350 Fda 350 Fda 8-11-10

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

2010 350 FDA Email Model - 8.11.10 FINAL.xlsx

Previously Cleared ICs from prior Generic ICR

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf
Model Instance Name:

red & strike-through: DELETE






#REF!

underlined & italicized: RE-ORDER






#REF!

pink: ADDITION






Date: 8.11.2010 blue + -->: REWORDING

















#REF!
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
EDO05135
Is the frequency of the FDA email alerts appropriate? Yes, the frequency is fine
Drop down, select one Single Y
Frequency



I would like to receive it more often.









I would like to receive it less often.






EDO05136
When would you like to receive email alerts? During the week business hours only
Drop down, select one Single Y
Time



During the week business and evening hours









During the week business and evening hours and on weekends






EDO05137
Which of the following best describes your role? Physician
Radio button, one-up vertical Single Y OPS Group Role



Pharmacist/Pharmacy technician









Nurse/Nurse Practitioner









Physician Assistant









Medical resident or fellow









Medical, pharmacy, nursing, or allied health professional student









Medical Informatics/librarian in health system setting









Medical information provider/reporter









Consumer (not healthcare professional/student)









Other (please specify) A





EDO05138 A Please describe your role:

Text area, no char limit
N OPS Group Other Role
EDO05139
Which of the following best describes your primary work setting? Department of Defense (DOD) or Veteran's Affairs (VA)
Radio button, one-up vertical Single Y OPS Group Work Environment



Other government agency









Private practice; self-employed









Community-based small group (less than 5 practitioners)









Multi-specialty group practice, Health Maintenance Organization (HMO)









Academic medical center









Community hospital









Academia









Pharmaceutical, device, or biological industry









Retail pharmacy









Investment firm









News media









Other (please specify) B





EDO05140 B Please describe your primary work setting:

Text area, no char limit
N OPS Group Other Environment


Please select your level of agreement with the following statements about the MedWatch Safety Alert emails?


Single Y Matrix Group

EDO05141
There is an adequate amount of detail provided in the subject line Agree




Email Details



Somewhat Agree









Disagree






EDO05142
The audience identified in the email is accurate (accurately identifies for whom the information is relevant). Agree




Email Relevance



Somewhat Agree









Disagree






EDO05143
The length of the email is appropriate Agree




Email Length



Somewhat Agree









Disagree






EDO05144
There is enough information provided for me to take action on (if necessary) Agree




Email Info



Somewhat Agree









Disagree






EDO05145
The supplemental links provided in the email are useful Agree




Email Links



Somewhat Agree









Disagree






EDO05146
How do you use the MedWatch Safety Alert email information you receive? (Please select all that apply) To stay current on medical product safety
Radio button, one-up vertical Multi Y OPS Group Usage



To inform other colleagues and/or patients









To present new information at my committee meetings









To publish the information in professional newsletters









To add content to my organization's web site









To update drug information in my organization's electronic formulary or Electronic Medical Record (EMR)









Other (please specify) C





EDO05147 C Please describe how you use the MedWatch Safety Alert email information you receive?

Text area, no char limit
N OPS Group Other Usage
EDO05148
On average, with how many individuals in your organization do you share MedWatch Safety Alert emails information with? Zero
Radio button, one-up vertical Single Y
Forward On



1-5 people









6-10 people









11-20 people









21-50 people









51-100 people









101-499 people









More than 500 people






EDO05149
Which of the following product-specific emails are you interested in receiving? (Please select all that apply) Drugs and Biologics (Prescription and over-the-counter)
Radio button, one-up vertical Multi Y OPS Group Product Center



Medical devices (e.g. stents, implants, radiological products, diagnostics)









Blood, blood products and tissue









Vaccines









Dietary supplements









Food allergens









Food-related outbreaks









Cosmetics









Other (please specify) D





EDO05150 D Please describe the other product specific emails you would like to receive:

Text area, no char limit
N OPS Group

EDO05151
Which of the following types of information are you interested in receiving? (Please select all that apply) Emerging safety information about human medical products
Radio button, one-up vertical Multi Y OPS Group Information Topic



Labeling changes with associated "Dear Healthcare Professional" letter issued by manufacturer









Recalls of drugs with a potential for serious injury or death









Recalls of medical devices with a potential for serious injury or death









Notices of safety issues related to off label or inappropriate use of drugs or devices









Safety information about newly approved drugs









Counterfeit medical products









Other (please specify) E





EDO05152 E Please describe the other types of information you would like to receive:

Text area, no char limit
N OPS Group

EDO05153
Which of the following audience specific emails would you like to receive? (Please select all that apply) General health professionals (e.g., Pharmacists, Nurses, Physicians)
Radio button, one-up vertical Multi
OPS Group Audience



Medical specialty audiences (e.g. Urology, Oncology)









General public









Other (please specify) F





EDO05154 F Please describe the audience you would like to receive emails for:

Text area, no char limit

OPS Group

EDO05155
How else would you like to receive or access MedWatch Safety Alerts or MedWatch information about Monthly Drug Safety Labeling Changes? (Please select all that apply) Text messages on my mobile phone
Radio button, one-up vertical Multi
OPS Group




Audio (i.e. Podcast)









Video (i.e. YouTube









Blogs









Facebook









Twitter









MySpace









GoogleWave









LinkedIn









Other (please specify) G





EDO05156 G Other ways to access or receive information:

Text area, no char limit




EDO05157
What is the one improvement you would like MedWatch Safety Alerts to make to their emails?

Text area, no char limit


One Improvement











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