Participant 6-month Follow-up Survey

Supporting Statement A

For the Paperwork Reduction Act of 1995: Request for an Extension for the Six-Month Follow-up Survey for the Job Search Assistance Strategies Evaluation

Attachment A: Six-month Follow-up Survey

OMB No. 0970-0440

October 26. 2015

Submitted by:

Office of Planning, Research & Evaluation

Administration for Children & Families

U.S. Department of Health and Human Services

Federal Project Officer

Carli Wulff

JOB SEARCH ASSISTANCE STRATEGIES EVALUATION

SIX-MONTH FOLLOW-UP SURVEY

1. Introduction and confirmation of identity

1. Introduction

Hello, my name is [ ]. May I please speak with _____?

Thank you for taking the time to talk with me today. I work for Abt SRBI. Abt SRBI is an independent research company and we are helping the Administration for Children and Families (ACF) in the U.S. Department of Health and Human Services (HHS) with its study of job search assistance strategies. We are conducting interviews with people who agreed to be in a study about a program offered at [NAME OF ORGANIZATION] called [PROGRAM NAME.] You agreed to be part of the study around [RAD]. You may recall signing a consent form and completing a short survey at that time.

This interview will include questions on your job search activities, your current or last job, how many people live with you, and your household income. This interview will take about 20 minutes to complete. When we are done, we will send you a $25 check, as a token of appreciation. We need to talk with everyone who agreed to participate in the study. Your participation in this study and your experiences will help policymakers and program administrators better understand how to better help people find jobs.

Before we begin the survey, I would like to remind you that your participation in this survey is 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 any programs or your receipt of any kinds of public benefits or services. I want to assure you that all of your responses on this survey will be kept private; your name will not appear in any written reports we produce. The information you provide will be kept private and only used for this study. 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 0970-0440 and it expires xx/xx/xxxx. If you have comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, please contact Karin Martinson, Study Project Director, at (301)-652-7322.Do you have any questions before we begin?

Let’s begin now.

Screener/Verification:

First I just need to verify that I am speaking with the correct person.

1. What is your date of birth? ___________ (MM/DD/YYYY)

INTERVIEWER: ENTER DATE USING FORMAT BELOW.

CATI/CAPI NOTE: DISPLAY DOB

Respondent’s Birthday: ________ / ________ / ____________

<SC1_MM>, <SC1_DD>, <SC1_YY> MM DD YYYY

<SC1_REF> REFUSED  ₇

<SC1_DK> DON’T KNOW  ₈

CATI/CAPI: IF DOB AGREES WITH THE BIRTH DATE ON THE FILE, SKIP TO B1. ELSE, CONTINUE.

2. What are the last 4 digits of your Social Security Number?

INTERVIEWER – ENTER LAST 4 DIGITS OF SSN CATI/CAPI NOTE: DISPLAY LAST 4 DIGITS SSN

<SC2_4SSN> RECORD LAST 4 DIGITS: ___ ___ ___ ___

<SC2_REF> REFUSED  ₇

<SC2_DK> DON’T KNOW  ₈

CATI/CAPI: IF THE 4 DIGITS GIVEN BY RESPONDENT AGREE WITH THE NUMBER ON THE FILE, SKIP TO B1.

IF SSN IS MISSING IN THE SAMPLE OR IS A MISMATCH WITH WHAT IS ENTERED AND THERE IS A MISMATCH IN DOB, DISPLAY DISCONTINED TEXT:

DISCONTINUED TEXT: I’m sorry. I was unable to pull up the correct questionnaire. I will need to check with my supervisor to look into the problem. I will re-contact you when the problem is resolved. Thank you for your time.

Note for OIRA/OMB Review: Yellow text boxes indicate sources for questions. Interviewers will not see these boxes. They will only be visible to instrument reviewers. The main item sources were:

• The Health Profession Opportunity Grants (HPOG) (OMB No. 0970-0394 )/Pathways to Advancing Careers and Education (PACE) (OMB No. 0970-0397) 36-Month Survey currently being conducted by Abt Associates for ACF.

• The Green Jobs and Health Care Impact Survey, recently conducted by Abt Associates for the Department of Labor (OMB No. 1205-0506).

• The Jobs Initiative 36-Month Follow-up Survey conducted by Abt Associates for the Annie E. Casey Foundation.

• The Moving to Opportunity (MTO) Interim follow-up survey conducted by Abt Associates for the Department of Housing and Urban Development ) OMB NO: 2528-0218).

• The Welfare to Work Survey Voucher Study conducted by Abt Associates for the Department of Housing and Urban Development (OMB No. 2528-0204)

• The Job Search Assistance Strategies Staff Survey (developed for this evaluation) (OMB No. pending)

• The baseline information form for the Ready to Work evaluation conducted by Abt Associates for the Department of Labor (OMB No. 1225-0086).

• The HOPE VI Panel Survey status, conducted by Abt Associates as a sub-contractor to the Urban Institute, for the Annie E. Casey Foundation, the John D. and Catherine T. MacArthur Foundation, the Rockefeller Foundation and the Department of Housing and Urban Development (OMB 2577-0236).

• The Benefit Offset National Demonstration (BOND) 36-month follow-up survey conducted by Abt Associates for the Social Security Administration (OMB No. 0960-0785).

• The PACE 18-month follow-up survey being conducted by Abt Associates for ACF (OMB No. 0970-0397).

• New questions are identified as such.

2. Employment Status

This first set of questions are about your current employment. I would like you to think back to [MONTH AND YEAR OF RAD] when you agreed to participate in this study.

Source: HPOG/PACE 36 Month Survey, Green Jobs and Health Care Impact Survey (OMB No. 0970-0394) and (OMB No. 0970-0397)

B1. Since [MONTH AND YEAR OF RAD], have you worked at any job for pay?

YES ₁

NO ₂(SKIP TO B8)

REFUSED ₇(SKIP TO C1)

DON’T KNOW ₈(SKIP TO C1)

Source: HPOG/PACE 36 Month Survey (OMB No. 0970-0394) and (OMB No. 0970-0397), Green Jobs and Health Care Impact Survey (OMB No. 1205-0506)

B2. What was the date you started work at your first job after [MONTH AND YEAR OF RAD]? [Accept month and year if exact date unknown.]

| | | | month, day, year

REFUSED ₇

DON’T KNOW ₈

Source: New question

B3. Did you turn down any job offers since [MONTH AND YEAR OF RAD] before taking that job?

YES ₁

NO ₂ (SKIP TO B5)

REFUSED ₇ (SKIP TO B5)

DON’T KNOW ₈ (SKIP TO B5)

Source: New question

B4. How may offers did you turn down before taking that job?

_________ number turned down

REFUSED ₇

DON’T KNOW ₈

Source: HPOG/PACE 36 Month Survey (OMB No. 0970-0394) and (OMB No. 0970-0397), Green Jobs and Health Care Impact Survey (OMB No. 1205-0506)

B5. Are you currently working at any job for pay?

YES ₁

NO ₂ (SKIP TO B7)

REFUSED ₇ (SKIP TO C1)

DON’T KNOW ₈ (SKIP TO C1)

Source: HPOG/PACE 36 Month Survey (OMB No. 0970-0394) and (OMB No. 0970-0397), Green Jobs and Health Care Impact Survey (OMB No. 1205-0506)

B6. What is the name of your current employer?

______________________ (SKIP TO C1)

REFUSED ₇ (SKIP TO C1)

DON’T KNOW ₈ (SKIP TO C1)

Source: HPOG/PACE 36 Month Survey (OMB No. 0970-0394) and (OMB No. 0970-0397), Green Jobs and Health Care Impact Survey (OMB No. 1205-0506)

B7. What was the name of your last employer?

______________________

REFUSED ₇

DON’T KNOW ₈

Source: Jobs Initiative survey, MTO survey (OMB No. 2528-0218), Welfare to Work survey (OMB No. 2528-0204)

B8. Have you been actively looking for work over the last four weeks?

YES ₁

NO ₂ (SKIP TO C1)

REFUSED ₇ (SKIP TO C1)

DON’T KNOW ₈ (SKIP TO C1)

Source: Jobs Initiative survey, MTO survey (OMB No. 2528-0218), Welfare to Work survey (OMB No. 2528-0204)

B9. Last week, could you have started a job had one been offered?

YES ₁

NO ₂

REFUSED ₇

DON’T KNOW ₈

3. Job search assistance activities under tanf

You agreed to participate in this study on [RAD]. At that time you were receiving/applying for cash assistance through the [PROGRAM NAME] program. I would like you to think back to any help you had looking for a job or getting ready to look for a job during the first few weeks after you started receiving or applied for cash assistance. [Tailor for depending on whether study involves cash assistance applicants or recipients]. Sometimes these job search services are provided in groups or classes. Other times you may have worked one-on-one with a staff person and looked for work with their guidance.

Source: New question

C1. For how many weeks did you participate in any type of job search assistance services as part of the [PROGRAM NAME] program?

______________________ (weeks)

REFUSED ₉₇

DON’T KNOW ₉₈

IF C1=97 or 0 SKIP TO C7

Source: New question

C2. During those weeks, for about how many hours per week did you participate in these job search services?

______________________ (weeks)

REFUSED ₉₇

DON’T KNOW ₉₈

Source: JSA Staff Survey (adapted)

C3. During those weeks, how often did you participate in group job search services, such as attending classes?

Never ₁

Every day ₂

2-3 times per week ₃

Once a week ₄

Attended one class ₅

Attended 2-3 classes total ₆

Other (specify)__________ ₇

REFUSED ₉₇

DON’T KNOW ₉₈

Source: A mixture of items from the Green Jobs and Health Care Impact Survey (OMB No. 1205-0506), modified items from the JSA staff survey, and new items

C4. [IF C3=1, 97 OR 98 SKIP TO C6] Next, I am going to read you a list of topics that are sometimes covered as part of group job search classes and one-on-one job search meetings. I am going to ask you about group job searches first. Thinking about your experiences in group job search classes , please tell me on a scale of one to three—where 1 is none of the time, 2 is some of the time and 3 is a lot of the time, how much of the group time was devoted to the activity of:

	SELECT ONE RESPONSE PER ROW
	NONE OF THE TIME	SOME OF THE TIME	A LOT OF THE TIME	REF	DK
a. Helping me create or edit my resume	1 □	2 □	3 □	7 □	8 □
b. Helping me figure out what sorts of jobs and careers might be right for me	1 □	2 □	3 □	7 □	8 □
c. How to look for a job, like figuring out all the different sources of information for job openings	1 □	2 □	3 □	7 □	8 □
d. Use of web-based job search engines like Monster	1 □	2 □	3 □	7 □	8 □
e. Helping me find specific job leads	1 □	2 □	3 □	7 □	8 □
f. Assistance filling out job applications	1 □	2 □	3 □	7 □	8 □
g. Learning about messages that I may be unintentionally sending with my dress, body language, or manner of speaking when I apply for a job	1 □	2 □	3 □	7 □	8 □
h. Practice job interviews	1 □	2 □	3 □	7 □	8 □
i. Helping me figure out how to handle stress and anxiety I might feel at a new job	1 □	2 □	3 □	7 □	8 □
j. How to communicate well with your boss and co‑workers	1 □	2 □	3 □	7 □	8 □
k. Helping me learn to manage any anger and frustrations that you might have	1 □	2 □	3 □	7 □	8 □
l. Proper workplace behaviors	1 □	2 □	3 □	7 □	8 □
m. Having a good work ethic, such as what you need to do if you can’t show up to work on time or need to miss work	1 □	2 □	3 □	7 □	8 □
n. Problem solving, such as how you approach problems that come up at work or in your personal life	1 □	2 □	3 □	7 □	8 □
o. How to manage my money and plan my finances	1 □	2 □	3 □	7 □	8 □
p. How to set and manage my goals	1 □	2 □	3 □	7 □	8 □
q. Helping me think how I might balance work and family responsibilities	1 □	2 □	3 □	7 □	8 □
r. Helping me deal with rejection, for example, if an employer turns you down	1 □	2 □	3 □	7 □	8 □

Source: JSA Staff Survey (adapted)

C5. During those early weeks, how often did you meet one-on-one with a staff person to help you find a job?

Never ₁

Every day ₂

2-3 times per week ₃

Once a week ₄

Once total ₅

2-3 times total ₆

Other (specify)__________ ₇

REFUSED ₉₇

DON’T KNOW ₉₈

Source: A mixture of items from the Green Jobs and Health Care Impact Survey (OMB No. 1205-0506), modified items from the JSA staff survey, and new items

C6. [IF C4=1, 7, 8 SKIP TO C7] Now I am going to read the same list again, but this time, please think about your experiences during one-on-one job search sessions. For each topic I read, please tell me on a scale of one to three— where 1 is none of the time, 2 is some of the time and 3 is a lot of the time, how much time was spent on the following topics during one-on-one with a staff person from the [PROGRAM NAME]:

	SELECT ONE RESPONSE PER ROW
	NONE OF THE TIME	SOME OF THE TIME	A LOT OF THE TIME	REF	DK
a. Helping me create or edit my resume	1 □	2 □	3 □	7 □	8 □
b. Helping me figure out what sorts of jobs and careers might be right for me	1 □	2 □	3 □	7 □	8 □
c. How to look for a job, like figuring out all the different sources of information for job openings	1 □	2 □	3 □	7 □	8 □
d. Use of web-based job search engines like Monster	1 □	2 □	3 □	7 □	8 □
e. Helping me find specific job leads	1 □	2 □	3 □	7 □	8 □
f. Assistance filling out job applications	1 □	2 □	3 □	7 □	8 □
g. Learning about messages that I may be unintentionally sending with my dress, body language, or manner of speaking when I apply for a job	1 □	2 □	3 □	7 □	8 □
h. Practice job interviews	1 □	2 □	3 □	7 □	8 □
i. Helping me figure out how to handle stress and anxiety I might feel at a new job	1 □	2 □	3 □	7 □	8 □
j. How to communicate well with your boss and co‑workers	1 □	2 □	3 □	7 □	8 □
k. Helping me learn to manage any anger and frustrations that you might have	1 □	2 □	3 □	7 □	8 □
l. Proper workplace behaviors	1 □	2 □	3 □	7 □	8 □
m. Having a good work ethic, such as what you need to do if you can’t show up to work on time or need to miss work	1 □	2 □	3 □	7 □	8 □
n. Problem solving such as how you approach problems that come up at work or in your personal life	1 □	2 □	3 □	7 □	8 □
o. How to manage my money and plan my finances	1 □	2 □	3 □	7 □	8 □
p. How to set and manage my goals	1 □	2 □	3 □	7 □	8 □
q. Helping me think how I might balance work and family responsibilities	1 □	2 □	3 □	7 □	8 □
r. Helping me deal with rejection, for example, if an employer turns you down	1 □	2 □	3 □	7 □	8 □

Please continue to think about these weeks after [RAD] when answering the next set of questions.

Source: MTO survey (OMB No. 2528-0218), Welfare to Work survey (OMB No. 2528-0204)

C7. During those early weeks, about how many hours per week did you spend looking for work?

Enter number of hours: ______________

	DON’T KNOW	 7
	REFUSED	 8

Source: MTO survey (OMB No. 2528-0218), Welfare to Work survey (OMB No. 2528-0204)

C8. With how many different employers did you make direct contact, either by phone, mail, e-mail, or in-person, during that time period?

Enter number of employers ______________

	DON’T KNOW	 7
	REFUSED	 8

Source: JSA Staff Survey (adapted)

C9. Now I am going to read you a list of on-line tools that people sometimes use to look for jobs. Thinking about the weeks after [RA DATE], please tell me on a scale of one to three— where 1 is none of the time and 3 is a lot of the time, whether you used the tool during that time.

	SELECT ONE RESPONSE PER ROW
	None of the time	Some of the time	A lot of the time	REF	DK
a. The state or government job bank …………………	1 □	2 □	3 □	7 □	8 □
b. Commercial job search services like Monster	1 □	2 □	3 □	7 □	8 □
c. LinkedIn	1 □	2 □	3 □	7 □	8 □
d. Facebook	1 □	2 □	3 □	7 □	8 □
e. Twitter	1 □	2 □	3 □	7 □	8 □
f. Craig’s List	1 □	2 □	3 □	7 □	8 □
g. On-line searches using Google, Bing, Yahoo, or another general search engine	1 □	2 □	3 □	7 □	8 □
h. Web-based tools to help me figure out what jobs match my skills and interests	1 □	2 □	3 □	7 □	8 □
i. Web-based instruction on job interview skills	1 □	2 □	3 □	7 □	8 □
j. Web-based instruction on life skills like managing stress	1 □	2 □	3 □	7 □	8 □
k. On-line or mobile tools for creating resumes and/or posting resumes	1 □	2 □	3 □	7 □	8 □
l. Other (specify)_____________________	1 □	2 □	3 □	7 □	8 □

Source: New question

C10. During early weeks after [RAD], when you agreed to be part of this study, did you participate in or receive any of the following services?

	SELECT ONE RESPONSE PER ROW
	YES	NO	REF	DK
a. Classes to learn English as a second language	1 □	0 □	7 □	8 □
b. Classes to help you finish high school or earn a GED	1 □	0 □	7 □	8 □
c. Classes to prepare you for a specific occupation like nurse or welder.	1 □	0 □	7 □	8 □
d. On-the-job training or subsidized employment (where you received a pay check)	1 □	0 □	7 □	8 □
e. Assistance with child care expenses while you searched for work	1 □	0 □	7 □	8 □
f. Bus fares, gas money, or taxi fares to get you to job interviews	1 □	0 □	7 □	8 □
g. Unpaid work experience	1 □	0 □	7 □	8 □

1. tools of last successful job search

[SKIP TO SECTION E IF NEVER EMPLOYED SINCE RAD]

Now I would like you to think about the search that led to your job at [NAME OF LAST/CURRENT EMPLOYER FROM B6/B7].

Construct: Factors Contributing to Finding Job

Source: Jobs Initiative survey, MTO survey (OMB No. 2528-0218), Welfare to Work survey (OMB No. 2528-0204) (adapted)

D1. I am going to read you a list of things you might have done to find your job at [NAME OF LAST/CURRENT EMPLOYER FROM B6/B7]. For each search activity, I would like to know if you did it at least once and then I would like to know how important it was to your success finding that job. If you engaged in the activity, please judge its importance on a scale of 1 to 3 where 1 means that you did it, but you don’t think it did any good, 2 means that you did and you think it may have helped, and 3 means that you think that it was a big part of your success in finding the job.

	SELECT ONE RESPONSE PER ROW
	Never did it	Did it, but did not help	Did it and may have helped	Did it and was big part of your success	REF	DK
a. Checked ads on my own in the newspaper	0 □	1 □	2 □	3 □	7 □	8 □
b. Placed an ad about my availability	0 □	1 □	2 □	3 □	7 □	8 □
c. Followed leads given by the [PROGRAM NAME]	0 □	1 □	2 □	3 □	7 □	8 □
d. Followed leads given by a private employment agency	0 □	1 □	2 □	3 □	7 □	8 □
e. Followed leads given by a friend or family member	0 □	1 □	2 □	3 □	7 □	8 □
f. Called employers on the phone	0 □	1 □	2 □	3 □	7 □	8 □
g. Looked for help wanted signs at stores or other establishments	0 □	1 □	2 □	3 □	7 □	8 □
h. Asked for jobs at establishments without help-wanted signs	0 □	1 □	2 □	3 □	7 □	8 □
i. Checking for jobs on the state or government job bank or posting …………………	0 □	1 □	2 □	3 □	7 □	8 □
	Never did it	Did it, but did not help	Did it and may have helped	Big part of your success	REF	DK
j. Checking for jobs on commercial job search services like Monster	0 □	1 □	2 □	3 □	7 □	8 □
k. Findings job openings on LinkedIn	0 □	1 □	2 □	3 □	7 □	8 □
l. Finding job openings on Facebook	0 □	1 □	2 □	3 □	7 □	8 □
m. Finding job openings through Twitter	0 □	1 □	2 □	3 □	7 □	8 □
n. Craig’s List	0 □	1 □	2 □	3 □	7 □	8 □
o. On-line searches using Google, Bing, Yahoo, or another general search engine	0 □	1 □	2 □	3 □	7 □	8 □
p. Other search tools (please specify): ___________	0 □	1 □	2 □	3 □	7 □	8 □

Source: New question

D2. It can be hard to apply for a job or decide to apply for one. I am going to read some factors that might affect a person’s decision on whether or not to apply for a job. For each factor I read, please tell me if you think it affected your decision to apply to [NAME OF LAST/CURRENT EMPLOYER FROM B6/B7].

	SELECT ONE RESPONSE PER ROW
	Yes, applied to me	No, did not apply to me	REF	DK
a. I knew they were looking for someone with my skills and experience	1 □	2 □	7 □	8 □
b. I had a good reference	1 □	2 □	7 □	8 □
c. Someone at the employer was a friend of a friend or a friend of someone in your family	1 □	2 □	7 □	8 □
d. Someone at the [NAME OF PROGRAM] helped me apply	1 □	2 □	7 □	8 □
e. A friend or family member helped me apply	1 □	2 □	7 □	8 □
e. I felt like I needed to take anything I could get	1 □	2 □	7 □	8 □
f. The person at the employer looked friendly	1 □	2 □	7 □	8 □
g. I did not have anything to lose	1 □	2 □	7 □	8 □
h. I was dressed well	1 □	2 □	7 □	8 □
i. I had a good night’s sleep	1 □	2 □	7 □	8 □
j. I felt strong and healthy	1 □	2 □	7 □	8 □

5. job search skills

The next set of questions cover a wide range of beliefs and attitudes about yourself and life in general.

Source: HPOG (OMB No. 0970-0394)/PACE (OMB No. 0970-0397) 36-month follow-up survey

E1. I’m going to read some statements about how people approach various tasks in life. For each, please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly disagree that the statement applies to you. Be honest—there are no right or wrong answers!

		Strongly agree	Somewhat agree	Somewhat disagree	Strongly disagree	REF	DK
a.	New ideas and projects sometimes distract me from previous ones. Do you…	0 □	1 □	2 □	3 □	7 □	8 □
b.	Setbacks don’t discourage me. Do you….	0 □	1 □	2 □	3 □	7 □	8 □
c.	I have been obsessed with a certain idea or project for a short time but later lost interest. Do you….	0 □	1 □	2 □	3 □	7 □	8 □
d.	I am a hard worker.	0 □	1 □	2 □	3 □	7 □	8 □
e.	I often set a goal but later choose to pursue a different one.	0 □	1 □	2 □	3 □	7 □	8 □
f.	I often have difficulty maintaining my focus on projects that take more than a few months to complete.	0 □	1 □	2 □	3 □	7 □	8 □
g.	I finish whatever I begin.	0 □	1 □	2 □	3 □	7 □	8 □
h.	I am diligent.	0 □	1 □	2 □	3 □	7 □	8 □

Source: HPOG (OMB No. 0970-0394)/PACE (OMB No. 0970-0397) 36-month follow-up survey

E2. Now I’m going to read a series of statements about your feelings about different aspects of life. For each one, please tell me whether you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with that statement:

(READ RESPONSE OPTIONS AFTER FIRST ITEMS THEN REPEAT AS NEEDED)

		Strongly agree	Somewhat agree	Somewhat disagree	Strongly disagree	REF	DK
a.	I am confident I get the success I deserve in life. Do you…	0 □	1 □	2 □	3 □	7 □	8 □
b.	Sometimes I feel depressed. Do you…	0 □	1 □	2 □	3 □	7 □	8 □
c.	When I try, I generally succeed. Do you…	0 □	1 □	2 □	3 □	7 □	8 □
d.	Sometimes when I fail I feel worthless.	0 □	1 □	2 □	3 □	7 □	8 □
e.	I complete tasks successfully.	0 □	1 □	2 □	3 □	7 □	8 □
f.	Sometimes, I do not feel in control of my work.	0 □	1 □	2 □	3 □	7 □	8 □
g.	Overall, I am satisfied with myself.	0 □	1 □	2 □	3 □	7 □	8 □
h.	I am filled with doubts about my competence.	0 □	1 □	2 □	3 □	7 □	8 □
i.	I determine what will happen in my life.	0 □	1 □	2 □	3 □	7 □	8 □
j.	I do not feel in control of my success in my career.	0 □	1 □	2 □	3 □	7 □	8 □
k.	I am capable of coping with most of my problems.	0 □	1 □	2 □	3 □	7 □	8 □
l.	There are times when things look pretty bleak and hopeless to me.	0 □	1 □	2 □	3 □	7 □	8 □

Source: HPOG (OMB No. 0970-0394)/PACE (OMB No. 0970-0397) 36-month follow-up survey

E3. When it comes to careers, some people are more certain than others that they know where they are headed and how to get there. Please indicate for each item whether you strongly agree, somewhat agree, somewhat disagree, or strongly disagree that it reflects your career situation: (READ RESPONSE OPTIONS AFTER FIRST 3 ITEMS AND THEN REPEAT AS NEEDED)

		Strongly agree	Somewhat agree	Somewhat disagree	Strongly disagree	REF	DK
a.	I’m not sure how to accurately assess my abilities and challenges. Do you…	0 □	1 □	2 □	3 □	7 □	8 □
b.	I know how to make a plan that will help me achieve my goals for the next 5 years. Do you…	0 □	1 □	2 □	3 □	7 □	8 □
c.	I know how to get help from staff and teachers with any issues that might arise when I am at school. Do you…	0 □	1 □	2 □	3 □	7 □	8 □
d.	I’m not sure what type of job is best for me.	0 □	1 □	2 □	3 □	7 □	8 □
e.	I know the type of employer I want to work for.	0 □	1 □	2 □	3 □	7 □	8 □
f.	I know the occupation I want to be in.	0 □	1 □	2 □	3 □	7 □	8 □
g.	I’m not sure what kind of education and training program is best for me.	0 □	1 □	2 □	3 □	7 □	8 □

6. MOTIVATION TO WORK/ATTITUDES TOWARD JOB SearCH

The next set of questions is about your views about what is important to you when deciding if you will accept a job.

Source: Jobs Initiative survey

F1. Overall, how important is it to you that you have a job? Would you say it is very important, somewhat important, or not important at all?

VERY IMPORTANT ₁

SOMEWHAT IMPORTANT ₂

NOT IMPORTANT AT ALL ₃

REFUSED ₇

DON'T KNOW ₈

Source: Ready to Work Survey (OMB No. 1225-0086)

F2. People vary in how willing they are to take various types of jobs. I am going to read you some statements about how you might feel about taking a particular job. Please indicate for each statement whether you strongly agree, somewhat agree, somewhat disagree, or strongly disagree that it reflects your willingness.

	MARK ONE PER ROW PER COLUMN
	strongly agree	SOMEWHAT agree	SOMEWHAT disagree	strongly disagree	REF	DK
a. I will take any job even if the pay is low. Do you…	1 	2 	3 	4 	7 □	8 □
b. I want only the kind of job that I trained for. Do you…	1 	2 	3 	4 	7 □	8 □
c. I am willing to work part-time if no full-time offer is available. Do you…	1 	2 	3 	4 	7 □	8 □
d. I am willing to work unusual or unpredictable schedules	1 	2 	3 	4 	7 □	8 □

Source: Green Jobs and Health Care Impact Survey (OMB No. 1205-0506)

F3. How much must a job pay per hour for it to make sense for you to take it? [If necessary: What is the lowest hourly wage you are willing to accept. Think about the costs of taking a job, which might include child care and transportation.] $ | | | |.| | |

97  REFUSED

98.  DON’T KNOW

7. FACTORS ThAT AFFECT ABILITY TO WORK

The next few questions are about things in life that can make it hard to work, or to look for work.

Source: HOPE VI Panel survey (OMB 2577-0236); BOND 36-month follow-up (OMB No. 0960-0785); Green Jobs and Health Care Impact Survey (adapted) (OMB No. 1205-0506); and PACE 15-month (OMB No. 0970-0397), HPOG 36-month (OMB No. 0970-0394), PACE 36-month surveys (OMB No. 0970-0397)

G1. In the past 12 months, please note how often each of the following situations interfered with your work, job search, or ability to take a job: Would you say, very often, fairly often, sometimes, almost never, or never. (READ RESPONSE OPTIONS AFTER FIRST 3 ITEMS AND THEN REPEAT AS NEEDED)

		Very often	Fairly often	Some-times	Almost never	Never	REF	DK
a.	Child care arrangements? Would you say…	0 □	1 □	2 □	3 □	4 □	7 □	8 □
b.	Transportation? Would you say…	0 □	1 □	2 □	3 □	4 □	7 □	8 □
c.	Alcohol or drug use? Would you say…	0 □	1 □	2 □	3 □	4 □	7 □	8 □
d.	An illness or health condition?	0 □	1 □	2 □	3 □	4 □	7 □	8 □

8. Job cHARACTERISTICS

[SKIP TO I1, IN SECTION I IF B1=NO SINCE RAD]

I would now like to ask you several questions about your job at [NAME OF LAST/CURRENT EMPLOYER FROM B6/B7].

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397)

H1. How many hours per week on average [did you work/are you currently working] at [NAME OF LAST/CURRENT EMPLOYER FROM B6/B7]?

___ ___ hours/week (1-80)

97 REFUSED

98. DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397), BOND 36-month follow-up survey (OMB No. 0960-0785)

H2. About how much [did/do] you typically earn per hour before taxes?

$ ($2.50-75.00)___ ___ . ___ ___ PER HOUR [SKIP TO H3]

9997 REFUSED [SKIP TO H3]

9998 DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397), BOND 36-month follow-up survey (OMB No. 0960-0785)

H2a. Can you tell me how much you [used to/currently] earn for some other time period besides hourly, such as per day, per week, every two weeks, or month?

$(1-400)___ ___ ___ ___ PER DAY

$(1-4000) ___ ___ ___ ___ PER WEEK

$(1-8000) ___ ___ ___ ___ EVERY 2 WEEKS/TWICE A MONTH

$ (1-16000)___ ___ ___ ___ EVERY MONTH

$ (0.20-100.00)___ ___ ___ ___ PER JOB/PER PIECE

$ (10-5000)___ ___ ___ ___ PER COMMISSION

$ (1-80000)___ ___ ___ ___ ANNUALLY

99997 REFUSED

99998 DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397)

H3. [Do/Did] you usually work a regular daytime schedule or some other schedule?

INTERVIEWER READ IF ASKED: A regular daytime shift is one in which you work anytime between the hours of 6AM to 6PM and your schedule is the same week to week.

1. A REGULAR DAYTIME SCHEDULE (ANYTIME BETWEEN 6AM TO 6PM) (SKIP TO H4)

2. SOME OTHER SCHEDULE

7. REFUSED (SKIP TO H4)

8. DON’T KNOW (SKIP TO H4)

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397)

H3a. Which of the following best describes the type of shift you usually (work/worked)?

1. A regular evening shift (Anytime between 2 pm to Midnight),

2. A regular night shift (Anytime around 9pm to 8am),

3. A rotating shift - one that changes periodically from day to evenings or night,

4. A split shift - one consisting of two distinct periods each day,

5. An irregular schedule arranged by employer, or

6. Some other schedule? (SPECIFY)

7. REFUSED

8. DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397), BOND 36-month follow-up survey (OMB No. 0960-0785)

H4. [Are/Were] any of the following benefits available to you at [NAME OF LAST/CURRENT EMPLOYER FROM B6/B7]? That is, if you wanted it, [can you receive/could you have received]:

	YES	NO	REF	DK
Health insurance?	1 □	2 □	7 □	8 □
Paid vacation?	1 □	2 □	7 □	8 □
Paid holidays?	1 □	2 □	7 □	8 □
Paid sick days?	1 □	2 □	7 □	8 □
Retirement or pension benefits?	1 □	2 □	7 □	8 □

9. Household structure and income

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397) (re-ordered)

Now I’d like to talk to you about your family and current household.

I1. Besides you, who among the following live in your household at least half the time?

1. Your spouse?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

2. Your unmarried partner?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

3. Your [IF I1A=YES: or your spouse’s/IF I1B=YES: or your partner’s] mother or father?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

4. Your [IF I1A=1: or your spouse’s/IF I1B=1: or your partner’s] adult children or other relatives aged 18 or older?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

5. Anyone else aged 18 or older such as friends or housemates?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

6. Your [IF I1A=YES: or your spouse’s/IF I1B=YES: or your partner’s] biological, adopted, or step children aged 17 or younger?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

7. Your [IF I1A=YES: or your spouse’s/IF I1B=YES: or your partner’s] other relatives aged 17 or younger such as younger siblings, nephews and nieces?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

8. Anyone else aged 17 or younger such as foster children, and children of friends or housemates?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

CATI/CAPI: ASK I2 ONLY IF I1F OR I1G OR I1H =YES; ELSE SKIP TO NOTE BEFORE I3.

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397)

I2. How many persons aged 17 or younger live with you at least half the time? Include biological, adopted, foster, step, and any other children, as well as younger siblings.

___ ___ (0-99)number of persons aged 17 or younger

7. REFUSED

8. DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397)

CATI/CAPI: ASK I3 ONLY IF I1A OR I1B OR I1E OR I1F OR I1H =YES; ELSE SKIP TO NOTE BEFORE I4.

I3. How many adults live with you at least half the time?

___ ___ (0-99)number of persons aged 18 or older

7. REFUSED

8. DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397), BOND 36-month follow-up survey (OMB No. 0960-0785), Green Jobs and Health Care Services Impact Survey (adapted) (OMB No. 1205-0506)

Now, I am going to ask you some questions about your personal and household income in [PRIOR MONTH]. Again, I want to assure you that none of your answers will be discussed with anyone. [IF RESPENDENT HAS OTHER HOUSEHOLD MEMBERS [ANY I1A-H = YES]:] I will ask you first about your personal income then I will ask about the income of other members of your household.

I4. Did you personally have income or benefits from any of the following sources in [PRIOR MONTH]?

	YES	NO	REF	DK
Supplemental Nutrition Assistance Program (SNAP) benefits	1 □	2 □	7 □	8 □
Temporary Assistance for Needy Families (TANF) benefits	1 □	2 □	7 □	8 □
Women, Infants and Children Program also known as WIC (“wick”)	1 □	2 □	7 □	8 □
Unemployment Insurance or Worker’s Compensation	1 □	2 □	7 □	8 □
Medicaid	1 □	2 □	7 □	8 □
Subsidized Child Care	1 □	2 □	7 □	8 □
Section 8 or Public Housing	1 □	2 □	7 □	8 □
Low Income Home Energy Assistance Program or LIHEAP (“lie-heap”)	1 □	2 □	7 □	8 □
Free or reduced lunch program	1 □	2 □	7 □	8 □
Child Support.--please include official and or unofficial sources	1 □	2 □	7 □	8 □
Family and friends who did not live with you at least half of the time last month	1 □	2 □	7 □	8 □

Source: Green Jobs and Health Care Impact Survey (adapted) (OMB No. 1205-0506)

I5. [IF I4h=1] How much did you personally receive in child support last month?

$ ____________________ ($0-5,000 NO DECIMAL)

9997 REFUSED

9998 DON’T KNOW

Source: New question

I6. [IF I4i=1] How much did you personally receive from family and friends outside your household last month?

$ ____________________ ($0-5,000 NO DECIMAL)

9997 REFUSED

9998 DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397), BOND 36-month follow-up survey (OMB No. 0960-0785) (adapted)

I7. [IF I4d=1 (YES)] What was the total amount of your child care subsidy in [PRIOR MONTH]?

$ ____________________ ($0-1,000 NO DECIMAL)

9997 REFUSED

9998 DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397), BOND 36-month follow-up survey (OMB No. 0960-0785), Green Jobs and Health Care Services Impact Survey (adapted) (OMB No. 1205-0506)

I8. Thinking of all of the income received by you ([IF ANY I1A-H = YES:] and the people in your household) last month, what was your total income ([IF ANY I1A-H = YES:] for everyone living together in your household) in [PRIOR MONTH]?

([IF ANY I1A-H = YES:] Please consider anyone who lived in your household for at least half of [PRIOR MONTH] when you answer this question, including yourself.)

(IF NEEDED: Please do not include any refunds of federal, state or local income taxes paid in past years.)

$ ____________________ ($0-10,000 NO DECIMAL) (SKIP TO CLOSING)

99997 REFUSED (SKIP TO CLOSING)

99998 DON’T KNOW

Source: HPOG/PACE 36-month follow-up survey (OMB No. 0970-0394) and (OMB No. 0970-0397), BOND 36-month follow-up survey (OMB No. 0960-0785), Green Jobs and Health Care Services Impact Survey (adapted) (OMB No. 1205-0506)

(adapted)

I8a. Which of the following categories best describes your total household income? Please consider income received by anyone who lived in your household for at least half of [PRIOR MONTH] when you answer this question, including yourself. Would you say your total household income in [PRIOR MONTH] was

1. None ($0)

2. $500 or less

3. $501 to $1,000

4. $1,001 to $1,500

5. $1,501 to $2,000

6. $2,001 to $2,500

7. $2,501 or more

97. REFUSED

98. DON’T KNOW

closing. That is all the questions I have for you. In appreciation for your time spent completing this interview I will send you a check for $25. You should receive this check in XX weeks. Thank you very much for your time today.