Form SCS-1 School Crime Supplement to the NCVS

Generic Clearence for Questionnaire Pretesting Research

ombschoolcrime4enc1.wpd

Cognitive Research on the National Crime Victimization Survey, School Crime Supplement

OMB: 0607-0725

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NOTICE - We are conducting this survey under the authority of Title 13, United States Code, Section 8. Section 9 of this law requires us to keep all information about you and your household strictly confidential. We may use this information only for statistical purposes. Also, Title 42, Section 3732, United States Code, authorizes the Bureau of Justice Statistics, Department of Justice, to collect information using this survey. Title 42, Sections 3789g and 3735, United States Code also requires us to keep all information about you and your household strictly confidential.

ASK OF ALL PEOPLE AGES 12-18

FORM SCS-1 U.S. DEPARTMENT OF COMMERCE

Economics and Statistics Administration

U.S. Census Bureau

ACTING AS COLLECTING AGENCY FOR THE

BUREAU OF JUSTICE STATISTICS

U.S. DEPARTMENT OF JUSTICE


SCHOOL CRIME SUPPLEMENT

TO THE NATIONAL CRIME

VICTIMIZATION SURVEY

2009

We estimate that it will take from 5 to 15 minutes to complete this interview with 10 minutes being the average time. If you have any comments regarding these estimates or any other aspect of this survey, send them to the Associate Director for Finance and Administration, Room 2027, U.S. Census Bureau, Washington DC 20233, or to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. According to the Paperwork Reduction Act of 1995, no such persons are required to respond to a collection of information unless such collection displays a valid OMB control number.

Control number

PSU Segment/Suffix Sample Designation/Suffix Serial/Suffx HH No. Spinoff Indicatior

A. FR Code


001 □□□

B. Respondent

Line No. Age Name

002 □□ 003 □□

FIELD REPRESENTATIVE - Complete an SCS-1 form for all NCVS interviewed people ages 12-18. Do NOT complete an

SCS-1 form for Type Z noninterview people or for people in

Type A noninterview households.


C. Type of SCS Interview


004 1 □ Personal - Self }

2 □ Telephone - Self } SKIP to INTRO 1

3 □ Personal - Proxy }

4 □ Telephone - Proxy }

5 □ Noninterview - FILL ITEM D

D. Reason for SCS noninterview


005 2 □ Refused

3 □ Not available

FIELD REPRESENTATIVE - Read introduction.

INTRO 1 - Now I have some additional questions about your school. These answers will be kept confidential, by law.

E. SCREEN QUESTIONS FOR SUPPLEMENT

1a. Did you attend school at any time this school year?



1b. During that time, were you ever home-schooled? That is, did you receive ANY of that schooling at home, rather than in a public or private school?


___________________________________________


1c. Was all of your schooling this school year home schooling?

006 1 □ Yes

2 □ No - SKIP to CHECK ITEM D on page 8



_______________________________________________


092 1 □ Yes

2 □ No - SKIP to 2b



____________________________________________


007 1 □ Yes - SKIP to CHECK ITEM D on page 8

2 □ No

2a. During the time you were home-schooled this school year, what grade would you have been in if you were in a public or private school?

093 0 □ Fifth or under - SKIP to CHECK ITEM D

on page 8


1 □ Sixth }

2 □ Seventh }

3 □ Eighth }

4 □ Nineth }SKIP to

5 □ Tenth }INTRO 2

6 □ Eleventh }

7 □ Twelfth }

8 □ Other - Specify ______________ }


9 □ College/GED/Post-graduate/

Other noneligible - SKIP to CHECK ITEM D on page 8

2b. What grade are you in?

008 0 □ Fifth or under - SKIP to CHECK ITEM D

on page 8


1 □ Sixth }

2 □ Seventh }

3 □ Eighth }

4 □ Nineth }SKIP

5 □ Tenth } to 3

6 □ Eleventh }

7 □ Twelfth }

8 □ Other - Specify ______________ }


9 □ College/GED/Post-graduate/

Other noneligible - SKIP to CHECK ITEM D on page 8

E. SCREEN QUESTIONS FOR SUPPLEMENT - Continued

FIELD REPRESENTATIVE - Read introduction only if any of the boxes 1-8 are marked in item 2a.

INTRO 2 - The following questions pertain only to your attendance at a public or private school and not to being home-schooled.

3. In what month did your current school year begin?

009 1 □ August

2 □ September

3 □ Other - Specify ___________________________

F. ENVIRONMENTAL QUESTIONS

6a. What is the complete name of your school?




____________________________________________

6b. In what city, county, and state is your school located?


FIELD REPRESENTATIVE - Probe if necessary.

_______________________________________________


_______________________________________________

012 □□□□□□□□□□□□ Office Use Only

______________________________________________


013 ___________________________________ City


____________________________________ County

014 □□□□Office Use Only

____________________________________ State

015 □□ Office Use Only

7a. Is your school public or private?


____________________________________________


7b. Is this the regular school that most of the students in your neighborhood attend?


___________________________________________


7c. Is your school church-related?

016 1 □ Public - ASK 7b

2 □ Private - SKIP to 7c

______________________________________________


017 1 □ Yes } SKIP to

2 □ No } 8


_______________________________________________


018 1 □ Yes

2 □ No

3 □ Don't know

8. What grades are taught in your school?


Pre-K or Kindergarten 00

01

02

03

04

05

06

07

08

09

10

11

12 H.S. Senior

13 Post-graduate

20 All ungraded

30 All Special Education

Grades:


020 □□ (lowest)

TO

021 □□ (highest)

9. How do you get to school most of the time?


FIELD REPRESENTATIVE - If multiple modes are used, code the mode in which the student spends the most time.

022 1 □ Walk

2 □ School bus

3 □ Public bus, subway, train

4 □ Car

5 □ Bicycle, motorbike, or motorcycle

6 □ Some other way - Specify






10. How long does it take you to get from your home to school most of the time?

023 1 □ Less than 15 minutes

2 □ 15-29 minutes

3 □ 30-44 minutes

4 □ 45-59 minutes

5 □ 60 minutes or longer

11. How do you get home from school most of the time?


FIELD REPRESENTATIVE - If multiple modes are used, code the mode in which the student spends the most time.


If the student volunteers that he or she does not go directly home after school, record the mode that the student uses to get to his or her first destination after school.

024 1 □ Walk

2 □ School bus

3 □ Public bus, subway, train

4 □ Car

5 □ Bicycle, motorbike, or motorcycle

6 □ Some other way - Specify

_____________________________


12a. How often do you leave school grounds at lunch time?


(READ CATEGORIES.)


___________________________________________


12b. Are students in your grade level allowed to leave school grounds to eat lunch?

026 1 □ Never

2 □ Once or twice a year

3 □ Once or twice a month

4 □ Once or twice a week

5 □ Almost every day

___________________________________________


025 1 □ Yes

2 □ No

3 □ Don't know


13. During this school year, have you participated in any of the following activities sponsored by your school:


a. Athletic teams at school ?. . . . . . . . . . . . . . . . . . . . .


b. Spirit groups, for example, Cheerleading, Dance Team, or Pep Club?. . . . . . . . . . . . . . . . . . . . . . . . . . .


c. Performing arts, for example, Band, Choir, Orchestra, or Drama ? . . . . . . . . . . . . . . . . . . . . . . . . .


d. Academic clubs, for example, Debate Team, Honor Society, Spanish Club, or Math Club ? . . . . . . . . . . .


e. Student government?. . . . . . . . . . . . . . . . . . . . . . . . . .


f. [IF GRADES 6, 7, or 8] Community service or volunteer clubs sponsored by your school,

for example, Peer Mediators, Ecology Club, or Recycling Club? . . . . . . . . . . . . . . .



[IF GRADES 9, 10, 11, or 12] Community service or volunteer clubs sponsored by your school, for example, Peer Mediators, Ecology Club, Key Club, or Interact? . . . . . . . . . . . .


g. Other school clubs or school activities,?. . . . . . . .




Yes No


120 1 □ 2 □



121 1 □ 2 □



122 1 □ 2 □



123 1 □ 2 □


124 1 □ 2 □




125 1 □ 2 □








126 1 □ 2 □

14. Does your school take any measures to make sure students are safe?


For example, does the school have:


a. Security guards or assigned police officers?. .


b. Other school staff or other adults supervising the hallway? . . . . . . . . . . . . . . . . . . . . . . . . . . . .


c. Metal detectors? . . . . . . . . . . . . . . . . . . . . . . . .



d. Locked entrance or exit doors during the day?



e. A requirement that visitors sign in? . . . . . . . . .



f. Locker checks? . . . . . . . . . . . . . . . . . . . . . . . . .



g. A requirement that students wear badges or picture identification?. . . . . . . . . . . . . . . . . . . . . .


h. One or more security cameras to monitor the school? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


i. A code of student conduct, that is, a set of written rules or guidelines that the school provides you?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




Yes No Don't know


028 1 □ 2 □ 3 □



029 1 □ 2 □ 3 □


030 1 □ 2 □ 3 □



031 1 □ 2 □ 3 □



032 1 □ 2 □ 3 □



033 1 □ 2 □ 3 □




094 1 □ 2 □ 3 □



095 1 □ 2 □ 3 □





096 1 □ 2 □ 3 □



15a. In your classes, how often are you distracted from doing your schoolwork because other students are misbehaving, for example, talking or fighting?


(READ CATEGORIES.)


___________________________________________


15b. How often do teachers punish students during your classes?


(READ CATEGORIES.)




156 1 □ Never

2 □ Almost never

3 □ Sometimes

4 □ Most of the time



__________________________


157 1 □ Never

2 □ Almost never

3 □ Sometimes

4 □ Most of the time

16a. I am going to read a list of statements that could describe a school. Thinking about your school, would you strongly agree, agree, disagree, or strongly disagree with the following ....


a. Everyone knows what the school rules are. . .



b. The school rules are fair . . . . . . . . . . . . . . . . . .



c. The punishment for breaking school rules is the same no matter who you are . . . . . . . . . . .



d. The school rules are strictly enforced . . . . . . .



e. If a school rule is broken, students know what kind of punishment will follow . . . . . . . . . . . . .




Strongly Strongly

Agree Agree Disagree Disagree


034 1 □ 2 □ 3 □ 4 □



035 1 □ 2 □ 3 □ 4 □




036 1 □ 2 □ 3 □ 4 □



037 1 □ 2 □ 3 □ 4 □




038 1 □ 2 □ 3 □ 4 □

16b. Thinking about the TEACHERS at your school, would you strongly agree, agree, disagree, or strongly disagree with the following .....


  1. Teachers treat students with respect. . . . . . . .



b. Teachers care about students . . . . . . . . . . . . . .



c. Teachers do or say things that make students feel bad about themselves . . . . . . . . . . . . . . . . . .



Strongly Strongly

Agree Agree Disagree Disagree


127 1 □ 2 □ 3 □ 4 □



128 1 □ 2 □ 3 □ 4 □




129 1 □ 2 □ 3 □ 4 □

16c. Thinking about all of the ADULTS including teachers, at your school, would you strongly agree, agree, disagree, or strongly disagree with the following ....


a. At school, there is an ADULT you can talk to, who cares about your feelings and what happens to you. . . . . . . . . . . . . . . . . . . . . . .


b. At school, there is an ADULT who helps you with practical problems, who gives good suggestions and advice about your problems. . . . . . . . . . . . . . .



Strongly Strongly

Agree Agree Disagree Disagree



130 1 □ 2 □ 3 □ 4 □





131 1 □ 2 □ 3 □ 4 □

16d. Thinking about FRIENDS at your school, would you strongly agree, agree, disagree, or strongly disagree with the following ....


a. At school, I have a FRIEND I can talk to, who cares about my feelings and what happens to me. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b. At school, I have a FRIEND who helps me with practical problems, who gives good suggestions and advice about my problems. . . . . . . . . . . . . .













Strongly Strongly

Agree Agree Disagree Disagree



132 1 □ 2 □ 3 □ 4 □




133 1 □ 2 □ 3 □ 4 □

FIELD REPRESENTATIVE - Read introduction.


INTRO 3 - Now I have some questions about things that happen at school. For this survey, "at school" includes the school building, on school property, on a school bus, or going to and from school. Your answers will not be given to anyone.

*Flag as sensitive


17a. The following question refers to the availability of drugs and alcohol at your school.


Tell me if you don't know what any of these items are. FIELD REPRESENTATIVE - For “Don’t Know” responses, probe if necessary to determine if respondent means they do not know if the drug is available or if they do not know the drug.


FIELD REPRESENTATIVE - For each item ask,


Is it possible to get _________________________

at your school?


a. Alcoholic beverages. . . . . . . . . . . . . . . . . . . . . . .

b. Marijuana. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c. Crack. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d. Other forms of cocaine. . . . . . . . . . . . . . . . . . . .

e. Uppers such as ecstasy, crystal meth or other illegal stimulants. . . . . . . . . . . . . . . . . . . . . . . . . .

f. Downers such as GHB or sleeping pills. . . . . . .

g. LSD or acid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h. PCP or angel dust. . . . . . . . . . . . . . . . . . . . . . . . .

i. Heroin or smack. . . . . . . . . . . . . . . . . . . . . . . . . .

xx. Performance enhancing drugs like steroids or

human growth hormone (HGH)

j. Prescription drugs illegally obtained without a prescription, such as Ritalin or Oxycontin . . . .

k. Other illegal drugs -. . . . . . . . . . . . . . . . . . . . . . .

If "Yes" is marked, ASK - What drugs?

(Exclude tobacco products.)


FIELD REPRESENTATIVE - Refer to Drug Slang Card (SCS-2). Reclassify the "other illegal drug(s)" to one of the categories a-i if possible. If able to reclassify the drug(s) mentioned, mark the "No" box in category j, otherwise, mark the "Yes" box in category j and enter the "other illegal drug(s)" mentioned in the Specify space.















Don’t

Yes No Don't know know drug

040 1 □ 2 □ 3 □ 4 □

041 1 □ 2 □ 3 □ 4 □

042 1 □ 2 □ 3 □ 4 □

043 1 □ 2 □ 3 □ 4 □


097 1 □ 2 □ 3 □ 4 □

098 1 □ 2 □ 3 □ 4 □

045 1 □ 2 □ 3 □ 4 □

046 1 □ 2 □ 3 □ 4 □

047 1 □ 2 □ 3 □ 4 □

xxx 1 □ 2 □ 3 □ 4 □


159 1 □ 2 □ 3 □ 4 □


048 1 □ 2 □ 3 □ 4 □


Specify _________________________________






17b. During this school year, did you know for sure that any students were on drugs or alcohol while they were at school?

101 1 □ Yes

2 □ No

17c. During this school year, did anyone offer, or try to sell or give you an illegal drug other than alcohol or tobacco at your school?

102 1 □ Yes

2 □ No

G. FIGHTING, BULLYING AND HATE BEHAVIORS

18a. During this school year, have you been in one or more physical fights at school?

103 1 □ Yes

2 □ No - SKIP to 19a

18b. During this school year, how many times have you been in a physical fight at school?

104 □□ (Number of times)

19a. Now I have some questions about what students do at school that make you feel bad or are hurtful to you. We often refer to this as being bullied. You may include events you told me about already. During this school year, has any student bullied you?


That is, has another student...


(Read each category a-g.)


a. Made fun of you, called you

names, or insulted you?

b. Spread rumors about you?

c. Threatened you with harm?

d. Pushed you, shoved you, tripped you, or spit on you?

e. Tried to make you do things you did not want to do, for example, give them money or other things?

f. Excluded you from activities on purpose?

g. Destroyed your property on purpose?









Yes No


134 1 □ 2


135 1 □ 2

136 1 □ 2


137 1 □ 2


138 1 □ 2


139 1 □ 2

140 1 □ 2

Check Item 19a Are all categories a-g marked “No” in Q19a above?

1 □ Yes - SKIP to 20a

2 □ No - SKIP to 19b

19b. During this school year, how often did (this/these things) happen to you?


(Read categories 1-4.)

142 1 □ Once or twice this school year

2 □ Once or twice a month

3 □ Once or twice a week, or

4 □ Almost every day

5 □ Don’t know

19c. Did (this event/these events) occur (Read categories.)


Mark (X) all that apply.

143 1 □ In the school building (for

example in a classroom, hallway, or gymnasium)?

144 2 □ Outside on school grounds?

145 3 □ On a school bus?

146 4 □ Somewhere else? - Specify

_______________________

19d. Was a teacher or some other adult at school notified about (this event/any of these events)?

147 1 □ Yes

2 □ No

CHECK Is Box 4 in Question 19a marked?

Item B

160 1 □ Yes - Ask 19e

2 □ No - Skip to 20a

19e. What were the injuries you suffered as a result of being pushed, shoved, tripped, or spit on?


Mark (X) all that apply.

148 1 □ None

149 2 □ Bruises or swelling

150 3 □ Cuts, scratches, or scrapes

151 4 □ Black eye/bloody nose

152 5 □ Teeth chipped or knocked out

153 6 □ Broken bones/internal injuries

154 7 □ Knocked unconscious

155 8 □ Other - Specify

_______________________

20a. Now I have some questions about what students do that could occur anywhere and that make you feel bad or are hurtful to you. You may include events you told me about already.


During this school year, has another student....


(Read each category a-f.)


a. Posted hurtful information about you on the Internet, for example, on a social networking site like MySpace?

b. Threatened or insulted you via email, other than instant messaging?

c. Threatened or insulted you via instant messaging?

d. Threatened or insulted you via text messaging?

e. Threatened or insulted you through an online gaming experience, for example, XBOX Live or Second Life?

f. Purposefully excluded you from a virtual social community, for example, a buddy list or friends list?








Yes No


161 1 □ 2




162 1 □ 2


163 1 □ 2


xxx 1 □ 2


xxx 1 □ 2


xxx 1 □ 2

Check Item 20a Are all categories a-c marked “No” in Q20a above?

1 □ Yes - SKIP to 21a

2 □ No - SKIP to 20b

20b. During this school year, how often did (this/these things) happen to you?


(Read categories 1-4.)

165 1 □ Once or twice this school year

2 □ Once or twice a month

3 □ Once or twice a week, or

4 □ Almost every day

5 □ Don’t know

20c. Was a teacher or some other adult at school notified about (this event/any of these events)?

166 1 □ Yes

2 □ No



21a. During this school year, has anyone called you an insulting or bad name at school having to do with your race, religion, ethnic background or national origin, disability, gender, or sexual orientation? We call these hate-related words.



065 1 □ Yes

2 □ No - SKIP to 22





21b. Were any of the hate-related words related to ...


a. Your race? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


b. Your religion? . . . . . . . . . . . . . . . . . . . . . . . . . . . .


c. Your ethnic background or national origin (for example, people of Hispanic origin)? . . . . . . . . .


d. Any disability (by this I mean physical, mental, or developmental disabilities) you may have? .


e. Your gender?. . . . . . . . . . . . . . . . . . . . . . . . . . . .


f. Your sexual orientation? . . . . . . . . . . . . . . . . . .


If "Yes," SAY - (by this we mean homosexual, bisexual, or heterosexual)




Yes No Don't know

107 1 □ 2 □ 3 □


108 1 □ 2 □ 3 □



109 1 □ 2 □ 3 □



110 1 □ 2 □ 3 □


111 1 □ 2 □ 3 □


112 1 □ 2 □ 3 □



22. During this school year, have you seen any

hate-related words or symbols written in school classrooms, school bathrooms, school hallways, or on the outside of your school building?




066 1 □ Yes

2 □ No

H. AVOIDANCE

23a. During this school year, did you ever STAY AWAY from any of the following places because you thought someone might attack or harm you there?


(READ CATEGORIES.)


a. The shortest route to school?. . . . . . . . . .


b. The entrance into the school? . . . . . . . . .


c. Any hallways or stairs in school? . . . . . .


d. Parts of the school cafeteria?. . . . . . . . . .


e. Any school restrooms?. . . . . . . . . . . . . . .


f. Other places inside the school building?


g. School parking lot? . . . . . . . . . . . . . . . . . .


h. Other places on school grounds? . . . . . .








Yes No

068 1 □ 2 □


069 1 □ 2 □


070 1 □ 2 □


071 1 □ 2 □


072 1 □ 2 □


073 1 □ 2 □


074 1 □ 2 □


167 1 □ 2 □



075 1 □ 2 □

23b. Did you AVOID any activities at your school because you thought someone might attack or harm you?


076 1 □ Yes

2 □ No

23c. Did you AVOID any classes because you thought someone might attack or harm you?

077 1 □ Yes

2 □ No

23d. Did you stay home from school because you thought someone might attack or harm you in the school building, on school property, on a school bus, or going to or from school?

078 1 □ Yes

2 □ No

I. FEAR

24. How often are you afraid that someone will attack or harm you in the school building or on school property?


(READ CATEGORIES.)

079 1 □ Never

2 □ Almost never

3 □ Sometimes

4 □ Most of the time

25. How often are you afraid that someone will attack or harm you on a school bus or on the way to and from school?


(READ CATEGORIES.)

080 1 □ Never

2 □ Almost never

3 □ Sometimes

4 □ Most of the time

26. Besides the times you are in the school building, on school property, on a school bus, or going to or from school, how often are you afraid that someone will attack or harm you?


(READ CATEGORIES.)

081 1 □ Never

2 □ Almost never

3 □ Sometimes

4 □ Most of the time

J. WEAPONS

*Flag as sensitive


27. Some people bring guns, knives, or objects that

can be used as weapons to school for protection. During this school year, did YOU ever bring the following to school or onto school grounds?


(READ CATEGORIES.)


a. A gun?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b. A knife brought as a weapon?. . . . . . . . . . . . . . . . .

c. Some other weapon?. . . . . . . . . . . . . . . . . . . . . . . . .










Yes No

082 1 □ 2 □

083 1 □ 2 □

084 1 □ 2 □

*Flag as sensitive

28a. Do you know of any (other) students who have brought a gun to your school during this school year?


085 1 □ Yes

2 □ No - Skip to 29

*Flag as sensitive


28b. Have you actually seen another student with a gun at school during this school year?



086 1 □ Yes

2 □ No

3 □ Don't know

*Flag as sensitive


29. During this school year, could you have gotten a loaded gun without adult supervision, either at school or away from school?



113 1 □ Yes

2 □ No

K. GANGS

FIELD REPRESENTATIVE - Read introduction.


INTRO 4 - Now, we'd like to know about gangs at your school. You may know these as street gangs, fighting gangs, crews, or something else. Gangs may use common names, signs, symbols, or colors. For this survey, we are interested in all gangs, whether or not they are involved in violent or illegal activity. Your responses are confidential.

*Flag as sensitive


30. Are there any gangs at your school?



058 1 □ Yes

2 □ No - SKIP to 33a

3 □ Don't know

*Flag as sensitive


31. During this school year, how often have gangs been involved in fights, attacks, or other violence at your school?


(READ CATEGORIES 1-5.)



089 1 □ Never

2 □ Once or twice this school year

3 □ Once or twice a month

4 □ Once or twice a week, or

5 □ Almost every day

6 □ Don't know

*Flag as sensitive


32. Have gangs been involved in the sale of drugs at your school during this school year?




090 1 □ Yes

2 □ No

3 □ Don't know

L. STUDENT CHARACTERISTICS

*Flag as sensitive


33a. During the last 4 weeks, did you skip any classes?



114 1 □ Yes

2 □ No - SKIP to 34

3 □ Don't know - SKIP to 34

*Flag as sensitive


33b. During the last 4 weeks, on how many days did you skip at least one class?


115 □□ (Number of days)

34. During this school year, across all subjects have you gotten mostly -


(READ CATEGORIES 1-5.)

116 1 □ A's

2 □ B's

3 □ C's

4 □ D's

5 □ F's

6 □ School does not give grades/no alphabetic

grade equivalent

35. Thinking about the future, do you think you will ...


a. Attend school after high school? . . . . . . . . . .



b. Graduate from a 4-year college? . . . . . . . . . . .


Yes No Don't know

117 1 □ 2 - SKIP to 3 □

CHECK ITEM C


118 1 □ 2 □ 3 □

CHECK Were the supplement questions asked in private,

ITEM C or was an adult member of the household or family present during at least part of the questions?


If not sure or if a telephone interview, ask -


Was an adult member of the household or family present during at least part of these questions?

091 1 □ Personal interview - No adult present

2 □ Personal interview - Adult present

3 □ Telephone interview - No adult present

4 □ Telephone interview - Adult present

5 □ Telephone interview - Don't know

Interviewer Debriefing Question(s)


36. In what language was this interview conducted?

11 Spanish

12 Arabic

13 Chinese

14 French

15 German

16 Greek

17 Italian

18 Japanese

19 Korean

20 Polish

21 Portugese

22 Russian

23 Tagalog

24 Urdu

25 Vietnamese

26 Other - specify

27 Language unknown

CHECK Is this the last household member to be

ITEM D interviewed?

119 □ Yes - END SUPPLEMENT

No - Interview next household member


NOTES

File Typeapplication/octet-stream
File Modified0000-00-00
File Created0000-00-00

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