| Measures Name/Client name (CQs and Answer choices) |
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| AHRQ ePSS App Implementation |
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| What feature of the ePSS mobile app do you use the most? Please select one. |
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About USPSTF |
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Radio button, one-up vertical |
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Y |
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Grade definitions |
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Tools |
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Search for patient specific recommendations |
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Browse recommendations by topic |
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Other |
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| In which of the following areas would you most like to see changes in layout and/or presentation? Please check your top choice for what you would like to see improved. |
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Search results |
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Radio button, one-up vertical |
Single |
Y |
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Risk Factor information |
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Clinical Considerations |
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Rational information |
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Tools retrieved within specific recommendations |
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| When using ePSS over the last 3 months, did you use it: |
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Mostly on the web |
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Radio button, one-up vertical |
Single |
Y |
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About the same on the web and on my mobile device |
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Mostly on my mobile device |
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Only on my mobile device |
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| Were you able to accomplish your intended task today? |
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Yes |
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Radio button, one-up vertical |
Single |
Y |
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No |
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Not yet |
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| Suggestions for improvements/enhancements or other comments? |
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Text area, no char limit |
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N |
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| How frequently do you visit this site? |
MMW0359A01 |
Daily |
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Radio button, one-up vertical |
Single |
Y |
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Frequency of Visit |
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MMW0359A02 |
About once a week |
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MMW0359A03 |
About once a month |
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MMW0359A04 |
Every few months |
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MMW0359A05 |
Every 6 months or less often |
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MMW0359A06 |
This is my first time visiting the site |
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Y |
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| HHS OMH 2011 Implementation |
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| What best describes your role in visiting the site today? |
MMW0360A01 |
Health Advocate |
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Radio button, one-up vertical |
Single |
Y |
OPS Group |
Primary Role |
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MMW0360A02 |
Minority group advocate |
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MMW0360A03 |
Physician/Health care professional |
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MMW0360A04 |
Researcher |
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MMW0360A05 |
Congressional Professional/Policy maker |
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MMW0360A06 |
Journalist/Media |
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MMW0360A07 |
Faith based organization |
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MMW0360A08 |
Non Profit organization |
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MMW0360A09 |
Educator |
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MMW0360A10 |
General Public |
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MMW0360A11 |
College/Graduate student |
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MMW0360A12 |
Other, please specify |
A |
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| What best describe your role in visiting the site today? |
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| Please select your primary reason for visiting the site today? (Please select all that apply). |
MMW0362A01 |
Funding Information |
A |
Checkbox, one-up vertical |
Multi |
Y |
Skip Logic Group |
Primary Reason |
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MMW0362A02 |
Data/Statistics |
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MMW0362A03 |
Cultural Competency |
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MMW0362A04 |
Health Topics |
B |
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MMW0362A05 |
Minority Populations |
C |
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MMW0362A06 |
National Partnership for Action (NPA) information |
D |
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MMW0362A07 |
Preconception Peer Education Program (PPE) |
E |
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MMW0362A08 |
Publications |
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MMW0362A09 |
Press releases |
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MMW0362A10 |
Just browsing |
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MMW0362A11 |
Employment information |
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MMW0362A12 |
Sign up for e-news letter |
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MMW0362A13 |
Other, please specify |
F |
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| Please describe your primary reason for visiting the site today. |
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Text area, no char limit |
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N |
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OE_Primary Reason |
| Please tell us specifically what funding information you were looking for. |
MMW0364A01 |
Non profit |
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Checkbox, one-up vertical |
Multi |
N |
Skip Logic Group |
Funding |
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MMW0364A02 |
Researcher |
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MMW0364A03 |
OMH |
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MMW0364A04 |
Student |
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MMW0364A05 |
Commercial Venders |
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MMW0364A06 |
Other, please specify |
AA |
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| Please tell us what funding information you were looking for today. |
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Text area, no char limit |
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N |
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OE_Funding |
| What health topics were you looking for today? (Please select all that apply) |
MMW0366A01 |
Low cost health care |
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Checkbox, one-up vertical |
Multi |
N |
Skip Logic Group |
Health Topics |
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MMW0366A02 |
Staying healthy |
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MMW0366A03 |
Disease specific information |
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MMW0366A04 |
Other, please specify |
BB |
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| Please tell us what health information you were looking for today. |
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Text area, no char limit |
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OE_Health Information |
| Please tell us which minority population you were seeking information on. |
MMW0368A01 |
African American |
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Minority Information |
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MMW0368A02 |
American Indian/Alaskan Native |
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MMW0368A03 |
Asian American |
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MMW0368A04 |
Hispanics/Latinos |
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MMW0368A05 |
Native Hawaiians/Pacific Islanders |
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MMW0368A06 |
Please tell us what other minority population you were seeking information for today. |
CC |
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| Please tell us what other minority population you were seeking information for today. |
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Text area, no char limit |
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N |
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OE_Other Minority Information |
| Please tell what NPA information you were looking for? |
MMW0370A01 |
General NPA Information |
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NPA Information |
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MMW0370A02 |
Download the NPA tool Kit |
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MMW0370A03 |
NPA Fact Sheet |
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MMW0370A04 |
NPA Guide |
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MMW0370A05 |
How to become a NPA partner |
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MMW0370A06 |
Share your NPA story |
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MMW0370A07 |
Take the NPA pledge |
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MMW0370A08 |
Other, please specify |
DD |
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| Please tell us what NPA information you were looking for today. |
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Text area, no char limit |
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OE_NPA Other Info |
| Please tell us what Preconception Peer Education Program information you were looking for. |
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Text area, no char limit |
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OE_PPE Other Info |
| What additional information would you like to have available on this site? |
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Text area, no char limit |
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N |
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OE_Additonal Information |
| Did you find what you were looking for on the site today? |
MMW0374A01 |
Yes |
|
Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Ability to Find |
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MMW0374A02 |
No |
A,B |
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| Please tell us why you were not able to find what you were looking for? |
MMW0375A01 |
I could not access the information on site |
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Checkbox, one-up vertical |
Multi |
N |
Skip Logic Group |
Unable to Find |
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MMW0375A02 |
The search results did not appear relevant |
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MMW0375A03 |
The links did not take me where I wanted |
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MMW0375A04 |
The labeling on lists didn't match what I was looking for |
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MMW0375A05 |
How the information is organized on the site wasn't clear |
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MMW0375A06 |
The navigation options were difficult to understand |
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MMW0375A07 |
Other |
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| Please tell us specifically what you couldn't find on the site today: |
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Text area, no char limit |
Single |
N |
Skip Logic Group |
OE_Ability to Find |
| After visiting the site today please tell us how likely you are to do the following activities: (Please select all that apply) |
MMW0377A01 |
Bookmark page for later use |
|
Checkbox, one-up vertical |
multi |
N |
OPS Group |
Use of Information |
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MMW0377A02 |
Do additional research online |
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MMW0377A03 |
Email the information to a colleague |
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MMW0377A04 |
Email the information to a friend or family member |
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MMW0377A05 |
Collaborate with an other organization or individuals working to improve minority health issues |
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MMW0377A06 |
Print the information and share it |
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MMW0377A07 |
Other, please specify |
B |
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| Other use of information obtained from the Office of Minority Health: |
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Text area, no char limit |
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OE_Use of Information |
| How did you look for information on the site today? (Please select all that apply.) |
MMW0379A01 |
Search feature at top of page |
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Checkbox, one-up vertical |
Multi |
Y |
OPS Group |
Navigation Tools |
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MMW0379A02 |
Knowledge Center publication search |
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MMW0379A03 |
Navigation tabs across the top of the page |
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MMW0379A04 |
Navigation links along left side of page |
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MMW0379A05 |
Navigation links along right side of page |
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MMW0379A06 |
The links in the body of the page |
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MMW0379A07 |
Other, please specify |
A |
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| Other way I looked for information: |
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Text area, no char limit |
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N |
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OE_Navigation |
| Do you use social media regularly (at least once a month)? |
MMW0381A01 |
Yes |
A,B |
Radio button, one-up vertical |
Single |
N |
Skip Logic Group |
Social Media Use |
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MMW0381A02 |
No |
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| Which of the following social media do you use regularly (at least once a month)? (please select all that apply). |
MMW0382A01 |
Facebook |
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MMW0382A02 |
Twitter |
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MMW0382A03 |
LinkedIn |
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MMW0382A04 |
Blogs |
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MMW0382A05 |
You Tube |
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MMW0382A06 |
Other, please specify |
AA |
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| Other social media used regularly: |
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Text area, no char limit |
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N |
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OE_Other SM |
| How would you like to use social media to interact with this site? (please select all that apply) |
MMW0384A01 |
Bookmark or tag pages |
|
Checkbox, two-up vertical |
Multi |
N |
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SM_Interact |
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MMW0384A02 |
In social networks |
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MMW0384A03 |
In virtual worlds |
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MMW0384A04 |
By adding comments, ratings, or reviews |
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MMW0384A05 |
Reading blogs |
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MMW0384A06 |
Contributing to wikis |
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MMW0384A07 |
Receiving newsletters/email updates |
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MMW0384A08 |
Subscribing to RSS feeds |
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MMW0384A09 |
Listening to Podcasts or audio |
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MMW0384A10 |
Adding a widget or gadget to my personalized page |
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MMW0384A11 |
Following a microblog |
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MMW0384A12 |
I'd prefer not to interact with this site through social media |
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MMW0384A13 |
Other, please specify |
BB |
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| Please tell us another way you would like to use social media to interact with us: |
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|
Text area, no char limit |
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N |
|
OE_SM |
| Please select the category that includes your age. |
MMW0386A01 |
Under 25 |
|
Drop down, select one |
Single |
N |
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Age |
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MMW0386A02 |
25-34 |
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MMW0386A03 |
35-44 |
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MMW0386A04 |
45-54 |
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MMW0386A05 |
55-64 |
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MMW0386A06 |
65-74 |
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MMW0386A07 |
75 or older |
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MMW0386A08 |
Prefer not to answer |
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| What is your gender? |
MMW0387A01 |
Male |
|
Drop down, select one |
Single |
N |
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Gender |
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MMW0387A02 |
Female |
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MMW0387A03 |
Prefer not to answer |
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| If you could recommend one change to improve this site what would it be? |
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|
Text area, no char limit |
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N |
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OE_Improvement |
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| NIST Satisfaction Survey v2 |
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| What was the primary search feature you used during your visit to NIST.gov today? |
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General Search |
A |
Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Primary Search |
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Publications Search |
B |
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Both General Search and Publications Search |
C |
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I did not use either search feature at NIST.gov |
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| Please rate your satisfaction with the general search feature at NIST.gov. |
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1=Very Dissatisfied |
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Radio Button Scale, No don't know |
Single |
Y |
Skip Logic Group |
Rate_Gen Search |
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9 |
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10=Very Satisfied |
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| Please rate your satisfaction with the publications search feature at NIST.gov. |
|
1=Very Dissatisfied |
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Radio Button Scale, No don't know |
Single |
Y |
Skip Logic Group |
Rate_Pub Search |
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2 |
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9 |
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10=Very Satisfied |
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| Please rate your satisfaction with the search functionality at NIST.gov. |
|
1=Very Dissatisfied |
|
Radio Button Scale, No don't know |
Single |
Y |
Skip Logic Group |
Rate_Search Function |
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2 |
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10=Very Satisfied |
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| GobiernoUSA v3 - Oct 2010 |
EE, EN, SP |
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| Please rate the clarity of the language used on this site. |
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1=Poor |
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Radio button, scale, has don't know |
Single |
Y |
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Clarity of Language |
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10=Excellent |
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Don't know |
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| Please rate this site' s use of language that the general public can understand the content. |
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1=Poor |
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Radio button, scale, has don't know |
Single |
Y |
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General Public understand Language |
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2 |
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10=Excellent |
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Don't know |
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| Please rate the site on its use of short, clear sentences. |
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1=Poor |
|
Radio button, scale, has don't know |
Single |
Y |
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Clear and Short Language |
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2 |
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5 |
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6 |
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7 |
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8 |
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9 |
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10=Excellent |
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Don't know |
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