Attachment D: COVID-19 Monthly Outcome Survey – Questionnaire
U.S. Department of Health and Human Services (HHS) COVID-19 Public Education Campaign
We would like to ask you about some COVID-19 content that may or may not have appeared in the media in the past month. This section will also ask you about your opinions on COVID-19 testing and vaccination.
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Item #: Q1
Question type: Single punch
// Soft Prompt: “We would like your response to this question.” //
CAM1_Aw: In the past month, that is since October 13, 2020, how frequently have you seen or heard any media content from the U.S. Department of Health and Human Services (HHS) COVID-19 Public Education Campaign? Campaign content would have included the statement [TAGLINE] and the images below.
[Campaign image collage]
Variable Label: Q1: Campaign awareness
Value  | 
		Value Label  | 
	
1  | 
		Never  | 
	
2  | 
		Rarely  | 
	
3  | 
		Sometimes  | 
	
4  | 
		Often  | 
	
5  | 
		Very often  | 
	
-99  | 
		Refused  | 
	
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Item #: Q2
Question Type: Single punch
// Ask if Q1 = 2|3|4|5 //
CAM2_Bel. How believable do you find the information from the HHS COVID-19 Public Education Campaign?
Variable Label: Q2: Believability of campaign
Value  | 
		Value Label  | 
	
1  | 
		Very unbelievable  | 
	
2  | 
		Unbelievable  | 
	
3  | 
		Neither believable nor unbelievable  | 
	
4  | 
		Believable  | 
	
5  | 
		Very believable  | 
	
-99  | 
		Refused  | 
	
-100  | 
		Valid skip  | 
	
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Item #: Q3
Question type: Single punch
// Ask if Q1 = 2|3|4|5 //
CAM3_Rel: Do you agree or disagree with the following statement? The HHS COVID-19 Public Education Campaign media content is for everyone, including me.
Variable Label: Q3: Relevance of campaign
Value  | 
		Value Label  | 
	
1  | 
		Strongly disagree  | 
	
2  | 
		Disagree  | 
	
3  | 
		Neither agree nor disagree  | 
	
4  | 
		Agree  | 
	
5  | 
		Strongly agree  | 
	
-99  | 
		Refused  | 
	
-100  | 
		Valid skip  | 
	
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Item #: Q4
Question Type: Single punch
// Ask if Q1 = 2|3|4|5 //
CAM4_Atn: Do you agree or disagree with following statement? The HHS COVID-19 Public Education Campaign media content grabbed my attention.
Variable Label: Q4: Attention grabbing of campaign
Value  | 
		Value Label  | 
	
1  | 
		Strongly disagree  | 
	
2  | 
		Disagree  | 
	
3  | 
		Neither agree nor disagree  | 
	
4  | 
		Agree  | 
	
5  | 
		Strongly agree  | 
	
-99  | 
		Refused  | 
	
-100  | 
		Valid skip  | 
	
// Page Break //
Item #: Q5
Question type: Single punch
CAM5_Test: If you were given the opportunity to take a free COVID-19 test within the next 3 days, would you take the test?
Variable Label: Q5: Would take test
Value  | 
		Value Label  | 
	
0  | 
		No, I would not take the test.  | 
	
1  | 
		Yes, I would take the test.  | 
	
-99  | 
		Refused  | 
	
// Page Break //
Item #: Q6
Question type: Single punch
CAM6_VaccWait: A Food and Drug Administration (FDA)-authorized vaccine to prevent COVID-19 is now available at no cost. How soon will you get vaccinated? For this question, assume there is enough vaccine so that everyone who wants it can get it.
Variable Label: Q6: Wait to get vaccinated
Value  | 
		Value Label  | 
	
1  | 
		I would get a vaccine as soon as I could  | 
	
2  | 
		I would wait to get a vaccine for one or more reasons  | 
	
60  | 
		I would never get a vaccine  | 
	
-99  | 
		Refused  | 
	
// Page Break //
Item #: Q7
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
CAM7_VaccBel: How much do you agree or disagree with the following statements about COVID-19? Select one response for each item.
Variable Label: Q7: Vaccine Beliefs
Variable Name  | 
		Variable Text  | 
		Variable Label  | 
	
CAM7_VaccBel_1  | 
		I would accept a COVID-19 vaccine offered during a regularly scheduled appointment with my healthcare provider.  | 
		CAM7_VaccBel_1: COVID vaccine likelihood  | 
	
CAM7_VaccBel_2  | 
		I am worried that a COVID-19 vaccine could give me COVID-19.  | 
		CAM7_VaccBel_2: Worried COVID from vaccine  | 
	
CAM7_VaccBel_3  | 
		I would rather build immunity by exposure to an infected individual than receive a COVID-19 vaccine.  | 
		CAM7_VaccBel_3: Immunity from exposure  | 
	
CAM7_VaccBel_4  | 
		I would get a COVID-19 vaccine if it would help life return to normal more quickly.  | 
		CAM7_VaccBel_4; Life return normal  | 
	
CAM7_VaccBel_5  | 
		I am worried about side effects of a COVID-19 vaccine for myself.  | 
		CAM7_VaccBel_5: Worried side effects  | 
	
CAM7_VaccBel_6  | 
		I am worried that side effects of a COVID-19 vaccine could be worse than COVID-19 itself.  | 
		CAM7_VaccBel_6: Worse side effects  | 
	
Value  | 
		Value Label  | 
	
1  | 
		Strongly disagree  | 
	
2  | 
		Disagree  | 
	
3  | 
		Neither agree nor disagree  | 
	
4  | 
		Agree  | 
	
5  | 
		Strongly agree  | 
	
-99  | 
		Refused  | 
	
// Page Break //
Item #: Q8
Question Type: Single-Punch
// Soft Prompt: “We would like your response to this question.” //
CAM8_SiteAw: Before today, have you heard of the website cdc.gov/coronavirus?
Variable Label: Q8: HHS site awareness
Value  | 
		Value Label  | 
	
0  | 
		No  | 
	
1  | 
		Yes  | 
	
-99  | 
		Refused  | 
	
// Page Break //
Item #: Q9
Question Type: Single-Punch
CAM9_SiteVis: Before today, have you visited the website cdc.gov/coronavirus?
Variable Label: Q9: HHS site visit
// Ask if Q8 (HHS site heard) = “Yes” //
Value  | 
		Value Label  | 
	
0  | 
		No  | 
	
1  | 
		Yes  | 
	
-99  | 
		Refused  | 
	
-100  | 
		Valid skip  | 
	
// Page Break //
Item #: Q10
Question Type: Grid
CAM10_SiteRec: How much do you agree or disagree with the following statements about the website cdc.gov/coronavirus? Select one response for each item.
Variable Label: CAM10_SiteRec: HHS website receptivity
// Ask if Q9 (HHS site visit) = “Yes” //
Variable Name  | 
		Variable Text  | 
		Variable Label  | 
	
CAM10_SiteRec_1  | 
		The information on the website is believable.  | 
		CAM10_SiteRec_1: Believable HHS website  | 
	
CAM10_SiteRec_2  | 
		The information on the website is helpful.  | 
		CAM10_SiteRec_2: Helpful HHS website  | 
	
CAM10_SiteRec_3  | 
		The website allows me to take action to protect myself from COVID-19.  | 
		CAM10_SiteRec_3: Actionable HHS website  | 
	
CAM10_SiteRec_4  | 
		The website grabbed my attention.  | 
		CAM10_SiteRec_4: Attention-grabbing HHS website  | 
	
CAM10_SiteRec_5  | 
		I like the website.  | 
		CAM10_SiteRec_5: Likeable HHS website  | 
	
Value  | 
		Value Label  | 
	
1  | 
		Strongly Disagree  | 
	
2  | 
		Disagree  | 
	
3  | 
		Neither Agree/Disagree  | 
	
4  | 
		Agree  | 
	
5  | 
		Strongly Agree  | 
	
-99  | 
		Refused  | 
	
-100  | 
		Valid skip  | 
	
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Colin Macfarlane | 
| File Modified | 0000-00-00 | 
| File Created | 2022-08-13 |