Veterans Experience Agency Priority Goal (APG) Trust Phone Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

APG Survey Coverage and Nonresponse Bias Follow Up Survey_v6 (3)

Veterans Experience Agency Priority Goal (APG) Trust Phone Survey

OMB: 2900-0770

Document [docx]
Download: docx | pdf







The Coverage and Nonresponse Bias Follow Up Study for Trust in VA Survey



PRA Statement: We are asking for this information so that you can provide compliments, comments, or concerns to VA. Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 10 minutes to participate. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain.



Section 1− Introduction and consent form

{Page start}

Introduction and informed consent

Hello. My name is __________. I’m calling from RTI International on behalf of the Department of Veteran Affairs. We would like to ask you a few questions to better understand your experience with the service you recently received from the VA in the past three months.

We greatly appreciate your help and hope you enjoy completing this short phone survey. Please remember, completing this survey should take only about 10 minutes.

Your personal information will never be connected to the answers you provide, and the collected data will be used only for statistical purposes.

Taking part in this phone survey is entirely voluntary. You can skip any questions you do not wish to answer.

Shall we begin?

___ Yes

___ No

{Page end}



Section 2− Access to Internet, smartphone, and email

  1. Do you own a smart phone?

___Yes

___No {skip Q2}

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. Do you get on to the Internet and browse websites from your smartphone?

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. Do you have access to the Internet at home {If Q1 is “Yes”, show conditional wording} besides using your smartphone {end of conditional wording}?

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. Do you have access to the Internet at work {If Q1 is “Yes”, show conditional wording} besides using your smartphone {end of conditional wording}?

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



{Ask Q5 if Q1 = No and Q3=No and Q4=No; else skip to Q6}

  1. Do you get on to the Internet at public libraries, internet café, or other public places?

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. Do you have an active email address that you have frequently checked in the past three months?

___Yes

___No {Skip to Q8; Not showing Q12}

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. How often do you check email? Would you say….

___At least once a day

___Few times a week

___Once a week

___once every other week

___Once a month or less

___Never

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



Section 3− APG

Next, I'm going to read you some words and phrases and ask you to rate your agreement on a scale of 1 to 5, where “1” means you strongly disagree and “5” means you strongly agree.

On a scale of 1 to 5, do you agree or disagree the following:


1

2

3

4

5

  1. I trust VA to fulfill our country’s commitment to Veterans






  1. I got the service I needed






  1. It was easy to get what I needed






  1. I felt like a valued customer






{Don’t know/Not applicable/Refusal will be available for all four rating questions; visible to interviewer only, do not read to respondents}





Section 4− NRFU

{Ask Q12 and Q13 if Q6=Yes}



  1. Have you received email invitations from VA to complete surveys in the past three months?

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. Have you responded to online surveys administered by VA in the past three months?

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



{Skip the set of Q14 if both Q12 and Q13 = Yes; show Q14 if either Q12 or Q13 = No}

  1. Next, I'm going to read you some reasons that prevent you from answering to the surveys administered by VA in the past three months. Remember, you can say agree or disagree to these reasons as I am reading through them.

{Randomizing the sequence of 14.1 – 14.6}

14.1 I do not have time to answer the survey.

___Agree

___Disagree

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



14.2 I am satisfied with the service you received.

___Agree

___Disagree

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



14.3 I am concerned about my privacy

___Agree

___Disagree

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



14.4 I do not remember the details about the services I received

___Agree

___Disagree

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



14.5 It is difficult for me to go online to answer the survey

___Agree

___Disagree

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



14.6 I do not think this survey will help me to get a better service from VA

___Agree

___Disagree

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. If you are willing to participate in future surveys administered by VA, how would you like VA contact you?

{Randomizing the sequence of 15.1 – 15.6}

15.1 By phone

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



15.2 By texting

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



15.3 By email

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



15.4 In person

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



15.5. By mail

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



Section 5− Demographic characteristics

  1. What is the highest level of schooling you have completed?

__ Never attended school

__ Kindergarten through Grade 8

__ Grades 9 through 11

__ Grade 12 or GED

__ Some college, Associate’s Degree, or Technical Degree

__ Bachelor’s Degree

__ Graduate or professional school after college

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. What is your race? Check all that apply.

___White

___Black or African American

___Asian

___American Indian or Alaskan Native

___Native Hawaiian or Pacific Islander

___Other, please specify____________________

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. Are you Hispanic or of Latino origin?

___Yes

___No

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



  1. In which state do you currently live?

{dropdown menu showing 50 states for selection}

___Don’t know {visible to interviewer only, do not read to respondents}

___Not applicable {visible to interviewer only, do not read to respondents}

___Refusal {visible to interviewer only, do not read to respondents}



Thank you for your participation, you have completed the survey and we appreciate your time to help us make VA better.

12


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorHsieh, Yuli Patrick
File Modified0000-00-00
File Created2021-01-21

© 2024 OMB.report | Privacy Policy