6-Month Follow-Up Participant Survey (Attachment J)

A ttachment J – 6-Month Follow-Up Participant Survey

^Introduction

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

IF RESPONDENT COMES TO THE PHONE: I’m calling on behalf of [BEES program].

IF PHONE OR IN-PERSON: I work for Abt Associates, or Abt, which is an independent research company. Abt is helping the Administration for Children and Families (ACF) in the U.S. Department of Health and Human Services (HHS) with its evaluation of the Building Evidence on Employment Strategies (BEES) study. We are conducting a survey with you because you agreed to be in a study about a program offered at [NAME OF ORGANIZATION] called [BEES program]. Thank you for taking the time to talk with me today.

This survey will include questions on your employment and education activities, your use of services, and your overall well-being. This survey will take about 15 minutes to complete. When we are done, we will send you a link to access a $15 gift card, as a thank you. You agreed to be part of the study around [RAD] when you signed a consent form to let researchers collect information from you. We need to talk with people who got into the program and those who did not. Your participation in this study will help policymakers and program staff better understand how to help people get better jobs, earn more, and improve general well-being.

Before we begin the survey, I would like to assure you that all of your responses during this survey will be kept private; your name will not appear in any written reports we produce. Your responses to these questions are completely voluntary. That means you may choose not to answer any question, or you may stop the survey 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. The information you provide will be kept private and only used for studies about the different types of employment services that are the focus of this study. By participating in this study, you will help the government learn if and how programs like [BEES program] make a difference in people’s lives and how to improve programs in the future.

According to the Paperwork Reduction Act (PRA), this collection of information is voluntary and will be used to understand programs that aim to improve employment outcomes for low-income adults. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. 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 number and expiration date for this collection are OMB #: XXXX-XXXX, Exp: XX/XX/XXXX. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Dan Bloom (MDRC); 200 Vesey Street, 23^rd Floor, New York, NY 10281-2103.

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.

Read the following text and ask Q1 of everyone.

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

Ask Q2 only if the DOB in Q1 does not match what is in our records.

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

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.

SECTION A: SERVICE RECEIPT AND PARTICIPATION

A1.

I would like you to tell me about assistance you may have received since random assignment (month, year) [RAMY] 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.

INTERVIEWER, IF NECESSARY, SAY: That is the date you applied to get into the [BEES program]. Please tell me about both help you have received from [BEES program], and help you have received from other programs or organizations.

Did you receive help with …
a. …preparing a resume or filling out job applications?	1 YES 2 NO 7 DK 8 REF
b. …preparing for job interviews?	1 YES 2 NO 7 DK 8 REF
c. …looking for jobs, including subsidized jobs, or deciding what kinds of jobs to look for?	1 YES 2 NO 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
e. …planning your future career or educational goals, including a work or job assessment?	1 YES 2 NO 7 DK 8 REF
f. …paying for transportation for a job or paying for work tools or uniforms?	1 YES 2 NO 7 DK 8 REF
g. …training to learn a new job or skill?	1 YES 2 NO 7 DK 8 REF
h. …education to learn a new job or skill?	1 YES 2 NO 7 DK 8 REF
i. … supports, accommodations, or coaching while working, provided by someone other than your employer?	1 YES 2 NO 7 DK 8 REF
j. …on-the-job training?	1 YES 2 NO 7 DK 8 REF
k. … 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 DK 8 REF
l. …some other employment service?	1 YES (SPECIFY: _______) 2 NO 7 DK 8 REF

A2.

Are you currently receiving any of these services related to finding or keeping a job?

1 YES

2 NO

7 DK

8 REF

A3.

You indicated that you received help related to finding or keeping a job since [RAMY].

IF NUMBER OF 1/YES RESPONSES IN A1 AND A2a SUMS TO 1, SHOW: Where did you receive this help most often? Was it…

IF NUMBER OF 1/YES RESPONSES IN A1 AND A2a SUMS TO MORE THAN 1, SHOW: Where did you receive most of these services? Was it…

INTERVIEWER: READ LIST, SELECT ONE.

1 [BEES program],

2 A WELFARE OFFICE,

3 A WORKFORCE CENTER, WIA OR ONE-STOP,

4 AN UNEMPLOYMENT OFFICE,

5 FOOD STAMP PROGRAM OR SNAP,

6 A clubhouse or other organization that addresses mental health or substance use, or

7 SOME OTHER SOURCE? (SPECIFY________________________)

97 DON’T KNOW

98 REFUSED

A4.

How much time since [RAMY] did you spend participating in these services related to finding or keeping a job? Please give your answer in either days, weeks, or months.

01 RESPONSE PROVIDED IN DAYS: SPECIFY: ____________ (RANGE 1-90)

02 RESPONSE PROVIDED IN WEEKS: SPECIFY: ____________ (RANGE 1-52)

03 RESPONSE PROVIDED IN MONTHS SPECIFY: ____________ (RANGE 1-25)

97 DK

98 REF

A5.

In the month after you applied to [BEES program], that is, [RESTORE RAMY + 1 MONTH], how much time did you spend, receiving these services related to finding or keeping a job? Please consider services from any source. Please give your answer in either days or weeks.

01 RESPONSE PROVIDED IN DAYS: SPECIFY: ____________ (RANGE 1-31)

02 RESPONSE PROVIDED IN WEEKS: SPECIFY: ____________ (RANGE 1-4)

96 NONE IN THAT MONTH

97 DK

98 REF

A6.

Thinking of the people you have worked with at agencies or organizations since [RAMY], is there a person to whom you can turn for advice or support when you have problems or things that worry you?

1 YES

2 NO [SKIP TO A9]

7 DON’T KNOW [SKIP TO A9]

8 REFUSED [SKIP TO A9]

A7.

At which organization or program did this person work? Was it…

1 A career center program or other [local program name],

2 Family Resource Centers, [state specific program], or Welfare to Work,

3 Vocational rehabilitation counselor,

4 A clubhouse, community mental health center, or other organization that addresses mental health or substance use,

5 A community-based organization that provides workforce development services, or

6 Some other place? (Specify________)

97 DK

98 REF

A8.

Are you still in touch with this person?

1 YES

2 NO

97 DON’T KNOW

98 REFUSED

A9.

Have you enrolled in any of the following types of education or vocational training classes since [RAMY]?

	1. YES	2. NO	7. DK	8. REF
1.) Vocational training program?
2.) Technical or trade school?
3.) ESL classes (English as Second Language)?
3.) Adult basic education or GED courses?
4.) 2-year or community college?
5.) 4-year college or university?
6.) Graduate school?
7.) Somewhere else? (SPECIFY:________)

A.9a. (IF YES TO ANY A9)

Was this class/were any of these classes taken online?

1 YES
2 NO

97 DON’T KNOW

98 REFUSED

A10.

Now I’d like to ask you about professional certifications and licensures that you’ve obtained. Since [RAMY], have you earned or received a professional certification 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, Certified Medical Assistant, Certified Construction Manager, a Project Management Profession or PMP certification, or an IT certification.

1 YES

2 NO [SKIP TO A12]

97 DON’T KNOW [SKIP TO A12]

98 REFUSED [SKIP TO A12]

A11.

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

A12.

Since [RAMY], 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, counselor, doctor, or other provider.

1 YES

2 NO [GO TO SECTION B]

97 DON’T KNOW [GO TO SECTION B]

98 REFUSED [GO TO SECTION B]

A13.

Where did you receive help with problems related to your emotions, nerves, anger management or mental health? Was it at…

1 [state specific or local program],

2 Private Therapist,

3 Vocational rehabilitation counselor,

4 or some other place? (Specify_______)

97 DK

98 REF

A14.

During the time in which you were receiving this help, how often did you receive help? Was it…

1. Two or more times a week,

2. Once a week,

3. 2-3 times a month,

4. Once a month, or

5. Less than once a month?

7. DK

8. REF

A15.

Since [RAMY], have you received help for problems related to substance use?

1 YES

2 NO [GO TO SECTION B]

7 DON’T KNOW [GO TO SECTION B]

8 REFUSED [GO TO SECTION B]

A16.

What type of treatment services did you receive for problems related to substance use? Was it …

1 hospital inpatient,

2 inpatient in a residential drug treatment program,

3 intensive outpatient,

4 outpatient.

5 or some other type? (Specify_______)

97 DK

98 REF

A17.

During the time in which you were receiving help for problems related to substance use, how often did you receive help? Was it…

1. Two or more times a week,

2. Once a week,

3. 2-3 times a month,

4. Once a month, or

5. Less than once a month?

7. DK

8. REF

A18.

Have you been taking any of the following while in the care of a medical professional during the past [30 days]?

1 methadone,

2 buprenorphine (including Subutex ®, Suboxone ®)

3 naltrexone (including Vivitrol ®)

97 DK

98 REF

SECTION B: PROGRAM SATISFACTION

PROGRAM GROUP ONLY

Now, I’m going to ask you some questions about your experiences with [BEES program].

b1.

Since [RAMY], have you received any services from [BEES program] or participated in any [BEES program] activities?

1          YES

             2          NO                               [SKIP TO B3]            

             7          DON’T KNOW            

             8          REFUSED                   

b2.

Which of the following best describes your current situation with [BEES program]?

1          Currently working with an [employment specialist], but haven’t found a job yet,

2          Found a job and currently working with an employment specialist,                   

             3          Started the program but stopped before you found a job, [SKIP TO B4]

             4          Started the program and stopped after you found a job, or

5          Never worked with [BEES program] staff on employment-related activities? [SKIP TO B3]

            7          DON’T KNOW                                                                        

            8          REFUSED

b3.

What was the primary reason you did not participate in [BEES program]?

1 You didn’t have transportation/had issues with transportation

2 You were incarcerated

3 You didn’t have the time

4 You got a job

5 You moved

6 You were expecting a child

7 You had child care problems

8 You had health problems or an injury

9 A family member became ill

10 You had pressure from your family

11 You did not like the program

12 You did not like or get along with the program staff

13 You no longer wanted to find employment

14 Some other reason (SPECIFY:________)

97 DK

98 REF

b4.

What was the primary reason you stopped going to [BEES program]?

1 You didn’t have transportation/had issues with transportation

2 You were incarcerated

3 You didn’t have the time

4 You got a job

5 You moved

6 You were expecting a child

7 You had child care problems

8 You had health problems or an injury

9 A family member became ill

10 You had pressure from your family

11 You did not like the program

12 You did not like or get along with the program staff

13 You no longer wanted to find employment

14 Some other reason (SPECIFY:________)

97 DK

98 REF

b5.

Did [BEES program] staff help you find a job?

1 YES

2 NO

7 DK

8 REF

b6.

How satisfied were you with the job you found? Were you…

1 Very satisfied,

2 Somewhat satisfied,

3 Not very satisfied, or

4 Not at all satisfied?

7 DK

8 REF

C. Contact Information

Respondent Information

Before we complete this portion of the survey, I would also like to make sure I have your contact information recorded correctly. This information will help us to reach you for future surveying efforts, and to ensure that we send your link to access your gift card to the correct email address. We may also use this information to call you and ask how your survey experience was.

1. I have your name recorded as [FIRST MI LAST]. Is this still correct or have you changed your name?

1. YES, STILL CORRECT (SKIP TO H2)

2. NO, NAME CHANGED

1. What is your first name now? [IF POSSIBLE, PREFILL FROM FIRST]

2. What is your middle initial now? [IF POSSIBLE, PREFILL FROM MIDDLE]

3. What is your last name now? [IF POSSIBLE, PREFILL FROM LAST]

2. I have your address recorded as [STREET, APT, CITY, STATE, ZIP]. Is this still correct or have you moved?

1. YES, STILL CORRECT (SKIP TO H3)

2. NO, MOVED

1. What is your new street address or PO box number?

2. Is there a complex or building name?

3. Is there an apartment number?

4. In what city?

5. In what state?

6. What is the zip code?

3. I have your primary phone number recorded as [xxx-xxx-xxxx]. Is this still correct or do you have a new primary phone number?

1. YES, STILL CORRECT (SKIP TO H4)

2. NO, CHANGED

1. What is the new number, starting with the area code?

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

2. Is that a home, cell, shelter, work, or other number?

1. Home

2. Cell

3. Shelter

4. Work

5. Other

4. IF MISSING, SKIP TO H5. IF ≠ MISSING: I have your secondary phone number recorded as [xxx-xxx-xxxx]. Is this still correct or do you have a new secondary phone number?

1. YES, STILL CORRECT (SKIP TO H5)

2. NO, CHANGED

1. What is the new number, starting with the area code?

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

2. Is that a home, cell, shelter, work, or other number?

1. Home

2. Cell

3. Shelter

4. Work

5. Other

5. Do you have another phone number where we can reach you?

1. YES, ADDITIONAL PHONE NUMBERS AVAILABLE

2. NO (SKIP TO H6)

1. What is the new number, starting with the area code?

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

2. Is that a home, cell, shelter, work, or other number?

1. Home

2. Cell

3. Shelter

4. Work

5. Other

[REPEAT H5 UNTIL ALL PHONE NUMBERS ARE RECORDED]

6. IF MISSING, SKIP TO H7. IF ≠ MISSING: I have your email address recorded as [abc@abc.abc]. Is this still correct or do you have a new email address?

1. YES, STILL CORRECT (SKIP TO H7)

2. NO, CHANGED

3. NO LONGER HAVE ANY WORKING EMAIL ADDRESSES (SKIP TO INSTRUCTION ABOVE I8)

1. What is your new email address?

7. Do you have [IF H6=MISSING: an email address / IF H6≠MISSING: any other email addresses]?

1. YES, ADDITIONAL EMAIL ADDRESSES ARE AVAILABLE

2. NO (SKIP TO INSTRUCTIONS ABOVE H8)

1. What is the additional email address?

[REPEAT H7 UNTIL ALL EMAIL ADDRESSES ARE LISTED]

To help us be able to get back in touch with you in the future, we would like to review the names, telephone numbers and addresses of three people we talked about last time we spoke who will always know how to reach you. This information will be kept strictly private and will only be used if we are unable to contact you.

8. When we last spoke in [MONTH AND YEAR OF RAD] you said that [CONTACT #1] was a person who would always know where you are and how to reach you. Is [CONTACT#1] still a person who does not live with you and will always know how to contact you?

1. YES (VERIFY CONTACT #1 INFORMATION THEN GO TO H9)

2. NO

7. REFUSED

8. DON’T KNOW

IF NO: Could you please tell me the name of a person who does not live with you and will always know how to contact you?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

IF YES:

	CONFIRM INFO BELOW	Check if correct	ENTER/CHANGE INFO
first name	[DISPLAY FIRST NAME]	□
middle name	[DISPLAY MIDDLE NAME]	□
Last name	[DISPLAY LAST NAME]	□
Suffix	[DISPLAY SUFFIX]	□
Street Address/PO Box	[DISPLAY STREET ADDRESS]	□
Complex or Building Name	[DISPLAY COMPLEX NAME]	□
Apartment Number	[DISPLAY APT NUMBER]	□
City	[DISPLAY CITY]	□
State	[DISPLAY STATE]	□
Zip	[DISPLAY ZIP]	□
Home Phone	[DISPLAY HOME PHONE]	□
Cell Phone	[DISPLAY CELL PHONE]	□
Email (enter NA if no working email address)	[DISPLAY EMAIL]	□
Relationship	[DISPLAY RELATIONSHIP]	□	1. Friend 2. Relative 3. Other Specify 7. REFUSED 8. DON’T KNOW

9. When we last spoke in [MONTH AND YEAR OF RAD] you said that [CONTACT #2] was a person who would always know where you are and how to reach you. Is [CONTACT#2] still a person who does not live with you and will always know how to contact you?

1. YES (VERIFY CONTACT #2 INFORMATION)

2. NO

7. REFUSED

8. DON’T KNOW

IF YES, GO TO I11; ELSE:

10. IF NO: Could you please tell me the name of a second person who does not live with you and will always know how to contact you?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

IF YES:

1. What is his/her first name?

2. What is his/her middle name?

3. What is his/her last name?

4. Does his/her name have a suffix?

5. What is the street address or PO box number?

6. Is there a complex or building name?

7. Is there an apartment number?

8. In what city?

9. In what state?

10. What is the zip code?

11. What is [his/her] home phone number, starting with the area code?

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

12. What is [his/her] cell phone number, starting with the area code?

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

13. What is [his/her] email address?

14. What is [his/her] relationship to you?

1. Friend

2. Relative

3. Other (Specify:)

7. REFUSED

8. DON’T KNOW

11. When we last spoke in [MONTH AND YEAR OF RAD] you said that [CONTACT #3] was a person who would always know where you are and how to reach you. Is [CONTACT#3] still a person who does not live with you and will always know how to contact you?

1. YES (VERIFY CONTACT #3 INFORMATION)

2. NO

7. REFUSED

8. DON’T KNOW

IF YES, GO TO CLOSING; ELSE:

12. IF NO: Could you please tell me the name of a second person who does not live with you and will always know how to contact you?

1. YES

2. NO

7. REFUSED

8. DON’T KNOW

IF YES:

1. What is his/her first name?

2. What is his/her middle name?

3. What is his/her last name?

4. Does his/her name have a suffix?

5. What is the street address or PO Box number?

6. Is there a complex or building name?

7. Is there an apartment number?

8. In what city?

9. In what state?

10. What is the zip code?

11. What is [his/her] home phone number, starting with the area code?

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

12. What is [his/her] cell phone number, starting with the area code?

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

13. What is [his/her] email address?

14. What is [his/her] relationship to you?

1. Friend

2. Relative

3. Other (Specify:)

7. REFUSED

8. DON’T KNOW

Thank you very much for your time today.

We want to make sure we know where to send your gift card. How would you like us to send your gift card?

• Email: Please provide your email.

• Text it to your cell phone: Please provide your cell phone number.

• Mail it to you: Please provide your address we can mail it to.

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