HMTS Radiation Focus Group and Emergencies Infographics

[SURVEY PREVIEW MODE] Attachment E-2 Survey Questions

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NOTE: Questions 9-15 will be asked following a
Protective Action infographic (specific images will be
rotated). See Attachment G (Infographics) for images

Attachment E-2 Survey Questions

Form Approved
OMB No. 0920-0572
Exp. 02/28/2015

*9. What was the main message of this brochure?

*10. On a scale from 1 to 5, where a 1 means "Strongly Disagree" and a 5 means
"Strongly Agree" how would you rate the following...?
1 - Strongly
Disagree

2

3

4

5 - Strongly Agree

This brochure was
easy to understand.
I liked the pictures in
this brochure.
I learned something
new by reading this.
I trust the information
in this brochure
[In an emergency], I
can do what this
brochure suggests.
The suggestions for
dealing with radiation
emergencies made in
the message are
doable.
I am confident that I
can protect myself in
a radiation
emergency

*11. How much of the brochure would you read?
I would only read the headline.

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[SURVEY PREVIEW MODE] Attachment E-2 Survey Questions

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I would only look at the images.
I would only read the headline and look at the images.
I would read the whole thing.
I wouldn’t read any of it.

*12. Were there any tips on here that you would not follow or comply with? Why?

*13. Is there anything you especially liked about this brochure? Please explain.

*14. Is there anything you would change about this brochure? Please explain.

*15. What other comments would you like to make about this brochure?

Public reporting burden of this collection of information is estimated to average 12 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 Information Collection Review
Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0572).

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[SURVEY PREVIEW MODE] Attachment E-2 Survey Questions

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Attachment E-2 Survey Questions

NOTE: Questions 16-21 will be asked following a
Health Effects infographic (specific images will be
rotated). See Attachment G (Infographics) for images
*16. What was the main message of this brochure?

*17. On a scale from 1 to 5, where a 1 means "Strongly Disagree" and a 5 means
"Strongly Agree" how would you rate the following...?
1 - Strongly
Disagree

2

3

4

5 - Strongly Agree

This brochure was
easy to understand.
I liked the pictures in
this brochure.
I learned something
new by reading this.
I trust the information
in this brochure.

*18. How much of the brochure would you read?
I would only read the headline.
I would only look at the images.
I would only read the headline and look at the images.
I would read the whole thing.
I wouldn’t read any of it.

*19. Is there anything you especially liked about this brochure? Please explain.

*20. Is there anything you would change about this brochure? Please explain.

*21. What other comments would you like to make about this brochure?

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[SURVEY PREVIEW MODE] Attachment E-2 Survey Questions

Page 2 of 2

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[SURVEY PREVIEW MODE] Attachment E-2 Survey Questions

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NOTE: Questions 22-26 will be asked following a Types
of Radiation Emergencies infographic (specific images
will be rotated). See Attachment G (Infographics) for
images.

Attachment E-2 Survey Questions

*22. What was the main message of this brochure?

*23. On a scale from 1 to 5, where a 1 means "Strongly Disagree" and a 5 means
"Strongly Agree" how would you rate the following...?
1 - Strongly
Disagree

2

3

4

5 - Strongly Agree

This brochure was
easy to understand.
I liked the pictures in
this brochure.
I learned something
new by reading this.
I trust the information
in this brochure.
The suggestions for
dealing with radiation
emergencies made in
the message are
doable.

*24. How much of the brochure would you read?
I would only read the headline.
I would only look at the images.
I would only read the headline and look at the images.
I would read the whole thing.
I wouldn’t read any of it.

*25. Is there anything you especially liked about this brochure? Please explain.

*26. Is there anything you would change about this brochure? Please explain.

http://www.surveymonkey.com/s.aspx?PREVIEW_MODE=DO_NOT_USE_THIS_LINK_FOR_... 8/19/2013