Questionnaire

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

D-Questionnaire -CDC_STOapplication_UX_01_07_2014 - OMB

Solve the Outbreak (14GM)

OMB: 0920-0956

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Attachment D

CDC Solve the Outbreak Mobile Application User Experience (UX): Questionnaire


Form Approved
OMB No: 0920-0956
Exp. Date: March 31, 2016

Public reporting burden of this collection of information is estimated to average 30 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0956) 







  1. Please tell us about your job:



    • Job Title: ____________________________________________________

    • Organization where you work: __________________________________

    • Number of years you have been in this field: ________________________

    • Subject(s) that you teach: ______________________________________

    • Grades of the students you work with: ____________________________



  1. Which device/s do you own or have access to? (select all that apply)

    • iPad

    • iPhone

    • iPod Touch

    • Android Tablet

    • Android Smartphone

    • Windows Tablet

    • Windows Smartphone

    • Other, please specify: ________________________



  1. Do you use any of the following types of apps for personal use or use in your work? (select all that apply)

    • Game apps Provide an example: ____________________________

    • Science apps Provide an example: ____________________________

    • Teacher apps Provide an example: ____________________________

    • Other, please specify: _____________________________



  1. Have you played CDC’s Solve the Outbreak iPad application?

    • Yes

    • No



  1. Do you use mobile devices in your classroom?

    • Yes

    • No (skip to question 8)



  1. Which mobile device/s do you use in your classroom with your students? (select all that apply)

    • iPad

    • iPhone

    • iPod Touch

    • Android Tablets

    • Android Smartphone

    • Windows Tablets

    • Windows Smartphone

    • Other, please specify: ________________________________





  1. Can you name a few apps that you’ve downloaded for use in your classroom? Please tell us how you learned about these apps (your own research, recommendations from other teachers, conferences, newsletters, etc.)

________________________________________________________________________________________________________________________________________________________________________________________________________________________

  1. Are you male or female?

    • Male

    • Female


  1. How old are you?

    • 19 or under

    • 20-34 years old

    • 35-49 years old

    • 50-64 years old

    • 65 or older



  1. What is your highest level of education?

    • High school or less

    • Some college

    • College degree

    • Advanced degree

FOR FACILITATOR: VERBAL FOLLOW-UP QUESTIONS

Facilitator will ask follow-up questions to teachers who use apps in their classrooms. These questions will be asked verbally to the teachers and the facilitator will take notes on their responses:



  1. Can you tell me more about how you use mobile devices in your classroom?



  1. Does your school have a mobile device program?



  1. Do your students have personal mobile devices that they can bring and use in school?



  1. Are there any restrictions to using mobile devices at school?



  1. In what ways do you use mobile devices during a lesson/class?



  1. How beneficial are the use of mobile devices in teaching and learning new concepts? Etc…



  1. How do you typically find mobile apps to use in your classroom?



FOR FACILITATOR: VERBAL FOLLOW-UP QUESTIONS

Facilitator will ask follow-up questions to teachers who have used the Solve the Outbreak application previously. These questions will be asked verbally to the teachers and the facilitator will take notes on their responses:



  1. How did you hear about the Solve the Outbreak application?



  1. How have you used the Solve the Outbreak application?



  1. Have you used the Solve the Outbreak application in your classroom?



  1. What is your general impression of the application?



  1. Do you have any suggestions for improvement before we begin?





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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorRichman, Lisa M. (CDC/OID/NCHHSTP)
File Modified0000-00-00
File Created2021-01-29

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