414 ePSS 414 ePSS Wave 1

American Customer Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Surveys

2011 414 ePSS Questionnaire Wave 1 Revised.xlsx

Previously Cleared ICs from prior Generic ICR

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf
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Date: 2/25/2011 blue + -->: REWORDING

















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QID Skip Logic Label Question Text Answer Choices
(limited to 50 characters)
Skip to Type (select from list) Single or Multi Required
Y/N
Special Instructions CQ Label
EDO10269
Which of the following best describes your position or situation? Physician
Radio button, one-up vertical Single Y OPS Group Role



Physician Assistant









Nurse









Nurse Practitioner









Medical Student









Other clinician









Medical assistant/ Medical office staff









Patient or consumer









Educator









Policy maker









Researcher









Other (please specify)






EDO10270
What is your position or situation?

Text field, <100 char

OPS Group Other Role
EDO10271
Have you ever searched or browed USPSTF recommendations on the ePSS before? Yes
Radio button, one-up vertical Single Y
First time



No






EDO10272
How often in the last six months have you gone to www.epss.ahrq.gov to use the ePSS? This is my first time visiting it
Radio button, one-up vertical Single Y
How often



Daily or almost daily









About once a week









About two or three times a month









About once a month









Every few months or less often






EDO10273
How often do you use the ePSS on a mobile device other than a laptop computer (PDA, Blackberry, iPhone/iPad, Android, smart phone,? Never
Radio button, one-up vertical Single Y
Mobile



Daily or almost daily









About once a week









About two or three times a month









About once a month









Every few months or less often






EDO10274
How often do you use the ePSS to learn more about a specific U.S. Preventive Services Task Force (USPSTF) recommendation? This is my first time visiting A, B Radio button, one-up vertical Single Y Skip Logic Group Specific Rec



Daily or almost daily A, B








About once a week A, B








About two or three times a month A, B








About once a month A, B








Every few months or less often A, B








Never A





EDO10275 B When searching for USPSTF recommendations based on a patient’s characteristics (e.g. age, sex, tobacco use, etc) the search results provide __________. The right amount of information
Radio button, one-up vertical Single Y Skip Logic Group Information



Too much information









Not enough information









Not sure






EDO10276 B When you or a member of your care team searches for preventive service recommendations specific to a patient, at what point do you usually do this? (Check all that apply) Prior to seeing the patient

Multi Y Skip Logic Group When search



With the patient









After seeing the patient









Other (please specify) C





EDO10277 C When do you search for recommendations?

Text field, <100 char
N Skip Logic Group Other when search
EDO10278 B Have you ever used the search function for identifying patient specific recommendations? Yes D Radio button, one-up vertical Single Y Skip Logic Group Used search



No






EDO10279 D How could the search feature be improved?

Text area, no char limit
N
Imp Search
EDO10280 A Have you ever used the browsing (by topic) capabilities in the ePSS? Yes E

Y Skip Logic Group Used Browse



No






EDO10281 E How could the browse feature be improved?

Text area, no char limit
N Skip Logic Group Imp Browse
EDO10282
When discussing preventive services with patients, how often do you actually show the patient the results from the ePSS? Every time
Radio button, one-up vertical Single Y





Most of the time









Some of the time









Never






EDO10283
How often do you or someone else in the office provide patients with any kind of take-home information on preventive health services, such as printed materials or web site addresses? Every time
Radio button, one-up vertical Single Y
Take home



Most of the time









Some of the time









Never






EDO10284
What other suggestions do you have for improving the ePSS application?

Text area, no char limit
N
Improvement











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