Form 1121 2014 876 NIH NIA Alzheimers Browse

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Overview

Welcome and Thank You
Original Model
Current CQs
Current CQs (10-14-14)
CQs (9-18-14)
CQs (4-28-14)
CQs (4-22-14)
CQs (11-20-13)

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Sheet 1: Welcome and Thank You

Model Instance Name:
Alzheimer's
MID:	NEW
Date:	11/04/2013
Welcome and Thank You Text
	Directions:
	This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome and Thank you text shown in the boxes below. Please read comments before using any of the text.
					Examples
					Welcome Text Example
	Welcome Text
	Thank you for visiting NIA's Alzheimer's disease information website. You've been randomly chosen to take part in a brief survey to let us know where we can improve and what we're doing well. Please take a few minutes to share your opinions, which will help us provide the best online experience possible.
	Thank You Text
	Thank you for taking our survey. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website.
					Thank You Text Example

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Sheet 2: Original Model

Model Instance Name:
Alzheimer's
MID:		NEW
Partitioned (Y/N)?		Yes
Date:		11/04/2013
Alzheimer's
Model questions utilize the ACSI methodology to determine scores and impacts
	MQ Label	ELEMENTS (drivers of satisfaction)		MQ Label	CUSTOMER SATISFACTION		MQ Label	FUTURE BEHAVIORS
		Content (1=Poor, 10=Excellent, Don't Know)			Satisfaction			Return (1=Very Unlikely, 10=Very Likely)
1	Content - Accuracy	Please rate the accuracy of information on this site.	16	Satisfaction - Overall	What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied)	19	Return	How likely are you to return to this site in the next 30 days?
2	Content - Quality	Please rate the quality of information on this site.	17	Satisfaction - Expectations	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)			Recommend (1=Very Unlikely, 10=Very Likely)
3	Content - Freshness	Please rate the freshness of content on this site.	18	Satisfaction - Ideal	How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close)	20	Recommend	How likely are you to recommend this site to someone else?
		Site Performance (1=Poor, 10=Excellent, Don't Know)						Primary Resource (1=Very Unlikely, 10=Very Likely)
4	Site Performance - Loading	Please rate how quickly pages load on this site.				21	Primary Resource	How likely are you to use this site as your primary resource for Alzheimer's and dementia information?
5	Site Performance - Consistency	Please rate the consistency of speed from page to page on this site.
6	Site Performance - Completeness	Please rate how completely the page content loads on this site.
		Functionality (1=Poor, 10=Excellent, Don't Know)
7	Functionality - Usefulness	Please rate the usefulness of the website features (such as clinical trials listing, news, and publications) provided on this site.
8	Functionality - Convenient	Please rate the convenient placement of the website features (such as clinical trials listing, news, and publications) on this site.
9	Functionality - Variety	Please rate the variety of website features (such as clinical trials listing, news, and publications) on this site.
		Look and Feel (1=Poor, 10=Excellent, Don't Know)
10	Look and Feel - Appeal	Please rate the visual appeal of this site.
11	Look and Feel - Balance	Please rate the balance of graphics and text on this site.
12	Look and Feel - Readability	Please rate the readability of the pages on this site.
		Navigation (1=Poor, 10=Excellent, Don't Know)
13	Navigation - Organized	Please rate how well the site is organized.
14	Navigation - Options	Please rate the options available for navigating this site.
15	Navigation - Layout	Please rate how well the site layout helps you find what you are looking for.

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Sheet 3: Current CQs

Model Instance Name:			red & strike-through: DELETE
Alzheimer's			underlined & italicized: RE-ORDER
MID: NEW			pink: ADDITION
Date:	10/10/2014		blue + -->: REWORDING
Alzheimer's CUSTOM QUESTION LIST
CQID	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	CQ Label
MAC2665		What type of information are you looking for on the site today?	Alzheimer's symptoms, causes, etc.		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Type of Info
			Other dementias
			Clinical trials	A
			Research centers
			Caring for a person with Alzheimer's
			Publications	C
			News about Alzheimer's
			Other
CAS0065164	A	For how many patients are you seeking a clinical trial?	One		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Number of Patients
			Between 2 and 10
			More than 10
MAC2667	C	For any publications you used today, did you…	Download/save		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Publications
			Print
			Order
			Read online
MAC2668	C	Do you generally prefer to read information online or order printed materials?	Online		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Online or Print
			Printed
MAC2663		In what role are you primarily visiting the site today? I am a…	Person diagnosed with Alzheimer's	H	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Role
			Person concerned I might have Alzheimer's	H
			Family or friend of person with Alzheimer's	H
			Caregiver	H
			Health professional	J
			Student	H
			Housing or social services organization	H
			Educator	H
			Researcher or scientist	H
			Advocate	H
			Media	H
			Other	H
CAS0056782	H	Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	DYF All Other
			No
			Partially
CAS0056783	J	Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	DYF HP
			No	K
			Partially	K
CAS0056784	K	What were you looking for that you could not find?			Open text field	Open	No	Skip Logic Group*	Unable to Find
CAS0065164		Are you comfortable getting health information in English?	Yes		Radio button scale, one up vertical	Single	Yes		Info in English
			No
MAC2674		Did you search for Alzheimer's clinical trials today?	Yes	G	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Search For Trials
			No
MAC2675	G	Were you able to locate a clinical trial meeting your criteria?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Locate Trials
			No	M
CAS0056785	M	I was not able to find a clinical trial meeting my needs because:	There are no trials in my geographic area		Radio button scale, one up vertical	Single	No	Skip Logic Group*	Not Find Trial Because
			There are no trials for which I (or my family member or client) fit the criteria
			There was not enough information about the trial
			I prefer to use another trial service
			The clinical-trial search tool did not work properly
MAC2676	G	How did you search clinical trials?	Map		C heck boxes, one up vertical	Multi-select	No	Skip Logic Group*	How Search Trials
			Zip code
			Key word
			Category
MAC2677		Please select the category that includes your age.	40 or under		Radio button scale, one up vertical	Single	No		Age
			41 – 60
			61 – 70
			71 – 80
			81 or over

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Sheet 4: Current CQs (10-14-14)

Model Instance Name:			red & strike-through: DELETE
Alzheimer's			underlined & italicized: RE-ORDER
MID: NEW			pink: ADDITION
Date:	10/10/2014		blue + -->: REWORDING
Alzheimer's CUSTOM QUESTION LIST
CQID	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	CQ Label
MAC2665		What type of information are you looking for on the site today?	Alzheimer's symptoms, causes, etc.		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Type of Info
			Other dementias
			Clinical trials	A
			Research centers
			Caring for a person with Alzheimer's
			Publications	C
			News about Alzheimer's
			Other
NEW	A	For how many patients are you seeking a clinical trial?	One		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Number of Patients
			Between 2 and 10
			More than 10
MAC2667	C	For any publications you used today, did you…	Download/save		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Publications
			Print
			Order
			Read online
MAC2668	C	Do you generally prefer to read information online or order printed materials?	Online		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Online or Print
			Printed
MAC2663		In what role are you primarily visiting the site today? I am a…	Person diagnosed with Alzheimer's	H	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Role
			Person concerned I might have Alzheimer's	H
			Family or friend of person with Alzheimer's	H
			Caregiver	H
			Health professional	J
			Student	H
			Housing or social services organization	H
			Educator	H
			Researcher or scientist	H
			Advocate	H
			Media	H
			Other	H
CAS0056782	H	Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	DYF All Other
			No
			Partially
CAS0056783	J	Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	DYF HP
			No	K
			Partially	K
CAS0056784	K	What were you looking for that you could not find?			Open text field	Open	No	Skip Logic Group*	Unable to Find
CAS0065164		Are you comfortable getting health information in English?	Yes		Radio button scale, one up vertical	Single	Yes		Info in English
			No
MAC2674		Did you search for Alzheimer's clinical trials today?	Yes	G	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Search For Trials
			No
MAC2675	G	Were you able to locate a clinical trial meeting your criteria?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Locate Trials
			No	M
CAS0056785	M	I was not able to find a clinical trial meeting my needs because:	There are no trials in my geographic area		Radio button scale, one up vertical	Single	No	Skip Logic Group*	Not Find Trial Because
			There are no trials for which I (or my family member or client) fit the criteria
			There was not enough information about the trial
			I prefer to use another trial service
			The clinical-trial search tool did not work properly
MAC2676	G	How did you search clinical trials?	Map		C heck boxes, one up vertical	Multi-select	No	Skip Logic Group*	How Search Trials
			Zip code
			Key word
			Category
MAC2677		Please select the category that includes your age.	40 or under		Radio button scale, one up vertical	Single	No		Age
			41 – 60
			61 – 70
			71 – 80
			81 or over

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Sheet 5: CQs (9-18-14)

Model Instance Name:			red & strike-through: DELETE
Alzheimer's			underlined & italicized: RE-ORDER
MID: NEW			pink: ADDITION
Date:	9/16/2014		blue + -->: REWORDING
Alzheimer's CUSTOM QUESTION LIST
CQID	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	CQ Label
MAC2665		What type of information are you looking for on the site today?	Alzheimer's symptoms, causes, etc.		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Type of Info
			Other dementias
			Clinical trials
			Research centers
			Caring for a person with Alzheimer's
			Publications	C
			News about Alzheimer's
			Other
MAC2667	C	For any publications you used today, did you…	Download/save		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Publications
			Print
			Order
			Read online
MAC2668	C	Do you generally prefer to read information online or order printed materials?	Online		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Online or Print
			Printed
MAC2663		In what role are you primarily visiting the site today? I am a…	Person diagnosed with Alzheimer's	H	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Role
			Person concerned I might have Alzheimer's	H
			Family or friend of person with Alzheimer's	H
			Caregiver	H
			Health professional	J
			Student	H
			Housing or social services organization	H
			Educator	H
			Researcher or scientist	H
			Advocate	H
			Media	H
			Other	H
CAS0056782	H	Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	DYF All Other
			No
			Partially
CAS0056783	J	Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	DYF HP
			No	K
			Partially	K
CAS0056784	K	What were you looking for that you could not find?			Open text field	Open	No	Skip Logic Group*	Unable to Find
		Are you comfortable getting health information in English?	Yes		Radio button scale, one up vertical	Single	Yes		Info in English
			No
MAC2674		Did you search for Alzheimer's clinical trials today?	Yes	G	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Search For Trials
			No
MAC2675	G	Were you able to locate a clinical trial meeting your criteria?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Locate Trials
			No	M
CAS0056785	M	I was not able to find a clinical trial meeting my needs because:	There are no trials in my geographic area		Radio button scale, one up vertical	Single	No	Skip Logic Group*	Not Find Trial Because
			There are no trials for which I (or my family member or client) fit the criteria
			There was not enough information about the trial
			I prefer to use another trial service
			The clinical-trial search tool did not work properly
MAC2676	G	How did you search clinical trials?	Map		C heck boxes, one up vertical	Multi-select	No	Skip Logic Group*	How Search Trials
			Zip code
			Key word
			Category
MAC2677		Please select the category that includes your age.	40 or under		Radio button scale, one up vertical	Single	No		Age
			41 – 60
			61 – 70
			71 – 80
			81 or over

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Sheet 6: CQs (4-28-14)

Model Instance Name:			red & strike-through: DELETE
Alzheimer's			underlined & italicized: RE-ORDER
MID: NEW			pink: ADDITION
Date:	4/25/2014		blue + -->: REWORDING
Alzheimer's CUSTOM QUESTION LIST
CQID	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	CQ Label
MAC2665		What type of information are you looking for on the site today?	Alzheimer's symptoms, causes, etc.		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Type of Info
			Other dementias
			Clinical trials
			Research centers
			Caring for a person with Alzheimer's
			Publications	C
			News about Alzheimer's
			Other
MAC2667	C	For any publications you used today, did you…	Download/save		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Publications
			Print
			Order
			Read online
MAC2668	C	Do you generally prefer to read information online or order printed materials?	Online		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Online or Print
			Printed
MAC2663		In what role are you primarily visiting the site today? I am a…	Person diagnosed with Alzheimer's	H	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Role
			Person concerned I might have Alzheimer's	H
			Family or friend of person with Alzheimer's	H
			Caregiver	H
			Health professional	J
			Student	H
			Housing or social services organization	H
			Educator	H
			Researcher or scientist	H
			Advocate	H
			Media	H
			Other	H
NEW	H	Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	DYF All Other
			No
			Partially
NEW	J	Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	DYF HP
			No	K
			Partially	K
NEW	K	What were you looking for that you could not find?			Open text field	Open	No	Skip Logic Group*	Unable to Find
MAC2671		Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Did You Find
			No
			Partially
MAC2674		Did you search for Alzheimer's clinical trials today?	Yes	G	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Search For Trials
			No
MAC2675	G	Were you able to locate a clinical trial meeting your criteria?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Locate Trials
			No	M
NEW	M	I was not able to find a clinical trial meeting my needs because:	There are no trials in my geographic area		Radio button scale, one up vertical	Single	No	Skip Logic Group*	Not Find Trial Because
			There are no trials for which I (or my family member or client) fit the criteria
			There was not enough information about the trial
			I prefer to use another trial service
			The clinical-trial search tool did not work properly
MAC2676	G	How did you search clinical trials?	Map		C heck boxes, one up vertical	Multi-select	No	Skip Logic Group*	How Search Trials
			Zip code
			Key word
			Category
MAC2677		Please select the category that includes your age.	40 or under		Radio button scale, one up vertical	Single	No		Age
			41 – 60
			61 – 70
			71 – 80
			81 or over

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Sheet 7: CQs (4-22-14)

Model Instance Name:			red & strike-through: DELETE
Alzheimer's			underlined & italicized: RE-ORDER
MID: NEW			pink: ADDITION
Date:	4/18/2014		blue + -->: REWORDING
Alzheimer's CUSTOM QUESTION LIST
CQID	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	CQ Label
MAC2663		In what role are you primarily visiting the site today? I am a…	Person diagnosed with Alzheimer's		Radio button scale, one up vertical	Single	Yes	OPS Group*	Role
			Person concerned I might have Alzheimer's
			Family or friend of person with Alzheimer's
			Caregiver
			Health professional
			Student
			Housing or social services organization
			Educator
			Researcher or scientist
			Advocate
			Media
			Other
MAC2665		What type of information are you looking for on the site today?	Alzheimer's symptoms, causes, etc.		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Type of Info
			Other dementias
			Clinical trials
			Research centers
			Caring for a person with Alzheimer's
			Publications	C
			News about Alzheimer's
			Other
MAC2667	C	For any publications you used today, did you…	Download/save		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Publications
			Print
			Order
			Read online
MAC2668	C	Do you generally prefer to read information online or order printed materials?	Online	D	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Online or Print
			Printed
MAC2669	D	What type of device do you prefer to use for online info?	Desktop / laptop (computer)		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Device Type
			Tablet
			Mobile device (smartphone)
MAC2671		Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Did You Find
			No
			Partially
MAC2674		Did you search for Alzheimer's clinical trials today?	Yes	G	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Search For Trials
			No
MAC2675	G	Were you able to locate a clinical trial meeting your criteria?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Locate Trials
			No
MAC2676	G	How did you search clinical trials?	Map		C heck boxes, one up vertical	Multi-select	No	Skip Logic Group*	How Search Trials
			Zip code
			Key word
			Category
MAC2677		Please select the category that includes your age.	40 or under		Radio button scale, one up vertical	Single	No		Age
			41 – 60
			61 – 70
			71 – 80
			81 or over

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Sheet 8: CQs (11-20-13)

Model Instance Name:			red & strike-through: DELETE
Alzheimer's			underlined & italicized: RE-ORDER
MID: NEW			pink: ADDITION
Date:	11/20/2013		blue + -->: REWORDING
Alzheimer's CUSTOM QUESTION LIST
CQID	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	CQ Label
MAC2663		In what role are you primarily visiting the site today? I am a…	Person diagnosed with Alzheimer's		Radio button scale, one up vertical	Single	Yes	OPS Group*	Role
			Person concerned I might have Alzheimer's
			Family or friend of person with Alzheimer's
			Caregiver
			Health professional
			Student
			Housing or social services organization
			Educator
			Researcher or scientist
			Advocate
			Media
			Other	A
MAC2664	A	Please explain.			Text box		No	OPS Group*	OPS Role
MAC2665		What type of information are you looking for on the site today?	Alzheimer's symptoms, causes, etc.		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Type of Info
			Other dementias
			Clinical trials
			Research centers
			Caring for a person with Alzheimer's
			Publications	C
			News about Alzheimer's
			Other	B
MAC2666	B	Please explain.			Text box		No	Skip Logic Group*	OPS Type of Info
MAC2667	C	For any publications you used today, did you…	Download/save		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Publications
			Print
			Order
			Read online
MAC2668	C	Do you generally prefer to read information online or order printed materials?	Online	D	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Online or Print
			Printed
MAC2669	D	What type of device do you prefer to use for online info?	Desktop / laptop (computer)		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Device Type
			Tablet	E
			Mobile device (smartphone)	E
MAC2670	E	What content would you most like to see made available for this device?			Text area			Skip Logic Group*	Make Available
MAC2671		Did you find what you were looking for?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Did You Find
			No	F
			Partially	F
MAC2672	F	What were you looking for that you couldn't find?			Text area		No	Skip Logic Group*	What Looking For
MAC2673		What additional information or resources would you like to see included on our site?			Text area		No		Additional Info
MAC2674		Did you search for Alzheimer's clinical trials today?	Yes	G	Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Search For Trials
			No
MAC2675	G	Were you able to locate a clinical trial meeting your criteria?	Yes		Radio button scale, one up vertical	Single	Yes	Skip Logic Group*	Locate Trials
			No
MAC2676	G	How did you search clinical trials?	Map		C heck boxes, one up vertical	Multi-select	No	Skip Logic Group*	How Search Trials
			Zip code
			Key word
			Category
MAC2677		Please select the category that includes your age.	40 or under		Radio button scale, one up vertical	Single	No		Age
			41 – 60
			61 – 70
			71 – 80
			81 or over