Form 1 ASA24 User Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

ASA24 User Survey_rev 6.13.18

ASA24 Customer Satisfaction Survey (NCI)

OMB: 0925-0642

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ASA24
Survey Administration Information

OMB No.: 0925-0642
Expiration Date: 05/31/2020
Collection of this information is authorized by The Public Health Service Act, Section 411 (42 USC
285a). Rights of study participants are protected by The Privacy Act of 1974. Participation is
voluntary, and there are no penalties for not participating or withdrawing from the study at any time.
Refusal to participate will not affect your benefits in any way. The information collected in this
study will be kept private to the extent provided by law. Names and other identifiers will not appear
in any report of the study. Information provided will be combined for all study participants and
reported as summaries. You are being contacted by email to complete this instrument so that we
can improve the information on the Automated Self-Administered 24-hour Dietary Assessment Tool
(ASA24) websites.
Public reporting burden for this collection of information is estimated to average 10 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974,
Bethesda, MD 20892-7974, ATTN: PRA (0925-0642). Do not return the completed form to this
address.

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ASA24
Welcome

Greetings,
Because you registered to use either the 2014 or 2016 versions of the Automated Self-Administered
24-hour (ASA24) Dietary Assessment Tool, I would like invite you to provide feedback about your
experience using ASA24 through this survey.
Your responses to the following questions will help us assess the usefulness of several aspects of
the ASA24 system, including the new Respondent Nutrition Report, materials about the system for
respondents as well as for those collecting dietary data, and the help desk support available to
ASA24 users.
All responses will remain anonymous, unless you choose to provide your contact information at
the end of the survey.
As the project officer for ASA24, I want to thank you on behalf of the entire ASA24 team for taking
the time to provide feedback about the ASA24 system,
Amy Subar, Ph.D., M.P.H., R.D.
National Cancer Institute
1. How many years have you used the ASA24 system?
< 1 year
1-2 years
2-5 years

2. Which version(s) of ASA24 have you used? (Select all that apply.)
ASA24-2016 (US version)
ASA24-2016 (Canadian version)
ASA24-2016 (Australian version)
ASA24-2014 (US version)
ASA24-2014 (Canadian version)
ASA24-2014 (Kids version)
Not sure
Other (please specify)

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3. What type of dietary data have you analyzed using ASA24?
Adults' intake
Children's intake
Menu analysis/coding
Retrospective data analysis
Other (please specify)

4. Which of the following best describes your primary role when using ASA24 to collect dietary data?
(Choose one)
Researcher

Educator

Study Coordinator

Clinician

Research Assistant
Other (please specify)

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ASA24
Researcher Questions

5. For how many studies have you used the ASA24 system to collect dietary data?
1
2-5
>5
Not sure
Other (please specify)

6. Have you provided study respondents with a copy of their Respondent Nutrition Report (RNR) after they
enter their data?
Yes
No
Not applicable - the RNR is not available in the ASA24 version that I am using.
Not sure

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ASA24
Clinician Questions

7. How often have you used the ASA24 system in your clinical practice?
Less than monthly
At least once per month
Weekly
On a daily basis
Other (please specify)

8. What types of diet counseling do you use the ASA24 system for?
Weight control

Kidney disease

Diabetes management

Oncology treatment

Heart disease

Clinical research

Other (please specify)

9. Have you provided patients with a copy of their Respondent Nutrition Report (RNR) after they enter their
data?
Yes
No
Not sure
Not applicable - the RNR is not available in the ASA24 version that I am using.

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ASA24
Educator Questions

10. How often have you used the ASA24 system in your teaching?
Less than once per semester or course
A few times per semester or course
At least monthly
Other (please specify)

11. How have you used the ASA24 system in your teaching?

12. Have you provided your students with the Respondent Nutrition Report (RNR) after they enter their
data?
Yes
No
Not sure
Not applicable - the RNR is not available in the ASA24 version that I am using.

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ASA24
Respondent Nutrition Report

13. Have you found the Respondent Nutrition Report (RNR) to be useful?
Yes
No
Not sure
Other (please specify)

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ASA24
RNR Use

14. If you have not used the RNR, why not?
I was not aware of this report.
I am concerned the RNR may influence future recalls/records.
I am not using ASA24-2016.
Other (please specify)

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ASA24
RNR Usefulness

15. If you did not find the RNR to be useful, why not?

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ASA24
RNR Suggestions

16. Do you have any suggested changes to the RNR to make it more useful?

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ASA24
Questions about ASA24 Materials for Respondents

17. Have you shared any of the downloadable ASA24 Quick Start Guides or Help Guides with your
respondents (e.g. study participants, students, or patients)? These are available at
https://epi.grants.cancer.gov/asa24/resources/resources.html.
Yes
No
Not sure

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ASA24
Use of Materials for Respondents

18. If you have not shared any of the downloadable ASA24 Quick Start or Help Guides with your
respondents, why not?
They are not helpful.
I was not aware of these resources.
Other (please specify)

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ASA24
Value of Materials for Respondents

19. How have you used the downloadable ASA24 Quick Start or Help Guides?

20. Have you found the downloadable ASA24 Quick Start or Help Guides to be useful?
Yes
No
Not sure

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ASA24
Suggestions for Respondent Materials

21. Do you have any suggestions for improving the downloadable ASA24 Quick Start or Help Guides?

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ASA24
Questions about Researcher Instructions

22. Have you used the Researcher Instructions document when using ASA24? This document is available
for download at https://epi.grants.cancer.gov/asa24/researcher/instructions.html.
Yes
No
Not sure
Other (please specify)

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ASA24
Usefulness of Researcher Instructions

23. Have you found the Researcher Instructions to be useful?
Yes
No
Not sure
I was not aware the Researcher Instructions existed.
Other (please specify)

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ASA24
Suggestions for Researcher Instructions

24. Do you have any suggestions for improving the Researcher Instructions?

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ASA24
Questions about NCI's ASA24 Website

25. Have you looked for information about the ASA24 system on the National Cancer Institute's website
(https://epi.grants.cancer.gov/asa24)?
Never
A few times per year
At least once per month
Not sure

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ASA24
Use of NCI's ASA24 Website

26. If you have not looked for information on NCI's ASA24 website, why not?
The website is not helpful.
I was not aware the website existed.
Other (please specify)

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ASA24
Value of NCI's ASA24 Website

27. What information on NCI's website has been useful to you?

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ASA24
Suggestions for NCI ASA24 Website

28. Can you suggest any improvements to the information about the ASA24 system on NCI's website?

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ASA24
Additional Comments

29. Is there any additional feedback you would like to provide about any aspect of the ASA24 system?

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ASA24
Contact Information (Optional)

30. If you would like someone from ASA24 to contact you to discuss concerns or suggestions provided in
your responses, please pprovide your contact information in the space provided below.
Name
Company
Country
Email Address
Phone Number

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ASA24
Thank You

Thank you very much for taking the time to respond to this survey about the ASA24 system. Your
feedback will help us identify whether there are additional improvements or changes we should
consider making to our ASA24 resources and support.

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File TitleView Survey
File Modified2018-06-13
File Created2018-06-13

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