| Model Instance Name: |
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| Girls Health V2 |
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| MID: |
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5RhJk5lpgxotMIk9FEJ9IQ4C |
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| Partitioned (Y/N)? Y |
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| FPI Included(Y/N)?N |
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| 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. |
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| Date: 10-24-2013 |
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Fill In Date |
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| Girls Health V2 |
| 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 |
FPI |
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MQ Label |
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MQ Label |
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MQ Label |
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Y? |
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Site Information (1=Poor, 10=Excellent, Don't Know) |
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Satisfaction |
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Return (1=Very Unlikely, 10=Very Likely) |
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Site Information - Thoroughness |
Please rate the thoroughness of information provided on this site. |
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Satisfaction - Overall |
What is your overall satisfaction with this site?
(1=Very Dissatisfied, 10=Very Satisfied) |
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Return |
How likely are you to return to this site? |
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Site Information - Understandable |
Please rate how understandable this site’s information is. |
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Satisfaction - Expectations |
How well does this site meet your expectations?
(1=Falls Short, 10=Exceeds) |
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Recommend (1=Very Unlikely, 10=Very Likely) |
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Site Information - Answers |
Please rate how well the site’s information provides answers to your questions. |
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Satisfaction - Ideal |
How does this site compare to your idea of an ideal website?
(1=Not Very Close, 10=Very Close) |
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Recommend |
How likely are you to say good things about this website in the next 30 days? |
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Site Performance (1=Poor, 10=Excellent, Don't Know) |
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Primary Resource (1=Very Unlikely, 10=Very Likely) |
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Site Performance - Loading |
Please rate how quickly pages load on this site. |
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Primary Resource |
How likely are you to use this website more than other websites for health information about girls in the next 30 days? |
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Site Performance - Consistency |
Please rate the consistency of speed from page to page on this site. |
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Visit Social Presence (1=Very Unlikely, 10=Very Likely) |
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Site Performance - Errors |
Please rate the ability to load pages without getting error messages on this site. |
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Visit Social Presence |
How likely are you to visit this agency's Facebook presence in the next 30 days? |
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Functionality (1=Poor, 10=Excellent, Don't Know) |
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Functionality - Usefulness |
Please rate the usefulness of the features provided on this site (Quizzes, Spotlight On, Free Stuff, Create a Journal). |
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Functionality - Convenient |
Please rate the convenient placement of the features on this site (Quizzes, Spotlight On, Free Stuff, Create a Journal). |
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Functionality - Variety |
Please rate the variety of features on this site (Quizzes, Spotlight On, Free Stuff, Create a Journal). |
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Look and Feel (1=Poor, 10=Excellent, Don't Know) |
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Look and Feel - Appeal |
Please rate the visual appeal of this site. |
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Look and Feel - Balance |
Please rate the balance of graphics and text on this site. |
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Look and Feel - Readability |
Please rate the readability of the pages on this site. |
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Navigation (1=Poor, 10=Excellent, Don't Know) |
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Navigation - Organized |
Please rate how well the site is organized. |
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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. |
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| #REF! |
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red & strike-through: DELETE |
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| #REF! |
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underlined & italicized: RE-ORDER |
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| #REF! |
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pink: ADDITION |
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| Date: |
3/1/2008 |
blue + -->: REWORDING |
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| #REF! |
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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. Leave blank if you want DOT to fill this part out.
CQ Label |
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| MHM0583 |
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How often do you visit this site? |
Daily or almost daily |
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Drop down, select one |
Single |
Y |
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Frequency of Visit |
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Two to three times a week |
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About once a week |
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Two to three times a month |
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About once a month |
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Once every two or three months |
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Every 6 months or less |
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First time |
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| MHM0585 |
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What were you mostly looking for on this website? |
Learn about general girls’ health and the body |
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Radio button, one-up vertical |
S |
Y |
Randomize |
Reason for visit |
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Learn about fitness and nutrition |
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Learn about relationships |
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Learn about drugs, alcohol, and smoking |
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Games/quizzes/activities |
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Health terms glossary |
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Girls’ health publications to order or download and print |
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Just browsing/nothing specific |
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Other |
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Anchor Answer Choice |
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| MHM0586 |
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Did you find the information you were looking for today? |
Yes |
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Drop down, select one |
S |
Y |
Skip Logic Group* |
Found Info |
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Kind of/partially |
A |
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Not yet/still looking |
A |
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No |
A |
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I wasn't looking for anything in particular / I'm just browsing |
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| MHM0587 |
A |
In which topic areas did you have difficulty finding information? |
Menstrual cycle/period |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Search Difficulty |
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Bullying |
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Body/body changes |
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Fitness/exercise |
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Randomize |
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Drugs, Alcohol and smoking |
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Friend relationships |
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Dating relationships |
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Puberty |
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Depression |
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Nutrition |
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Teen Survival Guide |
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Your Feelings |
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Safety |
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Illness and disability |
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Your Future |
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Environmental health |
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Topics/resources for educators |
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Topics/resources for parents/caregiver |
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Other |
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Anchor Answer Choice |
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| MHM0588 |
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If you have a question about health, where do you usually get your information? |
Parent |
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Radio button, one-up vertical |
S |
Y |
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Health Information Source |
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Teacher |
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School Counselor |
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Books |
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Randomize |
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Brochures |
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Friends and relatives |
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Doctor |
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Internet |
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Magazines |
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Newspapers |
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Professional journals |
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Television |
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Other |
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Anchor Answer Choice |
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| MHM0584 |
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Which of the following best describes you? |
Student 10 years old and under |
A, B |
Radio button, one-up vertical |
S |
Y |
Skip Logic Group* |
Age |
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Student 11 to 13 years old |
A, B |
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Student 14 to 16 years old |
A, B |
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Young adult 17 to 19 years old |
A, B |
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Young adult 20 years and older |
A, B |
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Parent/caregiver |
C, D |
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Teacher/educator |
C, D |
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Other |
C, D |
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| MHM0589 |
A |
What do you like most about the site? |
Colors |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Like Most |
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Useful information |
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Topics |
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Gives you facts that you need |
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Randomize |
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Dedicated to girls |
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Range of health information |
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The look and feel
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Appropriate for girls my age |
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Other |
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Anchor Answer Choice |
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| MHM0590 |
B |
What do you like least about the site? |
Colors |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Like Least |
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Does not give you useful information |
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Randomize |
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Topics |
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Does not give you facts that you need |
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Dedicated to girls |
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Range of health information |
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The look and feel |
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Not appropriate for girls my age |
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Other |
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Anchor Answer Choice |
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| MAD0046565 |
C |
What do you like most about the site? |
Colors |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Like Most_Non-Girl |
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Useful information |
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Topics |
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Gives you facts that you need |
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Randomize |
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Dedicated to girls |
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Range of health information |
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The look and feel |
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Appropriate for girls I care for or work with |
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Other |
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Anchor Answer Choice |
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| MAD0046564 |
D |
What do you like least about the site? |
Colors |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Like Least_Non-Girl |
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Does not give you useful information |
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Randomize |
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Topics |
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Does not give you facts that you need |
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Dedicated to girls |
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Range of health information |
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The look and feel |
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Not appropriate for girls I care for or work with |
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Other |
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Anchor Answer Choice |
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| MAD0046566 |
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What would you like to see more of on the site? |
Quizzes |
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Checkbox, one-up vertical |
M |
Y |
Randomize |
More Site Features |
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Videos |
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Games |
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Connection with social media |
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Downloadable apps |
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Printable handouts |
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Polls/surveys |
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Message boards/forums |
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Other |
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Anchor Answer Choice |
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| #REF! |
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red & strike-through: DELETE |
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| #REF! |
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underlined & italicized: RE-ORDER |
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| #REF! |
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pink: ADDITION |
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| Date: |
3/1/2008 |
blue + -->: REWORDING |
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| #REF! |
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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. Leave blank if you want DOT to fill this part out.
CQ Label |
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| MHM0583 |
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How often do you visit this site? |
Daily or almost daily |
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Drop down, select one |
Single |
Y |
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Frequency of Visit |
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Two to three times a week |
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About once a week |
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Two to three times a month |
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About once a month |
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Once every two or three months |
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Every 6 months or less |
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First time |
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| MHM0585 |
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What were you mostly looking for on this website? |
Learn about general girls’ health and the body |
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Randomize |
Reason for visit |
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Learn about fitness and nutrition |
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Learn about relationships |
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Learn about drugs, alcohol, and smoking |
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Games/quizzes/activities |
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Health terms glossary |
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Girls’ health publications to order or download and print |
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Just browsing/nothing specific |
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Other |
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Anchor Answer Choice |
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| MHM0586 |
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Did you find the information you were looking for today? |
Yes |
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Drop down, select one |
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Y |
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Found Info |
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Kind of/partially |
A |
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Not yet/still looking |
A |
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No |
A |
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I wasn't looking for anything in particular / I'm just browsing |
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| MHM0587 |
A |
In which topic areas did you have difficulty finding information? |
Menstrual cycle/period |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Search Difficulty |
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Bullying |
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Body/body changes |
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Fitness/exercise |
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Randomize |
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Drugs, Alcohol and smoking |
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Friend relationships |
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Dating relationships |
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Puberty |
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Depression |
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Nutrition |
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Teen Survival Guide |
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Your Feelings |
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Safety |
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Illness and disability |
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Your Future |
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Environmental health |
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Topics/resources for educators |
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Topics/resources for parents/caregiver |
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Other |
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Anchor Answer Choice |
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| MHM0588 |
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If you have a question about health, where do you usually get your information? |
Parent |
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Health Information Source |
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Teacher |
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School Counselor |
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Books |
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Randomize |
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Brochures |
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Friends and relatives |
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Doctor |
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Internet |
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Magazines |
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Newspapers |
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Professional journals |
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Television |
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Other |
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Anchor Answer Choice |
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| MHM0584 |
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Which of the following best describes you? |
Student 10 years old and under |
A, B |
Radio button, one-up vertical |
S |
Y |
Skip Logic Group* |
Age |
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Student 11 to 13 years old |
A, B |
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Student 14 to 16 years old |
A, B |
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Young adult 17 to 19 years old |
A, B |
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Young adult 20 years and older |
A, B |
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Parent/caregiver |
C, D |
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Teacher/educator |
C, D |
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Other |
C, D |
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| MHM0589 |
A |
What do you like most about the site? |
Colors |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Like Most |
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Useful information |
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Topics |
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Gives you facts that you need |
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Randomize |
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Dedicated to girls |
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Range of health information |
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The look and feel
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Appropriate for girls my age |
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Other |
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Anchor Answer Choice |
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| MHM0590 |
B |
What do you like least about the site? |
Colors |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Like Least |
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Does not give you useful information |
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Randomize |
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Topics |
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Does not give you facts that you need |
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Dedicated to girls |
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Range of health information |
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The look and feel |
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Not appropriate for girls my age |
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Other |
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Anchor Answer Choice |
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C |
What do you like most about the site? |
Colors |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Like Most_Non-Girl |
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Useful information |
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Topics |
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Gives you facts that you need |
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Randomize |
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Dedicated to girls |
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Range of health information |
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The look and feel |
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Appropriate for girls I care for or work with |
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Other |
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Anchor Answer Choice |
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D |
What do you like least about the site? |
Colors |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group* |
Like Least_Non-Girl |
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Does not give you useful information |
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Randomize |
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Topics |
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Does not give you facts that you need |
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Dedicated to girls |
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Range of health information |
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The look and feel |
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Not appropriate for girls I care for or work with |
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Other |
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Anchor Answer Choice |
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What would you like to see more of on the site? |
Quizzes |
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Checkbox, one-up vertical |
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Y |
Randomize |
More Site Features |
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Videos |
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Games |
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Connection with social media |
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Downloadable apps |
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Printable handouts |
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Polls/surveys |
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Message boards/forums |
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Other |
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Anchor Answer Choice |
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