your gender?

Male

Female

5. In which of the following ways did you hear about NHLBI’s health information services? Please check all that apply.

• Friend/family or colleague

• Health care provider

• Web search engine (such as Google)

• NHLBI Web site

• Web site (other than NHLBI’s Web site)

• NHLBI Health Information Network e-mails

• Television

• Radio

• Newspaper or magazine

• Conference or exhibit

• Other (Please describe): __________

Apply randomization to Q6

6. How interested are you in receiving NHLBI materials on each of the following topics?

	Not at all interested	Slightly interested	Moderately interested	Very interested
Heart diseases—symptoms, diagnosis, treatment
Lung diseases—symptoms, diagnosis, treatment
Blood diseases—symptoms, diagnosis, treatment
Sleep disorders—symptoms, diagnosis, treatment

Apply randomization to Q7

7. How interested are you in receiving NHLBI materials on each of the following topics?

	Not at all interested	Slightly interested	Moderately interested	Very interested
Prevention of heart, lung or blood diseases
Heart healthy eating
Physical activity
Obesity/overweight—causes, treatment

Apply Skip Logic tool—Physicians, nurses/nurse practitioners, other health care providers, health plan administrators, health care facility administrators, health educators, Government administrators will receive Question 8.

8. How useful would each of the following NHLBI materials be for you?

	Not at all useful	Slightly useful	Moderately useful	Very useful
Clinical practice guidelines
Guidelines at a glance
Downloadable PowerPoint slide presentations
Online continuing medical education
Interactive tools for your computer, cell phone, PDA
Health assessment tools (e.g., BMI calculator)
Tips for talking to your patients
Health information for people with low reading levels

9. How interested are you in materials about the health issues and concerns 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

Apply Skip Logic tool to Q10—Physicians, nurses/nurse practitioners, other health care providers, health plan administrators, health care facility administrators, health educators, Government administrators will receive all the selections as well as those highlighted.

10. What kinds of information are you looking for on the NHLBI Web site? Please check all that apply.

• Information about my own health

• Information about the health of a family member or friend

• Information for my professional development or training

• Educational materials for patients

• Information for a school project or class assignment

• Educational materials for my coworkers, customers, students, or employees

• Other (Please describe): __________

Apply randomization to Q11—“Other” always the last item.

11. Which statement below most accurately describes how you most prefer to receive health information from the NHLBI? Please choose one.

• Read NHLBI’s printed publications

• Read publications or articles online on the NHLBI Web site

• Download publications or articles from the NHLBI Web site and print them locally (i.e., on your printer)

• Preview publications online and order those I want in print

• Podcasts

• View video/listen to audio clips online on NHLBI’s Web sites

• Download video/audio clips from the NHLBI Web sites for later use

• Other (Please describe): __________

Apply randomization to Q12—“Other” always the last item.

12. In the last 12 months, how have you looked for health information?
    Please check all that apply.

• Web searches (e.g., Google)

• Asking a health care provider

• Asking friends or family members

• Health care search engines (e.g., healthline.com)

• Medical directory Web sites (e.g., WebMD)

• Television or radio shows

• E-mail services I subscribe to

• Books or magazines

• Telephone text messages

• Real Simple Syndication (RSS) feeds

• Social networking community Web sites (e.g., blog, MySpace, Facebook)

• Other (Please describe): __________

Apply randomization to Q13—“Other” always the last item.

13. In the past 12 months, from which of the following sources did you get health information? Please check all that apply.

• NHLBI Web site

• NHLBI print publications

• Other U.S. Government Web sites or publications

• Nongovernment Web sites about health

• Nongovernment print publications about health

• Professional journals

• Online communications from professional organizations

• Health sections in newspapers and magazines for the general public

• Books for the general public about health

• Radio and television programs about health

• Health care providers

• Family members, friends, or colleagues

• Other (Please describe): __________

NHLBI Supporting Statement A: Survey of NHLBI Constituents’ Health Information Needs A-8