Form 975 2015 975 AIDS Info CQ Changes 5.16.16_OMB

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Overview

Current Model Qsts
Current Custom Qs

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Sheet 1: Current Model Qsts

Model Name:
AIDSinfo v4
MID:	A8RkdEtwpdV1w9YJ4gU8MQ4C
Date:	7.22.14
Model questions utilize the ForeSee CXA methodology to determine scores and impacts
			CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Look and Feel (1=Poor, 10=Excellent, Don't Know)
Look and Feel - Appeal	Please rate the visual appeal of this site.		Satisfaction	Return	Return (1=Very Unlikely, 10=Very Likely)
Look and Feel - Balance	Please rate the balance of graphics and text on this site.	Satisfaction - Overall	What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied)		How likely are you to return to this site?
Look and Feel - Readability	Please rate the readability of the pages on this site.	Satisfaction - Expectations	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)	Recommend	Recommend (1=Very Unlikely, 10=Very Likely)
	Site Performance (1=Poor, 10=Excellent, Don't Know)	Satisfaction - Ideal	How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close)		How likely are you to recommend this site to someone else?
Site Performance - Loading	Please rate how quickly pages load on this site.			Primary Resource	Primary Resource (1=Very Unlikely, 10=Very Likely)
Site Performance - Consistency	Please rate the consistency of speed from page to page on this site.				How likely are you to use this site as your primary resource for obtaining treatment, prevention and statistical information about HIV/AIDS?
Site Performance - Completeness	Please rate how completely the page content loads on this site.
	Navigation (1=Poor, 10=Excellent, Don't Know)
Navigation - Organized	Please rate how well the site is organized.
Navigation - Options	Please rate the options available for navigating this site.
Navigation - Layout	Please rate how well the site layout helps you find what you are looking for.
	Information Browsing (1=Poor, 10=Excellent, Don't Know)
Information Browsing - Sort	Please rate the ability to sort information by criteria that is important to you on this site.
Information Browsing - Narrow	Please rate the ability to narrow choices to find the information you are looking for on this site.
Information Browsing - Features	Please rate how well the features on the site help you find the information you need.
	Site Information (1=Poor, 10=Excellent, Don't Know)
Site Information - Thoroughness	Please rate the thoroughness of information provided on this site.
Site Information - Understandable	Please rate how understandable this site’s information is.
Site Information - Answers	Please rate how well the site’s information provides answers to your questions.

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Sheet 2: Current Custom Qs

Model Name:

red & strike-through: DELETE

AIDSinfo v4

underlined & italicized: RE-ORDER

MID:

A8RkdEtwpdV1w9YJ4gU8MQ4C

pink: ADDITION

Date:

7.22.14

blue + -->: REWORDING

AIDSinfo v4 CUSTOM QUESTION LIST

QID (Group ID)

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

MAC5399Q002

What best describes your role in visiting the AIDS<em>info</em> site today?

Physician with fewer than 50 HIV/AIDS patients

H

Radio button, one-up vertical

Single

N

Skip Logic Group

Role

Physician with more than 50 HIV/AIDS patients

H

Nurse

H

Nurse practitioner

H

Physician Assistant

H

Pharmacist

H

Researcher or Scientist

Case manager

Someone living with HIV/AIDS

Family or friend of person living with HIV/AIDS

Student

Other

XX

XX

What other role describes you?

Text area, no char limit

N

Skip Logic Group

Other_Role

MAC5399Q003

H

Do you use a mobile device, such as a phone or a tablet, at the point of care?

Yes

C

Radio button, one-up vertical

Single

Y

Skip Logic Group

Access POC

No

MAC5399Q004

C

What AIDSinfo resources do you use at the point of care? (Select all that apply)

Clinical Care Guidelines from the site

Checkbox, one-up vertical

Multi

N

Skip Logic Group

POC Resources

Clinical Care Guidelines App

D, P

Drug Database

Clinical Trials

Patient Education Materials

E

Glossary

Other

D

How would you rate the USEFULNESS of the Clinical Care Guidelines App?

1 = Not at all Useful

ZX

Radio button, scale, no don't know

single

N

Skip Logic Group

Rate App

2

ZX

3

ZX

4

5 = Very Useful

ZX

How would you improve the Clinical Care Guidelines app?

Text area, no char limit

Single

N

Skip Logic Group

Improve Guidelines App

MAC5399Q006

P

How would you primarily like to view the guidelines in the app? (Select all that apply)

In its entirety

Checkbox, one-up vertical

Multi

N

Skip Logic Group

POC App Guidelines

Summary

Boxed Recommendations

Tables

Interactive Tables

Decision Tree

Treatment Algorithm

E

Considering your interactions with patients at the POC, how would you rate the USEFULNESS of the patient education materials available on the website?

1 = Not at all Useful

ZW

Radio button, scale, no don't know

single

N

Skip Logic Group

Rate patient edu materials

2

ZW

3

ZW

4

5 = Very Useful

ZW

How would you improve the patient education materials for use at the POC?

Text area, no char limit

N

Skip Logic Group

Improve Patient Education

MAC5399Q007

What is the primary reason for your visit to the AIDSinfo site today?

Access federal HIV/AIDS Clinical Care Guidelines

E

Radio button, one-up vertical

Single

N

Primary Reason

Access the HIV/AIDS Drug Database

Find general information about HIV/AIDS (e.g., prevention, symptoms)

Find information on HIV/AIDS clinical trials

Find patient education information and/or materials for myself, a family member, or a friend

Find education information and/or materials on HIV/AIDS for my patients

Other

Did you access the Clinical Care Guidelines on the website today?

Yes

E, ZZ, ZY

Radio button, one-up vertical

Single

Y

Skip Logic Group

Access Care Guidelines

No

Unsure

MAC5399Q008

E

Which Clinical Care Guidelines do you use? (Select all that apply.)

Adult and Adolescent Guidelines

Checkbox, one-up vertical

Multi

N

Skip Logic Group

Care Guidelines

Pediatric Guidelines

Perinatal Guidelines

Adult and Adolescent OI Guidelines

Pediatric OI Guidelines

Health-Care Worker Exposure Guidelines (PEP)

Nonoccupational Exposure Guidelines (nPEP)

Revised Guidelines for Counseling, Testing, and Referral

Incorporation of HIV Prevention Guidelines

ZZ

How would you primarily like to view the guidelines on the website? (Select all that apply)

In its entirety

Checkbox, one-up vertical

Multi

N

Skip Logic Group

WEB guidelines

Summary

Boxed Recommendations

Tables

Interactive Tables

Decision tree

Treatment Algorithm

ZY

How would you rate the USEFULNESS of the Clinical Care Guidelines on the website?

1 = Not at all Useful

ZX

Radio button, scale, no don't know

single

N

Skip Logic Group

Rate guide on website

2

ZX

3

ZX

4

5 = Very Useful

ZX

How would you improve the Clinical Care Guidelines?

Text area, no char limit

N

Skip Logic Group

OE_Improve Guidelines

Did you view any information written for patients?

Yes

WW

Radio button, scale, no don't know

single

N

Skip Logic Group

Use patient info

No

Unsure

WW

Did you have any difficulty with the information written for patients? (Select all that apply)

Needed more information

UU

Checkbox, one-up vertical

Multi

N

Skip Logic Group

Diff_patient info

Information was difficult to understand

Information was difficult to print or share

Need a place to ask questions

Information was difficult to find

Other

VV

I had no difficulties

Mutually Exclusive

VV

What other difficulty did you have with information written for patients?

Text area, no char limit

N

Skip Logic Group

OE_diff_patient info

MAC5399Q009

UU

Which topics would you like to see patient education materials developed for? (Select all that apply)

More basic information about symptoms, risk, detection, transmission

Checkbox, one-up vertical

Multi

N

Skip Logic Group

Patient materials

More information around treatment options, next steps, drug database, and clinical trials

More information for someone living with HIV/AIDS

More information on discordant couples and/or pregnancy

Patient education materials that delve deeper into topics

Patient education materials developed from the Pediatric ARV Guidelines

Patient education materials developed from the Pediatric OI Guidelines

Patient education materials developed from the Adult OI Guidelines

MAC5399Q010

Did you find the information you were looking for?

Yes

Radio button, one-up vertical

Single

N

Skip Logic Group

Find Info

No

P

Partially

P

P

What do you plan to do next? (Select all that apply)

Talk to a healthcare provider

Checkbox, one-up vertical

Multi

Y

Skip Logic Group

Do Next

Do additional research AIDSinfo.gov

Do additional research on a different website

Talk to family/friends

Nothing

Mutually exclusive

Something else not listed above

A

A

What else do you plan to do next?

Text area, no char limit

Single

N

OE_Do Next

Did you use the search feature during your visit today?

Yes

A, B

Radio button, one-up vertical

Single

Y

Skip Logic Group

Use Search

No

A

Did you try using the site's navigational links before using the search feature today?

Yes, I navigated first

Radio button, one-up vertical

Single

Y

Skip Logic Group

Nav Before Search

No, I went straight to the search feature

Don't recall

B

Please tell us about your experience with the site's search feature today. (Select all that apply)

Search results were helpful

Checkbox, one-up vertical

Multi

Y

Mutually exclusive

Search Experience

Results were not relevant / not what I wanted

Skip Logic Group

Too many results / I needed to refine my search

Not enough results

Returned NO results

Received error message(s)

Search speed was too slow

I experienced a different search issue

C

C

Please describe your search issue:

Text area, no char limit

Single

N

Skip Logic Group

OE_Search Issue

How would you describe your navigation experience on this site today? (Select all that apply)

I had no difficulty navigating / browsing on this site

Checkbox, one-up vertical

Multi

Y

Mutually exclusive

Navigation experience

Links often did not take me where I expected

Skip Logic Group

Had difficulty finding relevant information

Links/labels are difficult to understand

Too many links / navigational options to choose from

Had technical difficulties (error messages, broken links, etc.)

Could not navigate back to previous information

I had a navigation difficulty not listed above

A

A

Please describe your navigation experience:

Text area, no char limit

Single

N

Skip Logic Group

OE_Nav Difficulty

MAC5399Q026

After reviewing the information on this website, are there any changes that you would make? (Select all that apply)

I would not make any changes to this website

Checkbox, Two-up vertical

Multi

N

Mutually Exclusive

Site Improvements

17

Visual presentation of the information (e.g., graphs/charts, images)

Easier access to scientific research and/or publications

More downloadable content/factsheets

Randomize

Website content provided in different languages

Tutorial for navigating this website

More detailed information about HIV/AIDS treatments (e.g., drug side effects)

Question and Answer (Q & A) section

Different layout for the content provided

Information tailored specifically for physicians

Information tailored specifically for the general public

Information tailored specifically for someone with HIV/AIDS and family members

Information tailored specifically for researchers

I do not know which change(s) I would like to see

Mutually Exclusive

Some other change not listed

MAC5399Q001

How frequently do you visit this site?

First time

Radio button, one-up vertical

Single

N

Visit Frequency

Daily

About once a week

About once a month

Every 6 months or less

Which age category are you in?

18 and under

Radio button, one-up vertical

Single

N

Age

19-24 years old

25-34 years old

35-44 years old

45-54 years old

55-64 years old

65 years and older

I prefer not to respond

With which gender to you best identify?

Male

Radio button one-up vertical

Single

N

Gender

Female

Transgender

I prefer not to respond