Survey on Accessible Print Materials

For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.

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Table of Contents

Demographic questions (AGE)

Demographic questions (AGE) - Question identifier:AGE_Q01A

What is your date of birth?
Year

Min = 1901; Max = 2022

Demographic questions (AGE) - Question identifier:AGE_Q01B

What is your date of birth?
Month

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December

Demographic questions (AGE) - Question identifier:AGE_Q01C

What is your date of birth?
Day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31

Demographic questions (DEM)

Demographic questions (DEM) - Question identifier:DEM_Q05

To determine which geographic region you live in, please provide your postal code.

Long Answer Length = 7

Difficulties with print materials (DPM)

Difficulties with print materials (DPM) - Question identifier:DPM_R05

The following questions are about difficulties a person may have when reading print materials.

These print materials can include:
- Books or textbooks
- Newspapers
- Magazines
- Journals
- Pamphlets or brochures
- Menus or posters
- Forms
- Instructions on pill bottles
- Receipts or bills
- Letters or other mail.

Difficulties with print materials (DPM) - Question identifier:DPM_Q05

Do you wear glasses or contact lenses to improve your vision?

  • 1: Yes
  • 2: No
  • 9: DK

Difficulties with print materials (DPM) - Question identifier:DPM_Q10

In general, [with your glasses or contact lenses, which/which] of the following best describes your ability to see words in print?

Would you say:

  • 1: No difficulty seeing
  • 2: Some difficulty seeing
  • 3: A lot of difficulty seeing
  • 4: You are legally blind
  • 5: You are blind
  • 9: DK

Difficulties with print materials (DPM) - Question identifier:DPM_Q15

In general, how much difficulty do you have using your fingers to hold or turn the pages of a book or other paper-based print materials?

Would you say:

  • 1: No difficulty holding or turning
  • 2: Some difficulty holding or turning
  • 3: A lot of difficulty holding or turning
  • 4: You cannot do it at all
  • 9: DK

Difficulties with print materials (DPM) - Question identifier:DPM_Q20

In general, excluding a vision condition, how much difficulty do you have reading or understanding words in print?

Would you say:

  • 1: No difficulty reading or understanding
  • 2: Some difficulty reading or understanding
  • 3: A lot of difficulty reading or understanding
  • 4: You cannot do it at all
  • 9: DK

Aids and assistive devices (AAD)

Aids and assistive devices (AAD) - Question identifier:AAD_R05

The following questions are about various assistive aids, devices or technologies that you may use for your difficulty with print material.

Assistive aids, devices or technologies are devices or tools designed or adapted to help a person perform a particular task or activity.

Aids and assistive devices (AAD) - Question identifier:AAD_Q05

Due to your difficulty when reading print material, do you use any of the following?

Do you use:

  • 01: Eye glasses or contact lenses
  • 02: Screen reader (e.g., NVDA, JAWS or Voiceover)
  • 03: Read aloud function in an app on a device (e.g., optical character recognition (OCR))
  • 04: Braille refreshable display device, braille notetaker, braille reading materials, manual brailler
  • 05: Magnifiers (Include digital devices such as Ruby.)
  • 06: Screen magnifying software (e.g., magnifying software such as ZoomTech, MAGic)
  • 07: Large print reading materials
  • 08: Dark lined paper or dark ink pens
  • 09: The option to adjust colour, fonts, spacing
  • 10: Voice control, switches and eye tracking technologies
  • 11: Closed-circuit devices (e.g., CCTV)
  • 12: Low-tech vision aides (e.g., monocular, binocular, bioptics)
  • 13: Device for playing audio books (e.g., tablet, smart speaker such as Google Home or Amazon Echo)
  • 14: Device for reading e-books available in accessible format (e.g., tablet)
  • 15: Computer, laptop or tablet with specialized software or apps or other adaptations
  • 16: Cell phone, smartphone or smartwatch with specialized features or apps to help with your condition
  • 17: Other
  • 18: None
  • 99: DK

Aids and assistive devices (AAD) - Question identifier:AAD_Q10

Are there any assistive aids, devices or technologies or specialized equipment that you think you need but do not have?

  • 1: Yes
  • 2: No

Aids and assistive devices (AAD) - Question identifier:AAD_Q15

Which assistive aids, devices or technologies or specialized equipment do you need but do not have?

  • 01: Eye glasses or contact lenses
  • 02: Screen reader (e.g., NVDA, JAWS or Voiceover)
  • 03: Read aloud function in an app on a device (e.g., optical character recognition (OCR))
  • 04: Braille refreshable display device, braille notetaker, braille reading materials, manual brailler
  • 05: Magnifiers (Include digital devices such as Ruby.)
  • 06: Screen magnifying software (e.g., magnifying software such as ZoomTech, MAGic)
  • 07: Large print reading materials
  • 08: Dark lined paper or dark ink pens
  • 09: The option to adjust colour, fonts, spacing
  • 10: Voice control, switches and eye tracking technologies
  • 11: Closed-circuit devices (e.g., CCTV)
  • 12: Low-tech vision aides (e.g., monocular, binocular, bioptics)
  • 13: Device for playing audio books (e.g., tablet, smart speaker such as Google Home or Amazon Echo)
  • 14: Device for reading e-books available in accessible format (e.g., tablet)
  • 15: Computer, laptop or tablet with specialized software or apps or other adaptations
  • 16: Cell phone, smartphone or smartwatch with specialized features or apps to help with your condition
  • 17: Other
  • 18: None
  • 99: DK

Aids and assistive devices (AAD) - Question identifier:AAD_Q20

Why do you not have the aids, assistive devices or technologies that you need?

Is it:

  • 01: Cost (e.g., not covered by insurance, too expensive to purchase or repair)
  • 02: Do not know how to use assistive aids, devices or technologies
  • 03: Do not want to or not willing to upgrade from current aid or assistive device
  • 04: Unsure how or where to get aid or assistive device
  • 05: Not available through local service provider (e.g., public library, community centre, organizations that support persons with disabilities)
  • 06: On a waiting list
  • 07: Available aids cannot be adapted
  • 08: Other reasons

Alternate formats (ALT)

Alternate formats (ALT) - Question identifier:ALT_R05

The next questions ask about alternate formats for print materials. Alternate format refers to a different way to access information other than by standard text or standard presentation.

Examples can include:
- Audio versions to help those who experience visual strain when reading or have cognitive difficulties related to processing textual information
- Electronic versions to help those with pain-related or dexterity issues who may not be able to manipulate a book
- Braille versions and tactile graphics to help those who are blind or visually impaired to read printed text and visuals
- Descriptive video to help those who have difficulty interpreting visual elements of a text.

Alternate formats (ALT) - Question identifier:ALT_Q05

Do you use reading materials in any of the following alternate formats?

Would you say:

  • 01: Embossed Braille (e.g., paper-based)
  • 02: Electronic Braille (e.g., digital Braille displays)
  • 03: Tactile graphics
  • 04: Large print hard copy
  • 05: Large print digital format
  • 06: Accessible PDF (e.g., reflowable layout, tags and headings, descriptive alt text for images)
  • 07: EPub
  • 08: Digital Audio format (e.g., MP3)
  • 09: Hard Copy Audio format (e.g., CD-ROM)
  • 10: DAISY books
  • 11: Descriptive video
  • 12: Other
  • 13: None of the above
  • 99: DK

Alternate formats (ALT) - Question identifier:ALT_Q10

If it was available to you, would you use any of the following alternate formats?

Would you say:

  • 01: Embossed Braille (e.g., paper-based)
  • 02: Electronic Braille (e.g., digital Braille displays)
  • 03: Tactile graphics
  • 04: Large print hard copy
  • 05: Large print digital format
  • 06: Accessible PDF (e.g., reflowable layout, tags and headings, descriptive alt text for images)
  • 07: EPub
  • 08: Digital Audio format (e.g., MP3)
  • 09: Hard Copy Audio format (e.g., CD-ROM)
  • 10: DAISY books
  • 11: Descriptive video
  • 12: Other
  • 13: None of the above

Alternate formats (ALT) - Question identifier:ALT_Q15

In the past two years, was there ever a time when you needed an alternate format but you were unable to access it?

  • 1: Yes
  • 2: No
  • 3: Did not need to access alternate formats in the past two years
  • 9: DK

Alternate formats (ALT) - Question identifier:ALT_Q20

In the past two years, from which of the following providers have you received alternate format reading materials?

Was it:

  • 01: Public Library
  • 02: University or college library
  • 03: Centre for Equitable Library Access (CELA) or CNIB
  • 04: National Network for Equitable Library Service (NNELS)
  • 05: Bibliothèque et Archives nationales du Québec (BAnQ)
  • 06: Local or community organization (Include provincial, territorial or municipal organizations.)
  • 07: Book store in person or online (e.g., Amazon, Indigo, GooglePlay, AppleBooks)
  • 08: Own production or conversion into alternate format
  • 09: Other
  • 99: DK

Alternate formats (ALT) - Question identifier:ALT_Q25

In the past two years, how often have you received your required alternate formats when you needed them?

Would you say:

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Never
  • 9: DK

Alternate formats (ALT) - Question identifier:ALT_Q30

In the past two years, have you encountered any of the following barriers when accessing the materials that you needed?

Was it:

  • 01: Cost
  • 02: Not available in the alternate format of my choice
  • 03: Not enough copies in the alternate format of my choice
  • 04: The lack of accessibility features in the alternate format
  • 05: Difficulty finding information (e.g., availability of alternate formats or accessibility features)
  • 06: Lack of skills
  • 07: Not having access to the technology needed to use alternate format
  • 08: Technology in need of repair or upgrade
  • 09: Difficulty getting to service provider
  • 10: Not able to ship to my community
  • 11: Product was lower quality than expected (e.g., poor descriptions of images)
  • 12: Other
  • 13: Did not experience barriers
  • 99: DK

Alternate formats (ALT) - Question identifier:ALT_Q35

Do you receive government funding to buy alternate format reading materials?

  • 1: Yes
  • 2: No
  • 9: DK

Technology and internet use (TIU)

Technology and internet use (TIU) - Question identifier:TIU_R05

The following questions are about the use of the Internet and devices to access alternate format reading materials.

Technology and internet use (TIU) - Question identifier:TIU_Q05

In the past two years, have you used the Internet to obtain or access alternate format reading material?

  • 1: Yes
  • 2: No
  • 9: DK

Technology and internet use (TIU) - Question identifier:TIU_Q10

What are the reasons you have not used the Internet to obtain or access alternate format reading material?

Is it:

  • 01: Cost of service or equipment
  • 02: No need, no interest or no time
  • 03: Too difficult to use the Internet (e.g., lack of knowledge, skills or training)
  • 04: Limited due to health condition
  • 05: Confidentiality, security or privacy concerns
  • 06: Limited or no access to Internet
  • 07: No Internet-ready device available in dwelling (e.g., desktop, laptop or tablet computer)
  • 08: Require specialized adaptations or software
  • 09: Too many websites are inaccessible
  • 10: Lack of alternate formats available on the internet
  • 11: Other

Technology and internet use (TIU) - Question identifier:TIU_Q15

In the past two years, what was the main location where you regularly used the Internet to access alternate format reading material?

Was it:

  • 01: At home
  • 02: At work
  • 03: At school
  • 04: At a public library
  • 05: At a business establishment
  • 06: At another public location
  • 07: At someone else's home
  • 08: Did not connect to the Internet at any of these locations
  • 99: DK

Technology and internet use (TIU) - Question identifier:TIU_Q20

In the past two years, which of the following devices did you use to access alternate format reading material?

Would you say:

  • 1: A smartphone
  • 2: A laptop or netbook
  • 3: A tablet
  • 4: A desktop computer
  • 5: A media streaming device (e.g., DAISY Audio player, Victor Reader)
  • 6: Other devices
  • 7: None

Technology and internet use (TIU) - Question identifier:TIU_Q25

In the past two years, how often did you use digital technology to access alternate format reading material?

Was it:

  • 1: Daily
  • 2: A few times a week
  • 3: Once a week
  • 4: 2 to 3 times a month
  • 5: Once a month
  • 6: Less than once a month
  • 7: Never
  • 9: DK

Training and digital skills (TRN)

Training and digital skills (TRN) - Question identifier:TRN_R05

The next few questions are about your digital skills and ability to use technology. Technology includes software, hardware such as computers and tablets, and digital aids and assistive devices such as electronic Braille displays and electronic magnifiers.

Training and digital skills (TRN) - Question identifier:TRN_Q05

In general, how adequate do you feel your skills are to use your required software or digital aids and assistive devices to read alternate formats?

Would you say:

  • 1: More than adequate
  • 2: Adequate
  • 3: Barely adequate
  • 4: Inadequate
  • 5: Very inadequate
  • 9: DK

Training and digital skills (TRN) - Question identifier:TRN_Q10

If it was available to you, would you take training or participate in learning activities to improve your skills relating to your use of computers, devices, software or applications?

  • 1: Yes
  • 2: No
  • 9: DK

Impacts of COVID-19 (COV)

Impacts of COVID-19 (COV) - Question identifier:COV_R05

The following questions are about the COVID-19 pandemic and your use of digital technologies.

Impacts of COVID-19 (COV) - Question identifier:COV_Q05

Since the beginning of the COVID-19 pandemic in March 2020, have you bought or borrowed digital alternate format print materials online for the first time?

  • 1: Yes
  • 2: No
  • 9: DK

Impacts of COVID-19 (COV) - Question identifier:COV_Q10

Compared to before the COVID-19 pandemic in March 2020, how often are you currently buying or borrowing digital alternate format print materials online?

  • 1: More often
  • 2: Less often
  • 3: About the same
  • 4: Not applicable
  • 9: DK
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