OADC Material Feedback Survey - Health Material Questions (Text)

Attachment D: Message and Material Feedback Surveys — Health Material Questions (text)

OADC Message and Material Feedback Surveys — Health Material Questions (text)

Form Approved

OMB No. 0920-0572

Exp. Date 03/31/2018

Review Material

The next questions are about this health material. Please take a few minutes to read it entirely. After 90 seconds you’ll be able to continue to the next page (you may stay on this page as long as you like). 

As you read, please write down any words, phrases, or numbers that you think would be unclear to a family member or friend. [Participants will review the health material — See Attachment B for screenshots.]

1. One quick question before you get started: Do you see the health material above this question on your screen?

• Yes

• No [End survey]

[After 90 seconds, Continue button will allow participant to proceed]

Main Audience, Message, & Intended Behavioral Recommendation

Now, we’d like to ask you a few questions about the information you read in the health material.

Note: If you want to look at the health material again, click the Previous button. If you've answered any questions on this page click Next, then click Previous. Answers on previous pages are already saved. 

2. Please list any words, phrases, or numbers you think would be unclear to a family member or friend. (Your answer may be “none.”) [open-ended response]
   
   

3. Who do you think this material is written for? [open-ended response]
   
   

4. What is the main message of this material? [open-ended response]

[new survey page]

5. What is this material asking you to do? [open-ended response]
   
   

6. How likely are you to do this?

Very unlikely (1)

(2)

Unsure (3)

(4)

Very likely (5)

7. How confident are you that you can do this?

Not at all confident (1)

(2)

Neutral (3)

(4)

Very confident (5)

8. How important is this information to you?

Not important to me (1)

(2)

Neutral (3)

(4)

Very important to me (5)

Modified Consumer Information Rating Form (CIRF)

Next, we'd like to ask you what you thought about this material. For each of the following questions, please select the answer that most closely reflects your opinion.

To jog your memory, here's the material again. (Use your mouse to scroll through the material.)

9. Overall, how easy or hard would you say it is to…

	Very easy (1)	Pretty easy (2)	In between (3)	Pretty hard (4)	Very hard (5)
Read this information
Understand this information
Remember this information
Find important information

10. In your opinion, what would make this material easier to understand? [open-ended response]
    
    

11. Please indicate your opinion about how much information was provided in this material.

    • Not enough

    • Just right

    • Too much

Modified Consumer Information Rating Form (CIRF), continued

12. If you came into contact with this material for the first time and received this information, how likely is it that you would…

	Very likely (1)	Somewhat likely (2)	Unsure (3)	Somewhat unlikely (4)	Very likely (5)
Read the material
Use the information
Keep the material

13. In your opinion, what would make this material more useful? (Your answer may be “nothing.”) [open-ended response]
    
    

Modified Consumer Information Rating Form (CIRF), continued

Finally, we would like to ask you about how the material looks and sounds. Please select the choice that best describes your opinion.


To jog your memory, here's the material again. (Use your mouse to scroll through the material.)

[new survey page]

14. Organization

1 – Poorly organized

2

3

4

5 – Well organized

15. Attractiveness

1 – Unattractive

2

3

4

5 – Attractive

16. Text Size

1 – Poor

2

3

4

5 – Excellent

17. Tone

1 – Alarming

2

3

4

5 – Comforting

18. Helpfulness

1 – Unhelpful

2

3

4

5 – Helpful

19. Bias

1 – Biased

2

3

4

5 – Unbiased

20. Spacing between text and graphics

1 – Poor

2

3

4

5 – Excellent

21. In your opinion, what could improve the overall look and feel of this material? (Your answer may be “nothing.”) [open-ended response]

Thank You & End of Survey

Thank you for sharing your opinions with us. Please click Next to submit your response.