App_A_Omnibus_Survey_Text_Version

OMB#: 0925-0648
Expiration Date: 01/2015

APPENDIX A: OMNIBUS SURVEY TEXT VERSION

The National Institutes of Health is conducting a survey to assist in meeting the information needs of the general public around health and science issues. We are asking you to participate in this brief survey, which should take about 2 minutes.

Your participation in this survey will help the NIH more effectively communicate to the public about health and science. The NIH is authorized to conduct this study under section 42 USC 285f of U.S. Law. If you have questions about this study, please contact Daniel Eckstein by email at DEckstein@novaresearch.com or phone: 240-483-4192.

By clicking on the NEXT button below, you certify that you are at least 18 years of age and voluntarily consent to participate in this survey. Thank you!

From:

Marin P. Allen, Ph.D.
Deputy Associate Director for Communications and Public Liaison and Director of Public Information
National Institutes of Health

Public reporting burden for this collection of information is estimated to average 2 minutes per response. This time includes the length of time allotted for the survey questions. 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). Do not return the completed form to this address.
 

OMNIBUS SURVEY

Stakeholders: General Public

NIH Awareness and Information

1. To the best of your recollection, when was the last time you remember hearing about the National Institutes of Health (NIH) or its scientific or health research?

Within the past 6 months	
Between 6 months and 1 year ago	
Between 1 year and 2 years ago	
More than 2 years ago	
Do not remember	
Never heard about NIH	

[ONLY ASK IF RESPONSE TO PREVIOUS QUESTION IS “a”, “b”, or “c”]

2. To the best of your recollection, in the last 2 years, how many times do you remember hearing about medical or health research by NIH?

   1-2 times	
   3-4 times	
   More than 4 times	

3. The National Institutes of Health (NIH) is part of the federal government and funds most of the medical and health research in our country in all 50 states and the District of Columbia. Tell us how interested you are in learning about:

	Very Interested	Moderately Interested	Slightly Interested	Not at all Interested
NIH research funding in your state.
Discoveries from studies funded by NIH.
Clinical trials where volunteers are needed by NIH.
Health information from NIH.

Clinical Trials

4. Clinical trial research is medical research that involves people to test new treatments and therapies. If you have ever participated in clinical research, please rate your experience.

   Never participated	One of the best			One of the worst
   	1	2	3		4	5

5. Would you consider participating in clinical research as a volunteer in the future? 

• Definitely consider

• May consider

• Would not consider

Health Information

6. How satisfied are you with the health information you receive from the following sources?

   	Don’t use this source	Very Satisfied	Moderately Satisfied	Slightly Satisfied	Not at all Satisfied
   Your physician or health professional
   Doctors on TV or radio
   Friends or family members
   Disease support groups (in person)
   Disease support groups (on line)
   Federal government online sources (.gov)
   Commercial internet sources (.com)
   Printed material at public libraries
   Other (specify) _______

7. What kind of information would you like a Federal agency that supports medical and health research to provide?

________________________________________________________

________________________________________________________