724 2013 724 NIAMS Questionnaire

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

2013 724 NIAMS Questionnaire.xlsx

2013 722 CMS NGS DME MAC Questionnaire - 2013 726 MARAD Questionnaire

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf

Overview

Guidelines
Current Model Qsts
Current Custom Qsts
Custom Qsts (1-9-12)
Custom Qsts (9-28-10)
Types


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)







































Basic rules:








































1 This questionnaire has to match the live survey


















2 All changes to the live measure need to be tracked and archived in one document


















3 All CQ change requests have to be submitted using this document









































SRA: 1) marks up changes and submits the entire document to DOT







































DOT: 1) archives change request on separate tab



















2) implements change(s)



















3) updates the document to reflect all implemented changes in the "clean" questionnaire - SRA can send to the client and use for future CQ changes





































4 DOT safeguards correct formats - your next CQ changes have to be submitted using one survey document with appropriate color-coding






































































































Sheet 2: Current Model Qsts

Model Instance Name:




NIAMS Survey




MID: pNdwFkVhhx9dMQUowQBVVw==



Date: 8/8//2008







NIAMS Survey MODEL QUESTION LIST
Model questions utilize the ACSI methodology to determine scores and impacts

ELEMENTS (drivers of satisfaction)
CUSTOMER SATISFACTION
FUTURE BEHAVIORS







Content (1=Poor, 10=Excellent, Don't Know)
Satisfaction (1=Poor, 10=Excellent)
Likelihood to Return (1=Not Very Likely, 10=Very Likely)
1 Please rate the accuracy of information on this site. 23 What is your overall satisfaction with this site? 26 How likely are you to return to this site?
2 Please rate the quality of information on this site. 24 How well does this site meet your expectations?
Recommend (1=Not Very Likely, 10=Very Likely)
3 Please rate the freshness of content on this site. 25 How does this site compare to your idea of an ideal website? 27 How likely are you to recommend this site to someone else?

Functionality (1=Poor, 10=Excellent, Don't Know)


Primary Resource (1=Not Very Likely, 10=Very Likely)
4 Please rate the usefulness of the services provided on this site.

28 How likely are you to use this site as your primary resource for obtaining information from this organization?
5 Please rate the convenience of the services on this site.



6 Please rate the ability to accomplish what you wanted to on this site.




Look and Feel (1=Poor, 10=Excellent, Don't Know)



7 Please rate the ease of reading this site.



8 Please rate the clarity of site organization.

9 Please rate the clean layout of this site.

Navigation (1=Poor, 10=Excellent, Don't Know)
10 Please rate the degree to which the number of steps it took to get where you want is acceptable.
11 Please rate the ability to find the information you want on this site.



12 Please rate the clarity of site map/directory.



13 Please rate the ease of navigation on this site.




Site Performance (1=Poor, 10=Excellent, Don't Know)



14 Please rate the speed of loading the page on this site.



15 Please rate the consistency of speed on this site.



16 Please rate the reliability of site performance on this site.




Search (1=Poor, 10=Excellent, Don't Know)



23 Please rate the usefulness of search results on this site.



24 Please rate how this site provides comprehensive search results.



25 Please rate the organization of search results for this site.



26 Please rate how the search feature helps you to narrow the results to find the information you want.





Sheet 3: Current Custom Qsts

Model Instance Name:

red & strike-through: DELETE








NIAMS Survey

underlined & italicized: RE-ORDER








MID: pNdwFkVhhx9dMQUowQBVVw==

pink: ADDITION








Date: 3/1/2008 blue + -->: REWORDING





















NIAMS Survey CUSTOM QUESTION LIST


QID Skip Logic Label / question order 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


6139
How frequently do you visit this website? First time
Radio button, one-up vertical Single Y







More than once a day











Daily











About once a week











About once a month











Every 6 months or less








6143
Which of the following best describes your role in coming to the website today? General public
Radio button, one-up vertical Single Y Skip Logic Group






Representative from voluntary organization











Representative from professional organization











Patient











Family member of a patient











Scientist/Researcher











Student











Teacher











Retired











Health professional











Media











Other F







ACQCol0010235 F What other role describes you?

Text field, <100 char Open N Skip Logic Group Other_Role


6140
Which of the following best describes what you are looking for visiting the website today? Health related information A Radio button, one-up vertical Single Y







Patient research registries











Grant information











Contracts information











NIAMS laboratories











Clinical trials/studies with patients











Researcher resources











News and events











Employment opportunities











Information about NIAMS











Links to other organizations











Information in Spanish











Other B







6141 B What other information were you looking for today?

Text field, <100 char Open N




ACQOsl0002004 A What type of health related information were you primarily looking for today? Arthritis/rheumatic diseases
Radio button, one-up vertical Single Y







Bone health and/or diseases











Skin diseases











Muscle injury and/or diseases











Other C







ACQOsl0002005 C What other type of health related information were you looking for?

Text field, <100 char Open N




51948
Did you find what you were looking for? Yes
Dropdown (Select-one) Single Y







No A










Still looking








6142 A What information could you not find?

Text field, <100 char Open N




JDV00081
How do you plan to use the information you find on this site today? To share and discuss with my health care provider
Radio button, one-up vertical Single Y Skip Logic Group






To address personal health issues











To aid others who have health concerns











To pursue a career as a medical researcher











To support new or current research projects











To explore or support business opportunities in the field of biomedical research











To explore what you have to offer (just browsing)











Physicians & other health care providers - improved understanding of basic research concepts and findings for my own clinical research











Physicians & other health care providers - improved understanding of clinical research findings for my patient practice











Other Z







ACQCol0010236 Z How else do you plan to use the information you found on the site?

Text area, no char limit Single N Skip Logic Group Other_Use Info


51949
How did you look for the information today? I used the search function
Radio button, one-up vertical Single Y







I used links from the Home Page











I navigated using the top and left side navigation bars











I got to the page through a link of another site











I had a bookmark on the page I wanted











I was browsing








SAC6668
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





Video I saw on YouTube











Internet blogs or discussion forums



Adjust Template/Style Sheet






Advertising on social networks (Facebook, MySpace, Twitter)



Randomize






Message directly from the company on a social network











Mobile phone text messages or alerts











Instant Message from a friend or colleague











Familiarity with site/company/brand











Promotional email(s) from the agency











Search engine results











Word of mouth recommendation from someone I know











TV, radio, newspaper, or magazine advertising











Internet advertising











Don't know



Anchor Answer Choice






Other



Anchor Answer Choice



SAC6669
Rank 2 (Optional) Message or recommendation from a friend on a social network
Drop down, select one Single N Rank Group SV - Rank 2





Video I saw on YouTube











Internet blogs or discussion forums



Adjust Template/Style Sheet






Advertising on social networks (Facebook, MySpace, Twitter)



Randomize






Message directly from the company on a social network











Mobile phone text messages or alerts











Instant Message from a friend or colleague











Familiarity with site/company/brand











Promotional email(s) from the agency











Search engine results











Word of mouth recommendation from someone I know











TV, radio, newspaper, or magazine advertising











Internet advertising











Don't know



Anchor Answer Choice






Other



Anchor Answer Choice



SAC6670
Rank 3 (Optional) Message or recommendation from a friend on a social network
Drop down, select one Single N Rank Group SV - Rank 3





Video I saw on YouTube











Internet blogs or discussion forums



Adjust Template/Style Sheet






Advertising on social networks (Facebook, MySpace, Twitter)



Randomize






Message directly from the company on a social network











Mobile phone text messages or alerts











Instant Message from a friend or colleague











Familiarity with site/company/brand











Promotional email(s) from the agency











Search engine results











Word of mouth recommendation from someone I know











TV, radio, newspaper, or magazine advertising











Internet advertising











Don't know



Anchor Answer Choice






Other



Anchor Answer Choice



SAC6671
If you heard about this website from a social network, please specify the site (i.e. Facebook, Twitter)

Text area, no char limit
N
SV - Other Social Network


6144
How could we improve our information to best meet your needs?

Text area, no char limit Single N


















Sheet 4: Custom Qsts (1-9-12)

Model Instance Name:

red & strike-through: DELETE








NIAMS Survey

underlined & italicized: RE-ORDER








MID: pNdwFkVhhx9dMQUowQBVVw==

pink: ADDITION








Date: 3/1/2008 blue + -->: REWORDING





















NIAMS Survey CUSTOM QUESTION LIST


QID Skip Logic Label / question order 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


C6139
How frequently do you visit this website? First time
Radio button, one-up vertical Single Y







More than once a day











Daily











About once a week











About once a month











Every 6 months or less








C6143
Which of the following best describes your role in coming to the website today? General public
Radio button, one-up vertical Single Y Skip Logic Group






Representative from voluntary organization











Representative from professional organization











Patient











Family member of a patient











Scientist/Researcher











Student











Teacher











Retired











Health professional











Media











Other F








F What other role describes you?

Text field, <100 char Open N Skip Logic Group Other_Role


C6140
Which of the following best describes what you are looking for visiting the website today? Health related information A Radio button, one-up vertical Single Y







Patient research registries











Grant information











Contracts information











NIAMS laboratories











Clinical trials/studies with patients











Researcher resources











News and events











Employment opportunities











Information about NIAMS











Links to other organizations











Information in Spanish











Other B







C6141 B What other information were you looking for today?

Text field, <100 char Open N




ACQOsl0002004 A What type of health related information were you primarily looking for today? Arthritis/rheumatic diseases
Radio button, one-up vertical Single Y







Bone health and/or diseases











Skin diseases











Muscle injury and/or diseases











Other C







ACQOsl0002005 C What other type of health related information were you looking for?

Text field, <100 char Open N




C51948
Did you find what you were looking for? Yes
Dropdown (Select-one) Single Y







No A










Still looking








C6142 A What information could you not find?

Text field, <100 char Open N




CJDV00081
How do you plan to use the information you find on this site today? To share and discuss with my health care provider
Radio button, one-up vertical Single Y Skip Logic Group






To address personal health issues











To aid others who have health concerns











To pursue a career as a medical researcher











To support new or current research projects











To explore or support business opportunities in the field of biomedical research











To explore what you have to offer (just browsing)











Physicians & other health care providers - improved understanding of basic research concepts and findings for my own clinical research











Physicians & other health care providers - improved understanding of clinical research findings for my patient practice











Other Z








Z How else do you plan to use the information you found on the site?

Text area, no char limit Single N Skip Logic Group Other_Use Info


C51949
How did you look for the information today? I used the search function
Radio button, one-up vertical Single Y







I used links from the Home Page











I navigated using the top and left side navigation bars











I got to the page through a link of another site











I had a bookmark on the page I wanted











I was browsing










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





Video I saw on YouTube











Internet blogs or discussion forums



Adjust Template/Style Sheet






Advertising on social networks (Facebook, MySpace, Twitter)



Randomize






Message directly from the company on a social network











Mobile phone text messages or alerts











Instant Message from a friend or colleague











Familiarity with site/company/brand











Promotional email(s) from the agency











Search engine results











Word of mouth recommendation from someone I know











TV, radio, newspaper, or magazine advertising











Internet advertising











Don't know



Anchor Answer Choice






Other



Anchor Answer Choice





Rank 2 (Optional) Message or recommendation from a friend on a social network
Drop down, select one Single N Rank Group SV - Rank 2





Video I saw on YouTube











Internet blogs or discussion forums



Adjust Template/Style Sheet






Advertising on social networks (Facebook, MySpace, Twitter)



Randomize






Message directly from the company on a social network











Mobile phone text messages or alerts











Instant Message from a friend or colleague











Familiarity with site/company/brand











Promotional email(s) from the agency











Search engine results











Word of mouth recommendation from someone I know











TV, radio, newspaper, or magazine advertising











Internet advertising











Don't know



Anchor Answer Choice






Other



Anchor Answer Choice





Rank 3 (Optional) Message or recommendation from a friend on a social network
Drop down, select one Single N Rank Group SV - Rank 3





Video I saw on YouTube











Internet blogs or discussion forums



Adjust Template/Style Sheet






Advertising on social networks (Facebook, MySpace, Twitter)



Randomize






Message directly from the company on a social network











Mobile phone text messages or alerts











Instant Message from a friend or colleague











Familiarity with site/company/brand











Promotional email(s) from the agency











Search engine results











Word of mouth recommendation from someone I know











TV, radio, newspaper, or magazine advertising











Internet advertising











Don't know



Anchor Answer Choice






Other



Anchor Answer Choice





If you heard about this website from a social network, please specify the site (i.e. Facebook, Twitter)

Text area, no char limit
N
SV - Other Social Network


C6144
How could we improve our information to best meet your needs?

Text area, no char limit Single N


















Sheet 5: Custom Qsts (9-28-10)

Model Instance Name:

red & strike-through: DELETE




NIAMS Survey

underlined & italicized: RE-ORDER




MID: pNdwFkVhhx9dMQUowQBVVw==

pink: ADDITION




Date: 3/1/2008 blue + -->: REWORDING













NIAMS Survey CUSTOM QUESTION LIST
QID Skip Logic Label / question order Question Text Answer Choices
(limited to 50 characters)
Skip to Type (select from list) Single or Multi Required
Y/N
Special Instructions
C6139
How frequently do you visit this website? First time
Radio button, one-up vertical Single Y



More than once a day







Daily







About once a week







About once a month







Every 6 months or less




C6143
Which of the following best describes your role in coming to the website today? General public
Radio button, one-up vertical Single Y



Representative from voluntary organization







Representative from professional organization







Patient







Family member of a patient







Scientist/Researcher







Student







Teacher







Retired







Health professional







Media







Other




C6140
Which of the following best describes what you are looking for visiting the website today? Health related information A Radio button, one-up vertical Single Y



Patient research registries







Grant information







Contracts information







NIAMS laboratories







Clinical trials/studies with patients







Researcher resources







News and events







Employment opportunities







Information about NIAMS







Links to other organizations







Information in Spanish







Other B



C6141 B If you answered Other to the information you were looking for, please, specify:
What other information were you looking for today?


Text field, <100 char Open N
ACQOsl0002004 A What type of health related information were you primarily looking for today? Arthritis/rheumatic diseases
Radio button, one-up vertical Single Y



Bone health and/or diseases







Skin diseases







Muscle injury and/or diseases







Other C



ACQOsl0002005 C What other type of health related information were you looking for?

Text field, <100 char Open N
C51948
Did you find what you were looking for? Yes
Dropdown (Select-one) Single Y



No A






Still looking




C6142 A If you could not find what you were looking for, what was it?
What information could you not find?


Text field, <100 char Open N
CJDV00081
How do you plan to use the information you find on this site today? To share and discuss with my health care provider
Radio button, one-up vertical Single Y



To address personal health issues







To aid others who have health concerns







To pursue a career as a medical researcher







To support new or current research projects







To explore or support business opportunities in the field of biomedical research







To explore what you have to offer (just browsing)







Physicians & other health care providers - improved understanding of basic research concepts and findings for my own clinical research







Physicians & other health care providers - improved understanding of clinical research findings for my patient practice







Other




C51949
How did you look for the information today? I used the search function
Radio button, one-up vertical Single Y



I used links from the Home Page







I navigated using the top and left side navigation bars







I got to the page through a link of another site







I had a bookmark on the page I wanted







I was browsing




C6144
How could we improve our information to best meet your needs?

Text area, no char limit Single N










Sheet 6: Types

Types
Instructions
Text field, <100 char
Randomize
Text area, no char limit

Drop down, select one

Radio button, one-up vertical

Radio button, two-up vertical

Radio button, three-up vertical

Radio button, scale, has don't know

Radion button, scale, no don't know

Checkbox, one-up vertical

Checkbox, two-up vertical

Checkbox, three-up vertical

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