Form 399 NIDCR English 399 NIDCR English 399 NIDCR English 2011 Q's

Model Instance Name:			red & strike-through: DELETE
NIDCR English 2011			underlined & italicized: RE-ORDER
MID:	ZR0gEIlR8tRYV8UB5IJs1g==		pink: ADDITION
Date:	12/17/2010		blue + -->: REWORDING
NIDCR English 2011 CUSTOM QUESTION LIST
CQID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
SAC0834		How often do you visit the NIDCR website?	First time		Radio button, one-up vertical	Single	Yes		Visit Frequency
			Daily
			About once a week
			About once a month
			Once or twice a year
SAC0835		How did you find the NIDCR website today?	Search Engine (e.g. Google, Bing, Yahoo)		Radio button, one-up vertical	Single	Yes	Skip Logic Group	Visit Driver
			MedlinePlus					Randomize
			National Institutes of Health (NIH) web page
			Another site
			NIDCR e-newsletter
			NIDCR Twitter feed
			NIDCR print publications/products
			Bookmarked NIDCR website (favorite)
			Word of mouth recommendation
			Blog or discussion forum
			Message from friend on social network (e.g. Facebook, MySpace, Twitter)
			YouTube video
			Text message or alert
			Instant message
			Don't know					Anchor Answer Choice
			Other	A				Anchor Answer Choice
SAC0836	A	Please explain briefly how you found the NIDCR website today.			Text area, no char limit		No	Skip Logic Group	Other-Visit Driver
SAC0837		How did you access the site?	Desktop computer or laptop		Radio button, one-up vertical	Single	Yes		How Access
			Mobile phone or other mobile device such as iPad
SAC0838		What information were you looking for today?	Health information (for self or friend/family member)		Radio button, one-up vertical	Single	Yes	Skip Logic Group	What Info
			Health information (for patients, clients)					Randomize
			Clinical trials
			Grants/funding information
			Jobs, fellowships, internships
			Science news
			Dentist/dental care
			Data and statistics
			Research tools (e.g. animal models, tissue arrays)
			Teaching tools (for K-12 instruction)
			Teaching tools (for dental/medical professional or student instruction)
			Continuing education (CDE)
			NIDCR mission/plans
			Staff directory
			Spanish-language content
			Other	B				Anchor Answer Choice
SAC0839	B	Please explain briefly what you were looking for today.			Text area, no char limit		No	Skip Logic Group	Other-What Info
SAC0840		Did you find what you were looking for on the NIDCR site?	Yes		Radio button, one-up vertical	Single	Yes	Skip Logic Group	Did You Find
			No	C
			Still looking for information when survey popped
			Not looking for anything in particular
SAC0841	C	What specifically were you seeking?			Text area, no char limit		No	Skip Logic Group	What Seeking
SAC0842		How do you plan to use the information you find on this site today?			Text area, no char limit		No		Plan To Use
SAC0843		What additional information or resources would you like to see included on our site?			Text area, no char limit		No		Add'l Info
SAC0844		How would you best describe the information on this site?	Very easy to understand		Radio button, one-up vertical	Single	Yes		Level of Difficulty
			Somewhat easy to understand
			Somewhat difficult to understand
			Very difficult to understand
SAC0845		If you could make one improvement to the NIDCR site, what would it be?			Text area, no char limit		No		improvement
SAC0846		Which best describes you?	Person with a health concern		Radio button, one-up vertical	Single	Yes	Skip Logic Group	Role
			Family member/friend of a person with a health concern					Randomize
			Patient advocate
			Health educator
			Health care provider
			Scientist/Researcher	D
			NIDCR Council or committee member
			NIDCR staff
			Other government staff
			Media
			Policy analyst
			Student - K-12th grade
			Student - undergraduate, professional, or graduate
			Teacher - K-12th grade
			University faculty member
			Other	E				Anchor Answer Choice
SAC0847	E	Please specify your role in visiting the site today.			Text area, no char limit		No	Skip Logic Group	Other -Role
SAC0848	D	Have you ever...?	Applied for funding from NIDCR		Radio button, one-up vertical	Single	No	Skip Logic Group	Funding
			Received funding from NIDCR
SAC0849		Are you…?	Male		Radio button, one-up vertical	Single	No		Gender
			Female
SAC0850		Which age category best describes you?	Under 18		Radio button, one-up vertical	Single	No		Age
			18-24
			25-34
			35-44
			45-54
			55-64
			65-74
			75+
SAC0851		What is your race or ethnicity?	American Indian/Alaska Native		Radio button, one-up vertical	Single	No		Race
			Asian
			Black/African American
			Hispanic/Latino
			Native Hawaiian or Other Pacific Islander
			White
			Other
SAC0852		From where are you accessing this site?	United States		Radio button, one-up vertical	Single	Yes	Skip Logic Group	Accessing From
			Europe
			Canada
			Mexico
			South America
			Central America
			Australia
			Asia
			Africa
			Other	F
SAC0853	F	From what other part of the world are you accessing this site?			Text area, no char limit		No	Skip Logic Group	Other-Accessing From
SAC0854		In the last three months, have you done any of the following:	Browsed websites using mobile phone/device		Checkbox, one-up vertical	Multi	Yes		Activities
		(Please select all that apply)	Sent text messages using mobile phone/device
			Received text messages using mobile phone/device
			Used personalized web pages (such as My Yahoo!)
			Added a widget or gadget to personalized web page
			Participated in online social networks (such as MySpace, Facebook, etc.)
			Participated in virtual worlds (such as Second Life, Whyville, etc.)
			Bookmarked or tagged websites (using social bookmarking sites as Digg or Delicious)
			Read blogs or Wikis
			Written a blog or contributed to Wikis
			Posted comments, ratings or reviews on a website
			Listened to podcasts or audio on a website
			Watched videos on a website
			Uploaded videos to a website (such as YouTube)
			Browsed through photo galleries
			Subscribed to RSS feeds
			Signed up to receive e-mail updates from a website
			None of the above