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  Back to Surveys Visitor Survey 3
This survey, developed in conjunction with a blood test meter manufacturer, is designed to expand our knowledge of the visitors to children with DIABETES so we can provide children with diabetes and their parents with information and resources that meet their needs. This survey is for kids and teens 18 years and under or their parents.

The survey contains a total of 34 questions that you answer by clicking on a box or circle next to your answer. If you see a box, you can check more than one answer. If you see a circle, you can check only one answer. You will have to scroll down to answer all the questions.

Thank you very much for helping.

This survey is now closed. The results are being analyzed and will be posted soon.


  1. Who is answering this survey?
    Child or teenager 18 and under with diabetes
    Parent of child or teenager 18 and under with diabetes

    This survey is for kids and teens 18 years and under or their parents.

  2. Where do you live?
    USA
    Canada
    Mexico
    Europe
    Asia
    Australia/NZ
    Other (please specify)

  3. How many people are living in your home?
    One
    Two
    Three or more

  4. Age of child or teenager with diabetes?

  5. Is the child or teenager with diabetes a boy or girl?
    Boy
    Girl

  6. What is the ethnic background of child or teenager with diabetes?
    Caucasian
    African American
    Oriental
    Native American
    Other

  7. What was the age when diabetes was first diagnosed?

  8. What kind of doctor or specialist is seen for diabetes? (Check all that apply.)
    Pediatrician
    Family or general practitioner
    Specialist (endocrinologist or diabetologist)
    Diabetes Educator
    Other healthcare professional
    Don't know

  9. How is diabetes being controlled? (Check all that apply.)
    Insulin
    Pills
    Diet
    Exercise

  10. Are blood glucose levels tested at home or away from home (not at doctor's office) with a meter?
    Yes
    No

    If you don't use a meter at home or away from home, please skip to the Information and Internet Use questions.

  11. About how often is blood glucose tested with a meter either at home, away from home or school?
    5 or more times a day
    4 times a day
    3 times a day
    2 times a day
    Once a day
    Less than once a day

  12. How many meters do you use?

  13. What brands of meters do you use? (Check all that apply.)
    Glucometer Encore
    Glucometer Elite
    Other Glucometer or Bayer / Ames / Miles
    Accuchek I / II / III
    Accuchek Instant
    Accuchek Easy
    Accuchek Advantage
    Other Boehringer Mannheim
    One Touch Basic
    One Touch (Original)
    One Touch Profile
    One Touch II
    SureStep
    Other LifeScan / One Touch
    ExacTech Companion
    ExacTech Companion 1 or 2
    ExacTech Companion Jr.
    ExacTech RSG
    Precision QID
    Other MediSense / ExacTech
    Other Meter Brand

  14. If more than one meter is used, what brand is used most often? (Select one.)
    Glucometer Encore
    Glucometer Elite
    Other Glucometer or Bayer / Ames / Miles
    Accuchek I / II / III
    Accuchek Instant
    Accuchek Easy
    Accuchek Advantage
    Other Boehringer Mannheim
    One Touch Basic
    One Touch (Original)
    One Touch Profile
    One Touch II
    SureStep
    Other LifeScan / One Touch
    ExacTech Companion
    ExacTech Companion 1 or 2
    ExacTech Companion Jr.
    ExacTech RSG
    Precision QID
    Other MediSense / ExacTech
    Other Meter Brand

  15. At what locations are meters used? (Check all that apply.)
    At home
    At school
    At daycare or after school care
    Other places away from home

  16. How satisfied are you with meter you use most often?
    Completely satisfied
    Very satisfied
    Somewhat satisfied
    Not very satisfied
    Not at all satisfied

  17. How likely are you to recommend the meter you use most often to another child or teenager who has diabetes?
    Definitely recommend
    Probably recommend
    Might or might not recommend
    Probably not recommend
    Definitely not recommend

    Information and Internet Use Questions

  18. Where do you look for information about diabetes? (Check all that apply.)
    From parents
    From doctor/specialist
    From support groups
    Diabetes Magazines
    The Internet

  19. When did you first visit the children with DIABETES website?
    Within the past month
    Within the past 6 months
    Within the past year
    Over a year ago
    I don't remember

  20. How often do you visit the children with DIABETES website?
    Every day
    More than once a week
    Once a week
    Less than once a week
    This is my first visit

  21. How useful is the children with DIABETES website?
    Extremely useful
    Very useful
    Somewhat useful
    Not very useful
    Not at all useful

  22. What types of information on the children with DIABETES website are most useful to you? (Check all that apply.)
    Chat rooms
    News about research
    Other news
    Ask the Diabetes Team Questions and Answers
    General information about diabetes
    Product reviews
    Message board
    Food and diet
    Kids, parents and adults stories
    Camps
    School information
    Diabetes dictionary

  23. Check which of the following kinds of information you would like to have available on the children with DIABETES website. (Check all that apply.)
    General research on diabetes
    Information on new products
    Research studies looking for participants
    Research on cure for diabetes
    Children's rights at school
    Other (fill in)

  24. What, if any, of the following diabetes websites have you visited? (Check all that apply.)
    Juvenile Diabetes Foundation
    American Diabetes Association
    American College of Physicians
    Diabetes Monitor
    Local ADA Affiliates (independent websites)
    Diabetes and Hypoglycemia Forum on CompuServe
    Medilife
    Diabetes UK
    On-Line Resources for Diabetics

  25. Where do you access the Internet? (Check all that apply.)
    Home
    At school
    At friends
    At office

  26. For what reasons do you usually go on the Internet? (Check all that apply.)
    Sports/news/weather
    Education/information
    Shopping
    E-mail
    Chatroom
    Games
    Other reasons (please fill in)

  27. How many hours a week do you usually spend on the Internet?
    Less than one hour a week
    One to two hours a week
    Three to five hours a week
    Six to ten hours a week
    Over ten hours a week

    Please answer questions 28 to 32 only if you are the parent of a child with diabetes who uses a meter:

  28. How likely would you be to buy products over the Internet using a credit card, that is providing your credit card information on-line in order to make the purchase?
    Have already bought
    Definitely would buy
    Probably would buy
    Might or might not buy
    Probably not buy
    Definitely not buy

  29. How likely would you be to buy products over the Internet by calling an off-line customer service number and giving your credit card information over the phone?
    Have already bought
    Definitely would buy
    Probably would buy
    Might or might not buy
    Probably not buy
    Definitely not buy

  30. Which of the following types of products, if any, would you consider buying on a diabetes website? (Check all that apply.)
    Diabetes medications
    Diabetes home testing products (meters, strips, lancing devices, etc.)
    Clothing (T-shirts, shoes, etc.)
    Diabetes informational materials (videos, books, etc.)
    Personal care items (soap, toothpaste, etc.)
    General non-prescription drugs (cold/flu, pain relievers, etc.)
    None of these products

  31. Which of the following statements best describes how the last blood glucose meter was bought?
    Paid for the product with your own money and then sent in an insurance form to receive money back
    Paid for the product with your own money but your insurance company at the time did not cover that item
    You paid for the product with your own money because you had no health insurance at the time
    You presented a card to your pharmacist and paid a small amount of money for the product, sometimes called a co-pay
    You received the product free and there for didn't have to pay for it with your own money
    Don't know how the most recent meter was bought

  32. Which of the following statements best describes how the last box of strips was bought?
    Paid for the product with your own money and then sent in an insurance form to receive money back
    Paid for the product with your own money but your insurance company at the time did not cover that item
    You paid for the product with your own money because you had no health insurance at the time
    You presented a card to your pharmacist and paid a small amount of money for the product, sometimes called a co-pay
    You received the product free and there for didn't have to pay for it with your own money
    Don't know how the most recent box of strips was bought

    The remaining questions are for everyone.

  33. Would you be interested in participating in an on-line discussion group on your experiences with diabetes and products for treating diabetes?
    Yes
    No
    If you are interested, please enter your e-mail address so we can contact you. Your e-mail address will not be used for any other purpose.

  34. If you would like to add any comments, please do so here.

Thanks for helping with the survey.

This survey is now closed. The results are being analyzed and will be posted soon.



                 
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Last Updated: Thursday August 29, 2002 20:59:46
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