1. Did you find the information on the video helpful? |
______ Not at all |
______ A little |
______ Somewhat |
______ Quite a bit |
______ A great deal |
2. Did you learn something you did not know about heart disease after watching the video? |
______ Not at all |
______ A little |
______ Somewhat |
______ Quite a bit |
______ A great deal |
3. Was the atmosphere in the emergency department a good place to view the video? |
______ Yes |
______ No |
______ Unsure |
4. Did you feel comfortable watching the video in the emergency department waiting room? |
______ Not at all |
______ A little |
______ Somewhat |
______ Quite a bit |
______ A great deal |
5. How would you rate the length of the video? |
______ Too short |
______ A little short |
______ About right |
______ A little bit long |
______ Too long |
6. Would you watch this video again if you could? |
______ Yes |
______ No |
______ Unsure |
7. Do you think you would get more information if this video was shown in a place other than the Emergency Department? |
______ Yes |
______ No |
______ Unsure |
8. After watching the video, do you think you will change any part of your current lifestyle to decrease your chances of heart disease? |
______ Not at all |
______ A little |
______ Somewhat |
______ Quite a bit |
______ A great deal |
9. Was it difficult to watch the video in the Emergency Department waiting room? |
______ Not at all |
______ A little |
______ Somewhat |
______ Quite a bit |
______ A great deal |