Appendix P.1
12-Month Follow-up Survey
Appendix P.1
12-Month Follow-Up Survey
For Youth/Young Adult Sites
5.15.13
Table of Contents
Sample Member Identity Verification 4
A. Service Receipt (Participation) 5
Introduction
Thank you for taking the time to speak with me today. We are conducting interviews with people who agreed to be in a study about a program offered at [CBONAME] called [ETJDPRO/STEDPRO]. The study is called the [Enhanced Transitional Jobs Demonstration or ETJD/Subsidized and Transitional Employment Demonstration or STED] for short. It is funded by the U.S. Department of Labor and the U.S. Department of Health and Human Services and my company, [Abt SRBI/ Decision Information Resources, or DIR], is conducting this survey. You may have received a letter recently about the [ETJD/STED] study.
We need to talk with people who got into the program and those who did not. Your participation in this study will help policy-makers better understand how to help people find and keep jobs. This interview will include questions on your employment situation, your use of services, and your overall well being.
This interview should only take about 45 minutes. We will mail you a $40 gift card as a “thank you” for completing the interview.
All of your responses on this survey will be kept private; the research staff has been trained in protecting private information and your name will not appear in any written reports we produce. All of the study results will be reported for groups of individuals; no results will be analyzed or reported for individuals. Your responses to these questions are also completely voluntary. That means you may choose not to answer any question, or you may stop the interview if you wish, but we hope you don’t. Your responses to these questions will in no way affect your participation in the [ETJDPRO/STEDPRO] program or affect your receipt of any kinds of public benefits or services.
According to the Paperwork Reduction Act (PRA), an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is 0970-XXXX and it expires XX/XX/XXXX.
And finally, this interview might be monitored or recorded for quality control purposes. May we begin?
Sample Member Identity Verification
S1. Just to be sure I that I have brought up the correct record, could you please give me your date of birth?
BIRTH DATE: ___/___/____
MM/DD/YYYY
CATI: VALIDATE DOB FROM SAMPLE FILE; SAVE RESPONSE TO FILE AND AUTOMARK
DOB CONFIRMED 1 SKIP TO SECTION A
DOB NOT CONFIRMED 2
S2. Again, to confirm that I have brought up the correct record, could you please give me the last four digits of your social security number?
____________________________
CATIL VALIDATE LAST 4 SSN FROM SAMPLE FILE; SAVE RESPONSE TO FILE AND AUTOMARK.
SSN CONFIRMED 1 SKIP TO SECTION A
SSN NOT CONFIRMED 2
IF DOBCONF=2 and SSNCONF =2, DISPLAY: “Thank you for taking the time to answer these questions. The information you provided does not match our records. I will need to check with my supervisor to determine how to resolve this issue. If we are able to do so, I will give you a call back.”
CATI: CREATE VARIABLE “WKSRAD” TO HOLD #WEEKS SINCE RAD
During this interview I will be asking about the experiences you’ve had and services you may have received since [RAD]. This is the date you agreed to participate in the study. As a result, many of the questions I ask will refer to this date. Let’s begin.
A1.
Since [RAD] have you taken part in any Adult Basic Education (ABE) classes?
INTERVIEWER, IF NECESSARY SAY: Adult Basic Education (ABE) classes are for improving your basic reading and math skills.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A1 = 2, 7, 8 THEN GO TO A3
A2
How many weeks since [RAD] did you take these classes?
INTERVIEWER: ROUND UP IF LESS THAN A WHOLE WEEK.
CATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD.
IF RESPONSE IS GREATER THAN WKSRAD, SHOW:
INTERVIEWER SAY: You stated that you had participated for [RESPONSE] weeks; there have only been WKSRAD weeks since [RAD]. Is [RESPONSE] correct?
____________________
NUMBER OF WEEKS(RANGE 1-95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A3.
At any time since [RAD], have you taken any ESL classes, that is, English as a Second Language?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A3 = 2, 7, 8 GO TO A6
A5
For how many weeks since [RAD] did you take ESL classes?
INTERVIEWER: ROUND UP IF LESS THAN A WHOLE WEEK. .
CATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD. IF RESPONSE IS GREATER THAN WKSRAD, SHOW:
INTERVIEWER SAY: You stated that you had participated for [RESPONSE] weeks; there have only been WKSRAD weeks since [RAD]. Is [RESPONSE] correct?
____________________
NUMBER OF WEEKS(RANGE: 1 – 95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A6.
Since [RAD], have you taken part in any GED classes, or classes to prepare for a regular high school diploma?
INTERVIEWER, IF NECESSARY: A GED or “General Education Development” certificate is similar to a high school diploma. GED classes help prepare for the GED test.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A6 = 2, 7, 8 THEN GO TO A9
A7.
How many weeks since [RAD] did you take these classes?
INTERVIEWER: IF R REPORTS IN WEEKSCATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD.
IF RESPONSE IS GREATER THAN WKSRAD, SHOW:
INTERVIEWER SAY: You stated that you had participated for [RESPONSE] weeks; there have only been WKSRAD weeks since [RAD]. Is [RESPONSE] correct?
____________________ NUMBER OF WEEKS (RANGE: 1-95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A8.
Since [RAD], have you earned a GED certificate or high school diploma?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
A9.
Since [RAD] have you taken any courses at a community, two-year, or four-year college?
CATI: IF A1=1, A3=1, OR A6=1, ALSO SHOW: Not including any classes you have already mentioned.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A9 = 2, 7, 8 THEN GO TO A14
A10.
Were any of these courses taken to receive credit towards an associate or bachelor’s degree, that is, college credit?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A10 = 2, 7, 8 THEN GO TO A14
A11.
What type of degree are you working towards? Is it …
1 An associate’s degree,
2 A bachelor’s degree, or
3 Something else? (Specify: __________________________)
7 DON’T KNOW
8 REFUSED
A12.
What is your field of study? That is, what subject will your degree be in?
___________________________________________________________________
VERBATIM
97 DON’T KNOW
98 REFUSED
A13.
For those courses that were part of your degree, how many weeks or since [RAD] did you attend college?
INTERVIEWERROUND UP IF LESS THAN A WHOLE WEEK.
CATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD.
IF RESPONSE IS GREATER THAN WKSRAD, SHOW:
INTERVIEWER SAY: You stated that you had participated for [RESPONSE] weeks; there have only been WKSRAD weeks since [RAD]. Is [RESPONSE] correct?
____________________
NUMBER OF WEEKS (RANGE:1-95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A14.
At any time since [RAD], did you get training for a specific job, trade, or occupation? This is sometimes called vocational training. Sometimes these classes are offered at a community college or by a private training provider, but they don’t lead to a degree. Sometimes they lead to a certificate or license.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A14 = 2, 7, 8 THEN GO TO A18
A15.
What kind of job, trade, or occupation was this training for?
INTERVIEWER RECORD VERBATIM
______________________________
JOB/TRADE/OCCUPATION
97 DON’T KNOW
98 REFUSED
A16.
For how many weeks since [RAD] did you attend vocational training?
INTERVIEWERROUND UP IF LESS THAN A WHOLE WEEK.
CATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD.
SHOW INTERVIEWER: “NUMBER OF WEEKS SINCE RAD IS [WKSRAD] ”
____________________
NUMBER OF WEEKS (RANGE:1-95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A17.
Where was this vocational training offered?
INTERVIEWER, IF NEEDED: What was the name of the place you went for training?
______________________
VERBATIM
97 DON’T KNOW
98 REFUSED
A18.
Now I’d like to ask you about professional certifications and licensures that you’ve obtained since [RAD]. Since [RAD], have you earned or received a professional certiciation or state or industry license?
INTERVIEWER, IF NECESSARY: A professional certification or license shows you are qualified to perform a specific job and includes things like Licensed Realtor, Certification Medical Assistant, Certified Construction Manager, a Project Management Profession or PMP certification, or an IT certification.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A18 = 2, 7, 8 THEN GO TO A20
A19.
What type of license or certification is it?
INTERVIEWER PROBE: What type of trade or work does it qualify you to do?
_________________________
VERBATIM
97 DON’T KNOW
98 REFUSED
A20.
I would like you to tell me about assistance you may have received since [RAD] from organizations and programs in your community to help you find or keep a job, or to help you deal with problems that interfered in your ability to work. For each type of help, I’d like to know whether you received help, where you got this help, and how much help you received. First…
CATI: A20, A21 AND A23 ARE ASKED TOGETHER FOR EACH TYPE OF HELP IN A20. IF A20 IS YES, FOLLOW WITH A21 AND A22. IF A1 IS NO, DK OR REF, GO TO NEXT A20 SUBITEM.
FOR A21, USE THE LIST BELOW TO CODE SOURCES OF HELP.
FOR A22, THE AMOUNT OF HELP RECEIVED IS FOR THE HELP TYPE SO IF MULTIPLE SOURCES ARE RECORDED IN A21, USE THE WORDING IN THE BRACKETS.
1 AN EMPLOYMENT OR INTERNSHIP PROGRAM
2 WELFARE OFFICE
3 PAROLE OFFICE
4 CHILD SUPPORT AGENCY
5 WORKFORCE CENTER (WIA)/ONE-STOP
6 UNEMPLOYMENT OFFICE OR EMPLOYMENT SERVICES PROGRAM
7 FOOD STAMPS PROGRAM/SNAP
8 OTHER, SPECIFY ____________________________________________
97 DON’T KNOW
98 REFUSED
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Did you receive help with …
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CATI: IF YES TO A20, ASK A21 & A22 |
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A21. Where did you get this help? Where else? INTERVIEWER: CHECK ALL THAT APPLY |
A22. How much help did you get [from all of these programs]? Would you say… |
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a. …preparing a resume or filling out job applications? |
1 YES 2 NO 7 DK 8 REF |
SHOW A21 LIST |
1 very little, 2 some, or 3 a lot? 7 DK 8 REF |
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b. …preparing for job interviews? |
1 YES 2 NO 7 DK 8 REF |
SHOW A21 LIST |
1 very little, 2 some, or 3 a lot? 7 DK 8 REF |
|
c. …looking for jobsor deciding what kinds of jobs to look for. |
1 YES 2 NO 7 DK 8 REF |
SHOW A21 LIST |
1 very little, 2 some, or 3 a lot? 7 DK 8 REF |
|
d. ...getting referrals to available jobs or setting up interviews for specific job openings? |
1 YES 2 NO 7 DK 8 REF |
SHOW A21 LIST |
1 very little, 2 some, or 3 a lot? 7 DK 8 REF |
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e. …assessing your skills for particular jobs? |
1 YES 2 NO 7 DK 8 REF |
SHOW A21 LIST |
1 very little, 2 some, or 3 a lot? 7 DK 8 REF |
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f. …planning your future career or educational goals? |
1 YES 2 NO 7 DK 8 REF |
SHOW A21 LIST |
1 very little, 2 some, or 3 a lot? 7 DK 8 REF |
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g.…paying for transportation to/from work or while looking for a job? |
1 YES 2 NO 7 DK 8 REF |
SHOW A21 LIST |
1 very little, 2 some, or 3 a lot? 7 DK 8 REF |
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A23.
Have you participated in any activities since [RAD] that were about how to act when you are at work? This includes issues like being on time, managing your tasks, relating to your supervisor, and handling conflicts.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A23 = 2, 7, 8 GO TO A25
A24.
For how many weeks since [RAD] did you participate in these activities?
INTERVIEWER: ROUND UP IF LESS THAN A WHOLE WEEK.
CATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD. IF RESPONSE IS GREATER THAN WKSRAD, SHOW:
INTERVIEWER SAY: You stated that you had participated for [RESPONSE] weeks; there have only been WKSRAD weeks since [RAD]. Is [RESPONSE] correct?
.
____________________
NUMBER OF WEEKS(RANGE=1-95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A25.
At any time since [RAD], did you work at an unpaid job or internship so that you could get some experience working or to learn a specific skill or trade while working? You would not have received a paycheck from anyone for doing this work.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A25 = 2, 7, 8 GO TO A29
A26.
Did you arrange this internship on your own or did you get it through an organization or program in your community?
1 ON MY OWN
2 THROUGH A PROGRAM
7 DON’T KNOW
8 REFUSED
A27.
For how many weeks or since [RAD] did you work at an unpaid job or internship?
INTERVIEWERROUND UP IF LESS THAN A WHOLE WEEK. CATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD. IF RESPONSE IS GREATER THAN WKSRAD, SHOW:
INTERVIEWER SAY: You stated that you had participated for [RESPONSE] weeks; there have only been WKSRAD weeks since [RAD]. Is [RESPONSE] correct?
____________________ NUMBER OF WEEKS(RANGE=1-95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A28.
On average, while you were working the unpaid job or internship, how many hours per week did you work?
__________________________
HOURS PER WEEK (RANGE: 1-95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A29.
The next few questions are about problems you may have had with substance abuse or mental health. This may be a very personal area for you and I want to reassure you that your answers to these questions will be kept private to the fullest extent allowed under the law.
Since [RAD] have your received help such as treatment or counseling related to your use of alcohol or any drug, not counting cigarettes? This includes participation in self-help groups like Alcoholics Anonymous or Narcotics Anonymous.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A29 = 2, 7, 8 THEN GO TO A31
A30.
For how many weeks since [RAD] did you receive treatment or participate in counseling for issues related to alcohol or drug use?
INTERVIEWER: ROUND UP IF LESS THAN A WHOLE WEEK. IF
CATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD.
SHOW INTERVIEWER: “NUMBER OF WEEKS SINCE RAD IS [WKSRAD] ”
____________________ NUMBER OF WEEKS (RANGE: 1- 95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A31.
Since [RAD] have you received help for problems related to your emotions, nerves, anger management or mental health? This would include help dealing with depression, anxiety, or other conditions from a mental health center, a therapist, a psychologist or psychiatrist, social worker, or counselor. Do not include any assistance related to alcohol or drug use.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A31 = 2, 7, 8 THEN GO TO A33
A32.
For how many weeks since [RAD] did you receive treatment or participate in counseling for these issues?
INTERVIEWER: ROUND UP IF LESS THAN A WHOLE WEEK. IF
CATI: CHECK TO MAKE SURE NOT GREATER THAN WKSRAD. IF RESPONSE IS GREATER THAN WKSRAD, SHOW:
INTERVIEWER SAY: You stated that you had participated for [RESPONSE] weeks; there have only been WKSRAD weeks since [RAD]. Is [RESPONSE] correct?
____________________
NUMBER OF WEEKS (RANGE: 1-95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
A33.
Since [RAD], have you felt like you needed or wanted help related to alcohol/drug use or mental health issues but you didn’t get it?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
A34.
Now I’d like to talk about your interactions with people that were doing the same activities as you. This could be people who were in the same class or training program as you or people who were receiving the same kind of help that you received.
Think of the activities that you participated in since [RAD] that you think were the most helpful to you and how you related with the other participants. Tell me how much you agree or disagree with following statements.
INTERVIEWER, IF NEEDED: These questions are about the other people who were in your same or a similar position while you were getting help.
A34a.
We gave each other advice. Would you say you…
1 strongly agree,
2 agree
3 neither agree nor disagree
4 disagree, or
5 strongly disagree?
7 DON’T KNOW
8 REFUSED
A34b.
We supported each other. Would you say you…
1 strongly agree,
2 agree
3 neither agree nor disagree
4 disagree, or
5 strongly disagree?
7 DON’T KNOW
8 REFUSED
A34c.
We helped each other feel more positive about our circumstances and future goals. Would you say you…
1 strongly agree,
2 agree
3 neither agree nor disagree
4 disagree, or
5 strongly disagree?
7 DON’T KNOW
8 REFUSED
A34d.
We did not interact with each other. Would you say you…
1 strongly agree,
2 agree
3 neither agree nor disagree
4 disagree, or
5 strongly disagree?
7 DON’T KNOW
8 REFUSED
A3523.
Thinking of the people you have worked with at agencies or organizations since [RAD], is there someone to whom you can turn for advice or support with personal or family issues?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A35= 2, 7, OR 8, GO TO A38
A36.
At which organization or program did this person work?
1 [LOCAL TJ PROGRAM ]
2 WELFARE OFFICE
3 PAROLE OFFICE
4 CHILD SUPPORT AGENCY
5 WORKFORCE CENTER (WIA)/ONE-STOP
6 UNEMPLOYMENT OFFICE OR EMPLOYMENT SERVICES PROGRAM
7 FOOD STAMPS PROGRAM
8 OTHER, SPECIFY ____________________________________________
97 DON’T KNOW
98 REFUSED
A37.
Are you still in touch with this person?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
A38.
Thinking of the people you have worked with at agencies or organizations since [RAD], is there someone who can help you guide you pesonnaly and professionally?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF A38= 2, 7, OR 8, GO TO B1
A39.
At which organization or program did this person work?
1 [LOCAL TJ PROGRAM ]
2 WELFARE OFFICE
3 PAROLE OFFICE
4 CHILD SUPPORT AGENCY
5 WORKFORCE CENTER (WIA)/ONE-STOP
6 UNEMPLOYMENT OFFICE OR EMPLOYMENT SERVICES PROGRAM
7 FOOD STAMPS PROGRAM
8 OTHER, SPECIFY ____________________________________________
97 DON’T KNOW
98 REFUSED
A41.
Are you still in touch with this person?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF R HAD HIGH SCHOOL DEGREE/GED OR HIGHER AT BASELINE, GO TO A23.
B1.
Are
you currently working for pay? This includes any work where you get
paid including self-employment, paid internships, temporary work,
work as a day laborer, and paid work at an employment program.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF B1= 2, 7, 8 THEN GO TO B27
B2.
How
many jobs do you currently have?
INTERVIEWER: SELF-EMPLOYMENT OR TEMPORARY OR “TEMP” WORK IN THE SAME FIELD COUNTS AS ONE JOB.
_________________
NUMBER OF JOBS (RANGE: 1 – 10)
97 DON’T KNOW
98 REFUSED
CATI: IF B2=1, THEN GO TO B4
B3.
For whom do you usually work the most hours?
INTERVIEWER PROBE: What is your employer’s name?
INTERVIEWER, IF HOURS ARE THE SAME: Who have you worked for the longest?
______________________
VERBATIM
96 SELF EMPLOYED
97 DON’T KNOW
98 REFUSED
B4.
CATI: IF B3 = 97, 98, SHOW THE FIRST WORDING. ELSE SHOW THE
SECOND WORDING.
I'd like to ask you some questions about your (the job you currently work at where you work the most hours or have worked the longest/ that job.)
.
When did this job start?
INTERVIEWER: IF MM/YYYY IS BEFORE [RAD], CONFIRM DATE IS CORRECT.
CATI: SHOW RAD DATE ON SCREEN FOR B4
___________
MM/YYYY
INTERVIEWER PROBE FOR SEASON IF DON’T KNOW MONTH.
02 WINTER
05 SPRING
08 SUMMER
11 FALL
97/9997 DON’T KNOW
98/9998 REFUSED
CATI: IF B3=96 (self-employed), CODE B5 AS 2 AND GO TO B8
B5.
What type of organization (are/were) you working for?
INTERVIEWER PROBE: Who did the paycheck come from?
Is it…
1 self-employment,
2 a temporary agency,
3 a for-profit company or employer,
4 a non-profit company or employer],
5 a government employer, or
6 some other work arrangement? (SPECIFY)________________
97 DON’T KNOW
98 REFUSED
CATI: if (B3 has verbatim reponse ) OR (B5 = 1) THEN GO TO B7
B6.
What is your employer's name?
______________________
EMPLOYER
97 DON’T KNOW
98 REFUSED
B7.
What kind of business or industry is that in? What do they make or what service do they provide?
_____________________
VERBATIM
97 DON’T KNOW
98 REFUSED
B8.
What (is/was) your occupation on this job?
IF NEEDED:
What kind of work do you do? That is, what are your main duties in this job?
_____________________
VERBATIM
97 DON’T KNOW
98 REFUSED
B9.
Is this job…
1 permanent regular employment,
2 seasonal work, temporary work through a temp agency, day labor, an odd job, or
3 something else? (SPECIFY _____________________)
97 DON’T KNOW
98 REFUSED
B10.
Which of the following best describes your usual weekly work
schedule at your job during the last month that you worked? Do/did
you work a…
1 daytime shift,
2 evening shift,
3 night shift,
4 rotating shift (one that changes regularly from days to evenings to nights),
5 split shift (one consisting of two distinct periods each day),
6 an irregular schedule (one that changes from day to day), or
7 something else? (SPECIFY________________________ )
97 DON’T KNOW
98 REFUSED
B11.
Including overtime, how many hours per week (do/did) you usually work in this job?
INTERVIEWER: IF SCHEDULE IS IRREGULAR OR VARIES:
How many hours did you work in the last week you worked at this job?
INTERVIEWER: CONFIRM IF MORE THAN 60 AS HOURS PER WEEK
___________________
NUMBER OF HOURS (RANGE: 1 TO 995)
996 996 OR MORE
997 DON’T KNOW
998 REFUSED
B12.
For this job, what is the easiest way to tell me your wages BEFORE taxes and other deductions: hourly, weekly, annually, or something else?
1 HOURLY
2 WEEKLY
3 BI-WEEKLY
4 TWICE MONTHLY
5 MONTHLY
6 ANNUALLY
7 PER DAY/TASK
8 OTHER (SPECIFY ______________)
97 DON’T KNOW
98 REFUSED
CATI: IF B12 = 7, 8, 97, 98 THEN GO TO B16
B13.
How much is your regular pay for that period?
CATI: SHOW ANSWER TO B12.
INTERVIEWER, IF NEEDED: Don’t include tips, commissions, bonuses, or overtime pay.
$ ___ ___ , ___ ___ ___ . ___ ___
AMOUNT (RANGE: .01 -to 50,000.00)
99999.96 MORE THAN $50,000
99999.97 DON’T KNOW
99999.98 REFUSED
CATI: IF B13 = 99999.97, 99999.98 THEN GO TO B15
B14.
Is that …
1 before taxes, or
2 after taxes?
7 DON’T KNOW
8 REFUSED
B15.
Do you receive tips, commissions, or overtime pay in addition to this?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF B15 = 2, 7, 8 THEN GO TO B18
B16.
How much did you make the last week you worked at this job, including tips, commissions, and any overtime pay?
$___ , ___ ___ ___ AMOUNT PER WEEK (Range: 1 to 9,995)
9996 More than $9,995
9997 DON’T KNOW
9998 REFUSED
CATI: IF B16=9997 OR 9998 GO TO B18.
B17.
Was that:
1 before taxes, or
2 after taxes?
7 DON’T KNOW
8 REFUSED
CATI: FOR B18, IF B5=2 (self-employed), GO TO B27, ELSE ASK B18.
B18.
Some employers offer health insurance for their employees, but sometimes workers don’t participate or receive health coverage due to cost or other reasons. For this job, would you say:
1 no health insurance is available,
2 health insurance is available, but you don’t participate, or
3 you are covered by health insurance made available by your employer?
7 DON’T KNOW
8 REFUSED
B19.
Which of the following benefits are/were available to you on your job, even if you are not receiving them?
|
YES |
NO |
DON’T KNOW |
REFUSED |
a. Sick days with full pay? |
1 |
2 |
7 |
8 |
b. Paid vacation? |
1 |
2 |
7 |
8 |
c. Paid holidays other than Christmas and New Year’s Day? |
1 |
2 |
7 |
8 |
d. Dental benefits, including any offered at a cost to you? |
1 |
2 |
7 |
8 |
e. A retirement or 401K plan? |
1 |
2 |
7 |
8 |
f. Tuition reimbursement? |
1 |
2 |
7 |
8 |
B20.
Are you a member of a labor union or an employee association like a union at this job?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
B
7-
Since
[RAD], have you received a promotion while working there, meaning
that you moved to a higher position or job title? This does not
include raises or changes in your wage or salary.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
B22.
Do you think you are likely to move up or be promoted?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
B23.
Did
staff from any agency or organization help you get this job?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF B23 = 2, 7, 8 THEN GO TO B25
B15.
What agency or program was it?
1 [LOCAL TJ PROGRAM ]
2 WELFARE OFFICE
3 PAROLE OFFICE
4 CHILD SUPPORT AGENCY
5 WORKFORCE CENTER (WIA)/ONE-STOP
6 UNEMPLOYMENT OFFICE OR EMPLOYMENT SERVICES PROGRAM
7 FOOD STAMPS PROGRAM/SNAP
8 OTHER, SPECIFY ____________________________________________
97 DON’T KNOW
98 REFUSED
B25.
From the following options, which was the most important resource you used to find this job?
INTERVIEWER, READ OPTIONS AND CHOOSE ONE
1 A friend, relative or acquaintance,
2 a job posting or help-wanted ad found in the newspaper, on the computer, or somewhere else,
,
3 an employment placement service at school or training provider,
a church or community center,
5 an employer that decided to retain you permanently after you were placed in a temporary, transitional, or subsidized job, or
6 some other source? (SPECIFY______________________)
97 DON’T KNOW
98 REFUSED
CATI: ASK B26 IF B25=1, ELSE GO TO B27
B26.
Is this someone you’ve known for a long time or only met within the last year?
1 KNOWN FOR A LONG TIME
2 ONLY MET WITHIN LAST YEAR
7 DON’T KNOW
8 REFUSED
CATI: FOR B27,
IF B2 > 1 and < 97 THEN ASK B27.
ELSE (B2=blank, 97,98) GO TO B47
CATI: B27 AND THE B28-B46 SERIES ASK ONLY ABOUT OTHER CURRENT JOBS HELD BY THE R.
CREATE “NUMOTHCUR” ( for number of other current jobs). NUMOTHCUR = B2-1 OR SEVEN, WHICHEVER IS LESS.
TOTAL JOBS TO ASK ABOUT IN B27 =NUMOTHCUR
B27.
Thinking now about the other jobs, including internships, that you’re currently working, tell me all of the other places that you currently work.
INTERVIEWER PROBE: What are your employers’ names?
INTERVIEWER: IF R IS SELF EMPLOYED, CHECK ‘SELF EMPLOYED’ AND RECORD THE NAME OF THE COMPANY OR THE KIND OF WORK DONE
CATI: CREATE A CHECK BOX FOR EACH JOB ALLOWING INTERVIEWER TO INDICATE IF THE JOB IS SELF EMPLOYMENT
INTERVIEWER: RECORD AS MANY OTHER CURRENT JOBS AS INDICATED HERE.
CATI: SHOW : “NUMBER OF CURRENT OTHER JOBS TO REQUEST IS [NUMOTHCUR]”.
Abt/DIR: this does not need to be in table form in CATI, but this information should be collected for all (up to 7) other current jobs at this time.
OTHER JOB # |
VERBATIM |
SELF EMPLOYED |
DON’T KNOW |
REFUSED |
1 |
a. |
96 |
97 |
98 |
2 |
b. |
96 |
97 |
98 |
3 |
c. |
96 |
97 |
98 |
4 |
d. |
96 |
97 |
98 |
5 |
e. |
96 |
97 |
98 |
6 |
f. |
96 |
97 |
98 |
7 |
g. |
96 |
97 |
98 |
INTERVIEWER: IF R’S LIST OF OTHER JOBS IS DIFFERENT FROM THE COUNT EXPECTED, CONFIRM NUMBER AND NAMES WITH R AND CONFIRM ALL ARE CURRENT. IF STILL DISAGREE, ENTER NEW NUMBER HERE.
____________
NUMBER IF DISAGREE
CATI: SERIES B28-46 WILL BE ASKED FOR EACH OF UP TO 7 ADDITIONAL JOBS THAT R IS CURRENTLY WORKING AS RECORDED IN B27
DO NOT ASK ABOUT JOBS WHERE B27 = 97 OR 98.
FLAG ALL B27 JOBS WITH A VARIABLE CALLED “OTHCURJOB”. SET DEFAULT OTHCURJOB TO 1 FOR EACH JOB. IF B27=97 OR 98, SET OTHCURJOB TO 2.
THE ANSWERS GIVEN IN B27 WILL BE USED TO REFER TO EACH OF THE OTHER JOBS. AT THE END OF EACH SERIES, THE ANSWER TO B27 WILL DETERMINE WHETHER TO BEGIN THE SERIES FOR ANOTHER JOB OR CONTINUE TO B47. THE SERIES ITEMS FOR EACH JOB SHOULD USE THE SAME SUFFIX, FOR EXAMPLE, B34a, B35a, B36a ALL REFER TO THE FIRST ADDITIONAL JOB.
B28a.-B28g.
CATI: FOR EACH B27 JOB, IF OTHCURJOB=1, CONTINUE WITH B28.
IF OTHCURJOB=2, USE NEXT B27 JOB.
IF NO NEXT B27 JOB, GO TO B47.
Thinking of [B27 JOB NAME], when did this job start?
INTERVIEWER: IF MM/YYYY IS BEFORE [RAD], CONFIRM DATE IS CORRECT.
CATI: SHOW RAD DATE IN INTERVIEWER INSTRUCTION
___________
MM/YYYY
INTERVIEWER PROBE FOR SEASON IF DON’T KNOW MONTH.
02 WINTER
05 SPRING
08 SUMMER
11 FALL
97/9997 DON’T KNOW
98/9998 REFUSED
CATI: IF B27=96 (self-employed), CODE B29 AS 2 AND GO TO B31
B29a.-B29g.
What type of company or organization are you working for at [B27 JOB NAME]?
INTERVIEWER PROBE: Who does the paycheck come from?
Is it…
1 self-employment,
2 temporary agency
3 a for-profit company or employer,
4 a non-profit company or employer,
5 a government employer, or
6 someone else? (SPECIFY)________________
97 DON’T KNOW
98 REFUSED
B30a.-B30g.
What kind of business or industry is that employer? What do they make or what service do they provide?
_____________________
VERBATIM
97 DON’T KNOW
98 REFUSED
B31a.-B31g.
What is your occupation on this job?
IF NEEDED:
What kind of work do you do? That is, what are your main duties in this job?
_____________________
VERBATIM
97 DON’T KNOW
98 REFUSED
B32a.-B32g.
Is
this job…
1 permanent regular employment,
2 seasonal work, temporary work through a temp agency, day labor, an odd job, or
3 something else? (SPECIFY _____________________)
97 DON’T KNOW
98 REFUSED
B33a.-B33g.
Which of the following best describes your usual weekly work
schedule at this job during the last month? Do you work a…
1 daytime shift,
2 evening shift,
3 night shift,
4 rotating shift (one that changes regularly from days to evenings to nights),
5 split shift (one consisting of two distinct periods each day),
6 an irregular schedule (one that changes from day to day or week to week), or
7 something else? (SPECIFY________________________ )
97 DON’T KNOW
98 REFUSED
B34a.-B34g.
Including overtime, how many hours per week do you usually work on this job?
IF SCHEDULE IS IRREGULAR OR VARIES:
How many hours did you work in the last week you worked at this job?
INTERVIEWER: CONFIRM IF MORE THAN 60 AS HOURS PER WEEK
___________________
NUMBER OF HOURS (RANGE: 1 to 995)
996 996 OR MORE
997 DON’T KNOW
998 REFUSED
B35a.-B35g.
For this job, what is the easiest way to tell me your wages BEFORE taxes and other deductions: hourly, weekly, annually, or something else?
1 HOURLY
2 WEEKLY
3 BI-WEEKLY
4 TWICE MONTHLY
5 MONTHLY
6 ANNUALLY
7 PER DAY/TASK
8 OTHER (SPECIFY ______________)
97 DON’T KNOW
98 REFUSED
CATI: IF B35 = , 7, 8, 97, 98 THEN GO TO B39
B36a.-B36g.
How much is your regular pay for that period?
CATI: SHOW ANSWER TO B35.
INTERVIEWER, IF NEEDED: Don’t include tips, commissions, bonuses, or overtime pay.
$ ___ ___ , ___ ___ ___ . ___ ___
AMOUNT (RANGE: .01 -to 50,000.00)
99999.96 MORE THAN $50,000
99999.97 DON’T KNOW
99999.98 REFUSED
CATI: IF B36 = 99999.97, 99999.98 THEN GO TO B39
B37a.-B37g.
Is that …
1 before taxes, or
2 after taxes?
7 DON’T KNOW
8 REFUSED
B38a.-B38g.
Do you receive tips, commissions, or overtime pay in addition to this?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF B38 = 2, 7, 8 THEN GO TO B41
B39a.-B39g.
How much did you make the last week you worked at this job, including tips, commissions, and any overtime pay?
$___ , ___ ___ ___ . ___ ___
AMOUNT PER WEEK (Range: 1 to 9,995)
9996.96 More than $9,995
9997.97 DON’T KNOW
9998.98 REFUSED
B40a.-B40g.
Was that:
1 before taxes, or
2 after taxes?
7 DON’T KNOW
8 REFUSED
CATI: FOR B41,
IF B27=96 (self-employed) AND THERE ARE ADDITIONAL CURRENT JOBS, GO TO B28 NEXT JOB.
IF B27=96 AND THERE ARE NO ADDITIONAL JOBS, GO TO B47.
IF B27 <>96, ASK B41
B41a.-B41g.
Which of the following other benefits are available to you on your job, even if you do not participate or use them?
|
YES |
NO |
DON’T KNOW |
REFUSED |
a. Sick days with full pay? |
1 |
2 |
7 |
8 |
b. Paid vacation? |
1 |
2 |
7 |
8 |
c. Paid holidays? |
1 |
2 |
7 |
8 |
d. Health insurance, including any offered at a cost to you? |
1 |
2 |
7 |
8 |
e. Dental benefits, including any offered at a cost to you? |
1 |
2 |
7 |
8 |
f. A retirement or 401K plan? |
1 |
2 |
7 |
8 |
g. Tuition reimbursement? |
1 |
2 |
7 |
8 |
B42a-B42g.
Are you a member of a labor union or an employee association like a union at this job?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
B43a.-B43g.
Did
staff from any agency or organization help you get this job?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF B43 = 2, 7, 8 THEN GO TO B45
B44a.-B44g.
What agency or program was it?
____________________
NAME OF AGENCY/PROGRAM
97 DON’T KNOW
98 REFUSED
B45a.-B45g..
From the following options, which was the most important resource you used to find this job? Was it…
INTERVIEWER, READ OPTIONS AND CHOOSE ONE
1 a friend, relative, or acquaintance,
2 a job posting or help-wanted ad found in the newspaper, on the computer, or somewhere else,
3 an employment placement service at school or training provider,
4 a church or community center,
5 an employer that decided to retain you permanently after you were placed in a temporary, transitional, or subsidized job, or
6 something else? (SPECIFY______________________)
97 DON’T KNOW
98 REFUSED
CATI:
IF B45 > 1 AND THERE ARE ADDITIONAL CURRENT JOBS THEN GO TO B28 NEXT JOB.
IF B45>1 AND THERE ARE NO ADDITIONAL JOBS, GO TO B47.
IF B45=1, ASK B46.
B46a.-B46g.
Is this someone you’ve known for a long time or only met within the last year?
1 KNOWN FOR A LONG TIME
2 ONLY MET WITHIN LAST YEAR
7 DON’T KNOW
8 REFUSED
CATI: AFTER ASKING B46, IF THERE ARE ADDITIONAL CURRENT JOBS, GO TO B28. ELSE CONTINUE WITH B47.
B47.
[CATI: IF B2=1-96, USE THE FIRST QUESTION. IF B2=blank, 97,98 USE THE SECOND QUESTION.
CATI: USE FIRST TEXT OPTION ONLY IF B2=1.]
Besides the (job/jobs) we’ve already talked about, did you work at any other jobs, including paid internships, since [RAD]?
Did you work at any jobs since [RAD]?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF B47=1, ASK B48
IF B47=2, 7, 8 AND B1=1 THEN GO TO SECTION C
IF B47=2, 7, 8 AND B1=2, 7, 8 THEN GO B62
CATI: SERIES B48-B61 WILL BE ASKED FOR EACH OF UP TO 7 ADDITIONAL JOBS THAT STOPPED SOMETIME AFTER [RAD]. AT THE END OF EACH SERIES, THE LAST QUESTION WILL DETERMINE WHETHER TO BEGIN THE SERIES FOR ANOTHER JOB OR CONTINUE TO SECTION C. THE SERIES ITEMS FOR EACH JOB SHOULD USE THE SAME SUFFIX, FOR EXAMPLE, B48a, B49a, AND B50a ALL REFER TO THE FIRST ADDITIONAL JOB.
B48a.
For the job that ended most recently, where did you work?
B48b.-B48g.
Where did you work before [PRIOR B48 JOB NAME]?
INTERVIEWER PROBE: What was your employer’s name?
_____________________
VERBATIM
97 DON’T KNOW
98 REFUSED
B49a – B49g.
When did that job end?
____/_______
MM/YYYY
INTERVIEWER PROBE FOR SEASON IF DON’T KNOW MONTH.
02 WINTER
05 SPRING
08 SUMMER
11 FALL
97/9997 DK
98/9998 REFUSED
CATI: IF B1=1 AND (B49 BEFORE [RAD] OR (MONTH OR YEAR =IS DK/REF)) , GO TO SECTION C.
IF B1=2,7,8 AND (B49a BEFORE RAD OR (MONTH OR YEAR =DK/REF)) GO TO B62.
IF B1=2,7,8 AND (B49b-g BEFORE RAD OR (MONTH OR YEAR =DK/REF)) GO TO B63.
B50a.-B50g.
When did it start?
____/_______
MM/YYYY
CATI: CHECK THAT DATE PRECEDES DATE GIVEN IN B49
INTERVIEWER PROBE FOR SEASON IF DON’T KNOW MONTH.
02 WINTER
05 SPRING
08 SUMMER
11 FALL
97/9997 DK
98/9998 REFUSED
B51a. – B51g.
What kind of employer were you working for?
INTERVIEWER PROBE: Who did the paycheck come from?
Is it…
1 self-employment,
2 a temporary agency,
3 a for-profit company or employer,
4 a non-profit company or employer,
5 a government employer, or
6 some other work arrangement? (SPECIFY)________________
97 DON’T KNOW
98 REFUSED
B52a.-B52g.
What was your occupation on this job?
IF NEEDED:
What kind of work did you do? That is, what were your main duties in this job?
_____________________
VERBATIM
97 DON’T KNOW
98 REFUSED
B53a – B453g.
Including overtime, how many hours per week (do/did) you work on this (job/job when you left)?
IF SCHEDULE IS IRREGULAR OR VARIES:
How many hours did you work the last week you had the job?
INTERVIEWER: CONFIRM IF MORE THAN 60 HOURS PER WEEK
______________________
HOURS PER WEEK (RANGE: 1 to 995)
996 996 OR MORE
997 DON’T KNOW
998 REFUSED
B54a.-B54g.
How much did you make the last week you worked at that job?
$___ , ___ ___ ___ . ___ ___
AMOUNT PER WEEK(Range: 1 to 9,995)
9996 More than $9,995
9997.97 DON’T KNOW
9998.98 REFUSED
B55a.-B55g.
Was that:
1 before taxes, or
2 after taxes?
7 DON’T KNOW
8 REFUSED
B44a – B44g.
(Do / Did) you get health or medical benefits, including any offered at a cost to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
B56a. – B56g.
Which of the following benefits were available to you on that job, even if you did not participate or use them?
|
YES |
NO |
DON’T KNOW |
REFUSED |
a. Sick days with full pay? |
1 |
2 |
7 |
8 |
b. Paid vacation? |
1 |
2 |
7 |
8 |
c. Paid holidays? |
1 |
2 |
7 |
8 |
d. Health insurance, including any offered at a cost to you? |
1 |
2 |
7 |
8 |
e. Dental benefits, including any offered at a cost to you? |
1 |
2 |
7 |
8 |
f. A retirement or 401K plan? |
1 |
2 |
7 |
8 |
g. Tuition reimbursement? |
1 |
2 |
7 |
8 |
B57a.-B57g.
Were you a member of a labor union or an employee association like a union at this job?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
B58a – B58g.
Did staff from any agency or organization help you get this job?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF B58=2,7,8 GO TO B60
B59a – B59g.
Which agency or organization?
_____________________
NAME OF AGENCY/PROGRAM
97 DON’T KNOW
98 REFUSED
B60a – B60g.
Why did you stop working at this job?
1 GOT A NEW/DIFFERENT JOB
2 LAID OFF
3 NOT INTERESTED IN WORKING
4 UNABLE TO WORK BECAUSE OF INJURY, ILLNESS, OR DISABILITY
5 INCARCERATED
6 PREGNANCY/CHILDBIRTH
7 FAMILY RESPONSIBILITIES
8 GOING TO SCHOOL
9 OTHER. SPECIFY___________________
97 DON’T KNOW
98 REFUSED
B61a.-B61g.
Did you have any other jobs that we haven’t talked about?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: AFTER EACH B61:
IF IN JOBS a-f:
IF B61=1, GO TO B48
IF B61=2,7,8 AND B1=1 THEN GO TO SECTION C
IF B61=2,7,8 AND B1=2, 7, 8 THEN GO TO B63
IF IN JOB g:
IF B1=1 THEN GO TO SECTION C
IF B1=2, 7, 8 THEN GO TO B63
ELSE ASK B62
CATI: B62 IS ASKED ONLY
IF (B1=2,7,8 AND B47=2,7,8)
OR
IF (B1=2,7,8 AND (B49a IS BEFORE RAD OR (MONTH OR YEAR IS DK/REF)))
B62.
What is the main reason you did not work at a job since [RAD]?
1 UNABLE TO WORK BECAUSE OF INJURY, ILLNESS, OR DISABILITY
2 INCARCERATED
3 PREGNANCY/CHILDBIRTH
4 FAMILY RESPONSIBILITIES
5 GOING TO SCHOOL
6 UNABLE TO FIND WORK
7 NOT INTERESTED IN WORKING
8 OTHER. SPECIFY___________________
97 DON’T KNOW
98 REFUSED
B63.
Have you done anything to find work during the past four weeks?
1 YES
2 NO
7 DK
8 REF
CATI: IF B63 = 2, 7, 8 THEN GO TO B67
B64.
From the following list, please indicate each of these things that you have done to find work during the past four weeks:
In the past four weeks, did you: |
YES |
NO |
DON’T KNOW |
REF |
a.…contact employers? |
1 |
2 |
7 |
8 |
b.…contact a public employment agency? |
1 |
2 |
7 |
8 |
c.…attend or enroll in a program or course? |
1 |
2 |
7 |
8 |
d.…contact a private employment agency? |
1 |
2 |
7 |
8 |
e.…contact friends or relatives? |
1 |
2 |
7 |
8 |
f.…interview for a job? |
1 |
2 |
7 |
8 |
g.…contact a school or university employer center? |
1 |
2 |
7 |
8 |
h.…send out a resume or fill out application? |
1 |
2 |
7 |
8 |
i.…check union or professional registers? |
1 |
2 |
7 |
8 |
j.…look at job advertisements? |
1 |
2 |
7 |
8 |
k.…place an ad or answer an ad? |
1 |
2 |
7 |
8 |
l.…attend job training? |
1 |
2 |
7 |
8 |
m.…do something else? (SPECIFY____________) |
1 |
2 |
7 |
8 |
B65.
During the past four weeks, about how many hours in total did you spend looking for work?
INTERVIEWER: CONFIRM IF MORE THAN 40 HOURS
______________
HOURS (RANGE: 1 to 95)
96 96 OR MORE
97 DON’T KNOW
98 REFUSED
B66.
With how many different employers have you made direct contact, either by phone, mail, or in person during the past four weeks?
INTERVIEWER: CONFIRM IF MORE THAN 20
_____________
NUMBER OF EMPLOYERS
97 DON’T KNOW
98 REFUSED
B67.
Last week, could you have started a job if one had been offered?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
IF B67=1,7,8 THEN GO TO SECTION C
B68.
Why is that?
1 WAITING FOR NEW JOB TO BEGIN
2 OWN TEMPORARY ILLNESS
3 GOING TO SCHOOL
4 OTHER (SPECIFY_________________ )
97 DON’T KNOW
98 REFUSED
C1.
Now I’d like to talk about your living arrangements. Where are you living right now – is it your own place, your parent’s home, or somewhere else?
IF NECESSARY: Where do you stay most often?
1 PARENT’S HOME
2 OTHER RELATIVE’S HOME
3 OWN HOME
4 SHARE WITH ROOMATES/FRIENDS/PARTNER
5 GROUP QUARTERS (DORMITORY, GROUP HOME, SHELTER, HOSPITAL, RESIDENTIAL FACILITY, PRISON, ETC.)
6 HOMELESS (NO REGULAR PLACE TO STAY)
7 OTHER (SPECIFY: ___________________________)
97 DON’T KNOW
98 REFUSED
CATI: IF C1=1,2, or 4 GO TO C4
IF C1=3 GO TO C3
IF C1=5 GO TO C2
ELSE GO TO C6
C2.
What type of group quarters do you live in?
1 DORMITORY
2 GROUP HOME
3 HOSPITAL/TREATMENT FACILITY
4 SHELTER
5 PRISON
6 OTHER (SPECIFY: _________________________)
7 DON’T KNOW
8 REFUSED
CATI: GO TO C6 IF C2 ASKED
C3.
Do you live alone or with others?
1 ALONE
2 WITH OTHERS
7 DON’T KNOW
8 REFUSED
CATI: IF C3=1 GO TO C6
C4.
Including you, how many people live there?
INTERVIEWER WAIT FOR ANSWER THEN SAY: And that includes you, correct?
__________________
NUMBER IN HOUSEHOLD (MUST BE 2 OR MORE)
97 DON’T KNOW
98 REFUSED
C5.
Are any of those that you live with …
a. your parents or grandparents?
b. your spouse, partner, or boyfriend/girlfriend?
c. your child?
d. your brother or sister?
e. your cousin, aunt or uncle, or other relation?
f. your friend or other non-relative?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
C6.
IF C1=1/2/3/4/6: How long have you lived there?
IF C1=5: How long have you been without a regular place to stay?
IF C1=97/98: Thinking of the place you live right now, how long have you lived there?
1 LESS THAN ONE YEAR
2 ONE YEAR OR LONGER
7 DON’T KNOW
8 REFUSED
CATI: IF C6=2, 7, 8 GO TO C8
C7.
Where were you living before?
1 PARENT’S HOME
2 OTHER RELATIVE’S HOME
3 OWN HOME
4 SHARE WITH ROOMATES/FRIENDS/PARTNER
5 GROUP QUARTERS (DORMITORY, GROUP HOME, SHELTER, HOSPITAL, RESIDENTIAL FACILITY, PRISON, ETC.)
6 HOMELESS (NO REGULAR PLACE TO STAY)
7 OTHER (SPECIFY: ___________________________)
97 DON’T KNOW
98 REFUSED
CATI: IF C5c=2, 7, or 8 GO TO C14
C8a-C8o.
Now I want to talk about your children – this would be any biological, adoptive, foster, step, or other children for whom you’re responsible that live with you.
[FIRST CHILD] What is the birth date of the oldest child under age 19 that lives with you?
[OTHER CHILDREN] What is the birth date of the next oldest?
INTERVIEWER: IF R ONLY KNOWS MONTH AND YEAR, CODE DAY AS 15.
CATI: CHECK THAT CHILD IS UNDER AGE 19. INFORM INTERVIEWER IF CHILD IS TOO OLD.
BIRTH DATE: ___/___/____
MM/DD/YYYY
97/97/9997 DON’T KNOW
98/98/9998 REFUSED
CATI: IF C8 IS VALID DATE (MONTH AND YEAR), GO TO C10.
C9A.a-C9A.o.
How old is she or he?
_____ ____
AGE IN YEARS AGE IN MONTHS IF LESS THAN 1 YEAR
97 DON’T KNOW
98 REFUSED
C10a-C10o.
Are there any more children under age 19 who live with you in your household?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF C10=1 AND LESS THAN 15 CHILDREN HAVE BEEN RECORDED, LOOP BACK TO C8.
C11.
Since [RAD], have you received help with …
a. finding or making arrangement for child care?
b. paying for child care?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF C11=2, 7,8 GO TO C14
C12.
Where did you receive this help?
1 AN EMPLOYMENT OR INTERNSHIP PROGRAM
2 WELFARE OFFICE
3 PAROLE OFFICE
4 CHILD SUPPORT AGENCY
5 WORKFORCE CENTER (WIA/ONE-STOP)
6 UNEMPLOYMENT OFFICE
7 FOOD STAMPS/SNAP PROGRAM
8 OTHER (SPECIFY: __________________________)
97 DON’T KNOW
98 REFUSED
C13.
Have problems in finding or paying for child care made it difficult for you to go to work or school?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
C14.
IF C5c=1:
Do you have any children that don’t live with you?
ELSE:
Do you have any children
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF C14=2, 7, 8, GO TO C19. ELSE ASK C15 FOR UP TO 15 CHILDREN.
C15a-C15o.
CATI: RECORD BIRTH DATE FOR EACH CHILD. ALLOW FOR 15 CHILDREN.
[FIRST CHILD] What is the birth date of the oldest child under age 19 who you are responsible for but does not live with you?
[OTHER CHILDREN] What is the birth date of the next oldest?
INTERVIEWER: IF R ONLY KNOWS MONTH AND YEAR, CODE DAY AS 15.
CATI: CHECK THAT CHILD IS UNDER AGE 19. INFORM INTERVIEWER IF CHILD IS TOO OLD.
BIRTH DATE: ___/___/____
MM/DD/YYYY
97/97/9997 DON’T KNOW
98/98/9998 REFUSED
C15A.a-C15A.o.
How old is she or he?
_____ ____
AGE IN YEARS AGE IN MONTHS IF LESS THAN 1 YEAR
97 DON’T KNOW YEARS
98 REFUSED YEARS
C15B.a – C15B.o.
Are there any more children under age 19 who you are responsible for but do not live in your household?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF C15B =1 AND LESS THAN 15 CHILDREN HAVE BEEN RECORDED,CONTINUE WITH NEXT CHILD . ELSE GO TO C16.
C16.
Do you pay child support for your child/[any of your children] that do not live with you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
C17.
Since [RAD], have you received help with …
a. child support such as making arrangements to pay arrears or modifying the payment amounts?
b. making visitation arrangements?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF C17 = 2, 7, or 9 GO TO C19.
C18.
Where did you receive this help?
1 AN EMPLOYMENT OR INTERNSHIP PROGRAM
2 WELFARE OFFICE
3 PAROLE OFFICE
4 CHILD SUPPORT AGENCY
5 WORKFORCE CENTER (WIA/ONE-STOP)
6 UNEMPLOYMENT OFFICE
7 FOOD STAMPS/SNAP PROGRAM
8 OTHER (SPECIFY: __________________________)
97 DON’T KNOW
98 REFUSED
CATI: ALL RESPONDENTS GET C19.
C19.
Which of the following is your current marital status? Are you:
1 never married,
2 married,
3 in a civil union or domestic partnership,
4 separated,
5 divorced, or
6 widowed?
7 DON’T KNOW
8 REFUSED
C20.
IF FEMALE: Are you pregnant?
IF MALE: Is someone currently pregnant with your child?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
D. INCOME AND MATERIAL HARDSHIP
D1.
Now, I am going to ask you some questions about the income that you received last month. Again, I want to assure you that none of your answers will be discussed with anyone.
In [PRIOR MONTH], did you or anyone in your household receive any of the following sources?
|
YES |
NO |
DON’T KNOW |
REFUSED |
a. Job earnings? |
1 |
2 |
7 |
8 |
b. SSI or Supplemental Security Income? |
1 |
2 |
7 |
8 |
c. Public assistance or welfare, not including WIC or food stamps? |
1 |
2 |
7 |
8 |
d. Retirement or social security? |
1 |
2 |
7 |
8 |
e. Unemployment insurance? |
1 |
2 |
7 |
8 |
f. Worker’s compensation, disability? |
1 |
2 |
7 |
8 |
g. Child support ? |
1 |
2 |
7 |
8 |
h. Cash from family and friends who live outside of your household? |
1 |
2 |
7 |
8 |
i. Energy assistance? |
1 |
2 |
7 |
8 |
j. Child care subsidy? |
1 |
2 |
7 |
8 |
k. Housing choice voucher, also known as Section 8? |
1 |
2 |
7 |
8 |
l. Food stamps - also known as Supplemental Nutrition Assistance Program or SNAP? |
1 |
2 |
7 |
8 |
m. WIC? |
1 |
2 |
7 |
8 |
n. Free or reduced price school lunch program? |
1 |
2 |
7 |
8 |
D2.
Was there any other source of income you received last month that we haven’t talked about?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF D2=2,7,8 THEN GO TO D4
D3.
What was that other income?
IF NEEDED: Was it from a government program we haven’t talked about, a loan, or what?
_____________________
SOURCE
97 DON’T KNOW
98 REFUSED
D4.
Thinking of all of the income received by you last month, what was your total income in (PRIOR MONTH)? Please don’t include tax returns in your answer.
INTERVIEWER PROBE: Your best estimate is fine.
INTERVIEWER: ROUND TO NEAREST WHOLE DOLLAR.
$ _, _ _ _
AMOUNT (RANGE 1-9995)
9996 GREATER THAN $9995
9997 DON’T KNOW
9998 REFUSED
CATI: IF D4=9997, 9998, GO TO D5.
ELSE GO TO D6.
D5.
Would you say it was…
1 None ($0)
2 $500 or less,
3 $501-$1000,
4 $1001-$1500,
5 $1501-$2000,
6 $2000-$2500, or
7 $2500 or more?
97 DON’T KNOW
98 REFUSED
D6.
The federal government has a special rule that allows working people who make less than about $49,000 a year to take advantage of something called the Earned Income Tax Credit, or EITC. They can claim the Earned Income Tax Credit by filling out a special form called Schedule EIC when they fill out their income taxes, or they can fill out a special form with their employer.
Did you or will you claim the Earned Income Tax Credit for your earnings next?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
D7.
Now I have some questions about your financial situation. Sometimes due to circumstances beyond your control, it can be difficult to meet all of your financial obligations. As I read each question, please let me know if you have faced any of the following situations.
Since [RAD], has there been a time when…
|
YES |
NO |
DON’T KNOW |
REF |
a. …you did not pay the full amount of the rent or mortgage because you could not afford it? |
1 |
2 |
7 |
8 |
|
|
|
|
|
c. …you were evicted from your home or apartment for not paying the rent or mortgage? |
1 |
2 |
7 |
8 |
d. …you filed in court for bankruptcy? |
1 |
2 |
7 |
8 |
e. …you did not pay the full amount of the gas, oil, or electricity bills? |
1 |
2 |
7 |
8 |
f. …you had service turned off by the gas or electric company, or oil company would not deliver oil? |
1 |
2 |
7 |
8 |
g. …you had cellular or land telephone service disconnected because payments were not made? |
1 |
2 |
7 |
8 |
h…you ever needed to go to the doctor or dentist but didn’t because you didn’t think you could afford to pay for it? |
1 |
2 |
7 |
8 |
i. ...you could not fill or postponed filling a prescription for drugs when they were needed because you could not afford it? |
1 |
2 |
7 |
8 |
D8.
Getting enough food can be a problem for some people. Which of these statements best describes the food eaten in your household in the prior month? Would you say there is…
1 enough of the kind of foods you want,
2 enough, but not always the kinds of food you want,
3 sometimes not enough to eat, or
4 often not enough to eat?
7 DON’T KNOW
8 REFUSED
1.
Now I have some questions about your health and well-being. In general, would you say your health is…
1 excellent,
2 very good,
3 good,
4 fair, or
5 poor?
7 DON’T KNOW
8 REFUSED
In [PRIOR MONTH] were you covered by any form of health insurance?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E2=1, ASK E3. ELSE GO TO E4.
E3.
What types of health insurance were you covered by?
INTERVIEWER: MARK ALL THAT APPLY.
1 MEDICAID OR OTHER PUBLIC SYSTEM
2 EMPLOYER BASED OR COBRA
3 [INSERT NAME OF STATE’S CHILD HEALTH INSURANCE PROGRAM]
4 SELF PAID PRIVATE INSURACE
5 PARENT’S INSURANCE
6 INSURANCE PAID BY SOMEONE ELSE
7 OTHER, SPECIFY_________
97 DON’T KNOW
98 REFUSED
E3.
These next questions are about feelings you may have experienced over the past month.
During the month, how often did you feel…
INTERVIEWER: READ ITEM THEN READ THE RESPONSE CATEGORIES
|
Would you say you felt this way… |
|||||
|
often, |
sometimes, |
hardly ever, or |
never? |
DK |
REF |
a. …so sad that nothing could cheer you up? |
1 |
2 |
3 |
4 |
7 |
8 |
b. …nervous? |
1 |
2 |
3 |
4 |
7 |
8 |
c. …restless or fidgety? |
1 |
2 |
3 |
4 |
7 |
8 |
d. …hopeless? |
1 |
2 |
3 |
4 |
7 |
8 |
e. …that everything was an effort? |
1 |
2 |
3 |
4 |
7 |
8 |
f. …worthless? |
1 |
2 |
3 |
4 |
7 |
8 |
E4.
Taken all together, how would you say things were these days – would you say that you are…
1 very happy,
2 pretty happy,
3 not too happy?
7 DON’T KNOW
8 REFUSED
E5.
I’m going to read you a list of statements dealing with your general feelings about yourself. Please tell me how much you agree or disagree with each one.
a. I feel that I’m a person of worth, at least on an equal plane with others. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
INTERVIEWER: For B3b-B3j, only repeat answer options (“Do you …”) if necessary.
b. I feel that I have a number of good qualities. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
c. All in all, I am inclined to feel that I am a failure. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
d. I am able to do things as well as most other people. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
e. I feel that I do not have much to be proud of.
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
f. I take a positive attitude towards myself. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
g. On the whole, I am satisfied with myself. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
h. I wish I could have more respect for myself. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
i. I certainly feel useless at times. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
j. At times I think I am no good at all. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
E6.
The following statements describe the way some people may feel about themselves. After each statement, please indicate whether you strongly disagree, disagree,agree, or strongly agree.
a. I usually expect the best to happen. Do you …
1 strongly disagree,
2 disagree,
3 agree, or
4 strongly agree?
7 DON’T KNOW
8 REFUSED
INTERVIEWER: For E7b-E7f, only repeat answer options (“Do you …”) if necessary.
b. If something could go wrong for me, it will. Do you …
1 strongly disagree,
2 disagree,
3 agree, or
4 strongly agree?
7 DON’T KNOW
8 REFUSED
c. I am always optimistic about my future. Do you …
1 strongly disagree,
2 disagree,
3 agree, or
4 strongly agree?
7 DON’T KNOW
8 REFUSED
d. I hardly ever expect things to go my way. Do you …
1 strongly disagree,
2 disagree,
3 agree, or
4 strongly agree?
7 DON’T KNOW
8 REFUSED
e. I almost never count on good things happening to me. Do you …
1 strongly disagree,
2 disagree,
3 agree, or
4 strongly agree?
7 DON’T KNOW
8 REFUSED
f. Overall, I expect more good things to happen than bad. Do you …
1 strongly disagree,
2 disagree,
3 agree, or
4 strongly agree?
7 DON’T KNOW
8 REFUSED
E7.
Each of the next set of questions will ask you for your best guess at the chance that something will happen in the future. You can think of the percent chance that some event will occur as the number of chances out of 100 that the event will take place. If you think that something is impossible, consider it as having a 0 percent chance. If you think the event is possible but unlikely, you might say there is a 3 percent chance or a 15 percent chance. If you think the chance is pretty even, you can say there is a 46 percent chance or perhaps a 52 percent chance. If you think the event is likely, but not certain, you might say there is a 78 percent chance or a 94 percent chance. If you think it is certain to happen, give it a 100 percent chance.
Just to make sure that you are comfortable with the scale, I'd like you to do a few practice questions, and explain your answer to me.
a. What do you think is the percent chance that you will get the flu sometime in the next year?
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
b. What do you think is the percent chance that you will eat pizza sometime in the next year?
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
c. Think about yourself one year from now. The first questions concern what you expect to be doing then, in terms of school and work. What is the percent chance that you will be a student in a regular school one year from now?
IF NECESSARY: A regular school is one that offers an academic diploma or degree like a high school diploma or a bachelor’s degree.
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
d. Suppose you are in school a year from now, what is the percent chance that you will also be working for pay more than 20 hours per week?
IF NECESSARY: By working we mean working for pay for an employer, in a family business, or working for yourself.
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
e. Suppose you are not in school a year from now, what is the percent chance that you will be working for pay more than 20 hours per week?
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
f. What is the percent chance that you will be living in the same place you are living now one year from now?
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
g. [IF FEMALE] What is the chance you will become pregnant within one year from now?
[IF MALE] What is the percent chance that you will get someone pregnant within the next year?
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
h. What is the percent chance that you will be arrested, whether rightly or wrongly, at least once in the next year?
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
i. Now think ahead to when you turn 30 years old. What is the percent chance that you will have a four-year college degree by the time you turn 30?
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
j. What is the percent chance that you will be working for pay more than 20 hours per week when you turn 30?
______________________
Percent Chance
(Range: 0 to 100)
997 DON’T KNOW
998 REFUSED
E8.
Now I’d like to talk about specifically about your future employment. How much do you agree or disagree with the following statements? (Strongly Agree, Agree, Disagree, Strongly Disagree, Don’t Know, Refused)
a. I have specific goals for my future career. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
INTERVIEWER: For E9b-E9f, only repeat answer options (“Do you …”) if necessary.
b. I have a plan for achieving my future career goals. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
c. Planning for a career is not worth the effort. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
d. I haven’t thought much about my future career. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
e. If I have a career, I won’t be able to enjoy other things in life. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
f. Going to college is important to getting a good job. Do you …
1 strongly agree,
2 agree,
3 disagree, or
4 strongly disagree?
7 DON’T KNOW
8 REFUSED
E9.
Many people have life circumstances or events that happened in their past that create problems for them in achieving their goals. I am going to read a list of life challenges that might apply to you now or in the past. For each one, please tell me if it is something that applies to you.
Not having a high school degree or GED – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E9=2, 7, or 8 GO TO E10
E9a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E10.
Limited reading or math skills – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E10=2, 7, or 8 GO TO E11
E10a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E11.
Limited work history – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E11=2, 7, or 8 GO TO E12
E11a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E12.
Unstable housing – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E12=2, 7, or 8 GO TO E13
E12a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E13.
Experience in foster care – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E13=2, 7, or 8 GO TO E14
E13a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E14.
Pregnancy or taking care of your children – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E14=2, 7, or 8 GO TO E15
E14a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E15.
Physical or Medical disability – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E15=2, 7, or 8 GO TO E16
E15a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E16.
Mental Health difficulties – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E16=2, 7, or 8 GO TO E17
E16a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E17.
Criminal record – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E17=2, 7, or 8 GO TO E18
E17a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E18.
Alcohol or other substance abuse – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E18=2, 7, or 8 GO TO E19
E18a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E19.
Family responsibilities – is this something that applies to you?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF E19=2, 7, or 8 GO TO E20
E19a.
Is this something that holds you back or makes it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
E20.
Do you have other life circumstances that hold you back or make it difficult for you to achieve your goals?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
F2.
At any point since [RAD], have you been arrested?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF F2=1, ASK F4. ELSE GO TO F7.
CATI: F4 AND F5 RECORD DATE AND REASON FOR UP TO 15 ARRESTS. ARRESTS ARE RECORDED IN REVERSE CHRONOLOGICAL ORDER, STARTING WITH THE MOST RECENT ARREST.
F4a-F4o.
[CATI: FOR FIRST ARREST, DISPLAY:] When were you most recently arrested?
[FIRST TIME] INTERVIEWER, IF NEEDED: The most recent arrest.
[FIRST TIME]INTERVIEWER: IF DATE GIVEN IS BEFORE [RAD], CONFIRM AS MOST RECENT ARREST.
[CATI: FOR ARRESTS 2-15, DISPLAY:] What was the date of that previous arrest?
_ _/ _ _ _ _
MM/YYYY
97/9997 DON’T KNOW
98/9998 REFUSED
CATI: IF F4 ON OR AFTER [RAD], GO TO F5
IF F4 BEFORE [RAD], GO TO F7.
IF F4 NOT VALID DATE, ASK F4A.
F4Aa.-F4Ao.
Did this arrest occur after [RAD]?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF F4Aa = 2, 7, 8 GO TO F7.
F5a-F5o.
Why were you arrested then?
INTERVIEWER: RECORD VERBATIM RESPONSE.
______________
REASON
97 DON’T KNOW
98 REFUSED
F6a-F6o.
Did you have another arrest that occurred after [RAD DATE SHOWING DAY]?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
CATI: IF F6=1 AND FEWER THAN 15 ARRESTS HAVE BEEN RECORDED, LOOP BACK TO F4.
F7.
At any time since [RAD], have you been on parole or probation?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF F7 = 2, 7, 8 THEN GO TO F15
F8.
Since [RAD], have you been sanctioned or have you violated the conditions of your supervision? By sanction or violation, we mean that your parole or probation officer determined that you broke the rules of your parole/probation.
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF F8=1, ASK F9. ELSE GO TO F14.
CATI: SERIS F9-F13 WILL BE ASKED FOR EACH OF UP TO 15 VIOLATIONS, RECORDED IN REVERSE CHRONOLOGICAL ORDER, STARTING WITH THE MOST RECENT.
F9a – F9o.
[CATI: FOR FIRST VIOLATION, DISPLAY:] When was the last time your parole/probation officer issued a technical violation?
[FIRST VIOLATION] INTERVIEWER: IF DATE GIVEN IS BEFORE [RAD], CONFIRM AS MOST RECENT ARREST.
[CATI: FOR VIOLATIONS 2-15, DISPLAY:] What was the date of your previous violation?
_ _/ _ _ _ _
MM/YYYY
97/9997 DON’T KNOW
98/9998 REFUSED
CATI: IF F9 ON OR AFTER [RAD], GO TO F10
IF F9 BEFORE [RAD], GO TO F14.
IF F9 NOT VALID DATE, ASK F9A.
F9Aa.-F9Ao.
Was this technical violation issued after [RAD]?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF F9A = 2, 7, 8, GO TO F14.
F10a – F10o.
What was the reason you received the technical violation?
1 MISSED CURFEW
2 FAILURE TO REPORT FOR SCHEDULED APPOINTMENT WITH
PAROLE/PROBATION OFFICER
3 DRUG USE
4 FAILURE TO SEEK OR MAINTAIN EMPLOYMENT
5 ASSOCIATED WITH RESTRICTED PEOPLE
6 HOUSING
7 FAILURE TO PAY PAROLE/PROBATION FEES
8 DID NOT NOTIFY PAROLE/PROBATION OFFICER OF ADDRESS
CHANGE
9 CONTACT WITH VICTIM
10 ARRESTED FOR A NEW CRIME
11 FAILED TO ATTEND TREATMENT OR A PROGRAM AS DIRECTED
12 OTHER (SPECIFY______________________)
97 DON’T KNOW
98 REFUSED
F11a – F11o.
Were you sanctioned for the technical violation?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF F11=2, 7, 8 GO TO F13
F12a – F12o.
What type of sanction did your parole/probation officer impose for that violation?
INTERVIEWER: DO NOT READ LIST. CODE RESPONSE GIVEN. ONLY ONE RESPONSE ALLOWED.
1 TREATMENT
2 CURFEW
3 REPRIMAND
4 ELECTRONIC MONITORING
5 HOUSE ARREST
6 DAY REPORTING
7 INCARCERATION
8 OTHER (SPECIFY __________________)
97 DON’T KNOW
98 REFUSED
F13a-F13o.
Were you sanctioned or did you violate the conditions of your supervision another time since [RAD DATE SHOWING DAY]?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF F13=1, AND FEWER THAN 15 VIOLATIONS ARE REPORTED, GO TO F9. ELSE GO TO F14.
F14.
Was your parole or probation ever revoked since [RAD]?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: FOR F15, IF CURRENTLY INCARCERATED (F1=1), GO TO F16.
F15.
At any point since [RAD], have you spent time in jail or prison?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF F15=1, ASK F16. ELSE GO TO SECTION G.
F16.
What was the total amount of time that you spent in jail or prison since [RAD]?
INTERVIEWER, CONFIRM UNIT OF TIME: Was that days, week, months, or years?
INTERVIEWER, IF NEEDED: In total for all sentences.
RECORD BOTH TIME AND UNIT
__________________
AMOUNT OF TIME
1 DAYS,
2 WEEKS
3 MONTHS
4 YEARS
7 DON’T KNOW
8 REFUSED
CATI: IF F2=1, F7=1, F14=1, F15=1, or SITE=Chicago ASK F17.
ELSE GO TO NEXT SECTION.
F17.
Since [RAD] have you received any help with …
a. legal issues related to your convictions, like cleaning up your rap sheet?
b. learning how to answer employers’ questions about your criminal history?
1 YES
2 NO
7 DON’T KNOW
8 REFUSED
CATI: IF BOTH F17a and F17b = 2/7/8 GO TO SECTION G.
F18.
Where did you get this help?
1 AN EMPLOYMENT OR INTERNSHIP PROGRAM
2 WELFARE OFFICE
3 PAROLE OFFICE
4 CHILD SUPPORT AGENCY
5 WORKFORCE CENTER (WIA/ONE-STOP)
6 UNEMPLOYMENT OFFICE
7 FOOD STAMPS/SNAP PROGRAM
8 OTHER (SPECIFY: __________________________)
97 DON’T KNOW
98 REFUSED
G. SOCIAL SUPPORT AND NETWORK
G1.
The next set of questions is about support systems. People sometimes look to others for companionship, assistance, or other types of support. How often is each of the following kinds of support available to you if you need it?
a. Someone you can count on to listen to you when you need to talk. Would you say this kind of support is available to you …
1 none of the time,
2 a little of the time,
3 some of the time,
4 most of the time, or
5 all of the time?
7 DON’T KNOW
8 REFUSED
INTERVIEWER: For D1b-D1h, only repeat answer options (“Would you say this kind of support is available to you …”) if necessary.
b. Someone to give you information to help you understand a situation. Would you say this kind of support is available to you …
1 none of the time,
2 a little of the time,
3 some of the time,
4 most of the time, or
5 all of the time?
7 DON’T KNOW
8 REFUSED
c. Someone to give you good advice about a crisis. Would you say this kind of support is available to you …
1 none of the time,
2 a little of the time,
3 some of the time,
4 most of the time, or
5 all of the time?
7 DON’T KNOW
8 REFUSED
d. Someone to confide in or talk to about yourself or your problems. Would you say this kind of support is available to you …
1 none of the time,
2 a little of the time,
3 some of the time,
4 most of the time, or
5 all of the time?
7 DON’T KNOW
8 REFUSED
e. Someone whose advice you really want. Would you say this kind of support is available to you …
1 none of the time,
2 a little of the time,
3 some of the time,
4 most of the time, or
5 all of the time?
7 DON’T KNOW
8 REFUSED
f. Someone to share your most private worries and fears with. Would you say this kind of support is available to you …
1 none of the time,
2 a little of the time,
3 some of the time,
4 most of the time, or
5 all of the time?
7 DON’T KNOW
8 REFUSED
g. Someone to turn to for suggestions about how to deal with a personal problem. Would you say this kind of support is available to you …
1 none of the time,
2 a little of the time,
3 some of the time,
4 most of the time, or
5 all of the time?
7 DON’T KNOW
8 REFUSED
h. Someone who understands your problems. Would you say this kind of support is available to you …
1 none of the time,
2 a little of the time,
3 some of the time,
4 most of the time, or
5 all of the time?
7 DON’T KNOW
8 REFUSED
G2.
From time to time, most people discuss things that are important to them with others. These may include good or bad things that happen to you, problems you are having, or important concerns you may have. I’d like to ask you about the people with whom you often discuss things that are important to you. You may refer to these people in any way you want; for example you may use just their first names or nicknames or initials. I am not interested in the identities of these people. I just need to have some way to refer to them so that when I ask you a follow-up question we both know who we are talking about.
Over the last 6 months, who are the people with whom you most often discussed things that were important to you?
interviewer prompt: This could be a person you tend to talk to about things that are important to you.
CATI:
RECORD AS MANY NAMES IN G2 AS RESPONDENT OFFERS, UP TO 10.
CAPTURE ALL NAMES IN G2 BEFORE CONTINUING WITH G3.
CATI: IF FIRST PERSON IN G2 = 96, 97 OR 98, GO TO CLOSE.
CATI: WHEN PERSON 2-10 = 96, 97 or 98, GO TO G3.
interviewer: enter names in order in which they are identified by respondent.
interviewer: After each name, prompt: Who else?
1 NAME GIVEN, SPECIFY_________________
96 NO ONE ELSE
97 DON’T KNOW
98 REFUSED
G3.
People can have many different connections to others. For example, a woman can be your co-worker and also be your neighbor. Or a man could be your brother and also a member of your church. Now, I would like to go through the names you just gave me. Please list all the ways that person is connected to you. How is [NAME FROM LIST] connected to you?
CATI:
FOR EACH NAME OFFERED IN J1, ALLOW UP TO FOUR CONNECTIONS IN G3.
PRESENT EACH NAME ONE AT A TIME IN THE ORDER IT WAS COLLECTED.
ALSO PRESENT INTERVIEWER A CHECK BOX TO INDICATE “DONE” WITH A NAME.
WHEN INTERVIEWER CHECKS “DONE”, PRESENT NEXT NAME.
WHEN INTERVIEWER CHECKS “DONE” AND NO MORE NAMES ARE AVAILABLE, GO TO CLOSE.
INTERVIEWER: AFTER EACH CONNECTION, PROBE: What other ways is [NAME FROM LIST] connected to you?......What else?
INTERVIEWER: MARK UP TO FOUR CONNECTIONS FOR A NAME. CHECK “DONE” BOX TO START NEXT NAME.
FAMILY OR SEXUAL PARTNER
1 SPOUSE
2 EX-SPOUSE
3 ROMANTIC/SEXUAL PARTNER
4 PARENT
5 PARENT IN-LAW
6 OTHER IN-LAW
7 CHILD
8 STEP-CHILD
9 BROTHER OR SISTER
10 OTHER RELATIVE
FRIEND/NEIGHBOR
11 FRIEND
12 NEIGHBOR
OTHER CONNECTION
13 CO-WORKER OR BOSS
14 MINISTER, PRIEST, OR OTHER CLERGY
15 MEMBER OF THE SAME CONGREGATION
16 MEMBER OF THE SAME CLUB OR ACTIVITY GROUP
17 PSYCHIATRIST, PSYCHOLOGIST, COUNSELOR, OR THERAPIST
18 CASEWORKER/SOCIAL WORKER
19 JOB PLACEMENT/TRAINING PROGRAM STAFF
20 OTHER
97 DON’T KNOW
98 REFUSED
CLOSE
That was the last question I have for you today/tonight. I want to thank you again for your time.
P-
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Appendix A |
| Author | Joseph Broadus |
| File Modified | 0000-00-00 |
| File Created | 2021-01-27 |