Form 620 2013 620 NICHD_NCS Model
American Customer Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Surveys
2013 620 NICHD_NCS Model (3).xlsx
620 NICHD_NCS Model - 621 NIH gov Questionnaire
OMB: 1090-0008
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1090-0008 can be found here:
Document [xlsx]
Download: xlsx | pdf
Foreign Language Translation
Welcome & Thank You English
Welcome & Thank You Spanish
Model Qsts English
Model Qsts Spanish
CQs English
CQs Spanish
Overview
GuidelinesForeign Language Translation
Welcome & Thank You English
Welcome & Thank You Spanish
Model Qsts English
Model Qsts Spanish
CQs English
CQs Spanish
Sheet 1: Guidelines
| Questionnaire Management Guidelines | ||||||||||||||||||||
| Goals: | ||||||||||||||||||||
| � | One consolidated document to track all model and CQ changes throughout the life of the project | |||||||||||||||||||
| � | Questionnaire always matches the live survey | |||||||||||||||||||
| � | Easy and error-free way to submit CQ changes | |||||||||||||||||||
| � | All changes tracked and reflected in one document (DOT will help) | |||||||||||||||||||
| Questionnaire Resources: | ||||||||||||||||||||
| 1 | Questionnaire Design and Approval Process | |||||||||||||||||||
| 2 | Question Grouping Rules | |||||||||||||||||||
| 3 | OPS vs. Skip Logic Decision for "Other, Please Specify" | |||||||||||||||||||
| 4 | Foreign Language Survey Instructions | |||||||||||||||||||
Sheet 2: Foreign Language Translation
| Client Name: | |||||
| Measure Name: | NICHD_NCS | ||||
| Version of Code: | Please fill in | ||||
| Custom Qualifier Page | Please Select | ||||
| Custom Invitation Text? | Please Select | ||||
| Custom Tracker Text? | Please Select | ||||
| Custom Welcome/ Thank You Text? |
Please Select | ||||
| Language(s) | If other language not listed, please specify. | Website URL | MID(s) (DOT FILL THIS IN) |
Measure Name(s) (DOT WIll FILL THIS IN) |
Notes: |
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Sheet 3: Welcome & Thank You English
| Model Instance Name: | 
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| NICHD_NCS | |||||||||||
| MID: | Existing Measure - Please fill in; New Measure - DOT will fill in | ||||||||||
| Date: | 3/21/2013 | ||||||||||
| Welcome and Thank You Text | |||||||||||
| Directions: | |||||||||||
| This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome and Thank you text shown in the boxes below. Please read comments before using any of the text. | |||||||||||
| Examples | |||||||||||
| Welcome Text Example | |||||||||||
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| Welcome Text | |||||||||||
| Thank you for visiting our site. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible. |
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| Thank You Text Example | |||||||||||
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| ALTERNATE WEB Thank You Text | |||||||||||
| Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website. |
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Sheet 4: Welcome & Thank You Spanish
| Model Instance Name: |
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| NICHD_NCS | |||||||||||
| MID: | Existing Measure - Please fill in; New Measure - DOT will fill in | ||||||||||
| Date: | Fill In Date | ||||||||||
| Welcome and Thank You Text | |||||||||||
| Directions: | |||||||||||
| This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome and Thank you text shown in the boxes below. Please read comments before using any of the text. | |||||||||||
| Examples | |||||||||||
| Welcome Text Example | |||||||||||
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| Welcome Text | |||||||||||
| Gracias por visitar nuestro sitio Web. Usted ha sido elegido al azar para participar en una breve encuesta con el fin de hacernos saber qué hacemos bien y en qué podemos mejorar. La encuesta sólo toma unos minutos, y todas sus respuestas serán anónimas. Sus opiniones son esenciales para ayudarnos a proporcionar la mejor experiencia en línea posible. |
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| Thank You Text Example | |||||||||||
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|||||||||||
| ALTERNATE WEB Thank You Text | |||||||||||
| Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website. |
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Sheet 5: Model Qsts English
| Model Instance Name: | |||||||||
| NICHD_NCS | 
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| MID: | Existing Measure - Please fill in; New Measure - DOT will fill in | ||||||||
| Partitioned Yes | |||||||||
| FPI Included(Y/N)? | |||||||||
| NOTE: All non-partitioned surveys will NOT be imputed and the elements will be rotated as a default unless otherwise specified and approved by Research. | |||||||||
| Date: | 3/21/2013 | ||||||||
| NICHD_NCS | |||||||||
| Model questions utilize the ACSI methodology to determine scores and impacts | |||||||||
| ELEMENTS (drivers of satisfaction) | CUSTOMER SATISFACTION | FUTURE BEHAVIORS | |||||||
| MQ Label | MQ Label | MQ Label | |||||||
| Content (1=Poor, 10=Excellent, Don't Know) | Satisfaction | Return (1=Very Unlikely, 10=Very Likely) | |||||||
| Content - Accuracy | Please rate your perception of the accuracy of information on this site. | Satisfaction - Overall | What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied) |
Return | How likely are you to return to this site? | ||||
| Content - Quality | Please rate the quality of information on this site. | Satisfaction - Expectations | How well does this site meet your expectations? (1=Falls Short, 10=Exceeds) |
Recommend (1=Very Unlikely, 10=Very Likely) | |||||
| Content - Freshness | Please rate the freshness of content on this site. | Satisfaction - Ideal | How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close) |
Recommend | How likely are you to recommend this site to someone else? | ||||
| Look and Feel (1=Poor, 10=Excellent, Don't Know) | Primary Resource (1=Very Unlikely, 10=Very Likely) | ||||||||
| Look and Feel - Appeal | Please rate the visual appeal of this site. | Primary Resource | How likely are you to use this site as your primary resource for obtaining information from this organization? | ||||||
| Look and Feel - Balance | Please rate the balance of graphics and text on this site. | ||||||||
| Look and Feel - Readability | Please rate the readability of the pages on this site. | ||||||||
| Navigation (1=Poor, 10=Excellent, Don't Know) | |||||||||
| Navigation - Organized | Please rate how well the site is organized. | ||||||||
| Navigation - Options | Please rate the options available for navigating this site. | 
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| Navigation - Layout | Please rate how well the site layout helps you find what you are looking for. | ||||||||
| Navigation - Clicks | Please rate the number of clicks to get where you want on this site. | ||||||||
| Online Transparency (1=Poor, 10=Excellent, Don't Know) | |||||||||
| Online Transparency - Disclose | Please rate how thoroughly this site discloses information about what this organization is doing. | ||||||||
| Online Transparency - Quick | Please rate how quickly information about this organization is made available on this site. | ||||||||
| Online Transparency - Access | Please rate how well information about this organization's actions can be accessed by the public on this site. | ||||||||
| Search (1=Poor, 10=Excellent, Don't Know) | |||||||||
| Search - Results Relevance | Please rate the relevance of search results on this site. | ||||||||
| Search - Results Organization | Please rate the organization of search results on this site. | ||||||||
| Search - Results Help | Please rate how well the search results help you decide what to select. | ||||||||
| Search - Feature Narrow | Please rate how well the search feature helps you to narrow the results to find what you want. | ||||||||
| Site Performance (1=Poor, 10=Excellent, Don't Know) | |||||||||
| Site Performance - Loading | Please rate how quickly pages load on this site. | ||||||||
| Site Performance - Consistency | Please rate the consistency of speed from page to page on this site. | ||||||||
| Site Performance - Errors | Please rate the ability to load pages without getting error messages on this site. | ||||||||
Sheet 6: Model Qsts Spanish
| Model Instance Name: | |||||||||
| NICHD_NCS |
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| MID: | Existing Measure - Please fill in; New Measure - DOT will fill in | ||||||||
| Partitioned Yes | |||||||||
| FPI Included(Y/N)? | |||||||||
| NOTE: All non-partitioned surveys will NOT be imputed and the elements will be rotated as a default unless otherwise specified and approved by Research. | |||||||||
| Date: | 3/21/2013 | ||||||||
| NICHD_NCS | |||||||||
| Model questions utilize the ACSI methodology to determine scores and impacts | |||||||||
| ELEMENTS (drivers of satisfaction) | CUSTOMER SATISFACTION | FUTURE BEHAVIORS | |||||||
| MQ Label | MQ Label | MQ Label | |||||||
| Contenido (1=Deficiente, 10=Excelente, No sabe) | Satisfacción | Retornar (1=Muy poco probable, 10=Muy probable) | |||||||
| Clasifique su percepción de la exactitud de la información en este sitio Web. | ¿Cuál es su satisfacción en general con este sitio Web? (1=Muy satisfecho, 10=Muy satisfecho) |
¿Cuán probable es que usted vuelva a este sitio? | |||||||
| Clasifique la calidad de la información en este sitio. | ¿Cuán bien este sitio ha cumplido con sus expectativas? (1=No las alcanza, 10=Las supera) |
Recomienda (1=Muy poco probable, 10=Muy probable) | |||||||
| Clasifique la actualidad de la información en este sitio. | ¿Cómo se compara este sitio Web con su idea de uno ideal? (1=Muy diferente, 10=Muy parecido) |
¿Cuán probable es que usted recomiende este sitio Web a alguien más? | |||||||
| Aspecto (1=Deficiente, 10=Excelente, No sabe) | Recurso principal (1=Muy poco probable, 10=Muy probable) | ||||||||
| Clasifique el atractivo visual de este sitio. | ¿Cuán probable es que usted use este sitio Web como fuente principal para obtener información de esta organización? | ||||||||
| Clasifique el balance de gráficos y texto en este sitio. | |||||||||
| Clasifique la legibilidad de las páginas en este sitio. | |||||||||
| Exploración (1=Deficiente, 10=Excelente, No sabe) | |||||||||
| Clasifique lo bien que está organizado este sitio. | |||||||||
| Clasifique las opciones personales para explorar este sitio. | 
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| Clasifique cuán bien el diseño de este sitio le ayuda a encontrar lo que está buscando. | |||||||||
| Clasifique el número de clics para llegar a donde usted desea en este sitio. | |||||||||
| Transparencia en línea (1=Deficiente, 10=Excelente, No sabe) | |||||||||
| Clasifique cuán exhaustivamente este sitio divulga información sobre lo que esta organización hace. | |||||||||
| Clasifique cuán rápidamente la información sobre esta organización es puesta a disponibilidad en este sitio. | |||||||||
| Clasifique cuán bien la información sobre las acciones de esta empresa puede ser accedida por el público en este sitio. | |||||||||
| Búsqueda (1=Deficiente, 10=Excelente, No sabe) | |||||||||
| Clasifique la relevancia de los resultados de búsqueda en este sitio. | |||||||||
| Clasifique la organización de los resultados de búsqueda en este sitio. | |||||||||
| Clasifique cuán bien los resultados de búsqueda le ayudan a decidir qué seleccionar. | |||||||||
| Clasifique cuán bien la función de búsqueda le permite limitar los resultados para encontrar lo que usted desea. | |||||||||
| Rendimiento del sitio (1=Deficiente, 10=Excelente, No sabe) | |||||||||
| Clasifique cuán rápido se cargan las páginas en este sitio. | |||||||||
| Clasifique la consistencia de la velocidad de paso entre páginas del sitio. | |||||||||
| Clasifique la capacidad de cargar páginas sin obtener mensajes de error en este sitio. | |||||||||
Sheet 7: CQs English
| underlined & italicized: RE-ORDER | |||||||||
| pink: ADDITION | |||||||||
| 3/1/2008 | blue + -->: REWORDING | ||||||||
| 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 | |
| How frequently do you visit the National Children's Study site? | First time | Checkbox, one-up vertical | Single | Y | Visit Frequency | ||||
| Daily | |||||||||
| Weekly | |||||||||
| Monthly | |||||||||
| Less than Once a Month | |||||||||
| What information were you primarily looking for on the site today? | General study information | D,E | Radio button, one-up vertical | single | Y | Skip Logic Group* | Infor Type Seeking | ||
| Information about a specific Vanguard study location | D,E | ||||||||
| General information about participating in the Study | D,E | ||||||||
| Workshops and other Events | |||||||||
| Researcher-focused resources, like study design and methods development | |||||||||
| Study funding information | |||||||||
| Announcements and Public Notices | |||||||||
| Job or Business Opportunities | |||||||||
| Other, please specify | A | ||||||||
| A | what other type of information you were looking for | Text area, no char limit | N | Skip Logic Group* | OPS_Info Seeking | ||||
| D | Who is this information for? | Myself | Radio button, one-up vertical | single | Y | Skip Logic Group* | Info for Whom | ||
| My child | |||||||||
| A friend or other family member | |||||||||
| Research or researcher | |||||||||
| Someone I provide care for | |||||||||
| Other | |||||||||
| E | How do you plan to use the information you found on the site today? | For research purposes | Radio button, one-up vertical | single | Y | Skip Logic Group* | Info Use (Health) | ||
| Give information to a family member or friend | |||||||||
| Use for myself | |||||||||
| I'm not sure yet | |||||||||
| I didn't find what I was looking for | |||||||||
| Other | F | ||||||||
| F | Other use for the information you found on the site today: | Open-ended | Text area, no char limit | Skip Logic Group* | OPS_Info Use (Health) | ||||
| Did you find the information you were looking for? | Yes | Radio button, one-up vertical | single | Y | Skip Logic Group* | Find Info | |||
| Partially | A | ||||||||
| No | A | ||||||||
| A | What specifically were you looking for that you were unable to find? | Text area, no char limit | N | Skip Logic Group* | OE_Unable to Find | ||||
| Which of the following best describes you? | Health consumer/ general public | Radio button, two-up vertical | Single | Y | Skip Logic Group* | Role | |||
| Health Care Provider/Health Professional | |||||||||
| Scientist/Researcher | |||||||||
| Media/Journalist/Science Writer | |||||||||
| Policy Maker | |||||||||
| Representative of an Existing Study Partner | |||||||||
| Student/Teacher/Educator | |||||||||
| Other, please specify | A | ||||||||
| A | Other role that best describes you: | Text area, no char limit | N | Skip Logic Group* | OPS_Role | ||||
| What was your primary method of locating information on the NCS site today? | Top navigation menu | Single | Y | Skip Logic Group* | Navigation Method | ||||
| Left navigation bar | |||||||||
| Used an external search engine such as Google, Bing, or Yahoo | |||||||||
| Used a Bookmark or Favorite | |||||||||
| Followed a link into the NCS site from another site | B | ||||||||
| Followed a link from a page on the National Institutes of Health (NIH) Web site | |||||||||
| Site-wide search box (open text box in upper right corner) | |||||||||
| Other, please specify | A | ||||||||
| A | Other method of locating information: | Text area, no char limit | N | Skip Logic Group* | OPS_Nav Method | ||||
| B | Specifically, which site did you arrive from? | Text area, no char limit | N | Skip Logic Group* | OE_Site Arrived From | ||||
| How would you describe your navigation experience on this site today? (Please select all that apply.) | I had no difficulty navigating/browsing on this site | Checkbox, one-up vertical | Multi | Y | OPS Group | Navigation Exp. | |||
| Links often did not take me where I expected | |||||||||
| Had difficulty finding relevant information/products | |||||||||
| Links/labels are difficult to understand | |||||||||
| Too many links/navigational options to choose from | |||||||||
| Had technical difficulties (error messages, broken links, etc.) | |||||||||
| Could not navigate back to previous information | |||||||||
| I had a navigation difficulty not listed above: | A | ||||||||
| A | Other difficulty with navigation: | Text area, no char limit | N | OPS Group | OPS_Navigation Diff. | ||||
| Did you use the site-wide search feature during your visit today? | Yes | A | Radio button, one-up vertical | Single | Y | Skip Logic Group* | Search Use | ||
| No | |||||||||
| Don't remember | |||||||||
| A | Please tell us about your experience with the site's search feature today. (Please select all that apply.) | The search feature met my needs today | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Search Exp. | ||
| I had issues with the basic search process (how to use it, terms to enter) | B | ||||||||
| I had issues with the visual display of the search results (text size, images) | |||||||||
| I had issues with the search results I received | F | ||||||||
| I had issues with sorting, filtering, advanced search, or lack of these options | |||||||||
| B | What were your issues with the basic search process? (Please select all that apply.) | It was not clear to me how to use the search feature | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Search_Basic Issues | ||
| I did not know what terms to use to get the results I wanted | |||||||||
| There were too many steps or refinements to get to what I wanted | |||||||||
| I had a different issue with the basic search process: | C | ||||||||
| C | Other issue with the basic search process: | Open-ended | Text area, no char limit | N | Skip Logic Group* | OPS_Search Basic Issues | |||
| F | What were your issues with the search results? (Please select all that apply.) | Results were not relevant/not what I wanted | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Search_Results Issues | ||
| There were not enough results | |||||||||
| There were NO results | |||||||||
| There was too little information in the results to decide what to choose | |||||||||
| Many of the search results looked the same | |||||||||
| Couldn't find item from the catalog/store | |||||||||
| I had a different issue with the search results: | G | ||||||||
| G | Other issue with the search results: | Open-ended | Text area, no char limit | N | Skip Logic Group* | OPS_Search Results Issues | |||
| Is the design of the website pleasing and appropriate? | Yes | Radio button, one-up vertical | single | Y | Skip Logic Group* | Opinion of Site | |||
| No | A | ||||||||
| A | What aspects of the website design would you change? | Open-ended | Text area, no char limit | N | Skip Logic Group* | OE_Change Site Design | |||
| If you could make one change to the NCS site, what would it be? | Text area, no char limit | N | OE_One Change | ||||||
| What additional information or resources would you like to see included on our site? | Text area, no char limit | N | OE_Add'l Info | ||||||
Sheet 8: CQs Spanish
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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