Attachment D: Message and Material Feedback Surveys — Health Material Questions (text)
OADC Message and Material Feedback Surveys — Health Material Questions (text)
Form Approved
OMB No. 0920-0572
Review Material
The
next questions are about this health material. Please take a few
minutes to read it entirely. After
90 seconds you’ll be
able to continue to the next page (you may stay on this page as long
as you like).
As you read, please write down any words, phrases, or numbers that you think would be unclear to a family member or friend. [Participants will review the health material — See Attachment B for screenshots.]
One quick question before you get started: Do you see the health material above this question on your screen?
Yes
No [End survey]
[After 90 seconds, Continue button will allow participant to proceed]
Main Audience, Message, & Intended Behavioral Recommendation
Now, we’d like to ask you a few questions about the information you read in the health material.
Note: If you want to look at the health material again, click the Previous button. If you've answered any questions on this page click Next, then click Previous. Answers on previous pages are already saved.
Please list any
words, phrases, or numbers
you think would be unclear
to a family member or friend. (Your answer may be “none.”)
[open-ended response]
Who do you think this material is
written for?
[open-ended response]
What is the main message of this material? [open-ended response]
[new survey page]
What
is this material asking you to
do? [open-ended response]
How likely are you to do this?
Very unlikely (1) |
(2) |
Unsure (3) |
(4) |
Very likely (5) |
How confident are you that you can do this?
Not at all confident (1) |
(2) |
Neutral (3) |
(4) |
Very confident (5) |
How important is this information to you?
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Modified Consumer Information Rating Form (CIRF)
Next, we'd like to ask you what you thought about this material. For each of the following questions, please select the answer that most closely reflects your opinion.
To jog your memory, here's the material again. (Use your mouse to scroll through the material.)
Overall, how easy or hard would you say it is to…
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Very easy (1) |
Pretty easy (2) |
In between (3) |
Pretty hard (4) |
Very hard (5) |
Read this information |
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Understand this information |
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Remember this information |
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Find important information |
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In
your opinion, what would make this material easier
to understand? [open-ended
response]
Please indicate your opinion about how much information was provided in this material.
Not enough
Just right
Too much
Modified Consumer Information Rating Form (CIRF), continued
If you came into contact with this material for the first time and received this information, how likely is it that you would…
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Very likely (1) |
Somewhat likely (2) |
Unsure (3) |
Somewhat unlikely (4) |
Very likely (5) |
Read the material |
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Use the information |
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Keep the material |
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In
your opinion, what would make this material more
useful? (Your answer may be
“nothing.”) [open-ended response]
Modified Consumer Information Rating Form (CIRF), continued
Finally,
we would like to ask you about how the material looks
and sounds. Please select the
choice that best describes your
opinion.
To
jog your memory, here's the material again. (Use your mouse to scroll
through the material.)
[new
survey page]
Organization
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Attractiveness
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Text Size
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Tone
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Helpfulness
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Bias
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Spacing between text and graphics
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In your opinion, what could improve the overall look and feel of this material? (Your answer may be “nothing.”) [open-ended response]
Thank You & End of Survey
Thank you for sharing your opinions with us. Please click Next to submit your response.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Kelsey Jordan |
File Modified | 0000-00-00 |
File Created | 2021-01-25 |