Form 871 2014 871 CG Questionnaire

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Overview

Welcome and Thank You Text
Current Model Qsts
Current CQs

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Sheet 1: Welcome and Thank You Text

Model Instance Name:
The Community Guide
MID:	0
Date:	9/30/2014
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
	Thank you for visiting The Community Guide website. 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.
					Thank You Text Example
	DEFAULT Thank You Text
	Thank you for taking our survey - and for helping us serve you better. We appreciate your input!
	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 2: Current Model Qsts

Model Instance Name:
The Community Guide
MID:
Partitioned (Y/N)? Y
FPI Included(Y/N)? N
Date: 09/30/2014
The Community Guide
Model questions utilize the ForeSee CXA methodology to determine scores and impacts
		ELEMENTS (drivers of satisfaction)			CUSTOMER SATISFACTION			FUTURE BEHAVIORS
	MQ Label			MQ Label			MQ Label
		Navigation (1=Poor, 10=Excellent, Don't Know)			Satisfaction			Return (1=Very Unlikely, 10=Very Likely)
1	Navigation - Organized	Please rate how well the site is organized.	16	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 in the future?
2	Navigation - Options	Please rate the options available for navigating this site.	17	Satisfaction - Expectations	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)			Recommend (1=Very Unlikely, 10=Very Likely)
3	Navigation - Layout	Please rate how well the site layout helps you find what you need.	18	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?
		Site Performance (1=Poor, 10=Excellent, Don't Know)						Primary Resource (1=Very Unlikely, 10=Very Likely)
4	Site Performance - Loading	Please rate how quickly pages load on this site.					Primary Resource	How likely are you to use this site as your primary resource for health information, guidelines and recommendations?
5	Site Performance - Consistency	Please rate the consistency of speed from page to page on this site.
6	Site Performance -Errors	Please rate the ability to load pages without getting error messages on this site.
		Site Information (1=Poor, 10=Excellent, Don't Know)
7	Site Information - Thoroughness	Please rate the thoroughness of information provided on this site.
8	Site Information - Understandable	Please rate how understandable this site’s information is.
9	Site Information - Answers	Please rate how well the site’s information provides answers to your questions.
		Look and Feel (1=Poor, 10=Excellent, Don't Know)
10	Look and Feel - Appeal	Please rate the visual appeal of this site.
11	Look and Feel - Balance	Please rate the balance of graphics and text on this site.
12	Look and Feel - Readability	Please rate the readability of the pages on this site.
		Product Browsing (1=Poor, 10=Excellent, Don't Know)
13	Information Browsing - Sort	Please rate the ability to sort information by criteria that are important to you on this site.
14	Information Browsing - Narrow	Please rate the ability to narrow choices to find the information you are looking for on this site.
15	Information Browsing - Features	Please rate how well the features on the site help you find the information you need.

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Sheet 3: Current CQs

Model Instance Name:				red & strike-through: DELETE
The Community Guide				underlined & italicized: RE-ORDER
MID:				pink: ADDITION
Date: 10/15/2014				blue + -->: REWORDING
The Community Guide CUSTOM QUESTION LIST
QID	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 use/visit The Community Guide website?	Daily		Drop down, select one	S	Y		Frequency
			Weekly
			Monthly
			A couple times a year
			About once a year
			This is my first time
		Which of the following best describes you?	Student		Drop down, select one	S	Y	Skip Logic Group*	Role
			Volunteer
			Teacher/Instructor
			Lay Health Worker/CHW/Promoter
			Health Educator/Health Promotion Specialist
			Financial/Budget Manager
			Policy Maker/Analyst/Advisor
			Program Planner/Manager/Project Officer
			Social Worker
			Researcher
			Clinical Professional
			Other, please specify:	A
	A	Please specify other role.			Text area, no char limit		N	Skip Logic Group*	Other role
		Which of the following best describes where you work?	Academic Institution		Drop down, select one	S	Y	Skip Logic Group*	Work
			Advocacy Organization
			Business/For Profit
			Community-based organization/Community Coalition
			County or City Health Department
			County/Local Government Agency
			Faith-based Organization
			Federal Government Agency
			Foundation
			Hospital, Clinics, Health Care Systems
			Local Board of Health
			Managed Care Organization/HMO
			Professional Organization
			State Government Agency
			State Health Department
			Territorial Health Department
			Tribal Health Department
			Other, please specify:	A
	A	Please list where you work.			Text area, no char limit		N	Skip Logic Group*	Other work
		Which category best describes the health topics you were looking for?	Adolescent Health		Checkbox, one-up vertical	M	Y	Skip Logic Group*	Topic looking for
			Alcohol - Excessive Consumption
			Asthma
			Birth Defects
			Cancer
			Cardiovascular Disease
			Diabetes
			Emergency Preparedness
			Health Communication
			Health Equity
			HIV/AIDS, STIs, Pregnancy
			Mental Health
			Motor Vehicle Injury
			Nutrition
			Obesity
			Oral Health
			Physical Activity
			Tobacco
			Vaccination
			Violence
			Worksite
			I was just browsing the site
			Other, please specify	A
	A	Please specify other health topic you were looking for.			Text area, no char limit		N	Skip Logic Group*	Other topic
		Which of the following best describes the types of information you were looking for?	General information about the health topic selected		Checkbox, one-up vertical	M	Y	Skip Logic Group*	Information looking for
			Guidelines and recommendations for public health professionals
			Data and statistics
			Scientific research, articles, publications, and journals
			Guidelines and recommendations for healthcare providers
			Training for healthcare providers, researchers, public health professionals, etc.
			Educational materials
			Campaigns and initiatives
			Information about the Community Preventive Services Task Force
			Tools and resources
			Print materials (fact sheets, flyers, stories, etc.)
			Multimedia products (podcasts, videos, widgets, etc.)
			Information about the Community Guide Branch of CDC
			Information on methods for systematic reviews
			Information on content syndication
			Info graphics
			Other, please specify	A
	A	Please specify other type of information you were looking for.			Text area, no char limit		N	Skip Logic Group*	Other information
		How did you look for information on The Community Guide website today?	Site's search box	A	Drop down, select one	S	Y	Skip Logic Group*	How look for information
			Topics Section	C
			Links on the pages	C
			Combination of search and navigation	A,C
			I was just browsing the site	C
	A	Please tell us about your experience with the site's search feature today. (Please select all that apply.)	Search results were helpful		Checkbox, one-up vertical	M	Y	Skip Logic Group*	Search experience
			Results were not relevant/not what I wanted
			Too many results/I needed to refine my search
			Not enough results
			Returned NO results
			Received error message(s)
			Search speed was too slow
			I experienced a different search issue (please explain):	B
	B	Please specify search difficulty encountered.			Text area, no char limit		N	Skip Logic Group*	Other search experience
	C	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	M	Y	Skip Logic Group*	Navigation experience
			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:	D
	D	Please specify navigation difficulty encountered.			Text area, no char limit		N	Skip Logic Group*	Other nav experience
		Were you able to find what you were looking for?	Yes		Drop down, select one	S	Y	Skip Logic Group*	Able to find
			Partially
			No	A
	A	What were you trying to find? Please be as specific as possible.			Text area, no char limit		N	Skip Logic Group*	Information not found
		I'm planning to use the information I found today:	For my own health or my family's health		Radio button, one-up vertical	S	Y	Skip Logic Group*	Planning
			For my friend or family member (not living in my household)
			For a physician's office/hospital
			For a patient or client
			For a public health agency
			For a research institution
			For a business / workplace
			For an educational institution or teaching purposes
			For a school / class project
			For a news report or article
			Other, please specify:	A
	A	Please specify how you will use the information you are looking for today:			Text area, no char limit		N	Skip Logic Group*	Other planning
		If you could suggest one change to improve the Community Guide website, what recommendation would you make?			Text area, no char limit		N		Improvement
		Which of the following sources drove you to visit the site today? (Please rank the top 3, with number 1 being the most important) Rank 1 (Required)	Message directly from CDC on Facebook or Twitter		Drop down, select one	S	Y	Rank Group	SV - Rank 1
			Message or recommendation from a friend on Facebook or Twitter					Adjust Template/Style Sheet
			Video I saw on CDC's YouTube Page
			Advertisement on Facebook, or Twitter					Randomize
			CDC's mobile site
			Mobile phone text messages or alerts
			Mobile application or "app"
			Scanned a QR code
			Instant message from someone
			Familiarity with site/agency
			Email updates from the site
			Website is bookmarked
			Search engine results
			Word of mouth recommendation from someone I know
			TV, radio, newspaper, or magazine advertising
			Advertisement on another website
			Don't know					Anchor Answer Choice
			Other
		Rank 2 (Optional)	Message directly from CDC on Facebook or Twitter		Drop down, select one	S	N	Rank Group	SV - Rank 2
			Message or recommendation from a friend on Facebook or Twitter					Adjust Template/Style Sheet
			Video I saw on CDC's YouTube Page
			Advertisement on Facebook, or Twitter					Randomize
			CDC's mobile site
			Mobile phone text messages or alerts
			Mobile application or "app"
			Scanned a QR code
			Instant message from someone
			Familiarity with site/agency
			Email updates from the site
			Website is bookmarked
			Search engine results
			Word of mouth recommendation from someone I know
			TV, radio, newspaper, or magazine advertising
			Advertisement on another website
			Don't know					Anchor Answer Choice
			Other
		Rank 3 (Optional)	Message directly from CDC on Facebook or Twitter		Drop down, select one	S	N	Rank Group	SV - Rank 3
			Message or recommendation from a friend on Facebook or Twitter					Adjust Template/Style Sheet
			Video I saw on CDC's YouTube Page
			Advertisement on Facebook, or Twitter					Randomize
			CDC's mobile site
			Mobile phone text messages or alerts
			Mobile application or "app"
			Scanned a QR code
			Instant message from someone
			Familiarity with site/agency
			Email updates from the site
			Website is bookmarked
			Search engine results
			Word of mouth recommendation from someone I know
			TV, radio, newspaper, or magazine advertising
			Advertisement on another website
			Don't know					Anchor Answer Choice
			Other