Form NHTSA Form 1284 NHTSA Form 1284 Vehicle Technology Questionnaire

OMB Control No. 2127-XXXX

Expiration Date xx/xx/xxxx

Vehicle Technology Questionnaire

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-XXXX. Public reporting for this collection of information is estimated to be approximately 10 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Washington, DC, 20590

Part A

This questionnaire is designed to measure your opinions about different types of technology that can be installed in vehicles. You have recently had the opportunity to drive a particular vehicle and experience the technology installed in it. From this experience, we would like you to indicate your level of agreement with a series of statements. Your level of agreement with these statements will be used to measure your opinion about the technology.

For this questionnaire, we would like you to focus on your experience with the <seat belt assurance system: This system uses sensors to detect when you are not wearing your seat belt and then restricts your vehicle’s mobility in order to encourage you to use your seat belt.>¹

Effectiveness Please use this rating scale to indicate your level of agreement with these statements about the effectiveness of this vehicle technology. This technology…	Disagree Strongly	Disagree	Note Sure	Agree	Agree Strongly
Helps me enjoy driving.
Helps me get to my destination.
Helps me avoid traffic hazards.
Prevents crashes.
Reduces the risk of injury if there is a crash.
Benefits my passengers.
Benefits me as a driver.
Makes me drive at safe speeds.
Makes me keep a safe following distance.
Makes me wear my seat belt.
Efficiency Please use this rating scale to indicate your level of agreement with these statements about the efficiency of this vehicle technology.	Disagree Strongly	Disagree	Note Sure	Agree	Agree Strongly
It is easy to learn how to use this technology.
This technology is easy to operate.
I can always remember how to use this technology.
This technology always works reliably.
I understand how this technology works.
This technology does not require lots of my attention.
This technology communicates with me in a way I understand.
This technology does not distract me.
This technology makes it clear when it is not working properly
I can end my interaction with this technology whenever I want.
This technology relieves me from demanding front passengers wear seat belts.
Satisfaction Please use this rating scale to indicate your level of agreement with these statements about your level of satisfaction with this vehicle technology.	Disagree Strongly	Disagree	Note Sure	Agree	Agree Strongly
I enjoy this technology.
I trust this technology.
I rely on this technology.
I want this technology in my own car.
I would pay more to have this technology on my next car.
I look forward to using this technology.
I am satisfied with the function design of this technology.
I am never stressed by this technology.
I think the interface of this technology is clear.
I would recommend this technology to my friends.
I would like this technology to work on my rear seat passengers as well.

Finally, please answer these questions about your experience with this technology:

Describe what you liked most about the <seat belt assurance system>.²

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Describe what you disliked most about the <seat belt assurance system>.

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Describe your most frustrating experience when using the <seat belt assurance system>.

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Describe any changes you would recommend for the <seat belt assurance system> to make it more acceptable and useful.

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Do you want to have this system in your vehicle? If yes, how much would you pay to have this technology in your vehicle? $ ____________

Describe what you like/dislike most about the <seat belt assurance system> driver interface features (such as the flashing visual icon or audible chiming) and why?

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Describe how you would change the <seat belt assurance system> interface to make it more readable and useful.

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What do you like/dislike most about the front passenger feature of the <seat belt assurance system> (i.e., you cannot move the car if your front passenger refuse to buckle up), and why?

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How would you recommend changing the <seat belt assurance system>’s front passenger activation feature to make it more acceptable and useful.

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Part B (BMW system)

This questionnaire is designed to measure your opinions about different types of technology that can be installed in vehicles. You have recently had the opportunity to drive a particular vehicle and experience the technology installed in it. From this experience, we would like you to indicate your level of agreement with a series of statements. Your level of agreement with these statements will be used to measure your opinion about the technology.

For this questionnaire, we would like you to focus on your experience with the < For this questionnaire, we would like you to focus on your experience with the <Navigation System: This system provides active navigation functions to your driving.>

Describe what you liked most about the < Navigation system >.

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Describe what you disliked most about the < Navigation system >.

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Describe your most frustrating experience when using the < Navigation system >.

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Describe any changes you would recommend for the < Navigation system > to make it more acceptable and useful.

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Vehicle Technology Questionnaire Part B (GM system)

This questionnaire is designed to measure your opinions about different types of technology that can be installed in vehicles. You have recently had the opportunity to drive a particular vehicle and experience the technology installed in it. From this experience, we would like you to indicate your level of agreement with a series of statements. Your level of agreement with these statements will be used to measure your opinion about the technology.

For this questionnaire, we would like you to focus on your experience with the < For this questionnaire, we would like you to focus on your experience with the <Navigation System: This system provides active navigation functions to your driving.>

Describe what you liked most about the < On-star system >.

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Describe what you disliked most about the < On-star system >.

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Describe your most frustrating experience when using the < On-star system >.

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Describe any changes you would recommend for the < On-star system > to make it more acceptable and useful.

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1 Insert the name and description of any technology.

2 Insert name of technology.

NHTSA Form 1284