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Website Evaluation Form - For Fathers

Please let us know what you thought of our site.

NOTE: All information provided is protected and confidential, but also optional. Any information collected about you and your infant is for research purposes only.


Tell us about yourself:
Name:
Email Address:
City:
State:
Age:
 
Race/Ethnicity:
Race/Ethnicity Other :
Highest Education Level:
Highest Education Other:
Occupation:
Annual Household Income:
Relation to Infant's Mother :
Marital Status Other:
Total Number of Children:

Tell us about your infant:
Sex:
Date of Birth:
Current Age:
Any major delivery or health problems? Please describe:
Current Feeding Method:
Feeding Method Other:

If your infant is still being breastfed:

how long has your partner been breastfeeding?
months
If your infant is no longer breastfed:
how long did your partner breastfeed? months

 

Website Feedback

For each question below, please indicate the response that best fits your opinion and experience with the site. Space is provided below each question for additional comments (good or bad) about the areas assessed by the questions.

 

1. Did you use this site to:

1a. Prepare for a new baby?

1b. Help your partner troubleshoot a breastfeeding problem?

1c. Learn more about breastfeeding?

1d. Other:

2. How visually appealing did you find this website?

Why or why not?

 

3. How relevant to your experiences did you find the information provided by the site?

Why or why not?

 

4. How easy to understand did you find the information provided by the site?

Why or why not?

 

5. How interesting did you find the information provided by the site?

Why or why not?

 

6. Was there a piece of information that was most useful to:

6a. you?

6b. the mother of your infant?

6c. you in supporting the mother of your infant?

If so, what?

 

7. Did breastfeeding-related problems arise for you, your partner and/or your infant?

If so, what?

 

8. If problems occurred, did you use this resource to troubleshoot?

If so, how?

 

9. How easy was it to find the information you needed within this site?

Why or why not?

 

10. Was the website lacking any information you needed or think you might need in the future?

If so, please describe:

 

11. Did you use the downloads/tools provided by this site?

Why or why not?

 

12. Please indicate the extent to which you agree or disagree with the following statements:
  a. My ability to help my partner breastfeed was enhanced by this website.
  b. If not for this website, my partner would have stopped breastfeeding my infant at an earlier age.
  c. I felt comfortable helping my partner through her breastfeeding problems.
  d. I feel closer to my infant thanks to the tips and suggestions provided by this site.
  e. I would recommend this site to a friend.

 

13. Please rate the following features of this website for their usefulness:

  a. The PA Department of Health Downloads
  b. The "Help from Family and Friends" Checklist
  c. The "Input-Output Log "
  d. The "Infant Growth Tracking Chart"
  e. The "Nursing Nook" Checklist

14. How did you hear about this site?

14a. Other Sources

 

15. Do you have any additional questions, comments or concerns about this website?

You are done with this survey! Please check one more time to make sure you answered all of the questions, then click the button below to submit your feedback.