CDC Zika Text Message Service Survey

Form Approved

OMB Control No. 0920-1071

Exp. Date: 06/30/2018

To respondents: Thank you for agreeing to provide feedback on the CDC Zika text message service. The information you provide to us will be used to make decisions about continuing and improving the service. Your phone number will be cleaned of its identifiers, so your responses will not be linked to you. The survey should take less than 5 minutes to complete.

Screening Question:

1. Have you previously given CDC your feedback about the Zika text message service? If yes, survey terminates with a thank you message.

• Yes

• No

Service experience

2. What was the primary purpose of your trip? (Select one)

• Visit friends and relatives

• Business

• Medical

• Attend a major event

• Other (please specify)

• Leisure/pleasure

• School/education

• Humanitarian/Volunteer

3. For which destination did you receive Zika text messages? (State your primary destination; Open-ended)

4. Which best describes your phase of travel when you signed up for the Zika text message service (select one)?

• I signed up more than a week before my trip

• I signed up less than a week before my trip

• I signed up during my trip

• I signed up when I returned from my trip

• I signed up but did not take a trip

Usability

5. Thinking about the CDC Zika text message service, please let us know if you agree or disagree with the following statements.

Question	Agree/Disagree
The service worked like I expected.
I received the right number of text messages to keep me informed about Zika virus.
The text service helped me make decisions about my travel to countries with Zika.
The text service provides clear instructions on how to avoid the Zika virus.
I trusted the information I received from the CDC Zika text message service.
CDC Zika text messages made me think about precautions I could take to avoid Zika.
I plan to use a CDC text message service in the future.

12. Overall, how would you rate the CDC Zika text message service?

Poor Fair Good Excellent

Demographics

5. Age: 18-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

5. What gender do you identify as?

• Female

• Male

• Other, please specify (____)

5. Over the last 12 months, I mostly used my mobile phone to: (check all that apply)

• Make and receive phone calls

• Text

• Carry out work

• Look up information (e.g., Google)

• Look up health information

• Access apps (e.g., for shopping, news, or travel)

• Use social media apps (e.g., Facebook or Twitter)

5. What is your U.S. zip code? Type “00000” if you don’t live in the US. (number box)

5. What type of mobile phone do you most frequently use? (Select one)

Apple iPhone Android Microsoft Windows Blackberry Amazon Fire Phone

Standard cell phone (not smart phone) Other (specify)

12. How would you improve the CDC Zika text message service? (Open-ended)

` Thank you again for your time and honesty.

Public reporting burden of this collection of information is estimated to average 5 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 0920-1071