Form AHRQ USPSTF Q'aire AHRQ USPSTF Q'aire AHRQ USPSTF Q'aire 7-30-15_DOT

E-Government Website Customer Satisfaction Surveys

AHRQ USPSTF Q'aire 7-30-15_DOT.xlsx

Mapping and Questionnaire Documents IA 30812 A0 (AHRQ)

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf

Overview

Welcome and Thank You Text
Current Model Qsts
Current Custom Qsts
Custom Qsts (2-7-13)


Sheet 1: Welcome and Thank You Text

Model Instance Name:










AHRQ USPSTF










MID: QhsNxsAFgNF9dIwp1JMddQ==









5/17/2011









Welcome and Thank You Text













Directions:










This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome text shown in the box below.









Examples


Welcome Text Example































Welcome Text









Thank you for visiting the Agency for Healthcare Research and Quality (AHRQ) website. ForeSee Results is conducting the survey on behalf of AHRQ. Please take a few minutes to give us your input.

The questions in this survey refer only to the USPSTF website. Your response will be used to help guide future improvements to the site. We are seeking comments about the way the content is presented, not feedback on the content of USPSTF recommendations or on the process used to develop them. Your input will be kept strictly confidential



















































































































Thank You Text Example


















Thank You Text












Thank you for taking our survey - and for helping us serve you better.

Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our web site.



























































































































































































































Sheet 2: Current Model Qsts

Model Instance Name:







AHRQ USPSTF







MID:
QhsNxsAFgNF9dIwp1JMddQ==




Partitioned (Y/N)?
YES




NOTE: All non-partitioned surveys will NOT be imputed and the elements will be rotated as a default unless otherwise specified and approved by Research.



Date:
11/19/2012




AHRQ USPSTF
Model questions utilize the ACSI methodology to determine scores and impacts


ELEMENTS (drivers of satisfaction)

CUSTOMER SATISFACTION

FUTURE BEHAVIORS

MQ Label

MQ Label

MQ Label


Content (1=Poor, 10=Excellent, Don't Know)

Satisfaction

Return (1=Very Unlikely, 10=Very Likely)
1 Content - Accuracy Please rate your perception of the accuracy of information on this site. 17 Satisfaction - Overall What is your overall satisfaction with this site?
(1=Very Dissatisfied, 10=Very Satisfied)
20 Return How likely are you to return to this site?
2 Content - Quality Please rate the quality of information on this site. 18 Satisfaction - Expectations How well does this site meet your expectations?
(1=Falls Short, 10=Exceeds)


Recommend (1=Very Unlikely, 10=Very Likely)
3 Content - Freshness Please rate the freshness of content on this site. 19 Satisfaction - Ideal How does this site compare to your idea of an ideal website?
(1=Not Very Close, 10=Very Close)
21 Recommend How likely are you to recommend this site to someone else?


Functionality (1=Poor, 10=Excellent, Don't Know)





4 Functionality - Usefulness Please rate the usefulness of the website tools provided on this site.





5 Functionality - Convenient Please rate the convenient placement of the website tools on this site.





6 Functionality - Variety Please rate the variety of website tools on this site.







Look and Feel (1=Poor, 10=Excellent, Don't Know)





7 Look and Feel - Appeal Please rate the visual appeal of this site.





8 Look and Feel - Balance Please rate the balance of graphics and text on this site.





9 Look and Feel - Readability Please rate the readability of the pages on this site.







Navigation (1=Poor, 10=Excellent, Don't Know)





10 Navigation - Organized Please rate how well the site is organized.





11 Navigation - Options Please rate the options available for navigating this site.





12 Navigation - Layout Please rate how well the site layout helps you find what you are looking for.





13 Navigation - Clicks Please rate the number of clicks to get where you want on this site.







Site Performance (1=Poor, 10=Excellent, Don't Know)





14 Site Performance - Loading Please rate how quickly pages load on this site.





15 Site Performance - Consistency Please rate the consistency of speed from page to page on this site.





16 Site Performance - Errors Please rate the ability to load pages without getting error messages on this site.














































































Sheet 3: Current Custom Qsts

Model Instance Name:



red & strike-through: DELETE









































AHRQ USPSTF



underlined & italicized: RE-ORDER









































MID:
QhsNxsAFgNF9dIwp1JMddQ==

pink: ADDITION









































Date:
11/19/2012
blue + -->: REWORDING

























































































AHRQ USPSTF CUSTOM QUESTION LIST



































QID Meta Tag Skip Logic Label Question Text AnswerIDs (DOT) Answer Choices
(limited to 50 characters)
Skip to Type (select from list) Single or Multi Required
Y/N
Special Instructions CQ Label



































LNH3142

How frequently do you visit this site? LNH3142A01 This is my first visit
Radio button, one-up vertical Single Y
Frequency







































LNH3142A02 Every few months or less often













































LNH3142A03 Once a month













































LNH3142A04 Once a week













































LNH3142A05 Several times a week













































LNH3142A06 Daily









































LNH3143

Which of the following best describes your position or situation?
Physician/Physician’s Assistant
Radio button, one-up vertical Single Y OPS Group Role








































Nurse/Nurse Practitioner














































Student














































Other Health Care Provider














































Health Care Administrator














































Social Services Intermediary














































Consumer, Patient, or General Public














































Educator














































Government Policymaker














































Health Insurer














































Employer














































Researcher/Analyst














































Media /Press














































Librarian/Information Specialist














































System Administrator














































Other (please specify) A








































LNH3144
A What is your position or situation?


Text field, <100 char

OPS Group Other Role



































LNH3145

What is the primary goal of your visit to this site today? LNH3145A01 Find a recommendation for myself
Radio button, one-up vertical Single Y Skip Logic Group Primary Task







































LNH3145A03 Find a recommendation for a family member or friend













































LNH3145A02 Find a recommendation for a patient or client













































LNH3145A05 Review recommendations or evidence for work tasks













































LNH3145A06 Access information and references for school assignments or continuing education













































LNH3145A04 Other, please specify A








































LNH3146
A What other reason did you have for visiting the site today?


Text area, no char limit
N Skip Logic Group Other Reason for Visit



































LNH3147

Were you able to accomplish your primary task? LNH3147A01 Yes
Radio button, one-up vertical Single Y Skip Logic Group Accomplish







































LNH3147A02 No A












































LNH3147A03 Partially A








































LNH3148
A Please tell us what you were trying to accomplish.


Text area, no char limit Single N Skip Logic Group Information Seeking



































LNH3149

How did you look or information today? (please select all that apply) LNH3149A01 Search Box
Checkbox, one-up vertical Multi Y
Search Method







































LNH3149A02 Browsed Buttons and Links













































LNH3149A03 A-Z Topic Guide









































LNH3150

What areas of the site did you visit today? (Please select all that apply) LNH3150A09 About the USPSTF
Checkbox, one-up vertical Multi Y Skip Logic Group Areas of the Site







































LNH3150A01 Methods and Processes













































LNH3150A02 Recommendations













































LNH3150A03 Opportunity for Public Comment













































LNH3150A10 Nominate a New USPSTF Member













































LNH3150A04 Nominate a Recommendation Statement Topic













































LNH3150A05 Special Populations













































LNH3150A06 Tools for Primary Care Practice













































LNH3150A07 Newsroom













































LNH3150A11 Announcements













































LNH3150A08 Other, please specify A








































LNH3151
A What other areas of the site did you visit today?


Text area, no char limit
N Skip Logic Group Other Areas of Site



































LNH3157

If there is other information that would be helpful if added to USPSTF, please describe:


Text area, no char limit
N
Other Info Helpful



































LNH3158

What other suggestions do you have for improving the USPSTF site?


Text area, no char limit
N
Improvement



































ACQWro0021521

What tools on this site did you find most useful? ACQWro0021521A01 My Healthfinder Widget
Checkbox, one-up vertical Multi Y Skip Logic Group Useful Tools







































ACQWro0021521A02 Pocket Guide to Clinical Preventive Services













































ACQWro0021521A03 Electronic Preventive Services (ePSS)













































ACQWro0021521A04 Implementing USPSTF Recommendations into Health Professional Education













































ACQWro0021521A05 Resource Links













































ACQWro0021521A06 Other (please specify)









































ACQWro0021536

What other tools did you find useful on this site during your visit today?


Text area, no char limit
N Skip Logic Group Other Useful Tools



































ACQWro0021537

On a scale from 1 to 5, with 1 being not at all useful and 5 extremely useful, indicate how useful the following information is?
















































How to explain the risks and benefits of a particular USPSTF recommendation to a patient
1-Not at all useful
Radio button, scale, has don't know Single N
Risks Benefits








































2














































3














































4














































5- Extremely useful














































Not applicable









































ACQWro0021538

How to explain potential harms from various screenings or tests
1-Not at all useful
Radio button, scale, has don't know Single N
Potential Harms








































2














































3














































4














































5- Extremely useful














































Not applicable









































ACQWro0021539

How to explain recommendations where the supporting evidence is complex or insufficient
1-Not at all useful
Radio button, scale, has don't know Single N
Explain wo evidence








































2














































3














































4














































5- Extremely useful














































Not applicable









































ACQWro0021556

How to rephrase recommendations into consumer-friendly or “plain” language
1-Not at all useful
Radio button, scale, has don't know Single N
Plain Lang








































2














































3














































4














































5- Extremely useful














































Not applicable









































ACQWro0021557

How to better engage in shared decision making with patients when discussing preventive services
1-Not at all useful
Radio button, scale, has don't know Single N
Shared Decisions








































2














































3














































4














































5- Extremely useful














































Not applicable









































LNH3157

If other information would be helpful, please describe:


Text area, no char limit
N
Other Info Helpful



































LNH3158

What suggestions do you have for improving the USPSTF site?


Text area, no char limit
N
Improvement




















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Sheet 4: Custom Qsts (2-7-13)

Model Instance Name:


red & strike-through: DELETE









































AHRQ USPSTF


underlined & italicized: RE-ORDER









































MID: QhsNxsAFgNF9dIwp1JMddQ==

pink: ADDITION









































Date: 11/19/2012
blue + -->: REWORDING
























































































AHRQ USPSTF CUSTOM QUESTION LIST



































QID Skip Logic Label Question Text AnswerIDs (DOT) Answer Choices
(limited to 50 characters)
Skip to Type (select from list) Single or Multi Required
Y/N
Special Instructions CQ Label



































LNH3142
How frequently do you visit this site? LNH3142A01 This is my first visit
Radio button, one-up vertical Single Y
Frequency






































LNH3142A02 Every few months or less often












































LNH3142A03 Once a month












































LNH3142A04 Once a week












































LNH3142A05 Several times a week












































LNH3142A06 Daily









































LNH3143
Which of the following best describes your position or situation? LNH3143A01 Physician/Physician’s Assistant
Radio button, one-up vertical Single Y OPS Group Role






































LNH3143A02 Physician Assistant












































LNH3143A03 Nurse/Nurse Practitioner












































LNH3143A04 Nurse Practitioner












































LNH3143A05 Student












































LNH3143A06 Other Health Care Provider












































LNH3143A07 Health Care Administrator













































Social Services Intermediary












































LNH3143A08 Consumer, Patient, or General Public












































LNH3143A09 Educator












































LNH3143A10 Government Policymaker













































Health Insurer













































Employer












































LNH3143A11 Researcher/Analyst













































Media /Press













































Librarian/Information Specialist













































Sytem Administrator












































LNH3143A12 Other (please specify) A








































LNH3144 A What is your position or situation?


Text field, <100 char

OPS Group Other Role



































LNH3145
What is the primary goal of your visit to this site today? LNH3145A01 Find a recommendation for myself
Radio button, one-up vertical Single Y Skip Logic Group Primary Task






































LNH3145A03 Find a recommendation for a family member or friend












































LNH3145A02 Find a recommendation for a patient or client













































Review recommendations or evidence for work tasks













































Access information and references for school assignments or continuing education












































LNH3145A04 Other, please specify A








































LNH3146 A What other reason did you have for visiting the site today?


Text area, no char limit
N Skip Logic Group Other Reason for Visit



































LNH3147
Were you able to accomplish your primary task? LNH3147A01 Yes
Radio button, one-up vertical Single Y Skip Logic Group Accomplish






































LNH3147A02 No A











































LNH3147A03 Partially A








































LNH3148 A Please tell us what you were trying to accomplish.


Text area, no char limit Single N Skip Logic Group Information Seeking



































LNH3149
How did you look or information today? (please select all that apply) LNH3149A01 Search Box
Checkbox, one-up vertical Multi Y
Search Method






































LNH3149A02 Browsed Buttons and Links












































LNH3149A03 A-Z Topic Guide









































LNH3150
What areas of the site did you visit today? (Please select all that apply)
About the USPSTF
Checkbox, one-up vertical Multi Y Skip Logic Group Areas of the Site






































LNH3150A01 Methods and Processes












































LNH3150A02 Recommendations












































LNH3150A03 Opportunity for Public Comment













































Nominate a New USPSTF Member












































LNH3150A04 Nominate a Recommendation Statement Topic












































LNH3150A05 Special Populations












































LNH3150A06 Tools for Primary Care Practice












































LNH3150A07 Newsroom













































Announcements












































LNH3150A08 Other, please specify A








































LNH3151 A What other areas of the site did you visit today?


Text area, no char limit
N Skip Logic Group Other Areas of Site



































LNH3152
On a scale from 1 to 10, with 1 being not at all useful and 10 extremely useful, indicate how useful the following information is?
How to explain the risks and benefits of a particular USPSTF recommendation to a patient.

LNH3152A01 1-Not at all useful
Radio button, scale, has don't know Single Y
Risks Benefits






































LNH3152A02 2












































LNH3152A03 3












































LNH3152A04 4












































LNH3152A05 5












































LNH3152A06 6












































LNH3152A07 7












































LNH3152A08 8












































LNH3152A09 9












































LNH3152A10 10- Extremely useful












































LNH3152A11 I don't know/not sure









































LNH3153
How to explain potential harms from various screenings or tests. LNH3153A01 1- Not at all useful
Radio button, scale, has don't know Single Y
Potential Harms






































LNH3153A02 2












































LNH3153A03 3












































LNH3153A04 4












































LNH3153A05 5












































LNH3153A06 6












































LNH3153A07 7












































LNH3153A08 8












































LNH3153A09 9












































LNH3153A10 10- Extremely useful












































LNH3153A11 I don't know/not sure









































LNH3154
How to explain recommendations where the supporting evidence is complex or insufficient. LNH3154A01 1- Not at all useful
Radio button, scale, has don't know Single Y
Explain wo evidence






































LNH3154A02 2












































LNH3154A03 3












































LNH3154A04 4












































LNH3154A05 5












































LNH3154A06 6












































LNH3154A07 7












































LNH3154A08 8












































LNH3154A09 9












































LNH3154A10 10- Extremely useful












































LNH3154A11 I don't know/not sure









































LNH3155
How to rephrase recommendations into consumer-friendly or “plain” language LNH3155A01 1- Not at all useful
Radio button, scale, has don't know Single Y
Plain Lang






































LNH3155A02 2












































LNH3155A03 3












































LNH3155A04 4












































LNH3155A05 5












































LNH3155A06 6












































LNH3155A07 7












































LNH3155A08 8












































LNH3155A09 9












































LNH3155A10 10- Extremely useful












































LNH3155A11 I don't know/not sure









































LNH3156
How to better engage in shared decision making with patients when discussing decisions related to preventive services. LNH3156A01 1- Not at all useful
Radio button, scale, has don't know Single Y
Shared Decisions






































LNH3156A02 2












































LNH3156A03 3












































LNH3156A04 4












































LNH3156A05 5












































LNH3156A06 6












































LNH3156A07 7












































LNH3156A08 8












































LNH3156A09 9












































LNH3156A10 10- Extremely useful












































LNH3156A11 I don't know/not sure









































LNH3157
If there is other information that would be helpful if added to USPSTF, please describe:


Text area, no char limit
N
Other Info Helpful



































LNH3158
What other suggestions do you have for improving the USPSTF site?


Text area, no char limit
N
Improvement





































What tools on this site did you find most useful?
My Healthfinder Widget
Checkbox, one-up vertical Multi Y Skip Logic Group Useful Tools







































Pocket Guide to Clinical Preventitive Services













































Electronic Preventitive Services (ePSS)













































Implementing USPSTF Recommendations into Health Professional Education













































Resource Links













































Other (please specify)











































What other tools did you find useful on this site during your visit tiday?


Text area, no char limit
N Skip Logic Group Other Useful Tools





































On a scale from 1 to 5, with 1 being not at all useful and 5 extremely useful, indicate how useful the following information is?















































How to explain the risks and benefits of a particular USPSTF recommendation to a patient
1-Not at all useful
Radio button, scale, has don't know Single N
Risks Benefits







































2













































3













































4













































5- Extremely useful













































Not applicable











































How to explain potential harms from various screenings or tests
1-Not at all useful
Radio button, scale, has don't know Single N
Potential Harms







































2













































3













































4













































5- Extremely useful













































Not applicable











































How to explain recommendations where the supporting evidence is complex or insufficient
1-Not at all useful
Radio button, scale, has don't know Single N
Explain wo evidence







































2













































3













































4













































5- Extremely useful













































Not applicable











































How to rephrase recommendations into consumer-friendly or “plain” language
1-Not at all useful
Radio button, scale, has don't know Single N
Plain Lang







































2













































3













































4













































5- Extremely useful













































Not applicable











































How to better engage in shared decision making with patients when discussing preventive services
1-Not at all useful
Radio button, scale, has don't know Single N
Shared Decisions







































2













































3













































4













































5- Extremely useful













































Not applicable









































LNH3157
If other information would be helpful, please describe:


Text area, no char limit
N
Other Info Helpful



































LNH3158
What suggestions do you have for improving the USPSTF site?


Text area, no char limit
N
Improvement




























































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































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