Form 729 2013 729 Girls Health V2 10-31-13

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Overview

Welcome and Thank You Text
Current Model Qsts
Current Custom Qsts

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Sheet 1: Welcome and Thank You Text

Model Instance Name:
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
	Welcome Text
	Welcome to girlshealth.gov. We value your feedback! Would you help us make our website better? (If yes, survey will minimize and pop up upon exit/close.) Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.
					Thank You Text Example
	DEFAULT Thank You Text
	Thank you for your time in completing this survey. Your input is very valuable to us and we will take it into consideration.

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Sheet 2: Current Model Qsts

Model Instance Name:
Girls Health V2
MID:		Existing Measure - Please fill in; New Measure - DOT will fill in
Partitioned (Y/N)? Y
FPI Included(Y/N)?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: 10-24-2013		Fill In Date
Girls Health V2
Model questions utilize the ACSI methodology to determine scores and impacts
		ELEMENTS (drivers of satisfaction)			CUSTOMER SATISFACTION			FUTURE BEHAVIORS	FPI
	MQ Label			MQ Label			MQ Label		Y?
		Site Information (1=Poor, 10=Excellent, Don't Know)			Satisfaction			Return (1=Very Unlikely, 10=Very Likely)
	Site Information - Thoroughness	Please rate the thoroughness of information provided 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?
	Site Information - Understandable	Please rate how understandable this site’s information is.		Satisfaction - Expectations	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)			Recommend (1=Very Unlikely, 10=Very Likely)
	Site Information - Answers	Please rate how well the site’s information provides answers to your questions.		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 say good things about this website in the next 30 days?
		Site Performance (1=Poor, 10=Excellent, Don't Know)						Primary Resource (1=Very Unlikely, 10=Very Likely)
	Site Performance - Loading	Please rate how quickly pages load on this site.					Primary Resource	How likely are you to use this website more than other websites for health information about girls in the next 30 days?
	Site Performance - Consistency	Please rate the consistency of speed from page to page on this site.						Visit Social Presence (1=Very Unlikely, 10=Very Likely)
	Site Performance - Errors	Please rate the ability to load pages without getting error messages on this site.					Visit Social Presence	How likely are you to visit this agency's Facebook presence in the next 30 days?
		Functionality (1=Poor, 10=Excellent, Don't Know)
	Functionality - Usefulness	Please rate the usefulness of the features provided on this site (Quizzes, Spotlight On, Free Stuff, Create a Journal).
	Functionality - Convenient	Please rate the convenient placement of the features on this site (Quizzes, Spotlight On, Free Stuff, Create a Journal).
	Functionality - Variety	Please rate the variety of features on this site (Quizzes, Spotlight On, Free Stuff, Create a Journal).
		Look and Feel (1=Poor, 10=Excellent, Don't Know)
	Look and Feel - Appeal	Please rate the visual appeal of this site.
	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.
	Navigation - Layout	Please rate how well the site layout helps you find what you are looking for.

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Sheet 3: Current Custom Qsts

#REF!

red & strike-through: DELETE

#REF!

underlined & italicized: RE-ORDER

#REF!

pink: ADDITION

Date:

3/1/2008

blue + -->: REWORDING

#REF!

QID (Group ID)

FPI Y?

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. Leave blank if you want DOT to fill this part out. CQ Label

How frequently do you visit this site?

Daily or almost daily

Drop down, select one

Single

Y

Two to three times a week

Frequency of Visit

About once a week

Two to three times a month

About once a month

Once every two or three months

Every 6 months or less

First time

Which of the following best describes you?

Student 10 years old and under

Radio button, one-up vertical

S

Y

Age

Student 11 to 13 years old

Student 14 to 16 years old

Student 17 to 19 years old

Student 20 years and older

Parent/caregiver

Teacher/educator

Other

What were you primarily looking for on this website?

Learn about general girls’ health and the body

Radio button, one-up vertical

S

Y

Reason for visit

Learn about fitness and nutrition

Learn about relationships

Randomize

Learn about drugs, alcohol, and smoking

Games/quizzes/activities

Health terms glossary

Girls’ health publications to order or download and print

Just browsing/nothing specific

Other

Anchor Answer Choice

Did you find the information you were looking for today?

Yes

Drop down, select one

Found Info

Not yet

A

S

Y

No

A

A

In which topic areas did you have difficulty finding information?

Menstrual cycle/period

Checkbox, one-up vertical

M

Y

Health Information Source

Bullying

Body/body changes

Fitness/exercise

Randomize

Drugs, Alcohol and smoking

Friend relationships

Dating relationships

Puberty

Depression

Nutrition

Teen Survival Guide

Your Feelings

Safety

Illness and disability

Other

Anchor Answer Choice

If you have a question about health, where do you usually get your information?

Parent

Radio button, one-up vertical

S

Y

Health Information Source

Teacher

School Counselor

Books

Randomize

Brochures

Friends and relatives

Doctor

Internet

Magazines

Newspapers

Professional journals

Television

Other

Anchor Answer Choice

What do you like most about the site?

Colors

Checkbox, one-up vertical

M

Y

Health Information Source

Useful information

Topics

Gives you facts that you need

Randomize

Dedicated to girls

Range of health information

The teen and tween look

Appropriate for girls my age

Other

Anchor Answer Choice

What do you like least about the site?

Colors

Checkbox, one-up vertical

M

Y

Like Least

Does not give you useful information

Randomize

Topics

Does not give you facts that you need

Dedicated to girls

Range of health information

The teen and tween look

Not appropriate for girls my age

Other

Anchor Answer Choice