Form 1021 2017 1021 TRICARE Publications Functional 5.18.17

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Overview

Model Questions
Custom Questions

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Sheet 1: Model Questions

Model Name		TRICARE Publications Functional					Red & Strike-Through: Delete
Model ID		NEW MEASURE NEEDS MID					Underlined & Italicized: Re-order
Partitioned		No					Pink: Addition
Date		5/112017
Model Version		UPDATE					Blue: Reword
	Label	Element Questions		Label	Satisfaction Questions		Label	Future Behaviors

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Sheet 2: Custom Questions

Model Name	TRICARE Publications Functional				Red & Strike-Through: Delete
Model ID	NEW MEASURE NEEDS MID				Underlined & Italicized: Re-order
Partitioned	No				Pink: Addition
Date	5/11/2017				Blue: Reword
QID	Skip From	Question Text	Answer Choices	Skip To	Required Y/N	Type	Special Instructions	CQ Label
		What is your overall satisfaction with the content of TRICARE's publications?	1=Very Dissatisfied		Y	Radio button, scale, no don't know		Satisfaction
			2
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			10=Very Satisfied
		My primary interest in TRICARE's publications was:	For myself or a family member in my household		Y	Radio button, one-up vertical		Publ - Info Usage
			For a friend or family member (not living in my household)
			For a physician's office/hospital
			For a patient or client
			For a public health agency
			For a research institution
			For a business/workplace
			For an educational institution or teaching purposes
			For a school/class project
			For a news report or article
			Other
		How did you look for or obtain the publications of interest to you today? (Please select all that apply.)	I used the website's category dropdowns to narrow to items of interest	A	Y	Checkbox, one-up vertical	Skip Logic Group*	Access Method
			I used the website's publications key word entry field	A
			I looked over the entire list of publications on the website	A
			I came directly to the publication from an email link
			I came directly to the publication from a link on the internet
			I used an external search engine (Google, Bing, etc.)
			I received a physical copy of the publication
			I saw a printed reference (poster, brochure, magazine, mailing, etc.)
			Other
	A	Did you find the publication(s) you were interested in?	Yes	C	Y	Radio button, one-up vertical	Skip Logic Group*	Accomplish Site
			No	B
	B	Please tell us what publications you were unable to find:			N	Text area, no char limit	Skip Logic Group*	Accomplish Site No OE
	C	Was it easy to find the publication(s) you were seeking?	Yes		Y	Radio button, one-up vertical	Skip Logic Group*	Accomplish Site Easy
			No	C1
	C1	Please briefly describe the difficulty you had finding the publications you were seeking:			N	Text area, no char limit	Skip Logic Group*	Accomplish Site Not Easy OE
		Did the publication(s) you accessed contain relevant and complete information?	Yes		Y	Radio button, one-up vertical	Skip Logic Group*	Publication Relevance
			No	A
			I did not access any publications
	A	Please describe what information was irrelevant or incomplete (include publication name/topic if possible):			Y	Text area, no char limit	Skip Logic Group*	Publication Relevance OE
		Please select your level of agreement with the following statements about TRICARE's publications: Titles are relevant and easy to understand.	1=Strongly Disagree		Y	Radio button, scale, has don't know		Publ Agree: Subject Lines
			2
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			10=Strongly Agree
			Don’t know
		The information provided is valuable to me or my organization.	1=Strongly Disagree		Y	Radio button, scale, has don't know		Publ Agree: Valuable
			2
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			10=Strongly Agree
			Don’t know
		The content is clear and easy to understand.	1=Strongly Disagree		Y	Radio button, scale, has don't know		Publ Agree: Clarity
			2
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			10=Strongly Agree
			Don’t know
		There is enough information provided for me to take action on (if necessary).	1=Strongly Disagree		Y	Radio button, scale, has don't know		Publ Agree: Action
			2
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			9
			10=Strongly Agree
			Don’t know
		The supplemental links provided in the publication are useful.	1=Strongly Disagree		Y	Radio button, scale, has don't know		Publ Agree: Links Useful
			2
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			10=Strongly Agree
			Don’t know
		The length of the publication is appropriate.	1=Strongly Disagree		Y	Radio button, scale, has don't know		Publ Agree: Length
			2
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			9
			10=Strongly Agree
			Don’t know
		Which best describes you?	Active duty service member (includes all uniformed services)		Y	Radio button, one-up vertical	Skip Logic Group*	Role
			Retired service member
			National Guard or Reserve member (active, reserve or retired)
			Family of active duty service member
			Family of retired service member
			Family of National Guard or Reserve member
			Other (provider, staff, government, media, etc.)
		How often do you access TRICARE's publications?	This is my first time		Y	Radio button, one-up vertical	Skip Logic Group*	Access Frequency
			Once every 6 months or less often	A
			Once every few months	A
			Monthly	A
			Weekly or more often	A
	A	On what device do you typically access TRICARE's publications?	Desktop/laptop computer		Y	Radio button, one-up vertical	Skip Logic Group*	Access Device
			Smartphone
			Tablet
			None of these
	A	On average, how many other people do you share the information with?	No one other than myself		Y	Radio button, one-up vertical	Skip Logic Group*	Access Sharing
			1-5 people
			6-20 people
			21-50 people
			51-100 people
			More than 100 people
		What is your gender?	Male		N	Radio button, one-up vertical		Demos: Gender Fed Govt
			Female
			Prefer not to respond
		Which category includes your age?	Under 25		N	Radio button, one-up vertical		Demos: Age
			25 - 34
			35 - 44
			45 - 54
			55 - 64
			65 or older
			Prefer not to respond
		If there are any new topics you would like to see covered in a future publication, please share your idea here:			N	Text area, no char limit		New Publications
		If you have other thoughts on improving TRICARE's publications (regarding either the publications themselves, or on using the publications website area), please share them here:			N	Text area, no char limit		Improvements