Form 0920-1050 User Experience Survey

Form Approved

OMB Approval No. 0920-1050

Expiration Date: XX/XX/XXXX

eFSAP/eIPP User Experience Survey

What is your performance expectancy for eFSAP/eIPP?

I would find the system useful in my job.

Using the system enables me to accomplish tasks more quickly.

Using the system increases my productivity.

If I use the system, I will increase my chances of getting a raise.

What is your effort expectancy for eFSAP/eIPP?

My interaction with the system would be clear and understandable.

It would be easy for me to become skillful at using the system.

I would find the system easy to use.

Learning to operate the system is easy for me.

Do you have any social influence to use eFSAP/eIPP?

People who influence my behavior think that I should use the system.

People who are important to me think that I should use the system.

The senior management of this business has been helpful in the use of the system.

In general, the organization has supported the use of the system.

Do you have any facilitating conditions to use eFSAP/eIPP?

I have the resources necessary to use the system.

I have the knowledge necessary to use the system.

The system is not compatible with other systems I use.

A specific person (or group) is available for assistance with system difficulties.

What is your behavioral intention to use eFSAP/eIPP?

I intend to use the system in the future.

I will always try to use the system in my daily life.

I predict I would use the system in the next 3 months.

I plan to use the system in the next 6 months.

Do you have trust in using eFSAP/eIPP?

I believe the system is trustworthy.

I feel assured that legal and technological structures adequately protect me from problems with the system.

Even if not monitored, I would trust the system to do the job right.

Using the system has the ability to fulfill its task.

Additional open-ended questions

Please describe any difficulties you have experienced using eFSAP/eIPP.

Please suggest any improvements you would recommend for eFSAP/eIPP.

Public reporting burden of 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 CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1050).