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pdf2023 DOL/EBSA - Quantitative UX
Survey
Start of Block: Screener
Consent OMB Control No. 1225-0093 Expiration Date: 02/29/2024
Informed Consent for Research Participation:
Thanks for taking the time to complete the survey. Please read the statements below and sign
where indicated.
By submitting this form you are indicating that you have read the description of the study and
that you agree to the terms as described.
If you have any questions, or would like a copy of this consent form, please contact
[email protected].
What this study is about
This survey is being conducted by the CMRignite on behalf of the Department of Labor,
Employment and Benefits Security Administration (EBSA). This survey is about enhancing the
information and resources provided by EBSA on the website and improving the website user
experience. You were asked to participate by M-S-G, a third-party sample provider.
Your Involvement in the Study
We will ask you a series of questions about your awareness of EBSA, awareness of various
rights related to job-based health benefit and retirement benefit plans, and your opinions about
the EBSA website. The survey should take a maximum of 20 minutes total.
Your Participation is Voluntary
Participation is completely voluntary. You may refuse to answer any questions or end
participation at any time.
Confidentiality
We will take necessary and appropriate precautions to keep what you tell us confidential. We
may develop and present research reports that summarize the results of all the participants who
complete the survey. The reports are for internal use only. We will not use your real name in any
of our materials.
Storage of Personal Information and Session Data
We will securely store and process your personal information and session data until we deem
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the content no longer necessary for the research purposes outlined above. This data can
include your name, email address, and phone number.
Statement of Consent
I have read the above information and received answers to any questions I have asked. I
consent to take part in this survey and to have any information I provide be used in the manner
described above. I understand that my name will not be used in connection to survey
responses. I expressly release CMRignite from and against any and all claims that I have or
may have for invasion of privacy, defamation, or any other cause of action arising out of the
production, distribution, display, or publication of the results of the project, so long as the
conditions of use described above are met.
o By clicking here, you agree to participate in this study
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Intro Please answer a few questions to see if you qualify for the survey. These questions help
us combine your responses with others like you. Your answers provided will be kept confidential
and not shared outside the project team.
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Q1 What is your age group? (Select one)
o Less than 18 years old
o 18-24
o 25-34
o 35-44
o 45-54
o 55-64
o 65-67
o 68+
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End of Block: Screener
Start of Block: State
Q2 Where do you live? (Select one)
▼ Alabama ... I do not live in the United States
[Disqualify and end survey]” if potential respondents were younger than 18, over 68, and live
outside the U.S.
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End of Block: State
Start of Block: Main Questions
Intro The OMB control number for this collection is 1225-0093 and expires on 02/29/2024.
According to the Paperwork Reduction Act of 1995, no person is required to respond to a
collection of information unless such collection displays a valid OMB control number. Collection
of this information is authorized by OMB. The obligation to respond to this collection is
voluntary. We estimate it takes about 20 minutes to complete.
Thank you for answering these questions. You qualify to take part in the survey. Please answer
the following questions about websites.
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Q3 What device do you typically use to find information online, such as websites? (Select the
one you use the most)
o Computer/laptop
o Tablet (iPad, Microsoft Surface, etc.)
o Mobile phone
o Other (specify)
o None of the above
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Q4 What best reflects your level of agreement with the following statements?
Strongly
disagree
1
Disagree
2
Neutral
3
Agree
4
Strongly
agree
5
You are
familiar with
the U.S.
Department of
Labor,
Employee
Benefits
Security
Administration
You would
visit the U.S.
Department of
Labor,
Employee
Benefits
Security
Administration
website in the
next 6 months
You have
seen
information
online (e.g.,
social media)
related to or
about the U.S.
Department of
Labor,
Employee
Benefits
Security
Administration,
in the last 6
months
You are
familiar with
workers’ rights
related to jobbased health
benefit and
retirement
benefit plans.
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
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I trust the U.S.
Department of
Labor,
Employee
Benefits
Security
Administration,
to fulfill our
country's
commitment to
people with
job-based
health benefit
and retirement
benefit plans.
o
o
o
o
o
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WebIntro Please take a moment to review the website https://www.dol.gov/agencies/ebsa and
answer the following questions.
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Q5 Have you visited this website before? (Select one)
o Yes
o No
o Don't Know
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Q6 What best reflects your level of agreement with the following statements?
Strongly
disagree
1
The
information is
relevant to
you or a
loved one
It is easy to
navigate
The
information is
logically
organized
The font is
easy to read
The colors
work well
The
information is
easy to
understand
The website
design is
user-friendly
It is inclusive
and
welcoming for
all types of
people
The
information is
trustworthy
Disagree
2
Neutral
3
Agree
4
Strongly
agree
5
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
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Q7 What would it take for you to consider visiting the website
https://www.dol.gov/agencies/ebsa in the future? (Select all that apply)
▢
▢
▢
▢
▢
▢
▢
▢
Advice from a coworker/Human Resource person
Advice from a spouse/family member/friend
Being able to speak to an agency representative
A video/webinar about the agency
A letter/flyer in the mail about the agency
Ads about the agency
Stories/examples from people who have used the website
If you need information about workers’ rights related to health benefit or
retirement benefit plans
▢
▢
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Other (specify)
⊗Nothing would get me to consider visiting the website
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Q8 How likely is it that you would recommend the website https://www.dol.gov/agencies/ebsa to
a friend, family member, or someone you work with?
o 0 - Not at all likely
o1
o2
o3
o4
o5
o6
o7
o8
o9
o 10 - Extremely likely
o Don't know
End of Block: Main Questions
Start of Block: About Us Webpage
AboutUsIntro Please take a moment to review this web page About Usand answer the following
questions.
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Q9 What best reflects your level of agreement with the following statements?
Strongly
disagree
1
Disagree
2
Neutral
3
Agree
4
Strongly
agree
5
The
information is
relevant to
you or a
loved one
o
o
o
o
o
The
information is
logically
organized
o
o
o
o
o
The
information is
easy to
understand
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
The
information is
trustworthy
You learned
new
information
Page Break
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End of Block: About Us Webpage
Start of Block: Ask EBSA
AskEBSAIntro Please take a moment to review this web page Ask EBSA and answer the
following questions.
Q10 What best reflects your level of agreement with the following statements?
Strongly
disagree
1
Disagree
2
Neutral
3
Agree
4
Strongly
agree
5
The
information is
relevant to
you or a
loved one
o
o
o
o
o
The
information is
logically
organized
o
o
o
o
o
The
information is
easy to
understand
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
The
information is
trustworthy
You learned
new
information
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End of Block: Ask EBSA
Start of Block: Resources
ResourcesIntro Please take a moment to review this web page Resourcesand answer the
following questions.
Q11 What best reflects your level of agreement with the following statements?
Strongly
disagree
1
Disagree
2
Neutral
3
Agree
4
Strongly
agree
5
The
information is
relevant to
you or a
loved one
o
o
o
o
o
The
information is
logically
organized
o
o
o
o
o
The
information is
easy to
understand
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
The
information is
trustworthy
You learned
new
information
Page Break
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End of Block: Resources
Start of Block: MHPAEA
MHPAEAIntro Please take a moment to review this web page MHPAEA - Mental Health Parity
and Addiction Equity Act and answer the following questions.
Q12 What best reflects your level of agreement with the following statements?
Strongly
disagree
1
Disagree
2
Neutral
3
Agree
4
Strongly
agree
5
The
information is
relevant to
you or a
loved one
o
o
o
o
o
The
information is
logically
organized
o
o
o
o
o
The
information is
easy to
understand
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
The
information is
trustworthy
You learned
new
information
Page Break
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End of Block: MHPAEA
Start of Block: Surprise Billing
BillingIntro Please take a moment to review this web page Surprise Billing (Consolidated
Appropriations Act, 2021) and answer the following questions.
Q13 What best reflects your level of agreement with the following statements?
Strongly
disagree
1
Disagree
2
Neutral
3
Agree
4
Strongly
agree
5
The
information is
relevant to
you or a
loved one
o
o
o
o
o
The
information is
logically
organized
o
o
o
o
o
The
information is
easy to
understand
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
The
information is
trustworthy
You learned
new
information
Page Break
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End of Block: Surprise Billing
Start of Block: Messaging
Q14 Where would you prefer to hear/see messages about the U.S. Department of Labor,
Employee Benefits Security Administration? (Select all that apply)
▢
▢
▢
▢
▢
Digital/online ads (social media, online searches, websites, etc.)
Billboards
Radio ads
Television
Ads at different locations (grocery stores, gyms, gas stations, public
transportation)
▢
▢
▢
▢
Page Break
Word of mouth/friends
Other (specify)
⊗Don't know/Unsure
⊗None of these
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Display This Question:
If Where would you prefer to hear/see messages about the U.S. Department of Labor, Employee
Benefits... = Digital/online ads (social media, online searches, websites, etc.)
Q15 On what digital sources would you prefer to see ads about the U.S. Department of Labor,
Employee Benefits Security Administration? (Select all that apply)
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
Facebook
Gather
Instagram
Twitter
Snapchat
TikTok
Reddit
Google search
YouTube
A website
Other (specify)
⊗Don't know/Unsure
⊗None of these
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End of Block: Messaging
Start of Block: Demographics
Page Break
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Q16 About You: These questions help us combine your responses with others like you.
Were you born in the United States? (Select one)
o Yes
o No
o I prefer not to answer
Page Break
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Q17 What is the combined income of all members of your household for the past 12 months
(before taxes and from all sources)? (Select one)
o Less than $10,000
o $10,000 to under $25,000
o $25,000 to under $50,000
o $50,000 to under $75,000
o $75,000 to under $100,000
o $100,000 to under $150,000
o $150,000 to under $200,000
o $200,000 or more
o I prefer not to answer
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Q18 Are you of Spanish, Hispanic, or Latino origin? (Select one)
o Yes
o No
o I prefer not to answer
Page Break
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Q19 What race best describes you? (Select all that apply)
▢
▢
▢
▢
▢
▢
Page Break
American Indian or Alaska Native
Asian/Pacific Islander
Black/African American
White/Caucasian
Other (specify)
⊗I prefer not to answer
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Q20 What is the highest level of school you completed? (Select one)
o No high school diploma or GED
o High school diploma or GED
o Some college, no degree
o College degree, or vocational training degree or certificate (2-year program)
o College degree (4-year program)
o Master's/Graduate degree or higher
o I prefer not to answer
Page Break
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Q21 What was your gender at birth?
o Male
o Female
o Prefer not to answer
Page Break
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Q22 How do you describe your gender identity? (Select the best fit)
o Woman, female, or feminine
o Man, male, or masculine
o Transgender woman, female, or feminine
o Transgender man, male, or masculine
o Nonbinary, gender queer, or gender fluid
o Not listed here/I prefer to self-describe: (specify)
o I prefer not to answer
Page Break
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Q23 What is your marital status?
o Currently married
o Other
Page Break
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Q24 Including yourself, how many individuals 18 to 67 are in this household?
o One
o Two
o Three
o Four or more
Page Break
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Q25 Would you say that in general your health is:
o Excellent 1
o Very good 2
o Good 3
o Fair 4
o Poor 5
Page Break
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Q26 What language(s) do you speak? (Select all that apply)
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
▢
Page Break
English
Spanish
Chinese
Vietnamese
Korean
Haitian Creole
Polish
Tagalog
Arabic
Russian
Portuguese
French
Other (specify)
⊗I prefer not to answer
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Q27 Do you identify with any of the following statements? (Select all that apply)
▢
▢
▢
▢
▢
▢
Page Break
I wear glasses.
I have difficulty seeing small words or shapes.
I have difficulty seeing certain colors. (Please specify.)
I have a vision impairment. (Please specify.)
⊗I prefer not to answer.
⊗None of the above
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Q28 Do you have job-based health insurance or a job-based retirement plan? (Select one)
o Yes
o No
o I don't know
Page Break
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Display This Question:
If Do you have job-based health insurance or a job-based retirement plan? (Select one) = No
Or Do you have job-based health insurance or a job-based retirement plan? (Select one) = I don't
know
Q29 Do you receive benefits from a family member who has job-based health insurance or a
job-based retirement plan? (Select one)
o Yes
o No
Page Break
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Q30 Does the company/organization you work for (or the insured family member works for)
have more than 100 employees? (Select one)
o Yes
o No
o I don't know
Page Break
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Q31 Do you have coverage through any of these programs: Medicare, Medicaid, Indian Health
Services, Veterans Affairs Health Care, or TRICARE? (Select one)
o Yes
o No
o I don't know
Page Break
What do you do when you run into a website in a language you don’t know? (Select all that apply)
•
•
•
•
•
I use Google translate
I use translation settings on my browser like Chrome, Safari, etc.
I search for the language change on the website (i.e., translation options on the site)
I avoid websites in languages that I don't know
Other, please specify
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End of Block: Demographics
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| File Type | application/pdf |
| File Title | Microsoft Word - 2022_DOLEBSA_-_Quantitative_UX_Survey_New Question.docx |
| Author | Renee Holloway |
| File Modified | 2023-07-21 |
| File Created | 2023-07-21 |