Form 1 NLM AIDSource 2017 Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

NLM AIDSource 2017 Survey Instrument

NLM AIDSource 2017 Survey

OMB: 0925-0648

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OMB Control Number: 0925-0648
Expiration Date: 03/31/2018
Public reporting burden for this collection of information is estimated to average 5 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 current 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.

_________________________________________________________
2017 AIDSource Survey
1. What is your primary role in visiting AIDSource today?
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

Case manager/outreach worker
Educator
Friend or family of someone living with HIV
Healthcare professional
Librarian
Navigator
Person living with HIV
Researcher
Student
Other, please specify

1b. What is your job title?
1c. What type of navigator are you?
a.
b.
c.
d.

HIV navigator
Patient navigator
PrEP navigator
Other, please specify

1d. (Case Manager/outreach worker, HCP, Navigator, Researcher, Other). What populations do you
work with?
a.
b.
c.
d.
e.

Drug users
Homeless
LGBTQ
Minority populations
Older adults

f.
g.
h.
i.

Women
Youth
Not applicable
Other, please specify

1e. What type of educator are you?
2. What information were you looking for on AIDSource today?
3. Did you find what you were looking for?
a. Yes
b. No
c. Partially
3b. Please explain.
4. When coming to AIDSource, did you search for materials in languages other than English?
a. Spanish
b. Other, please specify
c. No
5. Finding information on AIDSource was:
a.
b.
c.
d.

Very easy
Somewhat easy
Somewhat difficult
Very difficult

6. What do you like about AIDSource?
7. What would make AIDSource better?
8. Would you recommend AIDSource to others who are looking for HIV-related resources?
a. Yes
b. No


File Typeapplication/pdf
AuthorCopty, Christina
File Modified2017-11-21
File Created2017-11-21

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