Who is answering this survey?
This survey is for kids and teens 18 years and under or their parents.
Where do you live?
How many people are living in your home?
Age of child or teenager with diabetes?
Is the child or teenager with diabetes a boy or girl?
What is the ethnic background of child or teenager with diabetes?
What was the age when diabetes was first diagnosed?
What kind of doctor or specialist is seen for diabetes? (Check all that apply.)
How is diabetes being controlled? (Check all that apply.)
Are blood glucose levels tested at home or away from home (not at doctor's office) with a meter?
If you don't use a meter at home or away from home, please skip to the Information and Internet Use questions.
About how often is blood glucose tested with a meter either at home, away from home or school?
How many meters do you use?
What brands of meters do you use? (Check all that apply.)
If more than one meter is used, what brand is used most often? (Select one.)
At what locations are meters used? (Check all that apply.)
How satisfied are you with meter you use most often?
How likely are you to recommend the meter you use most often to another child or teenager who has diabetes?
Information and Internet Use Questions
Where do you look for information about diabetes? (Check all that apply.)
When did you first visit the children with DIABETES website?
How often do you visit the children with DIABETES website?
How useful is the children with DIABETES website?
What types of information on the children with DIABETES website are most useful to you? (Check all that apply.)
Check which of the following kinds of information you would like to have available on the children with DIABETES website. (Check all that apply.)
What, if any, of the following diabetes websites have you visited? (Check all that apply.)
Where do you access the Internet? (Check all that apply.)
For what reasons do you usually go on the Internet? (Check all that apply.)
How many hours a week do you usually spend on the Internet?
Please answer questions 28 to 32 only if you are the parent of a child with diabetes who uses a meter:
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?
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?
Which of the following types of products, if any, would you consider buying on a diabetes website? (Check all that apply.)
Which of the following statements best describes how the last blood glucose meter was bought?
Which of the following statements best describes how the last box of strips was bought?
The remaining questions are for everyone.
Would you be interested in participating in an on-line discussion group on your experiences with diabetes and products for treating diabetes?
If you would like to add any comments, please do so here.
