490 OMH 490 OMH Questionnaire

#REF!

red & strike-through: DELETE

#REF!

underlined & italicized: RE-ORDER

#REF!

pink: ADDITION

Date:

9/1/2011

blue + -->: REWORDING

#REF!

QID

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Question Text

Answer Choices (limited to 50 characters)

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Type (select from list)

Single or Multi

Required Y/N

Special Instructions

CQ Label

MMW0359

How frequently do you visit this site?

Daily

Radio button, one-up vertical

Single

Y

Frequency of Visit

About once a week

About once a month

Every few months

Every 6 months or less often

This is my first time visiting the site

Y

ACQWro0007365

What best describes your role in visiting the site today?

Minority Group Advocate

Radio button, one-up vertical

Single

Y

OPS Group

Primary Role

Physician

Nurse/Health Care Professional

Allied Health Professional

Health Care Organization

Community Based Organization

Faith Based Organization

Foundation/National Non Profit

Government Agency

Congressional Staff/Policy Maker

Journalist/Media

Researcher

General Public

College/Graduate student

Other, please specify

A

ACQWro0007366

A

What best describe your role in visiting the site today?

MMW0362

Please select your primary reason for visiting the site today? (Please select all that apply).

Funding

A

Checkbox, one-up vertical

Multi

Y

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Primary Reason

Data/Statistics

Cultural Competency Information

Learn About a Health Topic

B

HHS Action Plan

OMH Disparities Reduction Efforts

National Partnership for Action (NPA) information

D

Minority Population Health Profiles

C

Preconception Peer Education Program (PPE)

E

Publications

Press Releases

Just Browsing

Employment/Internship Information

Sign up for e-newsletter/FYI

Other, please specify

F

MMW0363

F

Please describe your primary reason for visiting the site today.

Text area, no char limit

N

OE_Primary Reason

MMW0364

A

Please tell us specifically what funding information you were looking for.

Funding for Non Profits

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Multi

N

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Funding

Research/Fellowships

OMH Grants

Scholarships

OMH Grantee Profiles

Other, please specify

AA

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AA

Please tell us what funding information you were looking for today.

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N

OE_Funding

MMW0366

B

What health topics were you looking for today? (Please select all that apply)

Low Cost Health Care & Insurance

Checkbox, one-up vertical

Multi

N

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Health Topics

Staying Healthy

Disease Specific Information

Other, please specify

BB

MMW0367

BB

Please tell us what health information you were looking for today.

Text area, no char limit

OE_Health Information

MMW0368

C

Please tell us which minority population you were seeking information on.

African American

Minority Information

American Indian/Alaska Native

Asian American

Hispanic/Latino

Native Hawaiian/Pacific Islander

Other, please specify

CC

MMW0369

CC

Please tell us what other minority population you were seeking information for today.

Text area, no char limit

N

OE_Other Minority Information

MMW0370

D

Please tell what NPA information you were looking for?

General NPA Information

NPA Information

Regional Health Equity Councils

Download the Toolkit

Read the Blog

NPA Guide to Minority Health Resources

Join NPA

Take the NPA Pledge

Share your NPA Story

Other, please specify

DD

MMW0371

DD

Please tell us what NPA information you were looking for today.

Text area, no char limit

OE_NPA Other Info

MMW0372

E

Please tell us what Preconception Peer Education Program information you were looking for.

PPE Curriculum

OE_PPE Other Info

How to become a PPE?

Is there a PPE program in my area?

How organizations can be involved in the PPE program?

What colleges/universities have PPE programs?

Other, please specify

EE

EE

Please tell us what Preconception Peer Education Program information you were looking for.

Text area, no char limit

N

OE_PPE Program

MMW0373

What additional information would you like to have available on this site?

Open-ended

Text area, no char limit

N

OE_Additonal Information

ACQWro0007367

Did you find what you were looking for on the site today?

Yes

Radio button, one-up vertical

Single

Y

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Ability to Find

No

A,B

ACQWro0007355

A

Please tell us why you were not able to find what you were looking for?

I could not access the information on site

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Multi

N

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Unable to Find

The search results did not appear relevant

The links did not take me where I wanted

The labeling on lists didn't match what I was looking for

How the information is organized on the site wasn't clear

The navigation options were difficult to understand

Other

MMW0376

B

Please tell us specifically what you couldn't find on the site today:

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Single

N

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OE_Ability to Find

MMW0377

After visiting the site today please tell us how likely you are to do the following activities: (Please select all that apply)

Bookmark page for later use

Checkbox, one-up vertical

multi

N

OPS Group

Use of Information

Do additional research online

Email the information to a colleague

Email the information to a friend or family member

Collaborate with another organization or individuals

Print the information and share it

Other, please specify

B

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B

Other use of information obtained from the Office of Minority Health:

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OE_Use of Information

MMW0379

How did you look for information on the site today? (Please select all that apply.)

Search feature at top of page

Checkbox, one-up vertical

Multi

Y

OPS Group

Navigation Tools

Search Library Catalog

Navigation tabs across the top of the page

Navigation links along left side of page

The links in the body of the page

The links in the rotating banner

Other, please specify

A

MMW0380

A

Other way I looked for information:

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N

OE_Navigation

MMW0381

Do you use social media regularly (at least once a month)?

Yes

A,B

Radio button, one-up vertical

Single

N

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Social Media Use

No

MMW0382

A

Which of the following social media do you use regularly (at least once a month)? (please select all that apply).

Facebook

Twitter

LinkedIn

Blogs

You Tube

Other, please specify

AA

MMW0383

AA

Other social media used regularly:

Text area, no char limit

N

OE_Other SM

MMW0384

B

How would you like to use social media to interact with this site? (please select all that apply)

Bookmark or tag pages

Checkbox, two-up vertical

Multi

N

SM_Interact

In social networks

By adding comments, ratings, or reviews

Reading blogs

Receiving newsletters/email updates

Subscribing to RSS feeds

Audio/video podcasts

Adding a widget or gadget to my personalized page

Following a microblog (Twitter, Facebook, etc)

I'd prefer not to interact with this site through social media

Other, please specify

BB

MMW0385

BB

Please tell us another way you would like to use social media to interact with us:

Text area, no char limit

N

OE_SM

MMW0386

Please select the category that includes your age.

Under 25

Drop down, select one

Single

N

Age

25-34

35-44

45-54

55-64

65-74

75 or older

Prefer not to answer

MMW0387

What is your gender?

Male

Drop down, select one

Single

N

Gender

Female

Prefer not to answer

MMW0388

If you could recommend one change to improve this site what would it be?

Open-ended

Text area, no char limit

N

OE_Improvement