Formative - Developmental

Provider-Based Sampling Feasibility Study for the Vanguard (Pilot) Study and Data Collection Updates for the National Children's Study (NICHD)

Burden 38 Initial Acceptability Questionnaire 20110621 - LOI2-QUEX-14

Formative - Developmental

OMB: 0925-0593

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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 Typeapplication/msword
File TitleThe ASA24 Acceptability Questionnaire
Authorlporras
Last Modified ByNolen Morton
File Modified2011-06-17
File Created2010-10-29

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