433 BenefitsGov 433 BenefitsGov

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

2011 433 Benefits.gov.xlsx

Previously Cleared ICs from prior Generic ICR

OMB: 1090-0008

Document [xlsx]
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Model Instance Name:

red & strike-through: DELETE







underlined & italicized: RE-ORDER




MID: 1QRBQVt00VlYwxsMAAs01A==

pink: ADDITION




Date:
blue + -->: REWORDING













CUSTOM QUESTION LIST
QID
(Group ID)
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
EDO11044
Which of the following best describes you? Agency Representative
Radio button, one-up vertical Single Y OPS Group



Benefit Advocate/Caseworker







Disabled







Disabled Veteran







Disaster Victim







Federal employee or retiree







Injured/Sick







Low Income







Military (Active)







Military Dependent







Student






Senior/Retiree







Veteran







Veteran Dependent







Unemployed







Other, please specify: A



EDO11045 A Other role

Text area, no char limit Single N OPS Group
EDO11046
Is this your first time visiting BENEFITS.GOV? Yes







No




EDO11047
What was your primary purpose for visiting today? To find more information about a specific program
Radio button, one-up vertical Single Y



I need help, but do not know what is available







I am looking for free money from the government







I want to apply for a specific benefit online







I am curious about programs available to me







Other




EDO11048
What kind of information were you looking for today? Disability benefits
Radio button, one-up vertical Single Y Skip Logic Group



Financial assistance






Grants







Housing assistance







Loans







Lost money







Medicaid







General program information







Other, please specify:




EDO11049
What kind of information were you looking for today?

Text area, no char limit
N
EDO11050
Did you find what you were looking for? Yes
Radio button, one-up vertical Single Y OPS Group



Not yet, I was looking for: B



EDO11051 B

Text area, no char limit Single N OPS Group
EDO11052
What is the primary search method you used to search for benefits while on the site? Benefit Finder tool Y


Skip Logic Group



Search (located in the top right corner of the homepage) Y,D






Browse by category Y,D






Browse by state Y,D






Browse by federal agency Y,D






Other resources Y,D



EDO11053 Y Was the primary search method you used helpful? Yes
Radio button, one-up vertical Single Y Skip Logic Group



No C



EDO11054 C Why don't you feel the primary search method you used was helpful?

Text area, no char limit
N Skip Logic Group
EDO11055 D Why didn't you use the Benefit Finder tool? I did not see it



Skip Logic Group



It asked too many questions







I had a specific program I was looking for







I chose to use one of the other ways to search







Other, please specify: Z



EDO11056 Z Why didn't you use the Benefit Finder tool?

Text area, no char limit Single N Skip Logic Group
EDO11057
Were you (or the person for whom you were searching) eligible for any program(s)? Yes - eligible for at least one program DD Radio button, one-up vertical Single Y Skip Logic Group



No







I don't know yet







Not Applicable




EDO11058 DD Did you successfully email your results? Yes
Radio button, one-up vertical Single Y Skip Logic Group



No E



EDO11059 E Why didn't you successfully email your results?

Text area, no char limit
N Skip Logic Group
EDO11060
Did the Benefits detail provide enough information for you to move forward in your efforts to obtain help? Yes
Radio button, one-up vertical Single Y Skip Logic Group



No F



EDO11061 F What additional information do you need?

Text area, no char limit
N Skip Logic Group
EDO11062
How did you find out about our site? E-mail/Mail
Radio button, one-up vertical Single Y OPS Group



GovBenefits.gov Connection Newsletter






Government Website







Non-government Website







Newspaper/TV/Radio







Referral from a friend







Search Engine







Social Services/Counselor







Other, please specify: A



EDO11063 A Other, Find out about site

Text area, no char limit Single N OPS Group
EDO11064
Do you subscribe to the GovBenefits.gov Connections e-newsletter? Yes
Radio button, one-up vertical Single Y OPS Group



No







No, but I'd like to. My e-mail is A



EDO11065 A

Text area, no char limit Single N OPS Group
EDO11066
What is your gender? Male
Radio button, one-up vertical Single N



Female




EDO11067
How do you describe your race or ethnicity? Alaska Native
Radio button, one-up vertical Single N



American Indian







Asian







Black or African American







Hispanic







Native American







Pacific Islander







White or Caucasian




EDO11068
What is your age range? Under 18
Radio button, one-up vertical Single N



18-24







25-34







35-44







45-54







55-64







65 and older




EDO11069
What best describes your income range? Under $25,000
Radio button, one-up vertical Single N



$25,000 - $49,999







$50,000 - $74,999







$75,000 or higher




EDO11070
Which of the following best describes the highest level of education you have completed? Did not complete high school
Radio button, one-up vertical Single N



High school graduate







Some college/vocational school







College graduate







Some postgraduate school







Graduate/professional degree




EDO11071
We're trying to understand if visitors are finding programs and aren't eligible, or aren't finding programs at all. Do you have any thoughts on this topic?

Text area, no char limit Single N
EDO11072
If you could make one improvement to the site, what would it be?

Text area, no char limit Single N

















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