Calendar User Feedback Survey

Consent

Introduction: The Regional Integrated Fall Prevention & Management Strategy, in collaboration with the Ontario Age-Friendly Community Outreach Initiative, is conducting surveys to get feedback on a 14-month calendar. The calendar was distributed throughout the South Eastern Ontario region to increase awareness of fall risk factors and services available in the region.

Purpose: The purpose of this survey is to collect feedback from users on how useful they found the calendar. We want to find out if it improved their awareness of some of the causes of falls and how to avoid them. We also want to find out if it increased their awareness of resources for older adults in their community.

Description of the survey procedures: If you agree to complete this survey, you will be asked to provide feedback on the 2017-2018 calendar. You will be asked to answer and elaborate on a series of questions regarding your opinions of the calendar. The survey should take approximately 20 minutes to complete.

Voluntary participation: Participation in this survey is completely voluntary. You may refuse to answer any questions or withdraw at any time without affecting your relationship with the investigators. In addition, you have the right to request that your feedback not be involved in the project.

Benefits of participation: Information collected in this survey may help community and health service providers understand how to better promote falls prevention information and participation in services. It will also support our ability to offer calendars in future years. 

Risks of participation: There are no anticipated risks associated with participating in this survey.

Confidentiality: Information collected from this survey will only be accessible to investigators directly involved with the project. Data regarding calendar feedback may be shared with other stakeholders for the purpose of improving the calendars for future years but no personal information about participants will be shared.

Consent: By proceeding to the following question you agree to complete this survey and that you have read and understood the information provided above.
1.Please provide the first 3 digits of your postal code
2.Please select the options below which best describe you. You may select more than one.
3.How would you describe the location of your home?
4.How would you describe the type of housing that you live in?
5.Please select all that apply
6.Do you think the calendar is a good way to provide fall prevention information?
7.Please indicate which of the recommended websites you visited as a result of the calendar. You may select more than one.
8.Did you feel the pictures in the calendar were representative of your community?
9.Did you like the pictures in the calendar?
10.Please rate the following characteristics of the calendar.
Needs Improvement
Fine
Good
Excellent
Print size
Calendar size
Calendar layout
Quality of pictures
11.Please rate the content of the calendar below.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
I learned something new from the calendar
The calendar inspired me to make a change
The calendar clearly outlines fall risk factors
The calendar clearly outlines ways to reduce risk of falling
12.Have you or will you use the calendar for the following:
I have
I have not
I plan to
Tracking Physical Activity
Tracking Falls or Near Falls
Setting Goals
13.Select any of the recommendations from the calendar that you have tried or will try as a result of reading the calendar. You may select more than one.
14.Are you more likely to investigate fall prevention or other programming after reading the calendar?
15.Did the calendar increase your awareness of falls prevention or seniors programs and services?
16.Did you learn about programs and services you weren't previously aware of?
17.Would you share this calendar with, or recommend this calendar to, a friend or family member?
18.Please select all that apply regarding your desire for a calendar in future years.
19.What did you like most about the calendar?
20.Is there anything missing or anything that should be changed about the calendar?
21.If you would like to be entered in a draw to win a $50 gift card, please put your name and contact information below.
22.Please check the following box if you are willing to participate in follow-up questions regarding the survey/calendar.