1 Survey Instrument

OMB CONTROL NO.: 0925-0648

EXPIRATION DATE: 3/2018

OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0925-0648. The time to complete this information collection is estimated as part of the 15 minutes, including the time for reviewing instructions and completing the information.

Public reporting burden for this collection of information is estimated to average 15 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0648).

This survey seeks your feedback on a draft version of a new informational brochure. Your responses to the survey will help the National Institute of Nursing Research (NINR) develop a final version of the brochure.

CONSENT FOR PARTICIPATION

Before you take the questionnaire today, we need to ask you to formally consent to participate. Please carefully read the following statements and check the box below acknowledging that you understand each statement and agree to participate in the survey.

1. I understand that my participation is voluntary. I can choose not to answer questions, and I can withdraw from the questionnaire at any point.

2. I understand that all information collected in the questionnaire is secure to the extent permitted by law, and will not be disclosed to anyone but the researchers conducting this study, except as otherwise required by law. All findings will be reported in aggregate.

3. I will not be asked any personally identifying information when responding to the questionnaire. My personal identity will be protected. A transcript of the questionnaire will be stored securely and will only be accessible to the research team. No one will be identified in reports resulting from this questionnaire.

NINR is authorized to conduct the following survey under section 42USC 285q of U.S. Law.

If you have questions about the survey or your participation, please contact the National Institute of Nursing Research by email at info@ninr.nih.gov or by phone at 301-496-0209.

By selecting “I Accept,” I acknowledge and accept the consent statement and agree to participate in the questionnaire. [REQUIRED]

1. Accept

2. I Do Not Accept [TERMINATE]

Please note: After you have selected an answer, hit the “next” button to continue to the next question. You will see a thank-you page when you have reached the end of the survey. For open ended questions, please do not enter any personally identifying information. To read NINR’s privacy policy, click here.

I am at least 18 years old. [REQUIRED]

1. Yes

2. No [TERMINATE]

SCREENER QUESTIONS

Had you heard of the National Institute of Nursing Research (NINR) before learning about this survey? [REQUIRED] (RECRUIT A 50/50 MIX)

1. Yes

2. No

Which of the following best describes you? If “other,” please use the text box to specify. [REQUIRED] (RECRUIT A MIX OF ALL TYPES – AROUND 25% EACH) (Select all that apply)

• Student

• Healthcare professional

• Educator

• Other: Please specify: __________ [Open-ended text box] [ANCHOR]

[TERMINATE ONCE THE QUOTA PER EACH GROUP IS MET]

MAIN QUESTIONNAIRE

Draft Brochure

You will now be shown a draft version of the brochure. Following your review, you will be asked a series of questions.

Brochure Content

First, we’ll ask you for your reactions to the brochure’s content (the topics and information). Later, we’ll ask about the brochure’s design and layout. Please first read the brochure below, and then respond to the questions that follow.

You may refer to the brochure at any time.

[Brochure mock-up to be displayed here.]

1. Overall, was the information presented clear and easy to understand?

• Yes

• No

• I prefer not to respond

[If the respondent selects “No,” go to the next question.]

1a. Please tell us what parts of the brochure were not clear or easy to understand and why. [open-ended text box]

_______________________________________________

2. Overall, how did you feel about the information provided within the brochure?

• The information provided was interesting

• The information provided was boring

• I prefer not to respond

[If the respondent selects “The content was boring,” go to the next question.]

2a. Please tell us what parts of the brochure were boring and why. [open-ended text box]

_______________________________________________

3. Please provide suggestions for other topics or information that should be included in this brochure (if any). [open-ended text box]

__________________________________________________­­­­

4. Overall, how did you feel about the length of the brochure?

• The brochure was too short

• The brochure was just the right length

• The brochure was too long

• I prefer not to respond

5. NINR is considering a few title options. Which title option is your favorite and best describes the information in the brochure? [RANDOMIZE]

• National Institute of Nursing Research: Nursing Science Improving Health

• National Institute of Nursing Research: Advancing Science, Improving Health

• National Institute of Nursing Research: Nursing Science Making a Difference

• National Institute of Nursing Research: Improving Health Across the Lifespan

• I don’t like any of these titles [ANCHOR]

• I prefer not to answer [ANCHOR]

[If the respondent selects “I don’t like any of these title options,” go to the next question.]

5a. What is the main reason you do not like any of these titles?

• The titles are too broad

• The titles are too generic

• The titles are not catchy

• The titles do not reflect what the brochure is about

• Other: Please specify: ______________

• I prefer not to answer

5b. Please provide your suggestions for a different brochure title: [open-ended text box]

__________________________________________________________________

Design and Layout of the Brochure

Now, we’ll ask you a few questions about the brochure’s design and layout. [Brochure mock-up to be displayed here.]

6. What do you think about the brochure’s design and layout?

• I like the design and layout

• I do not like the design and layout

• I prefer not to answer

[If the respondent selects “I do not like the design and layout,” go to the next question.]

6a. What is the main reason you do not like the design and layout of the brochure? [open-ended text box]

__________________________________________________________________

7. What do you think about the photos used throughout the brochure?

• I like the photos

• I do not like the photos

• I prefer not to answer

[If the respondent selects “I do not like the photos,” go to the next question.]

7a. What is the main reason you do not like the photos in this brochure? [open-ended text box]

__________________________________________________________________

8. What do you think about the number of photos in this brochure?

• There are too few photos

• There is just the right number of photos

• There are too many photos

• I prefer not to answer

9. Please offer suggestions for improving the brochure’s design or layout. [open-ended text box]

__________________________________________________________________

10. Please provide any final comments on anything (content- or design-related) about this brochure. [open-ended text box]

__________________________________________________________________

Thank you so much for completing this survey. Your feedback is very important to us.