HRRET POSTTEST Survey - WORD

Form Approved

OMB No. 0920-0840

Expiration Date 02/29/2016

Attachment 3b
Posttest Web-based Survey

Pilot Test Study for the HIV Risk Reduction Educational Tool

Public reporting burden of this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0840).

Consent

Introduction and Purpose:

You have been asked to take part in a research study. The purpose of this study is to learn your opinions about HIVprevention materials developed by the Centers for Disease Control and Prevention (CDC). RTI International, a nonprofit research organization in North Carolina, is conducting this CDC-sponsored study.

Procedures:

You will be asked to complete a brief survey so that we can learn more about you. After you complete the survey, you will be asked to review an online HIV prevention tool developed by CDC. You will then be asked to complete another brief survey so that we can learn your opinions about the online tool. The study will take about 45 minutes to complete.

Risks/Discomforts and Right to Refuse or Withdraw:

You might feel embarrassed or upset by some of the survey questions that ask about sexual behavior and alcohol and drug use or by the content of the tool. You can decline to answer any questions for any reason. You can also stop reviewing the tool (click the “Quit Exploring” button) or participating in the study (click the “Quit Study” button) at any time.

Benefits:

There is no direct benefit to you for being in this study. However, you may learn more about ways to prevent getting or giving someone else HIV.

Privacy:

Your responses will be kept private to the extent allowable by law. The survey does ask you for your email address. The survey vendor will send you a reminder email to complete the study if you stop participating before you finish the posttest survey. The survey vendor will also record participants’ IP addresses to help make sure people do not complete the study more than once. Email and IP addresses will be destroyed after all of the data are collected.

Only the survey vendor will know your email and IP address; neither RTI nor CDC will have access to this information. This means that RTI and CDC cannot link your survey answers to you as an individual. To help protect your privacy, we suggest that you participate in the study in a private location – either in your home and/or in a room with a door. Please also close your browser window once you are finished.

Token of Appreciation:

We will give you a $25 Amazon gift card as a token of appreciation. Instructions for redeeming the gift card will be provided after you complete the second survey.

Persons to Contact:

If you have questions about the study, you can call Jennifer Uhrig at 1-800-334-8571, extension 3311. She can be reached between 9 a.m. and 5 p.m., Eastern Standard Time, Monday–Friday. If you have questions about your rights as a participant, you can call RTI’s Office of Research Protection toll-free at 1-866-214-2043. If you have any questions about HIV, including how to locate services and ways to protect yourself, please contact CDC Info (http://www.cdc.gov/cdc-info/). To find local HIV testing sites, health centers, and other service providers, you can also visit AIDS.gov (http://locator.aids.gov/).

Section A: Materials Receptivity/Satisfaction

Now we would like to get your opinions about the materials you reviewed.

1. On the landing page, was there was a box in the middle of the screen with images that rotated?

₁ Yes

₂ No

₃ Don’t know

₉ Prefer not to answer

2. Were you given an option to customize the information you saw by answering a few questions about yourself?

₁ Yes

₂ No

₃ Don’t know

₉ Prefer not to answer

3. Did you choose to customize the information you saw?

₁ Yes

₂ No

₃ Don’t know

₉ Prefer not to answer

4. How hard or easy was it to customize the information?

₁ Very hard

₂ Hard

₁ Neither hard nor easy

₂ Easy

₃ Very easy

₉ Prefer not to answer

5. Please indicate how much you agree or disagree with the following statements.

	Strongly Disagree	Disagree	Neither Disagree nor Agree	Agree	Strongly Agree	Refuse to Answer
a. Overall, I liked the tool.	1	2	3	4	5	6
b. The information was easy to understand.	1	2	3	4	5	6
c. There was too much information.	1	2	3	4	5	6
d. The tool was easy to navigate.	1	2	3	4	5	6
e. I liked the way the information was organized.	1	2	3	4	5	6
f. I was interested in the topics.	1	2	3	4	5	6
g. It was hard to find the information I was interested in.	1	2	3	4	5	6
h. The information upset me.	1	2	3	4	5	6
i. The tool has important information for people like me.	1	2	3	4	5	6
j. The tool stereotypes certain people.	1	2	3	4	5	6
k. The tool was offensive. What, if anything, was offensive?	1	2	3	4	5	6
l. I trust the information in the tool.	1	2	3	4	5	6
m. I believe the information in the tool.	1	2	3	4	5	6
n. The information was convincing.	1	2	3	4	5	6
o. The tool said something important to me.	1	2	3	4	5	6
p. I learned something new from the tool.	1	2	3	4	5	6
q. The information in the tool was confusing. What, if anything, was confusing?	1	2	3	4	5	6
r. The information in the tool speaks to me.	1	2	3	4	5	6
s. The tool gave me good reasons to take responsibility for my health.	1	2	3	4	5	6
t. The tool gave me good reasons to take responsibility for my sex partners’ health.	1	2	3	4	5	6
u. The tool gave me good reasons to talk to my sex partners about ways we can prevent HIV.	1	2	3	4	5	6
v. The tool gave me good reasons to get tested for HIV.	1	2	3	4	5	6
w. The tool gave me good reasons to take my HIV medications consistently and correctly.	1	2	3	4	5	6
x. By doing the behaviors suggested in the tool, I can protect myself from getting or transmitting HIV.	1	2	3	4	5	6
y. There are many things I can do to prevent getting or transmitting HIV.	1	2	3	4	5	6
a. The information in the tool was persuasive.	1	2	3	4	5	6
aa. The information in the tool was motivating.	1	2	3	4	5	6
bb. The tool was boring.	1	2	3	4	5	6
cc. There were too many hyperlinks in the tool.	1	2	3	4	5	6
dd. I found the information I needed.	1	2	3	4	5	6
ee. I would recommend the tool to others.	1	2	3	4	5	6
ff. The tool used a fresh, new approach to communicate information about HIV.	1	2	3	4	5	6
gg. I would share the tool with others.	1	2	3	4	5	6
hh. The tool was made for a person like me.	1	2	3	4	5	6
ii. I would look at the tool again if I wanted more information.	1	2	3	4	5	6
jj. I liked the way the tool looks.	1	2	3	4	5	6
kk. I liked the colors, images and graphics.	1	2	3	4	5	6
ll. I do not like the tool.	1	2	3	4	5	6
mm. The tool grabbed my attention.	1	2	3	4	5	6
nn. Real people would look like the people in the tool.	1	2	3	4	5	6
oo. The people in the tool were more similar to me than different.	1	2	3	4	5	6
pp. I can do what the tool suggests.	1	2	3	4	5	6
qq. I will do what the tool suggests.	1	2	3	4	5	6
rr. The tool was fun to use.	1	2	3	4	5	6
ss. There was information in the tool about HIV risk that I had never seen before.	1	2	3	4	5	6
tt. There was information in the tool about HIV prevention strategies that I had never seen before.	1	2	3	4	5	6

6. How could the tool be changed to make it better?________ [no forced response]

7. Please indicate how much you agree or disagree with the following statements.

The tool …	Strongly Disagree	Disagree	Neither Disagree nor Agree	Agree	Strongly Agree	Refuse to Answer
a. Helped me recognize that the sexual behaviors I choose to do may increase or decrease my risk of getting or transmitting HIV	1	2	3	4	5	6
b. Prepared me to make a better decision about which behaviors I will do in the future	1	2	3	4	5	6
c. Helped me think about the pros/cons of different HIV prevention options	1	2	3	4	5	6
d. Helped me think about the pros/cons of different HIV prevention options that are most important to me	1	2	3	4	5	6
e. Prepared me to talk to my sex partners about HIV-related topics	1	2	3	4	5	6
f. Helped me know when and how often I should be tested for HIV	1	2	3	4	5	6

Section B: Perceived Risk and HIV Knowledge

In this section, we are going to ask you some questions about HIV.

8. Thinking about the sex you’ve had over the past 12 months, do you consider yourself to be low, medium or high risk for getting HIV?

₁ Low risk

₂ Medium risk

₃ High risk

₉ Prefer not to answer

9. Using a scale from 1 to 10, where 1=I know nothing and 10=I know everything I need to know, please rate your overall knowledge of HIV.

10. Tell me how risky you think each behavior is for [getting/transmitting] HIV if a person is not using any form of protection. Use a scale where 0 is lowest risk and 100 is highest risk. Please assign any number in that range to each of the behaviors listed.

a. Deep kissing _____

b. Receptive anal sex (“bottom”) with a condom _____

c. Receptive anal sex (“bottom”) without a condom _____

e. Receptive oral sex (“giving a blow job”) with a condom _____

f. Receptive oral sex (“giving a blow job”) without a condom _____

g. Insertive anal sex (“top”) with a condom _____

h. Insertive anal sex (“top”) without a condom _____

i. Insertive oral sex (“getting a blow job”) with a condom _____

f. Insertive oral sex (“getting a blow job”) without a condom _____

k. Prefer not to answer

11. Please drag and drop the behaviors below into a box based on how risky you think each behavior is for [getting/transmitting] HIV. Please assume that a person is not using any form of protection from HIV.

Little to no risk

High risk

Highest risk

a. Deep kissing _____

b. Receptive anal sex (“bottom”) with a condom _____

c. Receptive anal sex (“bottom”) without a condom _____

e. Receptive oral sex (“giving a blow job”) with a condom _____

f. Receptive oral sex (“giving a blow job”) without a condom _____

g. Insertive anal sex (“top”) with a condom _____

h. Insertive anal sex (“top”) without a condom _____

i. Insertive oral sex (“getting a blow job”) with a condom _____

f. Insertive oral sex (“getting a blow job”) without a condom _____

k. Prefer not to answer

12. Please indicate how much you disagree or agree with the following statements.

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Prefer not to answer
a. I know all I need to know about HIV.	1	2	3	4	5	6
b. I know about how to prevent getting or transmitting HIV.	1	2	3	4	5	6
c. I know whether and how often I should be tested for HIV.	1	2	3	4	5	6

13. Please indicate whether the following statements about HIV are true, false, or if you don’t know the answer.

	True	False	Don’t Know	Prefer not to answer
a. The window period is the time between when a person gets tested for HIV and when they get back the results.
b. HIV can be transmitted through tears, saliva, or sweat.
c. Antiretroviral therapy (ART) reduces the amount of HIV virus in blood and body fluids.
d. ART reduces the chance of an HIV positive person transmitting HIV to a partner who is negative
e. When an HIV positive person’s viral load is “undetectable”, they are cured.
f. Withdrawal or pulling out is an effective way to prevent HIV.
g. Heterosexual men who are circumcised are less likely to get HIV from their female sexual partners compared with men who have not been circumcised
h. Having a sexually transmitted disease (STD) increases a person’s risk for getting or transmitting HIV.
i. Condoms protect people from every type of sexually transmitted disease.
j. Vaginal sex is riskier for transmitting HIV than anal sex.
k. The chance of getting HIV from oral sex is lower than vaginal sex.
l. Having anal sex without using a condom is the riskiest type of sex for getting or transmitting HIV.
m. People who are HIV negative can take medications (called pre-exposure prophylaxis or PrEP) to prevent getting infected with HIV if they have sex with someone who is HIV positive.
n. A person who has been exposed to HIV can take medications (called post-exposure prophylaxis or PEP) to lower their chances of getting HIV. This only works if they take the medication within 72 hours of being exposed.

14. Please indicate how much you disagree or agree with the following statements.

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Prefer not to answer
a. When you live in a community where many people have HIV, the chances of having sex with someone who has HIV are higher.	1	2	3	4	5	6
b. Sexually active gay, bisexual and other men who have sex with men may benefit from HIV testing every 3 to 6 months.	1	2	3	4	5	6
c. Having multiple sex partners may increase a person’s risk for HIV.	1	2	3	4	5	6
d. All people between the ages of 13 and 64 should get tested for HIV at least once.	1	2	3	4	5	6
e. Looking for sexual partners with the same HIV status as you can prevent HIV.	1	2	3	4	5	6
f. Using your HIV status and your partner’s HIV status to determine which sexual activities (i.e., oral, vaginal, anal sex) you engage in can help reduce the risk of getting or transmitting HIV.	1	2	3	4	5	6
g. Using your HIV status and your partner’s HIV status to determine which sexual roles/positions (i.e., insertive/top or receptive/bottom) you engage in can help reduce the risk of getting or transmitting HIV.	1	2	3	4	5	6

Section C: Self-efficacy for HIV Prevention Behaviors and Informed Decision-Making

15. Please tell us how strongly you agree or disagree with the following statements.

I am confident that I can…	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Prefer not to answer
talk to someone I’m thinking about having sex with about using condoms.	1	2	3	4	5	6
always use condoms correctly with my sex partners.	1	2	3	4	5	6
talk to someone I’m thinking about having sex with about different options to prevent HIV	1	2	3	4	5	6
talk with someone I’m thinking about having sex with about sexually transmitted diseases	1	2	3	4	5	6
talk to someone I’m thinking about having sex with about my number of prior sex partners	1	2	3	4	5	6
tell someone I’m thinking about having sex with my HIV status	1	2	3	4	5	6
ask someone I’m thinking about having sex with about their HIV status	1	2	3	4	5	6
get tested for HIV as often as I should.	1	2	3	4	5	6
take my HIV medication (ART) correctly as prescribed by my doctor	1	2	3	4	5	6

16. How confident are you that you can…

	Not at all confident	Somewhat confident	Very confident	Prefer not to answer
Find information about the risks of different sexual behaviors for getting and transmitting HIV	1	2	3	6
Understand risky different sexual behaviors are for getting and transmitting HIV	1	2	3	6
Use information about HIV risk to make decisions about how to protect yourself from getting or transmitting HIV	1	2	3	6
Use information about HIV risk to make decisions about how to protect your partner from getting or transmitting HIV	1	2	3	6
Find information about the HIV prevention options available to you	1	2	3	6
Find information about the benefits of each HIV prevention option available to you	1	2	3	6
Find information about the risks of each HIV prevention option available to you	1	2	3	6
Understand HIV information enough to choose the prevention option that best suits you	1	2	3	6
Handle unwanted pressure from others in choosing an HIV prevention option	1	2	3	6

Section D. HIV Prevention Behavioral Intentions

Next, we will ask you a few questions about your plans to do or discuss doing various things.

17. Please tell us how strongly you agree or disagree with the following statements.

I plan to…	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Prefer not to answer
a. talk to someone I’m thinking about having sex with about using condoms.	1	2	3	4	5	6
b. always use condoms correctly with my sex partners.	1	2	3	4	5	6
c. talk to someone I’m thinking about having sex with about different options to prevent HIV	1	2	3	4	5	6
d. talk with someone I’m thinking about having sex with about sexually transmitted diseases (STDs)	1	2	3	4	5	6
e. tell someone I’m thinking about having sex with my HIV status	1	2	3	4	5	6
f. ask someone I’m thinking about having sex with about their HIV status	1	2	3	4	5	6
g. get tested for HIV as often as I should.	1	2	3	4	5	6
h. take my HIV medication (ART) correctly as prescribed by my doctor	1	2	3	4	5	6
i. find information about the risks of different sexual behaviors	1	2	3	4	5	6
j. use information about the risks of different sexual behaviors to protect myself from getting or transmitting HIV	1	2	3	4	5	6
k. use information about the risks of different sexual behaviors to protect my partner from getting or transmitting HIV	1	2	3	4	5	6

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