| Model Name |
HRSA V3 |
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| Model ID |
(MID) |
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| Partitioned |
2MQ |
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| Date |
(6/4/20153) |
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| Model questions utilize the Foresee methodology to determine scores and impacts |
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ELEMENTS (drivers of satisfaction) |
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CUSTOMER SATISFACTION |
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FUTURE BEHAVIORS |
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Look and Feel (1=Poor, 10=Excellent, Don't Know) |
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Satisfaction |
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Return (1=Very Unlikely, 10=Very Likely) |
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| Look and Feel - Appeal |
Please rate the visual appeal of this site. |
Satisfaction - Overall |
What is your overall satisfaction with this site?
(1=Very Dissatisfied, 10=Very Satisfied) |
Return |
How likely are you to return to this site? |
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| Look and Feel - Balance |
Please rate the balance of graphics and text on this site. |
Satisfaction - Expectations |
How well does this site meet your expectations?
(1=Falls Short, 10=Exceeds) |
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Recommend (1=Very Unlikely, 10=Very Likely) |
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| Look and Feel - Readability |
Please rate the readability of the pages on this site. |
Satisfaction - Ideal |
How does this site compare to your idea of an ideal website?
(1=Not Very Close, 10=Very Close) |
Recommend |
How likely are you to recommend this site to someone else? |
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Site Performance (1=Poor, 10=Excellent, Don't Know) |
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Primary Resource1=Very Unlikely, 10=Very Likely) |
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| Site Performance - Loading |
Please rate how quickly pages load on this site. |
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Primary Resource |
How likely are you to use this site as your primary resource for accessing health resources and services? |
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| Site Performance - Consistency |
Please rate the consistency of speed from page to page on this site. |
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| Site Performance - Completeness |
Please rate how completely page content loads on this site. |
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Navigation (1=Poor, 10=Excellent, Don't Know) |
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| Navigation - Organized |
Please rate how well the site is organized. |
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| Navigation - Options |
Please rate the options available for navigating this site. |
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| Navigation - Layout |
Please rate how well the site layout helps you find what you need. |
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Information Browsing (1=Poor, 10=Excellent, Don't Know) |
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| Information Browsing - Sort |
Please rate the ability to sort information by criteria that are important to you on this site. |
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| Information Browsing - Narrow |
Please rate the ability to narrow choices to find the information you are looking for on this site. |
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| Information Browsing - Features |
Please rate how well the features on the site help you find the information you need. |
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Site Information (1=Poor, 10=Excellent, Don't Know) |
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| Site Information - Thoroughness |
Please rate the thoroughness of information provided on this site. |
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| Site Information - Understandable |
Please rate how understandable this site's information is. |
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| Site Information - Answers |
Please rate how well the site's information provides answers to your questions. |
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| Model Name |
HRSA V3 |
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Red & Strike-Through: Delete |
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| Model ID |
(MID) |
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Underlined & Italicized: Re-order |
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| Partitioned |
No |
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Pink: Addition |
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| Date |
(6/4/20153) |
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Blue: Reword |
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| CUSTOM QUESTION LIST |
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QID
(Group ID) |
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 |
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How frequently do you visit this site? |
First time |
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Drop down, select one |
S |
Y |
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Frequency of Visit |
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More than once a day |
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Daily |
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About once a week |
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About once a month |
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Every 6 months or less |
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What source brought you to the site today? |
Internet search |
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Radio button, one-up vertical |
S |
Y |
OPS Group |
Reason for Visit |
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Link from other website |
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News article |
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My school or training program |
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I came directly to the site for a specific reason |
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I already knew about the site |
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Don't Know |
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Other, please specify |
A |
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A |
What other source brought you to the site? |
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Text field, <100 char |
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N |
OPS Group |
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What is your primary reason for visiting this site today? |
Grants |
B |
Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
Reason for Visit |
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Loans & Scholarships |
C |
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Data & Statistics |
D |
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Public Health Information |
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Randomize |
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Learn about HRSA |
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Get Health Care Information |
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Other, please specify: |
AA |
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Anchor Answer Choice |
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AA |
If you selected "other" to "what was your primary reason for visiting the site", please specify: |
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Text field, <100 char |
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N |
Skip Logic Group |
Other Reason for Visit |
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B |
Which of the following grants related activities did you attempt? |
Seek open grant opportunities |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group |
Grant Activity |
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Seek information on grant application assistance |
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Track my application |
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Randomize |
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Seek technical assistance |
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Manage my grant |
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Search for an active, awarded grant |
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Other, please specify: |
BB |
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Anchor Answer Choice |
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BB |
What other grant related activity did you attempt? |
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Text field, <100 char |
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N |
Skip Logic Group |
Other Grant Activity |
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C |
Which of the following loans & scholarships related activities did you attempt? |
Seek loan repayment information |
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Checkbox, one-up vertical |
M |
Y |
Skip Logic Group |
Loans & Scholarship Activity |
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Seek scholarship information |
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Randomize |
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Seek loan information |
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Other, please specify: |
CC |
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Anchor Answer Choice |
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CC |
What other loan and scholarship related activity did you attempt? |
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Text field, <100 char |
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N |
Skip Logic Group |
Other Loan & Scholarship Activity |
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D |
What type of data and/or statistics were you seeking? |
Data by topic |
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Checkbox, one-up vertical |
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Y |
Skip Logic Group |
Data/Statistics Activity |
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Mapping services |
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Health center data |
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Randomize |
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Customized report |
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XML download |
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Other, please specify: |
DD |
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Anchor Answer Choice |
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DD |
What other type of data and/or statistics were you seeking? |
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Text field, <100 char |
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N |
Skip Logic Group |
Other Data/Statistics Activity |
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Did you accomplish what you wanted to during your site visit? |
Yes |
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Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
Accomplish |
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Partially |
F |
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No |
F |
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What were you not able to accomplish today? |
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Text area, no char limit |
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N |
Skip Logic Group |
Not Able to Accomplish |
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Please describe your experience with navigation on this site today. |
I had no difficulty browsing on this site. |
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Checkbox, one-up vertical |
M |
Y |
Anchor Answer Choice |
Navigation Experience |
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Could not navigate back to previous information |
B |
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Skip Logic Group |
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Would often feel lost, not know where I was |
B |
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Randomize |
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Links did not take me where I expected |
B |
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Links/labels are difficult to understand |
B |
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Too many links or navigational choices |
B |
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Had technical difficulties (e.g. broken link) |
B |
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Other, please specify: |
AA |
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Anchor Answer Choice |
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AA |
What other navigation experience did you have today? |
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Text area, no char limit |
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N |
Skip Logic Group |
Other Navigation Experience |
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B |
Please tell us more about the issue you had with navigation today. |
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Text area, no char limit |
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N |
Skip Logic Group |
OE_Navigation |
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Did you use the search/text box feature of the site today? |
Yes |
A |
Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
Search Use |
| No, I did not use it |
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| No, I did not know there was a search feature |
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A |
If you used the search/text box feature of the site today to find your information, what was your experience with the search functionality? |
I did not encounter any difficulties |
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Checkbox, one-up vertical |
M |
N |
Anchor Answer Choice |
Search Experience |
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Matthew Castillo:
Made this mutually exclusive
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Skip Logic Group |
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Search results were not helpful |
B |
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Returned too many results |
B |
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Randomize |
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Returned not enough results |
B |
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Returned no results |
B |
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Returned results that were too similar/redundant |
B |
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Results were not relevant to my search |
B |
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Other, please specify: |
AA |
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Anchor Answer Choice |
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AA |
What other experience did you have with the search feature today? |
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Text area, no char limit |
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N |
Skip Logic Group |
Other Search Experience |
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B |
Please tell us more about the issue you had with search today. |
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Text area, no char limit |
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N |
Skip Logic Group |
OE_Search Experience |
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Which section or domain of the HRSA site did you primarily visit today? |
National Health Service Corps |
A, D, E,F,G,L |
Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
Sections of Site Visited |
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Loans and Scholarships |
H,I,M |
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Health Centers |
H,I,M |
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Affordable Care Act and HRSA |
H,I,M |
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Health Professions |
H,I,M |
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HIV/AIDs |
H,I,M |
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Other, please specify: |
O,H,I,M |
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O |
What other domains or sections of the HRSA site did you visit today? |
|
|
Text area, no char limit |
S |
N |
Skip Logic Group |
Other Sections of the Site Visited |
|
H |
Which best describes you? |
Physician/Nurse/Health Professional |
|
Radio button, one-up vertical |
S |
Y |
|
HRSA_Role2 |
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Student |
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Skip Logic Group |
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Employee of Fed/State/Local Gov’t |
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Grantee |
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Grant Writer |
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Researcher |
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Media Professional |
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General Public |
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Other, please specify: |
K |
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K |
If you selected "other" to "which best describes you", please specify: |
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|
Text field, <100 char |
|
N |
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Other Best Describes2 |
|
I |
How likely are you to access HRSA content from a mobile device? |
1--Not at All Likely |
|
Radio button, scale, has don't know |
S |
Y |
Skip Logic Group |
Likely to Use Mobile Device |
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2 |
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3 |
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4 |
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5 |
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6 |
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7 |
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8 |
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9 |
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10-Very Likely |
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NA |
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A |
What is your relationship to the National Health Service Corps? |
I am a partner |
Z |
Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
NHSC_Relationship |
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I am a current or former participant in an NHSC program |
B |
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I am an interested applicant |
B |
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I am a site representative |
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Other, please specify: |
X |
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Z |
Please describe your partnership: |
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Text field, <100 char |
|
N |
Skip Logic Group |
NHSC_Describe Partnership |
|
B |
What program are you affiliated with or interested in? |
NHSC Loan Repayment Program |
|
Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
NHSC_Program |
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NHSC Scholarship Program |
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NHSC Sites |
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Other, please specify: |
C |
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X |
Please describe your relationship, if other than the above: |
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Text field, <100 char |
|
N |
Skip Logic Group |
NHSC_Other Relationship |
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C |
If you are interested in or affiliated with a different program, what program is it? |
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Text field, <100 char |
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N |
Skip Logic Group |
NHSC_Other Program |
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D |
What specifically were you looking for on the NHSC site? |
Application Portal (where I would apply for programs/update my existing application/apply for site designation/or apply for a renewal) |
|
Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
NHSC_Reason for Visit |
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Basic program information (Application program guidance, eligibility requirements, checklists, etc.) |
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Resources and Technical Assistance related to my particular program (help navigating the program, networking, or fulfilling my duties within the program for which I have been selected) |
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NHSC Jobs Center (where I can look for jobs at NHSC sites) |
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Promotional materials for the Corps (basic information about the NHSC and who we serve, materials to share with others interested in joining, stories about the impact of the NHSC) |
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Other |
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E |
How likely are you to access NHSC content from a mobile device? |
1--Not at All Likely |
|
Radio button, scale, has don't know |
S |
Y |
Skip Logic Group |
NHSC_Mobile Device |
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2 |
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3 |
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4 |
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5 |
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6 |
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7 |
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8 |
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9 |
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10-Very Likely |
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NA |
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Are you likely to return to the NHSC site in the next 90 days? |
Yes |
T |
Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
NHSC_Return to Site |
|
F |
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No |
V |
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T |
Why? |
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Text field, <100 char |
|
N |
Skip Logic Group |
NHSC_Why Return |
|
V |
Why not? |
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Text field, <100 char |
|
N |
Skip Logic Group |
NHSC_Why Not Return |
|
G |
What other information would you like to see on the NHSC site? |
|
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Text field, <100 char |
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N |
Skip Logic Group |
NHSC_Other Information |
|
L |
Which best describes you? |
Primary Care Clinician |
|
Radio button, one-up vertical |
S |
Y |
Skip Logic Group |
NHSC_Role |
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Dental Care Clinician |
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Mental or Behavioral Health Clinician |
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Student |
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Employee of Fed/State/Local Gov’t |
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Healthcare Site Representative |
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Other |
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M |
What other information would you like to see on the HRSA site? |
|
|
Text area, no char limit |
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N |
Skip Logic Group |
Other Information on HRSA |
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|
If you could make one improvement to the site, what would it be? |
|
|
Text area, no char limit |
|
N |
|
Improvement |
