Form 1 HD Calc Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Attach 2_Full Survey with identified skips_HD Calc

Sub-Study #9 & #10 - HD*Calc Customer Satisfaction Survey for Different Category of Respondents: State (#9) and Federal Respondents (#10)

OMB: 0925-0642

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The National Cancer Institute (NCI) Health Disparities Calculator (HD*Calc) Software


Thank you very much for including the HD*Calc software (http://seer.cancer.gov/hdcalc/) on your website or social media platform.


The NCI would like to see how your organization may be using HD*Calc. If you believe that someone else in your organization would be better able to answer these questions, we would greatly appreciate your forwarding the web link for this survey to that person.


  1. Has your organization used the Health Disparities Calculator (HD*Calc) software (http://seer.cancer.gov/hdcalc/ )?

Yes? No?


  1. [ If no ], Does your organization have any specific plans to use HD*Calc?

Yes? No?

(If no, Go to question 11)


  1. [If yes to Q1], did your organization use HD*Calc for:

Reporting

Research (Check all that apply)

Analysis


  1. At any point in using HD*Calc, did you receive technical assistance from NCI?

Yes? No?


  1. [ If yes ] How helpful was the technical assistance you received from NCI?

Very Somewhat Not at all


  1. [If no], Why did you not receive technical assistance from NCI?

Did not need tech assistance

Did not know tech was available

Gave up


  1. How effective is the website (http://seer.cancer.gov/hdcalc/ ) for learning about HD*Calc?

Very Somewhat Not at all


  1. How have you integrated HD*Calc into your organization’s activities?

Monitoring system

Tool box

Data analysis

Health promotion planning

Other _______________


  1. Overall, how satisfied are you with the performance of the HD*Calc software?

Very Somewhat Not at all



  1. Have webinar presentations (http://seer.cancer.gov/hdcalc/webinars/ ) increased your understanding of the HD*Calc software?

Very Somewhat Not at all Have not seen the webinar

[Go to 12]


  1. Are there reasons for non usage of HD*Calc?

Too complicated

Lack of resources

Other ______________________


  1. Do you expect that your organization will use HD*Calc in the near future? 

Yes? No?



  1. How can we improve the HD*Calc software? (comment box here)




If you need technical assistance with using the HD*Calc software, please contact us at: [email protected]




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