Interviewing

Study of Community Family Life

Questionnaire

Conducted as part of the Evaluation of the

Community Healthy Marriage Initiative

February 2007

Sponsored by

Administration for Children and Families

U.S. Department of Health and Human Services

Prepared by

RTI International and The Urban Institute

CONTENTS

Section Page

A Introduction and Household Composition A-1

B Awareness of Media Messages and Services B-1

C Relationship Status and Attitudes C-1

D Receipt of Services D-1

E Social Ties E-1

F Relationship Quality F-1

G Child Well-Being G-1

H Respondent Characteristics and Background H-1

I Spouse/Partner Characteristics and Background I-1

J Non-Resident Parent Characteristics and Background J -1

K Household Self-Sufficiency K-1

L Contact Information L-1

M Household Observations M-1

A. INTRODUCTION AND HOUSEHOLD COMPOSITION

Household Composition

A1. INTERVIEWER: PLEASE ENTER INFORMATION ABOUT ALL HOUSEHOLD MEMBERS FROM THE PAPER SCREENER. THIS INFORMATION WILL BE USED TO VERYIFY THAT THE CORRECT RESPONDENT WAS SELECTED AND TO SELECT A FOCAL CHILD FOR LATER QUESTIONS.

A	B	C	D
Roster number	Age	Gender	Reason Excluded (enter code)
		1 = Male 2 = Female d = DK r = RF
1	|__|__|	|__|	|__|
2	|__|__|	|__|	|__|
3	|__|__|	|__|	|__|
4	|__|__|	|__|	|__|
5	|__|__|	|__|	|__|
6	|__|__|	|__|	|__|
7	|__|__|	|__|	|__|
8	|__|__|	|__|	|__|
9	|__|__|	|__|	|__|

Informed Consent

A2. INTERVIEWER: LOOK AROUND YOU IN ALL DIRECTIONS. ARE YOU OUT OF EARSHOT OF OTHER PEOPLE INCLUDING PEOPLE WHO MAY BE IN AN ADJACENT ROOM OR OUTSIDE?

FOR AN INTERVIEW SETTING TO BE CONSIDERED PRIVATE, YOU MUST BE CERTAIN THAT THE QUESTIONS YOU READ AND THE RESPONDENT’S ANSWERS CANNOT BE: (1) OVERHEARD, OR (2) ASCERTAINED BY SOMEONE LOOKING THROUGH A WINDOW. ARE YOU CONFIDENT THE INTERVIEW SETTING IS PRIVATE?

YES	1	A4
NO	2	A3

A3. INTERVIEWER: BECAUSE YOU HAVE INDICATED THE INTERVIEW SETTING IS NOT PRIVATE, YOU CANNOT PROCEED WITH THE INTERVIEW. YOU WILL NEED TO BREAK-OFF THE INTERVIEW AND RESCHEDULE FOR A TIME WHEN YOU CAN CONDUCT THE INTERVIEW IN PRIVATE.

A4. INTERVIEWER: HAND R INTERVIEW CONSENT FORM.

SAY: Before we begin, I would like to explain the study and what we are asking you to do. This document is called a consent form, and I’m going to read it out loud to you. After I’m done reading it, I will answer any questions you may have.

A5. INTERVIEWER: READ THE CONSENT FORM TO THE RESPONDENT.

IF R AGREES TO PARTICIPATE IN THE INTERVIEW, ACKNOWLEDGE AGREEMENT BELOW. GIVE R AN UNSIGNED COPY OF THE INTERVIEW CONSENT FORM.

R CONSENTED TO THE INTERVIEW	1	CONTINUE
R REFUSED THE INTERVIEW	2	END INTERVIEW

Relationship to Respondent

A6. IF R IS NOT SOLE HOUSEHOLD MEMBER: First, I have some (additional) questions about the people who live in this household. Because households are different, this information will help me to know which questions apply to you. What is the first name of the (GENDER) who is (AGE)? I just need to have a way of referring to (him/her).

PROBE: Initials are fine.

A7. How is (NAME) related to you?

A	B	C	D	E
Roster number (FILL)	Gender (FILL)	Age (FILL)	First Name	Relationship (Enter Code)
1	|__|	|__|__|		|__|__|
2	|__|	|__|__|		|__|__|
3	|__|	|__|__|		|__|__|
4	|__|	|__|__|		|__|__|
5	|__|	|__|__|		|__|__|
6	|__|	|__|__|		|__|__|
7	|__|	|__|__|		|__|__|
8	|__|	|__|__|		|__|__|
9	|__|	|__|__|		|__|__|

Relationship codes:

1. SPOUSE

2. PARTNER (BOY/GIRLFRIEND)

3. RESPONDENT’S MOTHER

4. RESPONDENT’S FATHER

5. PARENT-IN-LAW

6. BIOLOGICAL OR ADOPTED CHILD

7. STEPCHILD

8. FOSTER CHILD

9. GRANDCHILD

10. NIECE/NEPHEW

11. BROTHER/SISTER

12. AUNT/UNCLE

13. COUSIN

14. GRANDMOTHER OF RESPONDENT

15. GRANDFATHER OF RESPONDENT

16. SON-IN-LAW, DAUGHTER-IN-LAW OF RESPONDENT

17. NOT-RELATED ADULT/ROOMATE

18. NOT-RELATED CHILD

19. OTHER (SPECIFY)_________________________________________

Created

IF SPOUSE OR PARTNER IS THE SAME SEX AS RESPONDENT:

A8. Just to confirm, are you involved in a romantic relationship with (SPOUSE/PARTNER)?

YES	1
NO	2	INTERVIEWER: RETURN TO GRID AND CORRECT RELATIONSHIP CODE
DK	d
RF	r

Created

IF SPOUSE/PARTNER PRESENT IN HOUSEHOLD AND IF NUMBER OF PEOPLE IN HOUSEHOLD AGE 16+ =>4:

A9. Besides you and (SPOUSE/PARTNER), are any of the people in this household married to each other or living together in a romantic relationship?

IF SPOUSE/PARTNER NOT PRESENT IN HOUSEHOLD AND IF NUMBER OF PEOPLE IN HOUSEHOLD AGE 16+ =>3:

Are any of the people in this household married to each other or living together in a romantic relationship?

YES	1
NO	2	Section B
DK	d
RF	r

Created

A10. How many (other) couples are living in this household?

NUMBER OF COUPLES	|___|___|
DK	d
RF	r

B. AWARENESS OF MEDIA MESSAGES AND SERVICES

ATS

B1. This set of questions is about how you get information. In the past 30 days, about how often have you watched television? Would you say…

Every day	1
4-6 times a week	2
2-3 times a week	3
Once a week	4
Less than once a week, or	5
Never	6	B3
DK	d
RF	r

Created

B2. IF R WATCHED TELEVISION IN PAST 30 DAYS: Which of the following television channels do you usually watch? By usually, I mean at least 2-3 times a month.

	YES	NO	DK	RF
CHANNEL X	1	2	d	r
CHANNEL X	1	2	d	r
LIST OTHER LOCAL CHANNELS HERE	1	2	d	r

Created

B3. In the past 30 days, about how often have you listened to the radio? Would you say…

Every day	1
4-6 times a week	2
2-3 times a week	3
Once a week	4
Less than once a week, or	5
Never	6	B5
DK	d
RF	r

Created

B4. IF R LISTENED TO RADIO IN PAST 30 DAYS: Which of the following radio stations do you usually listen to? By usually, I mean at least 2-3 times a month.

	YES	NO	DK	RF
STATION X	1	2	d	r
STATION X	1	2	d	r
LIST OTHER LOCAL STATIONS HERE	1	2	d	r

ATS

B5. In the past 30 days, about how often have you read a newspaper? Would you say…

Every day	1
4-6 times a week	2
2-3 times a week	3
Once a week	4
Less than once a week, or	5
Never	6
DK	d
RF	r

Created

B6. Are you aware of any campaigns or advertising promoting healthy marriage, healthy relationships, or responsible parenting in your community?

YES	1
NO	2
DK	d
RF	r

Created

B7. In the past 30 days, have you seen or heard any advertising or campaigns with the following themes or slogans? CODE ALL THAT APPLY

		YES	NO	DK	RF
A	Marriage/ relationship classes are available	1	2	d	r
B	Marriage is better for kids	1	2	d	r
C	Married people are healthier	1	2	d	r
D	Married people are happier	1	2	d	r
E	It is important to be a good parent to your children	1	2	d	r
F	INSERT OTHER MEDIA MESSAGES/ REVISE AS MESSAGES BECOME KNOWN	1	2	d	r
G	Another type of theme or slogan? (SPECIFY)	1	2	d	r
IF ALL “NO” RESPONSES, GO TO B13

COMPLETE B8-B12 LOOP FOR EACH MESSAGE REPORTED IN B7.

B8. Now I’m going to ask you a few questions about the advertisement you saw about [FILL FROM B7a-g]. Where did you see or hear this advertising?

INTERVIEWER: READ LIST IF NECESSARY. CODE ALL THAT APPLY

TELEVISION	1
RADIO	2
INTERNET/WEB	3
BILLBOARD/POSTER	4
TRANSPORTATION SIGNAGE	5
FLIER/BROCHURE	6
OTHER (SPECIFY)______________	7
DK	d
RF	r

Legacy

B9. During the past 30 days, how often did you see advertisements about [FILL FROM B7a-g]? Would you say…

All of the time	1
Most of the time	2
Some of the time	3
Hardly ever	4
Never	5
DK	d
RF	r

Created

ATS

B10. How much do you agree with the statement: “The message of this advertising is important to me.” Do you…

Strongly agree	1
Agree	2
Disagree, or	3
Strongly disagree	4
DK/NO OPINION	d
RF	r

Created

B11. How much do you agree with the statement: “The advertising gave convincing information about the benefits of [FILL: being married/being a good parent].” Do you…

Strongly agree	1
Agree	2
Disagree, or	3
Strongly disagree	4
DK/NO OPINION	d
RF	r

ATS

B12. Did you talk to someone, such as a friend, a family member or someone at work about the message of this advertising?

YES	1
NO	2
DK	d
RF	r

Created

B13. Are you aware of any groups or places in your community that offer classes or workshops to help people improve their relationships with their spouse or partner?

YES	1
MAYBE, NOT SURE, I THINK SO	2
NO	3
DK	d
RF	r

Created

B14. Are you aware of any groups or places in your community that offer classes or workshops to help people improve their relationships with their children?

YES	1
MAYBE, NOT SURE, I THINK SO	2
NO	3
DK	d
RF	r

C. RELATONSHIP STATUS AND ATTITUDES

CHECK C1. IS A SPOUSE LISTED IN THE HOUSEHOLD GRID?

YES	1	C7
NO	2
DK	d
RF	r

TX

C1. Next, I’d like to ask you about some of the relationships you’ve had in your life. What is your marital status? Are you…

Married	1
Separated	2	CHECK C2
Divorced	3	CHECK C2
Widowed	4	CHECK C2
Never been married	5	CHECK C2
DK	d
RF	r

C2. What is the main reason that you and (SPOUSE) are not living together?

MARITAL PROBLEMS/NOT GETTING ALONG	1
SPOUSE WORKING IN DIFFERENT CITY	2
SPOUSE IN ARMED FORCES	3
SPOUSE LIVING IN ANOTHER COUNTRY	4
SPOUSE INCARCERATED	5
OTHER (SPECIFY)________________________	6
DK	d
RF	r

CHECK C2. IS A PARTNER LISTED IN THE HOUSEHOLD GRID?

YES	1	C6
NO	2
DK	d
RF	r

BSF

IF NO SPOUSE OR PARTNER LISTED IN THE HOUSEHOLD GRID:

C3. Are you currently involved in a romantic relationship with someone?

YES	1
NO	2	CHECK C3
DK	d	CHECK C3
RF	r	CHECK C3

BSF/FF

C4. Would you say you are romantically involved on a steady basis, or are you in an on-again, off-again relationship?

STEADY RELATIONSHIP	1
ON AGAIN, OFF AGAIN RELATIONSHIP	2
DK	d
RF	r

BSF

C5. What is your current partner’s first name?

PROBE: I just need to have some way of referring to (him/her). Initials are fine.

FIRST NAME OF PARTNER	___________________	STORE NAME
DK	d
RF	r

BSF

C6. IF R NOT IN SAME-SEX RELATIONSHIP:

What do you think the chances are that you will marry (PARTNER) in the future? Would you say…

IF R IS IN SAME-SEX RELATIONSHIP: Assume same-sex marriages or civil unions were recognized in your state. What are the chances that you would marry (PARTNER) in the future? Would you say…

No chance	1
A little chance	2
A 50-50 chance	3
A pretty good chance, or	4
An almost certain chance?	5
DK	d
RF	r

Created

C7. IF CHECK C1 = 1 OR C1 = 1 (MARRIED): About how long have you and (SPOUSE) been married?

IF CHECK C2 = 1 OR C3 =1 (PARTNERED OR DATING): About how long have you and (PARTNER) been together?

MONTHS OR YEARS	ENTER ONE: |___|___| MONTHS |___|___| YEARS
DK	d
RF	r

CHECK C3. CREATE RELATIONSHIP VARIABLE:

IF CHECK C1 = 1, THEN RESPONDENT = MARRIED AND CO-HABITATING (HENCEFORTH “MARRIED.”)

IF CHECK C2 = 1, THEN RESPONDENT = PARTNERED AND CO-HABITATING (HENCEFORTH “PARTNERED.”)

IF C3 = 1 AND C4 = 1 AND C7 = > 3 MONTHS, THEN RESPONDENT = PARTNERED BUT NOT CO-HABITATING (HENCEFORTH “DATING.”)

IF C3 = 2, THEN RESPONDENT = NOT MARRIED, PARTNERED OR CO-HABITATING (HENCEFORTH “SINGLE.”)

IF C1 = 1 OR 2, THEN RESPONDENT = MARRIED BUT LIVING APART, (HENCEFORTH “SINGLE.”)

LAFANS (modified)

C8. Next I’d like to ask about your opinions regarding marriage and relationships. For each of the following statements, please tell me if you strongly approve, approve, disapprove, or strongly disapprove. If you don’t know or aren’t sure, please just say so.

[INTERVIEWER: CODE, “IT DEPENDS” AS “NEITHER AGREE NOR DISAGREE”]

		Strongly Approve	Approve	VOL: NEITHER A/D	Disap- prove	Strongly Disap- prove	DK	RF
A	A couple lives together before they decide about getting married.	1	2	3	4	5	d	r
B	A couple decides to live together even though they do not intend to get married.	1	2	3	4	5	d	r
C	A woman has a baby without being married.	1	2	3	4	5	d	r
D	A man fathers a child without being married to the baby's mother.	1	2	3	4	5	d	r
E	A couple with children divorces because their marriage is not satisfying.	1	2	3	4	5	d	r
F	A couple raises their children without being married.	1	2	3	4	5	d	r
G	A couple raises their children in a marriage.	1	2	3	4	5	d	r
H	A couple facing a hard time in their relationship seeks help through their families, friends, place of worship, or counselor.	1	2	3	4	5	d	r
I	A couple facing a hard time in their relationship does not seek help.	1	2	3	4	5	d	r

LA FANS (modified)

C9. Regardless of your current situation and what you think is ideal, how likely would you be to do the following? (READ LIST) Would you say very likely, somewhat likely, somewhat unlikely, or not likely at all?

		Very Likely	Somewhat Likely	Somewhat Unlikely	Not Likely at All	DK	RF
A	Live with a partner before you decide about getting married.	1	2	3	4	d	r
B	Live with a partner who does not want to marry you.	1	2	3	4	d	r
C	(Have/ Father) a baby without being married.	1	2	3	4	d	r
D	Divorce if you were in an unhealthy relationship and you had children.	1	2	3	4	d	r
E	Raise your children without being married.	1	2	3	4	d	r
F	Raise your children in a marriage.	1	2	3	4	d	r
G	Seek help if facing hard times in your relationship from your families, friends, church, or counselor.	1	2	3	4	d	r
H	Participate in premarital or other relationship skills classes.	1	2	3	4	d	r

TX (modified)

C10. These next statements are about marriage and commitment. For each one, please tell me if you strongly agree, agree, disagree, or strongly disagree.

		Strongly Agree	Agree	Disagree	Strongly Disagree	DK	RF
A	A healthy, happy marriage is one of the most important things in life.	1	2	3	4	d	r
B	Unmarried parents living with children are not as likely to stay together as married parents.	1	2	3	4	d	r
C	Most first marriages end in divorce.	1	2	3	4	d	r
D	Even bad relationships can be improved through more effort and better skills.	1	2	3	4	d	r
E	Children do better if raised by married parents.	1	2	3	4	d	r
F	People in happy marriages do not argue.	1	2	3	4	d	r
G	Most married people will cheat on their spouse at least once.	1	2	3	4	d	r
H	Premarital and marriage education classes can improve marriages.	1	2	3	4	d	r