CCM GQ Coverage, Card Sorting Study, ACS Data Reliability Indicator

Generic Clearence for Questionnaire Pretesting Research

omb0928censushistoryenc2

CCM GQ Coverage, Card Sorting Study, ACS Data Reliability Indicator

OMB: 0607-0725

Document [doc]
Download: doc | pdf

Questionnaire on Computer and Internet Experience and Demographics


1. Do you use a computer at home or at work or both?

(Check all that apply.)

___ Home

___ Work

___ Somewhere else, such as school, library, etc.

2. If you have a computer at home,

a. What kind of modem do you use at home?

___ Dial up

___ Cable

___ DSL

___ Wireless (Wi-Fi)

___ Other _______________

___ Don’t know


b. Which browser do you typically use at home? Please indicate the version if you can recall it.

___ Firefox

___ Internet Explorer

___ Netscape

___ Other ______________

___ Don’t know


c. What operating system does your home computer run in?

___ MAC OS

___ Windows 95

___ Windows 2000

___ Windows XP

___ Windows Vista

___ Other _____________

___ Don’t know


3. On average, about how many hours do you spend on the Internet per day?

___ 0 hours ___ 1-3 hours ___ 4-6 hours ___ 7or more hours


4. On average, about how many hours do you use the Internet per week?

___ 0 hours ___ 1-3 hours ___ 4-6 hours ___ 7or more hours


5. What do you use the Internet for more:


_____ Searching / Surfing the web or ______ Answering / Sending e-mail


6. Have you ever done research on historical topics, including on genealogy?

Yes No


a. If yes, about how many times have you researched historical topics?_____

b. If yes, have you researched historical topics on the Internet in the last two months?

Yes No


7. How often do you use different media (i.e., photos, audio, video streams) on the Internet?


_________________________________________________________________________________________





8. Please rate your overall experience with the following:

Circle one number.

No experience Very experienced


Computers 1 2 3 4 5 6 7 8 9


Internet 1 2 4 5 5 6 7 8 9


9. What computer applications do you use?

Mark (X) for all that apply

___ E-mail

___ Internet

___ Word processing (MS-Word, WordPerfect, etc.)

___ Spreadsheets (Excel, Lotus, Quattro, etc.)

___ Databases (MS-Access, etc.)

___ Accounting or tax software

___ Engineering, scientific, or statistical software

___ Other applications, please specify_________________________________________________


Circle one number for each question below.


10. How comfortable are you in learning to navigate new Web sites?

Not Comfortable Comfortable

1 2 3 4 5


11. Computer windows can minimize, resize, and scroll through. How comfortable are you in manipulating a window?


12. How comfortable are you using and navigating through the Internet?



13. How often do you work with any type of data through a computer?


14. How often do you perform complex analyses of data through a computer?


15. How often do you use the Internet or Web sites to find information? (e.g., printed reports, news articles, data tables, blogs, etc.)



16. How familiar are you with the Census (terms, data, etc)?


17. How familiar are you with the current Census History Web site?


1 2 3 4 5



1 2 3 4 5


Never Very Often


1 2 3 4 5



1 2 3 4 5




1 2 3 4 5




Not familiar Very familiar


1 2 3 4 5



1 2 3 4 5





18. What is your date of birth? ___________________________________

month year


19. What is the highest grade of school you have completed, or the highest degree you have received?

a) [ ] Completed ninth grade or below

b) [ ] Some high school, but no diploma

c) [ ] Completed high school with diploma or received a GED

d) [ ] Vocational training beyond high school

e) [ ] Some college credit

f) [ ] Associates degree (AA/AS)

g) [ ] Bachelor’s Degree (BA/BS)

h) [ ] Master’s, Professional, or Doctoral degree


20. What is your gender?


_____ Male _____ Female


21. Do you consider yourself to be of Hispanic, Latino, or Spanish origin?


______ Yes ______ No


22. What is your race? Choose one or more races.

(Optional. We ask this question to ensure a diverse sample of people is in each study.)


_______White

_______Black or African American

_______Asian

_______Native Hawaiian or Other Pacific Islander

_______American Indian or Alaska Native




File Typeapplication/msword
File TitleQuestionnaire on Computer Use and Internet Experience
AuthorBureau Of The Census
Last Modified ByBureau Of The Census
File Modified2009-07-15
File Created2009-07-15

© 2024 OMB.report | Privacy Policy