The ASA-24 Acceptability Questionnaire
(Initial)
The purpose of this questionnaire is to obtain information about your experience with the ASA-24 (the computer tool that you used to tell us what you ate and drank in a 24 hour time frame). Please fill out this questionnaire after you have completed the first ASA recall. Your responses would be greatly appreciated as they will help us learn more about the foods people eat.
1. – Was it easy to find the ASA-24 on the website?
□01 Yes, it was easy to find
□02 No, it was not
2. – Did you have or are you having any of the following technical difficulties in using the ASA24?
(Check ALL boxes that apply)
□01 Wrong computer—website did not work on my computer
□02 Website crashed on me
□03 Got the following message: “Your computer screen’s resolution is not set to
recommended settings of 1024 X 768”
□04 I could not get to the dietary part on my own
□05 I could not navigate the software and make my way through it
□06 Other (please describe) _________________________________________________
________________________________________________________________________
□07 No problems
3. - Was it easy for you to get access to the website with the ASA24?
□01 Yes
□02 No
Why not?
□01 No computer available at that time
□02 Too busy with the household to get on computer
□03 Computer connection too slow
□04 I really have no quiet time to do this
□05 I had to go away from home to get computer access
□06 Other (please describe) ___________________________________
________________________________________________________________
4. – Did you ever quit the ASA24 because it took too long to finish or you could not figure out how to record your food intake? (Check ONE box)
□01 No, I never quit ASA24 before recording all the foods I ate
□02 One time I quit ASA24 before recording all the foods I ate
□03 More than one time I quit ASA24 before recording all the foods I ate
5. – How many times did you go to the ASA24 to enter a single day of food intake?
(Check ONE box)
□01 One Time only- I always completed the ASA24 in the same session as when I started reporting my diet
□02 More than one time- I entered some foods, had to do other things and continued
Later
If “More than one time”-- how many times did you stop and start again
last day of recall? ______
6. – Did the ASA24 include all foods that you wanted to report eating at your most recent recall?
□01 Yes
□02 No
If No, please name as many missing foods as you can think of from your last recall:
_____________________________________________________________________
_____________________________________________________________________
7. – How difficult was it for you to find your foods? (Check ONE box)
□01 Very easy
□02 Easy
□03 Moderate
□04 Somewhat difficult
□05 Difficult
□06 Very difficult
8. – Do you feel you were able to report the foods you ate in enough detail? (Check ONE box)
□01 Yes, there was enough detail on all the foods I ate
□02 Occasionally there was not enough detail on the ASA24 for the foods I ate
□03 Frequently I could not report the foods I ate to the exact detail
Please provide as many food examples or details you have liked to find (this is really helpful to researchers and to other mothers) _____________________________________
__________________________________________________________________________
__________________________________________________________________________
9. – Were you able to report the amount of the foods you ate? (Check ONE box)
□01 Yes, I was always able to report the right amount for foods I ate
□02 Occasionally I could not report the amount of the foods I ate
□03 Frequently I could not report the right amount of the foods I ate
□04 No, I could not report the right amount of the foods I ate
How could this be made easier? _______________________________________
_____________________________________________________________
__________________________________________________________________
10. – Were all the foods named the way you know them?
□01 Yes
□02 No
11. – Are there specific foods or foods names you think should be added to the ASA24?
□01 Yes
If Yes, please list as many foods as you can think of: ________________________________________________________________________
________________________________________________________________________________________________________________________________________________
□02 No
12. - About how long did it take to complete the ASA24?
|___|___|
Minutes
13. - How do you feel about the length of time it took to complete the ASA24? (Check ONE box)
□01 It took a short amount of time
□02 It took just the right amount of time
□03 It took too long
14. - Would you choose an internet-based tool to answer questions about your dietary habits if
you were asked again?
□01 Yes
□02 No
If No, What would you prefer? Please select from the following options (Check ONE box)
□03 Paper and pencil
□04 In person interview
□05 Phone interview
Thank you for your time and participation!
| File Type | application/msword |
| File Title | The ASA24 Acceptability Questionnaire |
| Author | lporras |
| Last Modified By | Nolen Morton |
| File Modified | 2011-06-17 |
| File Created | 2010-10-29 |