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pdfConsent to be in CDC Division of STD Prevention Twitter Survey
Form Approved
OMB No. 09201027
Expiration Date 08/31/2017
The 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D74, Atlanta, Georgia 30333 ATTN:
PRA (09201027)
Introduction: The Centers for Disease Control and Prevention (CDC) invites you to be in a survey about the Division of STD Prevention Twitter feed,
@CDCSTD. What is the purpose of this study? CDC’s Division of STD Prevention wants to find out more about its Twitter followers’ perceptions,
preferences, social media habits, and motivations for connecting with the Division online. This information will help us serve you better on social
media. What do you want me to do if I decide to be in this study? If you decide to be in this study, all you will need to do is complete a simple
online survey. This survey will take less than 10 minutes to complete. Are there any risks to me if I decide to be in this study? There are no risks to
participating in this study. Are there any benefits from being in this study? Participating in this study will not benefit you directly, but by providing
your feedback, we will be able to communicate better with our online audiences. Will the information I give you be kept private? The information
you give us will be kept private to the extent allowed by law. The surveys will not ask you for information that will personally identify you. We will
not ask you for your name, email address, or IP address. All data is stored in a password protected electronic format. Who should I call if I have a
question about my rights as a research volunteer? If you have any questions about your rights as a participant in this study, please contact
CDC/ATSDR’s Acting Deputy Associate Director for Science at 18005848814
. Leave a message with your name, phone number, and refer to
OMB Protocol No. 09201027, and someone will call you back. Do I have to be in this study? Participation in this study is completely voluntary.
You can choose whether or not you complete the survey. If you decide to participate in this research survey, you may withdraw at any time.
Electronic consent Clicking on the "agree" button below indicates that: • You have read the above information • You agree to participate in the
study • You are at least 18 years of age If you do not wish to participate in the research study, please decline participation by clicking on the
"disagree" button.
*1. Do you agree to participate in this survey?
j Agree
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j Disagree
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Thank you for agreeing to share your opinion about @CDCSTD, the Twitter feed maintained by CDC's Division of STD
Prevention. Your opinions are essential in helping us provide you with the best possible online experience.
All information collected is anonymous.
In this section, we'll gather information about your Twitter habits.
*2. How often do you check your Twitter feed?
j Several times a day
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j About once a day
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j Several times a week
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j About once a week
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j No more than a few times every month
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j Less often
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j Never
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3. How did you *first* find @CDCSTD?
j A link on www.cdc.gov
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j Referral or links from other websites
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j A text message from CDC
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j Media/news story
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j Search engine (Google, Yahoo, Bing, etc.)
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j Another CDC social media channel
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j Email
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j Word of mouth
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j Blog post
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j CDC mobile app
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j Another nonCDC Twitter user
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j Other (please specify)
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j Not sure
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4. What is the biggest reason that you follow @CDCSTD on Twitter?
j To share STDrelated information with my Twitter followers
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j To get information that keeps me uptodate for my work
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j To get information that helps me stay safe
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j Other (please describe)
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In this section, we'll gather information about your Twitter preferences.
*5. Please select the level to which you agree or disagree with the following statements.
@CDCSTD’s tweets are
Completely
Completely Agree
Mostly Agree
Slightly Agree
Slightly Disagree
Mostly Disagree
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Disagree
credible.
@CDCSTD’s tweets are
relevant.
@CDCSTD’s tweets are
useful.
@CDCSTD’s tweets are
informative.
@CDCSTD’s tweets are easy
to understand.
6. How frequently would you like to receive tweets from @CDCSTD?
j Several times a day
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j About once a day
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j Several times a week
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j About once a week
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j Several times a month
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j Every few months
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j Never
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7. Please rank the kinds of information you would like to see on @CDCSTD on a scale
from 1 to 4, with 1 being your top choice and 4 being your lowest choice:
Messages about how to
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prevent STDs
Current STD research and
data
Information about STD
prevention tools (fact
sheets, widgets, posters,
podcasts, mobile apps, etc.
CDC STD testing and
treatment
recommendations
8. Are there other kinds of information you would like to see on @CDCSTD?
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In this section, we'll gather information about what actions you take after seeing our social media content.
9. Which actions have you taken after seeing a @CDCSTD tweet? Check all that apply.
c Ignored it
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c Shared it with all my followers
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c Shared it with friends/family
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c Shared it with patients
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c Shared it with constituents
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c Visited the CDC website for more information
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c Visited a different website for more information
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c Got an STD or HIV test
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c Purchased condoms
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c Talked with a doctor or nurse about sexual health / STDs
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c Talked with a partner about sexual health / STDs
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c Other (please describe)
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10. How likely are you to visit the CDC’s STD website (www.cdc.gov/std) in the next
month?
j Definitely
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j Very likely
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j Likely
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j Not very likely
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j Definitely not
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11. How likely are you to recommend this CDC social media channel to someone else?
j Definitely
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j Very likely
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j Likely
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j Not very likely
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j Definitely not
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In this section, we'll gather some information about you.
*12. Which of these best describes you?
j Individual interested in health issues
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j Healthcare provider (physician, nurse, physician's assistant, nurse practitioner, pharmacist, or other healthcare provider)
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j Public health practitioner (epidemiologist, health educator, administrator, or other public health practitioner)
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j Researcher or scientist
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j Teacher or trainer
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j Student
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j Journalist or member of the media
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j Policymaker, legislator, or staff
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j Other (please specify)
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13. Describe your primary place of work as a public health practitioner.
j Community based organization / nonprofit organization
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j State health department
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j Local health department
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j Federal government
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j Hospital or clinic
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j College or university
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j Private sector
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j Other (please specify)
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14. What is your age?
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15. What is your gender?
j Female
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j Male
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j Transgender
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j Prefer not to answer
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16. How would you describe your sexual orientation?
j Heterosexual/straight
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j Homosexual/gay/lesbian
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j Bisexual
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j Other
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j Prefer not to answer
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17. What is the highest level of education you have completed?
j High school or less
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j Some college
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j College degree
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j Advanced degree
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j Prefer not to answer
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*18. What country do you live in?
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19. What city (and state, if applicable) do you live in?
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20. Do you have any additional feedback about how this CDC social media channel could
better meet your needs?
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File Type | application/pdf |
File Modified | 2014-08-25 |
File Created | 2014-08-22 |