| Model Instance Name: |
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| Benefits.gov v2 |
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| MID: 1QRBQVt00VlYwxsMAAs01A== |
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| Date: |
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| \ |
| Model questions utilize the ACSI methodology to determine scores and impacts |
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ELEMENTS (drivers of satisfaction) |
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CUSTOMER SATISFACTION |
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FUTURE BEHAVIORS |
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Benefit Search Process (1=Poor, 10=Excellent, Don't Know) |
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Satisfaction |
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Return (1=Very Unlikely, 10=Very Likely) |
| 1 |
Please rate the how well the benefit search features streamline the search process. |
21 |
What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied) |
24 |
How likely are you to return to this site? |
| 2 |
Please rate the features available for refining benefit search results. |
22 |
How well does this site meet your expectations? (1=Falls Short, 10=Exceeds) |
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Recommend (1=Very Unlikely, 10=Very Likely) |
| 3 |
Please rate how well the benefit search features minimize the amount of time needed to get useful results. |
23 |
How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close) |
25 |
How likely are you to recommend this site to someone else? |
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Look and Feel (1=Poor, 10=Excellent, Don't Know) |
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| 4 |
Please rate the visual appeal of this site. |
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| 5 |
Please rate the balance of graphics and text on this site. |
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| 6 |
Please rate the readability of the pages on this site. |
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| 7 |
Navigation (1=Poor, 10=Excellent, Don't Know) |
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| 8 |
Please rate how well the site is organized. |
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| 9 |
Please rate the options available for navigating this site. |
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Please rate how well the site layout helps you find what you are looking for. |
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| 10 |
Please rate the number of clicks to get where you want on this site. |
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| 11 |
Benefit Information (1=Poor, 10=Excellent, Don't Know) |
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| 12 |
Please rate the amount of information provided about the benefit programs. |
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| 13 |
Please rate the usefulness of the information about the benefit programs. |
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| 14 |
Please rate your perception of the accuracy of the information about the benefit programs. |
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| 15 |
Site Performance (1=Poor, 10=Excellent, Don't Know) |
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| 16 |
Please rate how quickly pages load on this site. |
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Please rate the consistency of speed from page to page on this site. |
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| 17 |
Please rate the ability to load pages without getting error messages on this site. |
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| 19 |
Benefit Search Results - Relevance (1=Poor, 10=Excellent, Don't Know) |
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| 20 |
Please rate how well the benefit search results match your request. |
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Please rate the benefit search results' listing/ranking order. |
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Please rate the relevance of the benefit search results to your information needs. |
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| Model Instance Name: |
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red & strike-through: DELETE |
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| Benefits.gov v2 |
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underlined & italicized: RE-ORDER |
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| MID: 1QRBQVt00VlYwxsMAAs01A== |
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pink: ADDITION |
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| Date: |
6/19/2012 |
blue + -->: REWORDING |
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| Benefits.gov v2 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 |
25 character limit.
CQ Label |
| EDO11044 |
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Which of the following best describes you? |
Agency Representative |
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Radio button, one-up vertical |
Single |
Y |
OPS Group |
Role |
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Benefit Advocate/Caseworker |
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Disabled |
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Disabled Veteran |
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Disaster Victim |
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Federal employee or retiree |
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Injured/Sick |
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Low Income |
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Military (Active) |
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Military Dependent |
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Parent/Caregiver |
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Student |
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Senior/Retiree |
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Veteran |
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Veteran Dependent |
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Unemployed |
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Other, please specify: |
A |
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| EDO11045 |
A |
Other role |
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Text area, no char limit |
Single |
N |
OPS Group |
Other_Role |
| EDO11046 |
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How frequently do you visit this site? |
This is my first time visiting |
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Radio button, one-up vertical |
Single |
Y |
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First Time Visitor |
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Weekly |
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Monthly |
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Several times per year |
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| EDO11047 |
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What was your primary purpose for visiting today? |
To find more information about a specific program |
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Radio button, one-up vertical |
Single |
Y |
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Purpose |
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I need help, but do not know what is available |
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I am looking for free money from the government |
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I want to apply for a specific benefit online |
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I am curious about programs available to me |
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Other |
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| EDO11048 |
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What kind of information were you looking for today? |
Disability benefits |
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Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Kind of Information |
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Financial assistance |
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Grants |
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Housing assistance |
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Loans |
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Lost money |
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Medicaid |
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General program information |
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Other, please specify: |
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| EDO11049 |
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What kind of information were you looking for today? |
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Text area, no char limit |
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N |
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OE_Kind of Information |
| EDO11050 |
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Did you find what you were looking for? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Find |
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Not yet |
B, F |
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| EDO11051 |
B |
What were you looking for? |
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Text area, no char limit |
Single |
N |
Skip Logic Group |
OE_Looking For |
| ACQWro0013993 |
F |
How will you continue your search for benefits, since you did not find what you were looking for?
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Text area, no char limit |
Single |
N |
Skip Logic Group |
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| EDO11052 |
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What is the primary search method you used to search for benefits while on the site? |
Benefit Finder tool |
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Skip Logic Group |
Search Method Used |
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Search (located in the top right corner of the homepage) |
D |
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Browse by category |
D |
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Browse by state |
D |
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Browse by federal agency |
D |
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Other resources |
D |
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| EDO11055 |
D |
Why didn't you use the Benefit Finder tool? |
I did not see it |
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Skip Logic Group |
Why Didn't Use Tool |
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It asked too many questions |
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I had a specific program I was looking for |
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I chose to use one of the other ways to search |
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Other, please specify: |
Z |
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| EDO11056 |
Z |
Why didn't you use the Benefit Finder tool? |
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Text area, no char limit |
Single |
N |
Skip Logic Group |
OE_Didn't Use Tool |
| ACQhar0020677 |
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Did you use any of the following resources to help you on the website today? |
YouTube tutorial video |
X |
Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Resources |
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FAQs |
X |
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Contact Us |
X |
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Advocacy Page |
X |
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Other, please specify |
V, X |
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I did not use any website resources to help me understand the tool. |
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| ACQhar0020678 |
V |
What other resource did you use to help you understand the website? |
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Text area, no char limit |
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N |
Skip Logic Group |
Other_Resources |
| ACQhar0020679 |
X |
Did the resource(s) you used help you understand how to use the website? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Resources Help |
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No |
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| ACQhar0020680 |
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Is there any resource that Benefits.gov could add to provide more guidance to help you using the website? If so, please explain. |
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Text area, no char limit |
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N |
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OE_Guidance |
| ACQWro0013996 |
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Please tell us about your experience with your primary search method. (Please select all that apply.) |
Search results were helpful |
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Checkbox, one-up vertical |
Multi |
Y |
OPS Group |
Search Experience |
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Results were not relevant/not what I wanted |
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Too many results/I needed to refine my search |
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Not enough results |
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Returned NO results |
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Received error message(s) |
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Search speed was too slow |
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I experienced a different search issue (please explain): |
L |
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| ACQWro0013997 |
L |
Other search issue: |
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Text field, <100 char |
Single |
N |
OPS Group |
Other_Search Experience |
| ACQWro0013995 |
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Were you looking for benefits for yourself or someone else? |
I was looking for benefits for myself. |
H |
Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
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I was looking for benefits for someone else. |
H |
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Not Applicable |
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| EDO11057 |
H |
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 |
Eligible for Programs |
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No |
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I don't know yet |
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| EDO11058 |
DD |
Did you successfully email your results? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Email Results Successfully |
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No |
E |
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I did not want to email my results. |
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| EDO11059 |
E |
Why didn't you successfully email your results? |
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Text area, no char limit |
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N |
Skip Logic Group |
OE_Email Results Unsuccessful |
| EDO11071 |
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Did you expect to be eligible for a program that was not on your list? |
|
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Text area, no char limit |
Single |
N |
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OE_Eligible for Other Programs |
| EDO11060 |
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Did the benefit program description give you enough information? |
Yes |
|
Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Description Enough Info |
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No |
F |
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| EDO11061 |
F |
What additional information do you need? |
|
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Text area, no char limit |
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N |
Skip Logic Group |
OE_Additional Information |
| EDO11064 |
|
Do you subscribe to the Benefits.gov Compass eNewsletter? |
Yes |
|
Radio button, one-up vertical |
Single |
Y |
OPS Group |
eNewsletter |
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No |
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No, but I'd like to. My e-mail is |
A |
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| EDO11065 |
A |
Email to subscribe to newsletter |
|
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Text area, no char limit |
Single |
N |
OPS Group |
Email Address for Newsletter |
| MMW2935 |
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Which of the following sources drove you to visit the site today? Please rank the top 3 (Rank 1 is most important).
Rank 1 (Required) |
Message or recommendation from a friend on a social network |
|
Drop down, select one |
Single |
Y |
Rank Group |
SV - Rank 1 |
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Video I saw on YouTube |
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Internet blogs or discussion forums |
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Adjust Template/Style Sheet |
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Advertising on social networks (Facebook, Twitter) |
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Randomize |
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Message directly from the company on a social network |
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Online Pinboard (Pinterest) |
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Mobile phone text messages or alerts |
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Instant Message from a friend or colleague |
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Familiarity with the site |
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Benefits.gov Compass eNewsletter |
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Search engine results |
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Referral from a friend, social services, counselor, or someone else I know |
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Newspaper, TV, Radio |
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Government Website |
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Non-government Website |
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Book |
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Don't know |
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Anchor Answer Choice |
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Other |
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Anchor Answer Choice |
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| MMW2936 |
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Rank 2 (Optional) |
Message or recommendation from a friend on a social network |
|
Drop down, select one |
Single |
N |
Rank Group |
SV - Rank 2 |
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Video I saw on YouTube |
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Internet blogs or discussion forums |
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Adjust Template/Style Sheet |
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Advertising on social networks (Facebook, Twitter) |
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Randomize |
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Message directly from the company on a social network |
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Online Pinboard (Pinterest) |
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Mobile phone text messages or alerts |
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Instant Message from a friend or colleague |
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Familiarity with the site |
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Benefits.gov Compass eNewsletter |
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Search engine results |
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Referral from a friend, social services, counselor, or someone else I know |
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Newspaper, TV, Radio |
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Government Website |
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Non-government Website |
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Book |
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Don't know |
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Anchor Answer Choice |
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Other |
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Anchor Answer Choice |
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| MMW2937 |
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Rank 3 (Optional) |
Message or recommendation from a friend on a social network |
|
Drop down, select one |
Single |
N |
Rank Group |
SV - Rank 3 |
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Video I saw on YouTube |
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Internet blogs or discussion forums |
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Adjust Template/Style Sheet |
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Advertising on social networks (Facebook, Twitter) |
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Randomize |
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Message directly from the company on a social network |
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Online Pinboard (Pinterest) |
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Mobile phone text messages or alerts |
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Instant Message from a friend or colleague |
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Familiarity with the site |
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Benefits.gov Compass eNewsletter |
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Search engine results |
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Referral from a friend, social services, counselor, or someone else I know |
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Newspaper, TV, Radio |
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Government Website |
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Non-government Website |
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Book |
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Don't know |
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Anchor Answer Choice |
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Other |
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Anchor Answer Choice |
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| ACQWro0013994 |
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If you heard about this website from a social network, please specify the site (i.e. Facebook, Twitter, YouTube) |
|
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Text area, no char limit |
|
N |
|
SV - Other Social Network |
| EDO11066 |
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What is your gender? |
Male |
|
Radio button, one-up vertical |
Single |
N |
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Gender |
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Female |
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| ACQSto0005806 |
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How do you describe your race or ethnicity? |
Black or African American |
|
Radio button, one-up vertical |
Single |
N |
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Ethnicity |
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White |
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Asian |
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American Indian or Alaska Native |
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Hispanic |
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Native Hawaiian or Other Pacific Islander (NHOPI) |
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Some other race |
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| EDO11068 |
|
What is your age range? |
Under 18 |
|
Radio button, one-up vertical |
Single |
N |
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Age |
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18-24 |
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25-34 |
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35-44 |
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45-54 |
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55-64 |
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65 and older |
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| EDO11069 |
|
What best describes your income range? |
Under $25,000 |
|
Radio button, one-up vertical |
Single |
N |
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Income |
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$25,000 - $49,999 |
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$50,000 - $74,999 |
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$75,000 or higher |
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| 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 |
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Education |
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High school graduate |
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Some college/vocational school |
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College graduate |
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Some postgraduate school |
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Graduate/professional degree |
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| ACQhar0020681 |
|
Approximately how long were you on the Benefits.gov website? |
Less than 30 minutes |
|
Radio button, one-up vertical |
Single |
Y |
Skip Logic Group |
Time |
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|
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30 minutes - 1 hour |
|
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1 - 2 hours |
Z |
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More than 2 hours |
Z |
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| ACQhar0020682 |
Z |
What could have been done to help you reduce the time you spent on Benefits.gov? |
|
|
Text area, no char limit |
|
N |
Skip Logic Group |
OE_Less Time |
| EDO11072 |
|
If you could make one improvement to the site, what would it be? |
|
|
Text area, no char limit |
Single |
N |
|
OE_Improvement |
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