0920-1050 Weeks 2-3 Task Questions

Form Approved

OMB Control No. 0920-1050

Exp. Date: 06/30/2025

ATTACHMENT 5a

Weeks 2-3 Task Questions for MFHP Usability Study

Weeks 2-3 Task Questions:

Weeks 2-3 Family history data collection

Weeks 2-3 Task(s):

Task 1: Please use these two weeks to collect and save your family history data using the app. You can either input the family profiles and info yourself, or send a request using the app. Please collect history from at least 1-2 family members during this time. Gather as many family health history profiles as you can to get the most accurate results later on.

Week 2-3 Survey Questions:

1. Which option did you use when you were collecting your family health history and filling out their profiles?

   1. I already knew the information and filled it in on the app myself

   2. I talked to my family members and filled the information in on the app myself

   3. I sent a request by email

   4. I sent a request by text message (SMS)

   5. I sent a request through another application such as WhatsApp, Facebook, or Instagram

   6. A mix of the options above

   7. Other [open text]

2. How many family member profiles were you able to complete?

   1. [Open-ended]

3. Which profiles were you able to complete? Check all that apply.

   1. [ ] Parents

   2. [ ] Siblings and/or Half-Siblings

   3. [ ] Grandparents

   4. [ ] Aunts and/or Uncles

   5. [ ] Your Children

   6. [ ] N/A

4. Thinking about the whole process of sending the request(s) (or entering the info yourself) and getting the family profiles (total profiles you ended up adding) filled out, about how long (in hours) did it take for you to collect the information for the additional profiles?

   1. [Open-ended]

5. How easy or hard was the process of getting your family health history information filled out?

   1. 1-5 (1 being very difficult to 5 being very easy)

6. Please tell us about the overall experience of filling out family profile information. Did you have any problems with this task? What did you think about the ways the app let you request profiles? Was it easy to figure out what to do? If yes, please describe below.

   1. [Open-ended]

Public reporting burden of this collection of information is estimated to average 1 hour (60 minutes) per response, including completing assigned weekly study tasks and associated surveys. 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 CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1050).