Building Strong Families Second (36-month) follow-up Instrument #1: Survey

O MB No.:

Expiration Date:

Contract No.:

MPR Reference No.: 8935-144

Building Strong Families: 36 Month Follow-Up Survey

June 4, 2008

Shannon Monahan

Robert Wood

Sheena McConnell

Shawn Marsh

Submitted to: U.S. Department of Health and Human Services Administration for Children and Families Office of Planning, Research, and Evaluation 7th Fl., West, Aerospace Center Bldg. 370 L’ Enfant Promenade, SW Washington, DC 20447 Project Officer: Nancye Campbell

Submitted by: Mathematica Policy Research, Inc. P.O. Box 2393 Princeton, NJ 08543-2393 Telephone: (609) 799-3535 Facsimile: (609) 799-0005 Project Director: Alan Hershey Survey Director: Shawn Marsh

OMB No.:

Expiration Date:

The Building Strong Families Evaluation

Thirty-Six Month Follow-Up Survey

Items CO1.a - CO1.j: Adapted and reproduced by special permission of the Publisher, Psychological Assessment Resources, Inc., 16204 North Florida Avenue, Lutz, Florida 33549, from the Parenting Alliance Measure by Richard Abidin, EdD and Timothy R Konold, PhD. Copyright 1999 by PAR, Inc. Further reproduction is prohibited without permission from PAR, Inc.

Items RR14.a – RR14.l: CTS2 copyright © 2003 by Western Psychological Services. Adapted for use in specific scholarly application by Mathematica Policy Research, Inc., under limited-use license from the publisher, Western Psychological Services, 12031 Wilshire Boulevard, Los Angeles, California 90025-1251, U.S.A. All rights reserved. No additional reproduction may be made, whether in whole or in part, without the prior, written authorization of Western Psychological Services ([email protected]).

COPYRIGHT FOR BPI

COPYRIGHT FOR CTSPC

COPYRIGHT FOR PKBS

[NEED OMB CONTROL NUMBER]

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is XXXX-XXXX. The time required to complete this information collection is estimated to average 45 minutes per respondent, including the time to review instructions, gather the data needed, and complete and review the information collected.

CONTENTS

Section Page

IN INTRODUCTION 1

FS FAMILY STRUCTURE 6

CO INVOLVEMENT WITH CHILD 35

CH CHILD OUTCOMES 43

RR RELATIONSHIP 51

WB PARENTAL WELL BEING (I) 64

SE RECEIPT OF SERVICES 69

PA PATERNITY AND CHILD SUPPORT 70

WW FAMILY SELF-SUFFICIENCY 76

WB PARENTAL WELL BEING (II) 93

BP COUNTRY OF ORIGIN AND BIOLOGICAL PARENTS 100

LO LOCATING INFORMATION 105

QUESTIONNAIRE FORMAT EXPLANATION

The purpose of this page is to illustrate the layout of questions in this instrument and help the reader to interpret the formatting and instructions, so they can follow the flow of the questions. This format was designed for ease of use by those who will be programming the computer-aided telephone interviewing (CATI) survey instrument. If this questionnaire was administered in a paper and pencil version, the formatting would be changed; however, the skip logic would remain the same.

Line 2: This box indicates if a previously answered question affects whether this question is asked or which part of the question is asked, and if so, the specific responses to the earlier question that trigger this question or a specific part of it.

FS42.2

IF FS42=most of the time (2), some of the time (3), OR none of the time (4)

h e if CMALE; she if CFEMALE

( IF FS42 =2 or 3) When [he/she] is not living with you,

Question

Text

(W/w)ho does [CHILD] live with?

These are skip instructions to the next question asked. You should follow the lowest number skip to the next question, to see if that question is appropriate. Instructions at those questions will tell you how to proceed.

F ATHER/MOTHER	1	F S42.3 OR FS43
GRANDPARENT(S)	2
OTHER RELATIVES(S)	3
ADOPTIVE PARENTS	4
FOSTER PARENTS	5
FRIEND(S)	6
SOMEONE ELSE	7	FS42.2.1
DK	d	FS42.3 OR FS43
REF	r

SECTION IN: INTRODUCTION

IN1

ALL

May I please speak with [SAMPLE MEMBER]? My name is [NAME] and I’m calling from Mathematica Policy Research, Inc., a research company in Princeton, New Jersey.

SAMPLE MEMBER AVAILABLE	1	IN3a if 15 MO = 0, IN3b if 15 MO = 1
SAMPLE MEMBER NOT AVAILABLE	2	IN2
SAMPLE MEMBER DECEASED	3	IN8

IN2

IN1=2

(When would be a good time to reach [SAMPLE MEMBER]?/ When would be a good time to do the interview?)

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

INSTRUCTION: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK.

INSTRUCTION: USE THE ‘APPOINTMENT’ TAB OR PRESS <CTRL-S> TO INVOKE THE APPOINTMENT MAKING DIALOG.

CALL BACK INFO

STRING OF 20

END

IN3a

IN1=1 and 15 Mo = 0

(Hello, my name is [NAME] and I’m calling from Mathematica Policy Research, Inc., a research company in Princeton, New Jersey.) I’m calling you about the Building Strong Families study you joined about three years ago. You may have received a letter recently to let you know that we would be calling you.

We last spoke with you on [RA DATE]. At that time, we told you that we would be contacting you again to learn how you are doing.

The interview will take about 45 50 minutes and you will receive $25 for completing the interview. Everything that you tell me is confidential and your privacy will be protected to the extent allowable by law. Your participation in the survey is voluntary and will not affect any benefits or services you or your family receive now or in the future. You do notn’t have to answer any questions that make you uncomfortable.

Because we want to get your opinion, it is important that you answer the questions without help from anyone else. Of course, you can share what you said with others after we have completed the interview.

This interview may be taped so my supervisor can monitor the interview and make sure that the questions are asked correctly.

Is now a good time to start?

OK TO CONTINUE	1	IN5
NOT A GOOD TIME	2	IN4

FOR THOSE WITH 15MONTH (PRELOADED)

IN3b

IN1=1 and 15 Mo=1

(Hello, my name is [NAME] and I’m calling from Mathematica Policy Research, Inc., a research company in Princeton, New Jersey.) I’m calling you about the Building Strong Families study you joined about three years ago. We spoke with you several years ago to see how you were doing and now we’d like to talk with you again and see how things are going for you. You may have received a letter recently to let you know that we would be calling you.

The interview will take about 50 minutes and you will receive $25 for completing the interview. Everything that you tell me is confidential and your privacy will be protected to the extent allowable by law. Your participation in the survey is voluntary and will not affect any benefits or services you or your family receive now or in the future. You do not have to answer any questions that make you uncomfortable.The interview will take about 45 minutes and you will receive $25 for completing the interview. Everything that you tell me is confidential. You don’t have to answer any questions that make you uncomfortable.

Because we want to get your opinion, it is important that you answer the questions without help from anyone else. Of course, you can share what you said with others after we have completed the interview.

This interview may be taped so my supervisor can monitor the interview and make sure that the questions are asked correctly.

Is now a good time to start?

OK TO CONTINUE	1	IN5
NOT A GOOD TIME	2	IN4

IN4

IN3a=2 or IN3b=2

When would be a good time to do the interview?

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

INSTRUCTION: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK.

INSTRUCTION: USE THE ‘APPOINTMENT’ TAB OR PRESS <CTRL-S> TO INVOKE THE APPOINTMENT MAKING DIALOG.

CALL BACK INFO

STRING OF 20

END

IN5

IN3a=1 or IN3b=1

I just need to verify that I am speaking with the correct person. What is your date of birth?

RESP. BIRTHDAY	MM/DD/YYYY	FS1
DK	d	IN6
REF	r	IN6
BIRTHDAY INCORRECT	MM/DD/YYYY	IN6

IN6

IN5=BIRTHDATE INCORRECT, d OR r

And what are the last 4-digits of your Social Security Number?

RESP. 4-DIGIT SSN	FF	FS1
DK	d	IN6a
REF	r	IN6a
SSN INCORRECT	FF	IN6a

IN6a

IN6=SSN INCORRECT, d OR r

Can you tell me the name of the street that you lived on when you first enrolled in the program on [RA DATE]?

RESP. ADDRESS CORRECT	1	FS1
DK	d	IN7
REF	r	IN7
RESP. ADDRESS INCORRECT	0	IN7

IN7

IN6a = 0, d OR r

I’m sorry. I need to check my records before I can interview you. Is this the best time to reach you in the future?

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

YES	1	END
NO, CALL BACK INFO	STRING OF 20	END

IN8

IN1 = 3

Thank you for taking time to speak with me. Good-bye.

END

SECTION FS: FAMILY STRUCTURE

FS1

ALL

Before we get started I would like to make sure we have your name recorded correctly.

What is your first name?

PROBE: Can you spell that for me please?

FIRST NAME OF RESPONDENT

STRING OF 20

FS2

FS2

ALL

And a middle name please?

PROBE: Can you spell that for me please?

MIDDLE NAME OF RESPONDENT

STRING OF 20

FS3

FS3

ALL

And a last name please?

PROBE: Can you spell that for me please?

LAST NAME OF RESPONDENT

STRING OF 20

FS4

FS4

ALL

Are you usually called [RESP FIRST NAME] or do you go by another name?

INSTRUCTION: IF SAME JUST HIT ENTER.

INSTRUCTION: IF DIFFERENT NAME, CHANGE TO USUAL NAME WHICH WILL BE USED AS FILL IN THE REMAINDER OF SURVEY.

PROBE: Can you spell that for me please?

FATHER/MOTHER USUAL FIRST NAME

STRING OF 20

FS5a (if 15 Mo=0 and NOTPREG) FS7 (if 15 Mo=0 and PREG) FS5b (if 15 Mo=1 and 15MO_FS5=1 or 3) BOX 1 (if 15 Mo=1 and 15MO_FS5=2 or 4)

FS5a

If not pregnant at baseline (NOTPREG) and 15 Mo = 0

FATHER NAME IF FEMALE/MOTHER NAME IF MALE

Our records indicate that you and [FATHER NAME/MOTHER NAME] had a baby on [BASELINE CHILD BDATE]. Is that correct?

INSTRUCTION: IF RESPONDENT REPORTS MULTIPLE BIRTHS, ENTER “YES.”

YES	1	FS6.1
YES, BUT BABY DIED	2	BOX 1
NO, OTHER DATE	3	FS6
NO, BABY DIED	4	BOX 1
DENY BABY EXISTS	5	BOX 1

FS5b

15 Mo=1 and 15 Mo_FS5=1, OR 15 Mo_FS7=1 OR 15 Mo_FS8=1

FATHER NAME IF FEMALE/MOTHER NAME IF MALE

When we interviewed you on [15MO SURVDATE], we asked you some questions about your child, [CHILD]. [CHILD] is around 3 years old now. Is that correct?

INSTRUCTION: IF RESPONDENT REPORTS MULTIPLE BIRTHS, ENTER “YES.”

YES	1	FS19
NO, CHILD DIED	2	BOX 1
NO, DENY CHILD EXISTS	3
DK	d
REF	r

FS6

IF 15 MO=0 AND NOTPREG AND FS5a=NO, OTHER DATE

When did you and [FATHER NAME/MOTHER NAME] have the baby?

CHILD BIRTHDAY

MM/DD/YYYY

FS6.1

FS6.1

IF 15 MO=0 AND NOTPREG AND FS5a=1

FATHER NAME IF MALE/MOTHER NAME IF FEMALE

INSTRUCTION: ENTER WITHOUT ASKING IF ALREADY KNOWN.

And you and [FATHER NAME/MOTHER NAME] had just one baby on [CHILD BDATE]?

INSTRUCTION: IF “NO” PROBE FOR NUMBER OF BABIES.

INSTRUCTION: IF “YES” ENTER ONE.

NUMBER OF BABIES	FF	FS10
DK	d
REF	r

FS7

If 15 Mo=0 AND pregnant at baseline (PREG)

FATHER NAME IF FEMALE/MOTHER NAME IF MALE

Our records indicate that you and [FATHER NAME/MOTHER NAME] were expecting a baby around [BASELINE CHILD EXPECTED DELIVERY DATE].

Did you have a baby around that time?

INSTRUCTION: IF RESPONDENT REPORTS DATE OF BIRTH, ANSWER “YES” AND ENTER DATE OF BIRTH ON NEXT SCREEN.

INSTRUCTION: IF RESPONDENT REPORTS MULTIPLE BIRTHS, ENTER “YES.” YOU WILL ENTER NUMBER OF BABIES ON ANOTHER SCREEN.

IF RESPONDENT ANSWERS NO, PROBE: I’m sorry. What happened?

YES	1	FS8
YES, BUT BABY DIED	2	BOX 1
NO, MISCARRIAGE	3
NO, ABORTION	4
NO, BABY DIED	5
NO, DENY PREGNANCY	6
DK	d
REF	r

BOX 1: IF FS5a=2, 4, 5 OR FS5b=2, 3 OR FS7=2,3,4,5, d OR r OR

15MO_FS5=2 OR 4

DO NOT ASK UNLESS OTHERWISE INDICATED

FS8 to FS17.6 AND FS42 TO FS46.1

CO1 TO CO4

WB0 (IF NO OTHER CHILDREN)

CHI-CH12 (SKIPPING ENTIRE CH SECTION)

PA1 TO PA12

FS8

IF 15 MO=0 AND PREG AND FS7=1

FATHER NAME IF MALE/MOTHER NAME IF FEMALE

On what date was the baby born?

INSTRUCTION: ENTER RESPONSE WITHOUT ASKING IF KNOWN.

BIRTHDAY	MM/DD/YYYY	FS9
BABY DIED	2	FS19

FS9

IF 15 MO=0 AND PREG AND FS7=1

FATHER NAME IF FEMALE/MOTHER NAME IF MALE

INSTRUCTION: ENTER WITHOUT ASKING IF ALREADY KNOWN.

And you and [FATHER NAME/MOTHER NAME] had just one baby on [CHILD BDATE]?

INSTRUCTION: IF “NO” PROBE FOR NUMBER OF BABIES.

INSTRUCTION: IF “YES” ENTER ONE.

NUMBER OF BABIES	FF	FS10
DK	d
REF	r

FS10

ALL

oldest or first born IF FS9>1 or FS6.1>1

What is the first name of this baby?

FIRST NAME OF CHILD

STRING OF 20

FS12

FS12

ALL

And a middle name please?

PROBE: Can you spell that for me please?

MIDDLE NAME OF CHILD

STRING OF 20

FS13

FS13

ALL

And a last name please?

PROBE: Can you spell that for me please?

LAST NAME OF CHILD

STRING OF 20

FS17

FS17

ALL

INSTRUCTION: DO NOT ASK IF ALREADY KNOWN.

Is [CHILD] male or female?

MALE	1	FS17.1
FEMALE	2

FS17.1

ALL

him IF FS17=CMALE; her IF FS17=CFEMALE

I want to make sure that we use [CHILD]’s correct first name. Do you call [him/her] [CHILD] or do you usually call [him/her] by a different name?

INSTRUCTION: IF DIFFERENT NAME, CHANGE TO USUAL NAME WHICH WILL BE USED AS FILL IN THE REMAINDER OF SURVEY.

USUAL FIRST NAME OF [CHILD]

STRING OF 20

FS17.3

FS17.3

IF FEMALE

he if CMALE; she if CFEMALE

At the time [he/she] was born, how much did [CHILD] weigh?

PROBE: You can tell me in pounds and ounces or in kilograms.

INSTRUCTION: FIRST ENTER IF ANSWER IS IN POUNDS AND OUNCES OR KILOGRAMS. YOU WILL ENTER THE WEIGHT ON THE NEXT SCREEN.

POUNDS AND OUNCES	1	FS17.4
KILOGRAMS	2	FS17.6
DK	d	FS19
REF	r

FS17.4

IF FS17.3=1 (pounds and ounces)

INSTRUCTION: ENTER NUMBER OF POUNDS.

POUNDS

FF

FS17.5

FS17.5

IF FS17.3=1 (pounds and ounces)

INSTRUCTION: ENTER NUMBER OF OUNCES.

OUNCES

FF

FS19

FS17.6

IF FS17.3=2 (kilograms)

INSTRUCTION: ENTER NUMBER OF KILOGRAMS.

KILOGRAMS

FF

FS19

FS19

ALL (IF BSF_PARTNER=DECEASED FROM 15 MO, THEN BOX 2)

he IF FEMALE; she IF MALE

father’s IF FEMALE; mother’s IF MALE

(IF FS5a=2 or 4 OR FS5b=2 OR FS7=2, 3 or 5) I am very sorry to hear that. Our condolences for your loss. If you don’t mind…

I’d like to ask you a few questions about [FIRST NAME OF FATHER/MOTHER].

I also want to make sure that I use [FIRST NAME OF FATHER NAME/MOTHER NAME]’s correct first name. Is [he/she] usually called [FIRST NAME OF FATHER NAME/MOTHER NAME] or does [he/she] go by a different first name?

INSTRUCTION: IF DIFFERENT NAME, CHANGE TO USUAL NAME WHICH WILL BE USED AS FILL IN THE REMAINDER OF SURVEY.

INSTRUCTION: IF RESPONDENT REPORTS THAT FATHER DIED CODE ’3’

YES, CORRECT NAME	1	FS25
NO, IS NOT CORRECT NAME	0	FS19.Fn
NO, DIED	3	BOX 2
DK	d	FS25
REF	r

FS19.Fn

if FS19=NO

What name does he/she usually go by?

ENTER USUAL FIRST NAME

USUAL FIRST NAME OF [FATHER/MOTHER]

STRING OF 20

FS25 (IF ‘98’ BOX 2)

FS25

IF FS19<>3 OR BSF_PARTNER NOT DECEASED FROM 15 MO

FATHER IF FEMALE; MOTHER IF MALE

The next questions are about you and [FATHER/MOTHER].

Are you and [FATHER/MOTHER]…

Married,	1	FS33
Divorced,	2	FS26
Separated, or	3	FS26
Have you never been married to each other?	4	FS26
MARRIAGE ANNULLED	5	FS26
WIDOWED	6	BOX 2
PARTNER DIED (NEVER MARRIED)	7
DK	d	FS26
REF	r

BOX 2: IF FS19=3 OR FS25=6 OR FS25=7 (FATHER/MOTHER died) OR 15MO_FS19=3 OR 15MO_FS25=6 OR 7

DO NOT ASK UNLESS OTHERWISE INDICATED

FS26 TO FS33.2.3

FS43.1 TO FS46.1

RR1 TO RR11

PA11.2 TO PA12

FS26

if FS25<>1

FATHER IF FEMALE; MOTHER IF MALE

Which of the following statements best describes your current relationship with [FATHER/MOTHER]?

We are romantically involved on a steady basis,	1	FS27
We are involved in an on-again and off-again relationship, or	2
We are not in a romantic relationship.	3	FS26.1
DK	d	FS27
REF	r

FS26.1

IF FS26=3 (no relationship) AND 15MO_FS26=3 then Go to FS27

FATHER IF MALE/MOTHER IF FEMALE

When did your romantic relationship with [FATHER/MOTHER] end?

PROBE: Just the month and year is fine.

INTERVIEWER: CODE 13 IF RESPONDENT ANSWERS THAT THEY WERE NEVER IN A RELATIONSHIP.

DATE END RELATIONSHIP

MM/YYYY

FS26.2

FS26.2

IF FS26=3 (no relationship) AND 15MO_FS26=3 then Go to FS27

him IF FEMALE; her IF MALE

I am going to read you a list of reasons that people give for why their relationships ended. For each reason, tell me if this is why your relationship with [FATHER/MOTHER] ended.

(For a thru f) Was it because you, [FATHER/MOTHER], or both of you…

(For g through i) Was it because…

				(IF YES FOR A THRU F)
				Was that you, [FATHER/MOTHER] or both of you?
a	Cheated or were unfaithful?	YES	1	YOU	1
				[FATHER/MOTHER]	2
				BOTH OF YOU	3
		NO	0
b	Went to jail or prison?	YES	1	YOU	1
				[FATHER/MOTHER]	2
				BOTH OF YOU	3
		NO	0
c	Were abusive or violent?	YES	1	YOU	1
				[FATHER/MOTHER]	2
				BOTH OF YOU	3
		NO	0
d	Used drugs or alcohol?	YES	1	YOU	1
				[FATHER/MOTHER]	2
				BOTH OF YOU	3
		NO	0
e	Could not keep a job or contribute enough financially to the family?	YES	1	YOU	1
				[FATHER/MOTHER]	2
				BOTH OF YOU	3
		NO	0
f	Were not a good parent or role model?	YES	1	YOU	1
				[FATHER/MOTHER]	2
				BOTH OF YOU	3
		NO	0
g	The two of you were not communicating well or were arguing too much?	YES	1
		NO	0
h	Of lack of support from family members?	YES	1
		NO	0
i	You and [FATHER/MOTHER] were living too far apart?	YES	1
		NO	0
j	Were there any other reasons why your romantic relationship ended?	YES	1	FS26.3
		NO	0	FS27 OR FS33

FS26.3

IF FS26.2J=1 AND 15MO_FS26=3 then Go to FS27

What were those other reasons?

INSTRUCTION: RECORD RESPONSE VERBATIM

REASONS RELATIONSHIP ENDED

STRING OF 100

FS27 OR FS33

FS27

IF FS25=4 (never been married to each other)

FATHER IF FEMALE; MOTHER IF MALE

What do you think the chances are you will marry [FATHER/MOTHER] in the future…

No chance,	0	FS33
A little chance,	1	FS28
A 50-50 chance,	2
A pretty good chance, or	3
An almost certain chance?	4
DK	d
REF	r

FS28

IF FS27<>0, DK

FATHER IF FEMALE; MOTHER IF MALE

Are you and [FATHER/MOTHER] engaged to be married?

YES	1	FS29
NO	0	FS33
DK	d
REF	r

FS29

IF FS28=YES

When are you planning to get married?

INSTRUCTION: ENTER 13 IF NO DATE HAS BEEN SET

DATE OF PLANNED WEDDING	MM/YYYY	FS33
DK/NO DATE YET	d
REF	r

FS33

ALL

FATHER IF FEMALE; MOTHER IF MALE

Do you currently live with [FATHER/MOTHER] in the same household…

All of the time,	1	FS42
Most of the time,	2
Some of the time, or	3	FS33.2
None of the time?	4
DK	d
REF	r

FS33.2

IF FS33>2

FATHER IF FEMALE; MOTHER IF MALE

How often do you and [FATHER/MOTHER] see or talk to each other? Is it…

Every day or almost every day,	1	FS42 OR FS37
A few times a week,	2
A few times a month,	3
About once a month,	4	FS33.2.1 OR FS37
Only a few times in the past year, or	5
Hardly ever or never?	6
DK	d
REF	r

FS33.2.1

OPTION 1: FS33=4 (not living together at all) AND FS25=1 (married)

OPTION 2: IF FS26=1,2 (romantically involved) AND FS33.2=4,5,6 (seeing each less than a few times)

FATHER IF FEMALE; MOTHER IF MALE

IF OPTION 1: Are you and [FATHER/MOTHER] not living together because you are not getting along or is there another reason?

IF OPTION 2: Are you and [FATHER/MOTHER] not seeing each other very much because you are not getting along or is there another reason?

NOT GETTING ALONG	1	FS37
ANOTHER REASON	2	FS33.2.2
DK	d	FS42
REF	r

FS33.2.2

FS33.2.1=2 AND

OPTION 1: FS33=4 (not living together at all) AND FS25=1 (married)

OPTION 2: IF FS26=1,2 (romantically involved) AND FS33.2=4,5,6 (seeing each less than a few times)

FATHER IF FEMALE; MOTHER IF MALE

IF OPTION 1: Why are you and [FATHER/MOTHER] not living together now?

IF OPTION 2: Why are you and [FATHER/MOTHER] not seeing each other very much?

INSTRUCTION: PROBE FOR MORE THAN ONE ANSWER.

1	PARTNER IS INCARCERATED	YES	NO	FS42
2	RESPONDENT INCARCERATED	YES	NO
3	PARTNER IN MILITARY	YES	NO
4	RESPONDENT IN MILITARY	YES	NO
5	PARTNER’S WORK	YES	NO
6	RESPONDENT’S WORK	YES	NO
7	OTHER REASON	YES	NO	FS33.2.3
	DK	d		FS42
	REF	r

FS33.2.3

IF FS33.2.2=7

INSTRUCTION:

SPECIFY OTHER REASON

FS42

FS37

IF FS25<>(1) (not married) and FS26<>(1,2) (not romantically involved) OR

(IF FS33.2.1=1) OR IF FS19=3

someone other than [FATHER/MOTHER] IF FS25<>6,7; with someone else IF FS25=6,7 OR IF FS19=3

FATHER IF FEMALE; MOTHER IF MALE

(IF FS19=3 or FS25=6 or 7) I am very sorry to hear that. If you don’t mind, I have a few more questions to ask.

Are you currently involved in a romantic relationship with [someone other than [FATHER/MOTHER]/someone else]?

YES	1	FS38
NO	0	FS42
DK	d
REF	r

FS38

IF FS37=YES

Just to be able to refer to your current partner by name in this interview, what is your current partner’s first name?

INSTRUCTION: IF RESPONDENT INDICATES MORE THAN ONE CURRENT PARTNER, PROBE FOR NAME OF MAIN OR PRIMARY CURRENT PARTNER.

FIRST NAME OF PARTNER

STRING OF 20

FS38.1

FS38.1

IF FS37=YES AND FS25<>1,3 (if not married or not separated)

Are you currently married to [CURRENT PARTNER]?

YES	1	FS40
NO	0
DK	d
REF	r

FS40

IF FS37=YES

Do you currently live with [CURRENT PARTNER] in the same household…

All of the time,	1	FS41
Most of the time,	2
Some of the time, or	3
None of the time?	4
DK	d
REF	r

FS41

IF FS37=1

Taking all things together, on a scale from 0 to 10, where 0 is not at all happy and 10 is completely happy, how happy would you say your relationship with [CURRENT PARTNER] is? You can pick any number from 0 to 10.

COMPLETELY HAPPY	10	FS42
	9
	8
	7
	6
	5
	4
	3
	2
	1
NOT AT ALL HAPPY	0
DK	d
REF	r

FS42

ALL

Next, I have some questions about [CHILD].

Do you currently live with [CHILD] in the same household…

All of the time,	1	FS43
Most of the time,	2	FS42.2
Some of the time, or	3
None of the time?	4
DK	d
REF	r

FS42.2

IF FS42=most of the time (2), some of the time (3), OR none of the time (4)

he if CMALE; she if CFEMALE

(IF FS42=2 or 3) When [he/she] is not living with you,

(W/w)ho does [CHILD] live with?

FATHER/MOTHER	1	FS42.3 OR FS43
GRANDPARENT(S)	2
OTHER RELATIVES(S)	3
ADOPTIVE PARENTS	4
FOSTER PARENTS	5
FRIEND(S)	6
SOMEONE ELSE	7	FS42.2.1
DK	d	FS42.2 OR FS43
REF	r

FS42.2.1

IF FS42.2=7

INSTRUCTION: PROBE FOR RELATIONSHIP OF THIS PERSON TO CHILD.

DESCRIBE OTHER PERSON

STRING OF 501

FS42.3 OR FS43

FS42.3

FS42=None of the time (4)

Did you and [CHILD] ever live together in the same household?

YES	1	FS43
NO	0	FS45
DK	d
REF	r

FS43

If FS42=all, most, some of the time (1,2,3) OR IF FS42.3=YES

him IF FS17=MALE; her if FS17=FEMALE

Since [CHILD] was born, did you live with [him/her] in the same household…

All the time,	1	FS43.1
Most of the time	2
Some of the time, or	3
None of the time?	4
DK	d
REF	r

PROGRAMMER: IF FS42<>4 THEN FS43<>5

FS43.1

If FS42=all, most, some of the time (1,2,3) OR IF FS42.3=YES

him IF FS17=CMALE; her if FS17=FEMALE

Since [CHILD] was born, did you live in the same household with both [him/her] and [FATHER/MOTHER]…

All the time,	1	FS45 OR FS46.1 OR FS50
Most of the time	2
Some of the time, or	3
None of the time?	4
DK	d
REF	r

FS45

IFS42=3, 4 (living with child some or none of the time)

Have you seen [CHILD] in the past month?

YES	1	FS46.1 OR FS50
NO	0
DK	d
REF	r

FS46.1

FS42.2<>1 OR NOT (FS33=1 AND FS42=1) (skip if respondent lives with mother/father and also child)

Has [FATHER/MOTHER] seen [CHILD] in the past month?

YES	1	FS50
NO	0
DK	d
REF	r

FS50

ALL

had IF FEMALE; fathered IF MALE

(IF FS5a=2 OR FS5b=2 OR FS7=2 OR FS8=2) Since the baby that died, have you [had/fathered] another baby or are you expecting another baby?

(IF FS5a=4 OR FS5b=4 OR FS7=5) Since your baby died, have you [had/fathered] another baby or are you expecting a baby now?

(IF FS7=4) Since the abortion, have you [had/fathered] a baby or are you expecting a baby now?

(IF FS7=3) Since the miscarriage, have you [had/fathered] another baby or are you expecting a baby now?

(ELSE) Since [CHILD] was born, have you [had/fathered] another baby or are you expecting a baby now?

(ALL) This can be a baby you had or are expecting with [FATHER/ MOTHER] or someone else.

(IF FS6.1>1 OR FS9>1) Don’t count the other babies born at the same time as [CHILD].

YES, HAD ANOTHER BABY/HAD OTHER BABIES	1	FS51
YES, EXPECTING A BABY NOW	2	FS51.1
YES, HAD ANOTHER BABY AND IS EXPECTING A BABY	3	FS51
NO	4	FS53
MISCARRIAGE/STILL BIRTH/ABORTION/ VOLUNTEERED	5
DK	d
REF	r

FS51

IF FS50=YES (1,3)

have IF FEMALE; father IF MALE

How many babies have you [had/fathered] since then?

NUMBER OF BABIES	FF	FS52 OR FS51.1
DK	d
REF	r

FS51.1

IF FS50=(2,3)

Are you expecting just one baby now?

YES	1	FS52
NO	0	FS51.2
DK	d	FS52
REF	r

FS51.2

IF FS51.1=YES

How many babies are you expecting?

NUMBER OF BABIES	FF	FS52
DK	d
REF	r

FS52

IF FS50=1, 2, or 3

this baby IF FS51=1 OR FS51.1=YES AND FS50<>3;

of these babies IF FS51>1 OR FS51.1=NO OR FS50<>3

FATHER IF FEMALE; MOTHER IF MALE

mother IF MALE; father IF FEMALE

Is [FATHER/MOTHER] the [father/mother] of [this baby/of these babies]?

PROBE: We are interested in babies you are expecting or were born since [CHILD].

YES	1	FS53
YES, BUT NOT OF ALL BABIES	2
NO	0
DK	d
REF	r

FS53

ALL

Now I have some questions about people in your household.

Altogether, how many children under 18 live with you all or most of the time? Include all children, even if they are not your own.

(IF FS42>1,2 AND FS5a<>2 OR 4 OR FS5b<>2 OR 4 OR FS7=1) Please include [CHILD] in your answer.

PROBE: All or most of the time should include anyone who sleeps in your house more than 4 nights a week.

NUMBER OF CHILDREN	FF	FS54
DK	d	FS55 54_1
REF	r	FS55 54_1

PROGRAMMER CHECK: FS53 CAN’T=0 IF FS42=1 OR 2

FS54

IF FS53>0

(or [FATHER/MOTHER/CURRENT PARTNER]) IF FS33=1,2 OR FS 40=1,2

FATHER/MOTHER IF FS33=1,2; CURRENT PARTNER IF FS40=1,2

FATHER IF FEMALE; MOTHER IF MALE

(IF FS53>1) How many of these [ANSWER IN FS53] children are you [or [FATHER/MOTHER/CURRENT PARTNER] primarily responsible for?

(IF FS53=1) Are you [or [FATHER/MOTHER/CURRENT PARTNER] the adult(s) who (is/are) primarily responsible for this child?

(IF FS53=1) INSTRUCTION: IF ‘YES’ ENTER 1 AND IF NO ENTER ‘0’.

NUMBER OF CHILDREN	FF	FS54.1
DK	d
REF	r

FS54.1

IF FS42=1 or 2 (respondent living with child all or most of the time)

Besides FATHER/MOTHER are, IF FS33=1,2

Besides CURRENT PARTNER are, IF FS40=1,2

Are IF FS33<>1,2 OR FS40<>1,2

[Besides [FATHER/MOTHER/CURRENT PARTNER are,] [Are] other adults living with you who are related to [CHILD]?

YES	1	FS54.2
NO	0	FS55
DK	d
REF	r

FS54.2

IF FS54.1=YES

Are any of these other adults employed?

YES	1	FS55
NO	0
DK	d
REF	r

FS55

IF FS25<>7

Next, I have some questions about marriage.

CONTINUE

FS56 OR FS66

SKIP IF FS25=4 OR 15MO_FS56=DATE

FS56

IF FS25=1,2,3,5,6 (married, separated, divorced, annulled, widowed)

FATHER IF FEMALE; MOTHER IF MALE

You previously told me that you [are/had been] married to [FATHER/MOTHER].

When did you get married to [FATHER/MOTHER]?

INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR.

DATE OF MARRIAGE	MM//YYYY	FS59, FS56.1 OR FS66
DK	d
REF	r

SKIP IF 15MO_FS25=3

FS56.1

IF FS25=3 (separated)

FATHER IF FEMALE; MOTHER IF MALE

When did you get separated from [FATHER/MOTHER]?

INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR.

DATE OF SEPARATION	MM//YYYY	FS59 OR FS66
DK	d
REF	r

SKIP IF 15MO_FS25=2,5,6, or 7 OR 15MO_FS19=3

FS59

IF FS25=divorced (2) OR FS25=annulled (5) OR FS25=6 (widowed) OR FS25=7

(partner died) OR FS19=3

FATHER IF FEMALE; MOTHER IF MALE

(IF FS25=2) When did the divorce from [FATHER/MOTHER] become final?

(IF FS25=5) When did the annulment of your marriage to [FATHER/MOTHER] take place?

(IF FS25=6 or 7 OR FS19=3) When did [FATHER/MOTHER] pass away?

INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR.

DATE OF END OF MARRIAGE	MM/YYYY	FS66 OR FS60
DK	d
REF	r

FS60

IF FS38.1=YES

You previously told me that you are married to [CURRENT PARTNER].

When did you get married to [CURRENT PARTNER]?

INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR.

DATE OF MARRIAGE	MM//YYYY	FS66
DK	d
REF	r

FS66

ALL

to someone else besides [FATHER/MOTHER] IF FS25=1,2,3,5,6 or FS38.1=YES

FATHER IF FEMALE

MOTHER IF MALE

and IF FS25=1,2,3,5,6 AND FS38.1=YES

Your current partner, [CURRENT PARTNER] IF FS38.1=YES

IF DID NOT HAVE A 15MO INTERVIEW: Have you ever been married [to someone else besides [FATHER/MOTHER] [and] [your current partner, [CURRENT PARTNER]?

IF DID HAVE A 15MO INTERVIEW: Since [15MO SURVDATE] have you been married [to someone else besides [FATHER/MOTHER] [and] [your current partner, [CURRENT PARTNER]?

YES	1	FS67
NO	0	NEXT SECTION
DK	d
REF	r

FS67

IF FS66=YES

to someone else besides [FATHER/MOTHER] IF FS25=1,2,3,5,6 or FS38.1=YES

FATHER IF FEMALE

MOTHER IF MALE

and IF FS25=1,2,3 AND FS38.1=YES

your current partner, [CURRENT PARTNER] IF FS38.1=YES

IF DID NOT HAVE A 15MO INTERVIEW: How many times have you been married [to someone else besides [FATHER/MOTHER] [and] [your current partner, [CURRENT PARTNER]?

IF DID HAVE A 15MO INTERVIEW: Since [15MO SURVDATE] how many times have you been married [to someone else besides [FATHER/MOTHER] [and] [your current partner, [CURRENT PARTNER]?

NUMBER OF MARRIAGES	FF	FS68
DK	d
REF	r

[RANGE 2<SOFT CHECK]

LOOP FOR EACH MARRIAGE IN FS67

FS68

IF FS66=YES

(to someone else) IF FS25=1,2,3,5,6 OR FS38.1=YES

COUNTER=NUMBER IN LOOP (first, second, third, etc.) IF FS67>1

Thinking about the [COUNTER] marriage IF FS67>1

a	Thinking about the [COUNTER] marriage (to someone else), when did you get married?	DATE OF MARRIAGE	MM/YYYY	FS68-b OR FS68-c
		DK	d
		REF	r
b	(IF FS25<>1,3 OR FS38.1=NO**) Are you still married to this person?	YES	1	NEXT IN LOOP OR NEXT SECTION
		NO	0	FS68-c
c	Did this marriage end through divorce or annulment, or did your spouse pass way?	DIVORCE	1	FS68-d
		ANNULMENT	2
		SPOUSE DIED	3
		DK	d
		REF	r
d	(IF FS68c=1) When did the divorce become final? (IF FS68c=2) When did the annulment take place? (IF FS68c=3) When did your spouse pass away? (IF FS68c=DK or R) When did this marriage end?	DATE MARRIAGE ENDED	MM/YYYY	NEXT IN LOOP OR NEXT SECTION
**Questions should also be skipped if previous answer in b=yes

END LOOP FOR EACH MARRIAGE

SECTION CO: INVOLVEMENT WITH CHILD

CO1

IF FS19<>3 OR FS25<>6,7 (father/mother alive)

FATHER IF FEMALE; MOTHER IF MALE

father IF FEMALE; mother IF MALE

he if CMALE; she IF CFEMALE

Now, I would like to talk about you and [FATHER/MOTHER] as parents.

The following statements are about [FATHER/MOTHER]’s and your involvement in the care of [CHILD].

For each statement, please answer if you strongly agree, agree, are not sure, disagree, or strongly disagree.

[STATEMENT a to o] Do you strongly agree, agree, are not sure, disagree, or strongly disagree with this statement?

		STRONGLY AGREE	AGREE	NOT SURE	DISAGREE	STRONGLY DISAGREE	DK	REF
a	I believe [FATHER/MOTHER] is a good parent.	1	2	3	4	5	d	r
b	[FATHER/MOTHER] and I communicate well about [CHILD].	1	2	3	4	5	d	r
c	I feel good about [FATHER/MOTHER]’s judgment about what is right for [CHILD].	1	2	3	4	5	d	r
d	[FATHER/MOTHER] makes my job of being a parent easier.	1	2	3	4	5	d	r
e	[FATHER/MOTHER] and I are a good team.	1	2	3	4	5	d	r
f	[FATHER/MOTHER] knows how to handle children well.	1	2	3	4	5	d	r
g	When there is a problem with [CHILD], FATHER/MOTHER] and I work out a good solution together.	1	2	3	4	5	d	r
h	[FATHER/MOTHER] is willing to make personal sacrifices to help take care of [CHILD].	1	2	3	4	5	d	r
i	Talking to [FATHER/MOTHER] about [CHILD] is something I look forward to.	1	2	3	4	5	d	r
j	[FATHER/MOTHER] pays a great deal of attention to [CHILD].	1	2	3	4	5	d	r
k	I am satisfied with the responsibility [FATHER/MOTHER] takes for raising [CHILD].	1	2	3	4	5	d	r
l	[FATHER/MOTHER] is committed to being there for [CHILD].	1	2	3	4	5	d	r
m	[CHILD] needs [FATHER/MOTHER] just as much as [he/she] needs me.	1	2	3	4	5	d	r
n	No matter what might happen between [FATHER/MOTHER] and me, when I think of [CHILD]’s future, it includes [FATHER/MOTHER].	1	2	3	4	5	d	r
o	[FATHER/MOTHER] is the type of [father/mother] I want for [CHILD].	1	2	3	4	5	d	r

LOOP FOR CO2

•  RESPONDENT ABOUT THEMSELVES IF FS45<>NO (contact with child in past month).

•  FEMALE RESPONDENT ABOUT FATHER IF FS45<>NO AND IF FS46.1<>NO (contact of father with child in past month) AND IF FS19<>3 OR FS25<>6,7 (father alive).

you IF RESPONDENT; FATHER FEMALE ABOUT MALE;

have IF RESPONDENT; has IF FEMALE ABOUT MALE

(IF COUNTER=1) The next question is about time spent with [CHILD].

In the past month, how often [have/has] [you/FATHER] spent one or more hours a day with [CHILD]? Was it…

Everyday or almost every day,	1	CO3
A few times a week,	2
A few times in the past month,	3
Once or twice, or	4
Never?	5
DK	d
REF	r

END LOOP CO2

CO3

FS45<> NO (contact with child in past month)

IF FEMALE ONLY, ASK a THRU d.

him If CMALE; her IF CFEMALE

The next questions are about things you may have done with [CHILD] in the past month.

In the past month, how often have you [STATEMENT a to l]? Was it more than once a day, about once a day, a few times a week, a few times a month, rarely, or not at all?

		MORE THAN ONCE A DAY	ABOUT ONCE A DAY	A FEW TIMES A WEEK	A FEW TIMES A MONTH	RARELY	NOT AT ALL	DK	REF
a	Sung songs with [CHILD].	1	2	3	4	5	6	d	r
b	Read or looked at books with [CHILD].	1	2	3	4	5	6	d	r
c	Told stories to [CHILD].	1	2	3	4	5	6	d	r
d	Played with games or toys with [CHILD].	1	2	3	4	5	6	d	r
e	Helped [CHILD] to get dressed.	1	2	3	4	5	6	d	r
f	Changed [CHILD]’s diapers or helped [him/her] use the toilet.	1	2	3	4	5	6	d	r
g	Fed [CHILD] or gave [him/her] something to eat.	1	2	3	4	5	6	d	r
h	Rolled a ball, tossed a ball, or played games with a ball with [CHILD].	1	2	3	4	5	6	d	r
i	Taken [CHILD] for a ride on your shoulders or back.	1	2	3	4	5	6	d	r
j	Turned [CHILD] upside down or tossed (her or him) up in the air	1	2	3	4	5	6	d	r
k	Played chasing games with [CHILD].	1	2	3	4	5	6	d	r
l	Played outside in the yard, a park, or a playground with [CHILD].	1	2	3	4	5	6	d	r
		CO3.1

CO3.1

FS45<> NO (contact with child in past month)

The next questions are about times you have spent with [CHILD] in the past month.

In the past month, how often would you say that [STATEMENT a to c]? Is that often, sometimes, rarely, or never?

		OFTEN	SOMETIMES	RARELY	NEVER	DK	REF
a	[CHILD] and you have warm close times together	1	2	3	4	d	r
b	You feel that [CHILD] likes you and wants to be near you	1	2	3	4	d	r
c	When you’re in a bad mood, you still show [CHILD] love	1	2	3	4	d	r

CO5

FATHER IF FEMALE AND IF FS46.1<>0 (contact with child in the past month)/MOTHER IF MALE AND IF FS46.1<>0 (contact with child in the past month)

CURRENT PARTNER IF FS37=YES (respondent has current partner)

FATHER IF FEMALE; MOTHER IF MALE

Children often do things that are wrong, disobey, or make their parents angry. We would like to know what you (or [FATHER/MOTHER] or [CURRENT PARTNER]) have done when [CHILD] did something wrong or made you upset or angry.

In the past month, did you (or [FATHER/MOTHER (or [CURRENT PARTNER])) [STATEMENT a to j)?

		YES	NO	(IF YES AND IF HAVE A CURRENT PARTNER OR BSF PARTNER IS LIVING) Was that you, [or FATHER/MOTHER] [or CURRENT PARTNER]?			DK	REF
a	Put [CHILD] in time out or send (him/her) to (his/her) room	1	0	ME (respondent)	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
b	Shout, yell or scream at [CHILD]	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
c	Spank [CHILD] on the bottom with a bare hand	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
d	Hit [CHILD] on the bottom with a belt, hairbrush, or stick	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
e	Threaten to spank or hit [CHILD] but did not actually do it	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
f	Give [CHILD] something to do instead of what (he/she) was doing wrong?	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
g	Swear or curse at [CHILD]	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
h	Slap [CHILD] on the hand, arm, or leg	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
i	Slap [CHILD] on the face, head, or ears	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r
j	Explain to [CHILD] why something was wrong	1	0	ME	YES	NO	d	r
				[FATHER/MOTHER],	YES	NO	d	r
				[CURRENT PARTNER],	YES	NO	d	r

SECTION CH: CHILD OUTCOMES

FOR THIS ENTIRE SECTION - ASK QUESTION OF

•  RESPONDENT: IF FEMALE AND FS42=1 OR 2 (mother lives with child all or most of the time)

•  RESPONDENT: IF FEMALE AND CO2=1 OR 2 (mother spends an hour or more a day with child at least a few times a week)

•  RESPONDENT: IF MALE AND (FS42=1 OR FS42=2) AND (FS33=3 OR FS33=4) (father lives with child all or most of the time AND father and mother live together only some of the time or not at all)

•  RESPONDENT: IF MALE AND (FS42=3 OR FS42=4) AND (FS42.2<> 1) AND (CO2=1 OR CO2=2) (father lives with child only some or none of the time AND child does not live with mother either AND father spends an hour or more a day with child at least a few times a week)

Now, I’d like to ask you some questions about [CHILD].

We will start with questions about [CHILD]’s health.

CH1

ALL

In general, would you say [CHILD]’s health is...

Excellent,	1	CH2
Very good,	2
Good,	3
Fair, or	4
Poor?	5
DK	d
REF	r

CH2

ALL

In the past month did [CHILD] have a cold, flu or fever that limited (his/her) ability to participate in (his/her) usual activities?

YES	1	CH3
NO	0
DK	d
REF	r

CH3

ALL

Has a doctor or other health professional ever told you that [CHILD] has asthma?

YES	1	CH4
NO	0	CH5
DK	d
REF	r

CH4

IF CH3=YES

Since [CHILD] was born, did [CHILD] have to visit an emergency room or urgent care center because of asthma?

YES	1	CH5
NO	0
DK	d
REF	r

CH5

ALL

Next, I have some questions about [CHILD’S] behavior. For each behavior I read to you, I’d like you to tell me how often you saw [CHILD] behave in this way in the last three months: never, rarely, sometimes or often.

During the last three months, how often was this like [CHILD]...

[CHILD] [STATEMENT A to I]? Was that never, rarely, sometimes, or often?

		never	rarely	sometimes	often	DK	REF
A	Tried to understand another child’s behavior (for example, [CHILD] asked “Why are you crying?”)	1	2	3	4	d	r
B	Participated in family or classroom discussions	1	2	3	4	d	r
C	Asked for help from adults when needed	1	2	3	4	d	r
D	Comforted other children who were upset	1	2	3	4	d	r
E	Invited other children to play	1	2	3	4	d	r
F	Sought comfort from an adult when hurt	1	2	3	4	d	r
G	Apologized for accidental behavior that may upset others	1	2	3	4	d	r
H	Was sensitive to adult problems (for example, [CHILD] asked “Are you sad?”)	1	2	3	4	d	r
I	Showed affection for other children	1	2	3	4	d	r

CH6

ALL

For each statement that I read, please answer if the statement is never true, sometimes true, or often true of [CHILD]’s behavior.

[CHILD] [STATEMENT A to Z]? Is that never true, sometimes true or often true of [CHILD’s] behavior?

		never true	sometimes true	often true	DK	REF
A	Has sudden changes in mood or feeling.	1	2	3	d	r
B	Feels or complains that no one loves (him/her).	1	2	3	d	r
C	Is rather high strung, tense and nervous	1	2	3	d	r
D	Cheats or tells lies.	1	2	3	d	r
E	Is too fearful or anxious.	1	2	3	d	r
F	Argues too much.	1	2	3	d	r
G	Has difficulty concentrating, cannot pay attention for long.	1	2	3	d	r
H	Is easily confused, seems to be in a fog.	1	2	3	d	r
I	Bullies or is cruel or mean to others.	1	2	3	d	r
J	Is disobedient.	1	2	3	d	r
K	Does not seem to feel sorry after (he/she) misbehaves.	1	2	3	d	r
L	Has trouble getting along with children (his/her) age.	1	2	3	d	r
M	Is impulsive, or acts without thinking.	1	2	3	d	r
N	Feels worthless or inferior.	1	2	3	d	r
O	Is not liked by other children (his/her) age.	1	2	3	d	r
P	Has a lot of difficulty getting (his/her) mind off certain thoughts.	1	2	3	d	r
Q	Is restless or overly active, cannot sit still	1	2	3	d	r
R	Is stubborn, sullen, or irritable.	1	2	3	d	r
S	Has a very strong temper and loses it easily.	1	2	3	d	r
T	Is unhappy, sad or depressed.	1	2	3	d	r
U	Is withdrawn, does not get involved with others.	1	2	3	d	r
V	Breaks things on purpose or deliberately destroys (his/her) own or another's things.	1	2	3	d	r
W	Cries too much.	1	2	3	d	r
X	Demands a lot of attention.	1	2	3	d	r
Y	Is too dependent on others.	1	2	3	d	r
Z	Worries too much.	1	2	3	d	r

CH7

ALL

My next questions are about some of the usual routines in your household.

(IF FS46.1≠0) In a typical week, please tell me the total number of days [CHILD] eats the evening meal with either you or [MOTHER/FATHER].

(IF FS46.1 = 0) In a typical week, please tell me the number of days [CHILD] eats the evening meal with you.

PROBE: IF VARIES, ‘On average, how many days’?

NUMBER OF DAYS	FF	CH8
DK	d
REF	r

CH8

ALL

When is [CHILD]’s regular bedtime? We are interested in what time (he/she) goes to bed, not what time (he/she) actually falls asleep.

PROBE: ‘On average?’

| | |:| | | P.M. GOTO CH9

| | |:| | | A.M. GOTO CH9

NO USUAL TIME 0 GOTO CH12

DON’T KNOW d GOTO CH10

REFUSED r GOTO CH10

CH9

ALL

How many times in the last week, Monday through Friday, was [CHILD] put to bed at that time?

NUMBER OF DAYS	FF	CH10
DK	d
REF	r

CH10

ALL

Some families have a routine of things they do when it is time to put a child to bed. Is there a regular routine of things done with [CHILD] to put (him/her) to bed?

YES	1	CH11
NO	0	CH12
DK	d
REF	r

CH11

IF CH10=1

How many times in the last week, Monday through Friday, was this bedtime routine for [CHILD] able to be followed?

NUMBER OF DAYS	FF	CH12
DK	d
REF	r

NOTE: NUMBER OF DAYS MUST BE IN THE RANGE 1-5.

CH12-SIMS

IF FS25=married (1) OR FS26=romantically involved (1) or on-again-off-again relationship (2) OR FS33=1 or 2 (live together all or most of the time) OR FS33.2=1, 2, or 3 (see each other at least a few times a month)

Next, I am going to ask you to describe [CHILD]’s reactions to seeing arguments and disagreements between you and [MOTHER/FATHER] during the past month. Tell me if [CHILD] reacts to witnessing arguments and disagreements in this way often, sometimes, rarely, or never.

[CHILD] [STATEMENT a to j]

		Often	Sometimes	Rarely	Never	DK	REF
a	Yells at family members.	1	2	3	4	d	r
b	Starts hitting, kicking, slapping, or throwing things at family members.	1	2	3	4	d	r
c	Appears angry.	1	2	3	4	d	r
d	Appears frightened.	1	2	3	4	d	r
e	Appears sad.	1	2	3	4	d	r
f	Still seems upset after we argue.	1	2	3	4	d	r
g	Can’t seem to calm down after we argue.	1	2	3	4	d	r
h	Causes trouble.	1	2	3	4	d	r
i	Appears upset.	1	2	3	4	d	r
j	Takes a while after the argument to act like (him/her) self again.	1	2	3	4	d	r

End section

SECTION RR: RELATIONSHIP

RR0

R=ALL

Next, I would like to have your opinion on a few statements about marriage. Tell me if you strongly agree, agree, disagree, or strongly disagree with the following statements…

		STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
A	A single parent can bring up a child just as well as a married couple.	1	2	3	4	d	r
B	It is better for a couple to be married than to just live together.	1	2	3	4	d	r
C	There are very few people who have good and happy marriages.	1	2	3	4	d	r
D	When a couple is committed to each other, it makes no difference whether they are married or living together.	1	2	3	4	d	r
E	It is better for children if their parents are married.	1	2	3	4	d	r
		RR0.1

RR0.1

ALL

Now I would like to ask you about your friends.

Do you strongly agree, agree, disagree, or strongly disagree with the following statement:

Most of my friends are not ready to settle down.

STRONGLY AGREE	1	RR1 or RR2 or RR8
AGREE	2
DISAGREE	3
STRONGLY DISAGREE	4
DK	d
REF	r

RR1

IF FS25=married (1) OR FS26=romantically involved (1) or on-again-off-again relationship (2)

FATHER IF FEMALE; MOTHER IF MALE

Now I would like to ask about your relationship with [FATHER/MOTHER]. Taking all things together, on a scale from 0 to 10, where 0 is not at all happy and 10 is completely happy, how happy would you say your relationship with [FATHER/MOTHER] is? You can pick any number from 0 to 10.

COMPLETELY HAPPY	10	RR1.1
	9
	8
	7
	6
	5
	4
	3
	2
	1
NOT AT ALL HAPPY	0
DK	d
REF	r

RR1.1

IF FS25=married (1) OR FS26=romantically involved (1) or on-again-off-again relationship (2)

FATHER IF FEMALE; MOTHER IF MALE

In the past month, about how many times did you and [FATHER/MOTHER] go out together—just the two of you—to do something fun?

NUMBER OF TIMES	XX	RR2
DK	d
REF	r

RR2

IF FS25=1 (married) OR FS26=1 (romantically involved) OR 2 (on-again-off-again relationship) OR FS33=1 OR 2 (live together all or most of the time) OR FS33.2=1,2,3 (see each other at least a few times a month)

FATHER IF FEMALE; MOTHER IF MALE

Now, I am going to read you some statements about things couples may experience when they are together. Tell me if this often happens, sometimes happens, rarely happens or never happens.

[STATEMENT a-dd] Does this happen often, sometimes, rarely, or never?

		OFTEN	SOMETIMES	RARELY	NEVER	DK	REF
a	When I have problems, [FATHER/MOTHER] really understands what I’m going through.	1	2	3	4	d	r
b	[FATHER/MOTHER] blames me for things that go wrong.	1	2	3	4	d	r
e	I feel appreciated by [FATHER/MOTHER].	1	2	3	4	d	r
j	I feel respected even when we disagree.	1	2	3	4	d	r
x	Even when arguing we can keep a sense of humor.	1	2	3	4	d	r
m	When we discuss something, [FATHER/MOTHER] acts as if I am totally wrong.	1	2	3	4	d	r
n	We are good at solving our differences.	1	2	3	4	d	r
q	When we argue, one of us is going to say something we will regret.	1	2	3	4	d	r
v	When we argue, I feel personally attacked by [FATHER/MOTHER].	1	2	3	4	d	r
4w	During arguments, we are good at taking breaks when we need them.	1	2	3	4	d	r
s	When we argue, I get very upset.	1	2	3	4	d	r
y	We are pretty good listeners, even when we have different positions on things.	1	2	3	4	d	r
z	[FATHER/MOTHER] is good at calming me when I get upset.	1	2	3	4	d	r
aa	Little arguments turn into ugly fights with accusations, criticisms, name calling or bringing up past hurts.	1	2	3	4	d	r
bb	[FATHER/MOTHER] puts down my opinions, feelings or desires.	1	2	3	4	d	r
cc	[FATHER/MOTHER] seems to view my words or actions more negatively than I mean them to be.	1	2	3	4	d	r
dd	When we argue, one of us withdraws and refuses to talk about it any more.	1	2	3	4	d	r
		RR4

RR4

IF FS25=1 (married) OR FS26=1 (romantically involved) OR FS26=2 (on-again-off-again relationship) ASK: ALL ITEMS

IF FS25<>1 OR FS26<>1,2, ONLY ASK: RRi, RRj, RRn, RRq, RRr, RRt

FATHER IF FEMALE; MOTHER IF MALE

him IF FEMALE; her IF MALE

FATHER IF FEMALE; MOTHER IF MALE

Tell me whether you strongly agree, agree, disagree, or strongly disagree with the following statements.

[STATEMENT B-Z] Do you strongly agree, agree, disagree, or strongly disagree?

		STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
B	[FATHER/MOTHER] and I often talk about things that happen to each of us during the day.	1	2	3	4	d	r
C	[FATHER/MOTHER] and I enjoy doing even ordinary, day-to-day things together.	1	2	3	4	d	r
I	[FATHER/MOTHER] is honest and truthful with me.	1	2	3	4	d	r
J	I can trust [FATHER/MOTHER] completely.	1	2	3	4	d	r
N	[FATHER/MOTHER] can be counted on to help me.	1	2	3	4	d	r
O	I may not want to be with [FATHER/ MOTHER] a few years from now.	1	2	3	4	d	r
P	My relationship with [FATHER/MOTHER] is more important to me than almost anything else in my life.	1	2	3	4	d	r
Q	[FATHER/MOTHER] knows and understands me.	1	2	3	4	d	r
R	[FATHER/MOTHER] listens to me when I need someone to talk to.	1	2	3	4	d	r
T	[FATHER/MOTHER] respects me.	1	2	3	4	d	r
V	I want this relationship to stay strong no matter what rough times we may have.	1	2	3	4	d	r
W	[FATHER/MOTHER] encourages or helps me to do things that are important to me.	1	2	3	4	d	r
X	[FATHER/MOTHER] shows love and affection for me.	1	2	3	4	d	r
Y	I am satisfied with my sexual relationship with [FATHER/MOTHER].	1	2	3	4	d	r
Z	My friends and relatives support my relationship with [FATHER/MOTHER]	1	2	3	4	d	r
		RR8

RR8

ALL

FATHER IF FEMALE; MOTHER IF MALE

IF STILL TOGETHER: (IF FS25=1 OR IF FS26 = 1 OR 2) Sometimes couples are not always faithful to each other. Since [RA DATE] has FATHER/MOTHER cheated on you with someone else? Is that…

IF NOT STILL TOGETHER: (IF FS25<>1 OR IF FS26<>1 OR 2) Sometimes couples are not always faithful to each other. Please think only about the time after [RA DATE] and before your romantic relationship with [FATHER/MOTHER] ended. Did FATHER/MOTHER cheat on you with someone else? Is that…

PROBE: (IF FS26 NOT EQUAL TO 1 OR 2) Please think only about the time after [RA DATE] and before your romantic relationship with [FATHER/MOTHER] ended.

INSTRUCTION: IF RESPONDENT ANSWERS ‘DK’ DO NOT PROBE.

Definitely yes,	1	RR9
Probably yes,	2
Probably no, or	3
Definitely no?	4
DK	d
REF	r

RR9

ALL

FATHER IF FEMALE; MOTHER IF MALE

man IF FEMALE; woman IF MALE

IF STILL TOGETHER: (IF FS26 = 1 OR 2) Since [RA DATE], have you cheated on [FATHER/MOTHER] with someone else?

IF NOT STILL TOGETHER: (IF FS26 NOT EQUAL TO 1 OR 2) Did you cheat on [FATHER/MOTHER] with someone else? Please think only about the time after [RA DATE] and before your romantic relationship with [FATHER/MOTHER] ended.

YES	1	RR10 or RR14
NO	0
DK	d
REF	r

RR10

IF FS25=1 (married) OR FS26=1 (romantically involved) OR 2 (on-again-off-again relationship)

FATHER IF FEMALE; MOTHER IF MALE

Do you think [FATHER/MOTHER] will cheat on you in the future? Is that…

Definitely yes,	1	RR11
Probably yes,	2
Probably no, or	3
Definitely no?	4
DK	d
REF	r

RR11

IF FS25=1 (married) OR FS26=1 (romantically involved) OR 2 (on-again-off-again relationship)

FATHER IF FEMALE; MOTHER IF MALE

Do you think you will cheat on [FATHER/MOTHER] in the future? Would you say…

Definitely yes,	1	RR14
Probably yes,	2
Probably no, or	3
Definitely no?	4
DK	d
REF	r

RR14

ALL

FATHER IF FEMALE IF FS19<>3 OR FS25<>6,7/MOTHER IF MALE AND IF FS19<>3 OR FS25<>6,7

CURRENT PARTNER IF FS37=YES (respondent has current partner)

FATHER IF FEMALE; MOTHER IF MALE

Next I’m going to read a list of things that might have happened to you in the past year. In the past year, did [FATHER/MOTHER/CURRENT PARTNER] or another partner you were involved with…

							(IF YES and SITENAME <> ATLANTA) How often did [FATHER/MOTHER], [CURRENT PARTNER], [this other partner] do this in the past year? Was it… (IF YES AND SITENAME = ATLANTA)How often did this happen to you in the past year?
		YES	NO	(IF YES and SITENAME <> ATLANTA) Was it [FATHER/MOTHER], [CURRENT PARTNER], or another partner who did that to you?			Once	twice	3-5 times	6-10 times	11-20 times	More than 20 times	DK		REF
a	Throw something at you that could hurt?	1	0	[FATHER/MOTHER],	YES	NO	1	2	3	4	5	6	d		r
				[CURRENT PARTNER],	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
b	Twist your arm or hair?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
c	Push or shove you?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
d	Grab you?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
e	Slap you?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
f	Use a knife or gun on you?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
g	Punch or hit you with something that could hurt?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
h	Choke you?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Some other partner	YES	NO	1	2	3	4	5	6	d		r
i	Slam you against the wall?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
j	Kick you?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
k	Beat you up?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
l	Burn or scald you on purpose?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
m	Use threats or force to make you have sex or do sexual things you didn’t want to do?	1	0	[FATHER/MOTHER]	YES	NO	1	2	3	4	5	6	d		r
				CURRENT PARTNER	YES	NO	1	2	3	4	5	6	d		r
				Other partner	YES	NO	1	2	3	4	5	6	d		r
					RR15

RR15

ALL

FATHER IF FEMALE IF FS19<>3 OR FS25<>6,7; MOTHER IF MALE IF FS19<>3 OR FS25<>6,7

CURRENT PARTNER IF FS37=YES (respondent has current partner)

In the past year, did you need to see a doctor because of a fight with [MOTHER/FATHER], [CURRENT PARTNER] or another partner you were involved with? Please include times when you needed to see a doctor, even if you didn’t go.

YES	1	RR15.1
NO	0	NEXT SECTION
DK	d
REF	r

RR15.1

IF RR15=YES AND SITENAME <> ATLANTA

FATHER IF FEMALE AND IF FS19<>3 AND FS25<>6,7; MOTHER IF MALE IF FS19<>3 AND FS25<>6,7

CURRENT PARTNER IF FS37=YES (respondent has current partner)

Was that because of a fight with [FATHER/MOTHER], [CURRENT PARTNER], or another partner?

FATHER/MOTHER	YES	NO	WB1.1
CURRENT PARTNER	YES	NO
OTHER PARTNER	YES	NO
DK	d
REF	r

SECTION WB: PARENTAL WELL BEING (I)

WB1.1

ALL

The next questions are mostly about you.

In the past year, about how often have you attended a religious service? Was it…

Never	1	WB1.2
A few times a year,	2
A few times a month, or	3
Once a week or more?	4
DK	d
REF	r

WB1.2

IF BASELINE Q20 PLUS BASELINE Q21 PLUS (FS9 minus 1) PLUS (FS6.1 minus 1) PLUS 1 (IF FS50=1 OR 3) MINUS 1 (IF FS5=3 OR FS7=2,3,4) >0

children IF BASELINE Q20 PLUS BASELINE Q21 PLUS (FS9 minus 1) PLUS

(FS6.1 minus 1) PLUS 1 (IF FS50=1 OR 3) MINUS 1 (IF FS5=3 OR FS7=2,3,4) >1;

child IF BASELINE Q20 PLUS BASELINE Q21 PLUS (FS9 minus 1) PLUS

(FS6.1 minus 1) PLUS 1 (IF FS50=1 OR 3) MINUS 1 (IF FS5=3 OR FS7=2,3,4)=1

Now, I am going to read you a list of ways you might have felt in the past month about being a parent.

During the past month, how often have you…

[STATEMENT a to d] Was it all of the time, most of the time, some of the time, or none of the time?

		ALL OF THE TIME	MOST OF THE TIME	SOME OF THE TIME	NONE OF THE TIME	DK	REF
a	Felt your (child/children) [is/are] much harder to care for than most?	1	2	3	4	d	r
b	Felt your (child does/children do) things that really bother you?	1	2	3	4	d	r
c	Felt you are giving up more of your life to meet your (child’s/children’s) needs than you ever expected?	1	2	3	4	d	r
d	Felt angry with your (child/children)?	1	2	3	4	d	r
		WB1.3

WB1.3

ALL

Now, I am going to read you a list of ways you might have felt or behaved during the past week. For each item on the list I will ask you how often you felt this way.

During the past week… [STATEMENT A-T] Would you say that happened rarely or none of the time; some of the time; a moderate amount of time; or most or all of the time?

PROBE: Rarely or none of the time” would mean less than 1 day in the past week; “some of the time” would mean 1 or 2 days in the past week; “a moderate amount of time” would mean 3 or 4 days in the past week; and “most of or all of the time” would mean 5 to 7 days in the past week.

STATEMENT		RARELY OR NONE OF THE TIME	SOME OF THE TIME	A MODERATE AMOUNT OF TIME	MOST OR ALL OF THE TIME	DK	REF
A	I was bothered by things that usually don't bother me.	1	2	3	4	d	r
B	I did not feel like eating; my appetite was poor.	1	2	3	4	d	r
C	I felt that I could not shake off the blues even with help from my family or friends.	1	2	3	4	d	r
E	I had trouble keeping my mind on what I was doing.	1	2	3	4	d	r
F	I felt depressed.	1	2	3	4	d	r
G	Everything I did felt like an effort.	1	2	3	4	d	r
J	I felt fearful.	1	2	3	4	d	r
K	My sleep was restless.	1	2	3	4	d	r
M	I talked less than usual.	1	2	3	4	d	r
N	I felt lonely.	1	2	3	4	d	r
R	I felt sad.	1	2	3	4	d	r
T	I could not get “going.”	1	2	3	4	d	r
		IF 2 OR MORE ANSWERS IN A THRU T >1 WB2 ELSE WB4

WB2

IF 2 OR MORE ANSWERS IN A THRU T >1 IN WB1

In the past week, how difficult did these feelings or problems make it for you to do your work or take care of things at home? Has it been…

Not at all difficult,	1	WB3
Somewhat difficult,	2
Very difficult, or	3
Extremely difficult?	4
DK	d
REF	r

WB3

IF 2 OR MORE ANSWERS IN A THRU T >1 IN WB1

And in the past week, how difficult have these feelings or problems made it for you to get along with other people?

Not at all difficult,	1	WB4
Somewhat difficult,	2
Very difficult, or	3
Extremely difficult?	4
DK	d
REF	r

WB4

ALL

4 = AMOUNT IF FEMALE; 5 = AMOUNT IF MALE

The next question is about drinking alcoholic beverages. By a “drink” we mean either a bottle of beer, a wine cooler, a glass of wine, a shot of liquor, or a mixed drink.

In the past year, how many times have you had [AMOUNT] or more drinks of alcohol in one day?

NUMBER OF TIMES	FF	WB5
DK	d
REF	r

WB5

ALL

In the past year, did you have any problems keeping a job or getting along with family or friends because of your alcohol or drug use?

YES	1	WB6 OR NEXT SECTION
NO	0
DK	d
REF	r

WB6

IF FS19<>3 OR FS25<>6,7

FATHER IF FEMALE; MOTHER IF MALE

his IF FEMALE; her IF MALE

And what about [FATHER/MOTHER]? In the past year, did [FATHER/MOTHER] have any problems keeping a job or getting along with family or friends because of [his/her] alcohol or drug use?

YES	1	NEXT SECTION
NO	0
DK	d
REF	r

SECTION SE: RECEIPT OF SERVICES

SE1

ALL

FATHER IF FEMALE; MOTHER IF MALE

(IF 15MO=1) Next I am going to ask you about programs you may have participated in since [15M SURVEY DATE]; that is about [NUMBER OF MONTHS SINCE 15M SURVEY DATE] months ago. Since [15M SURVEY DATE] did you and [FATHER/MOTHER] attended any classes, workshops, or group sessions to help your relationship? These sessions would have included other couples, not just you and [FATHER/MOTHER].

(IF 15MO=0) Next I am going to ask you about programs you may have participated in since [RA DATE]; that is about three years ago. Since [RA DATE] did you and [FATHER/MOTHER] attend any classes, workshops, or group sessions to help your relationship? These sessions would have included other couples, not just you and [FATHER/MOTHER].

YES	1	SE1.1
NO	0	NEXT SECTION
DK	d
REF	r

SE1.1

SE1=1 AND 15MO=0

FATHER IF FEMALE; MOTHER IF MALE

Have you participated in any of these classes since [RA DATE + 15 MONTHS]?

PROBE: That’s about 2 years ago.

YES	1	NEXT SECTION
NO	0
DK	d
REF	r

SECTION PA: PATERNITY AND CHILD SUPPORT

PA1

NOT MARRIED AT BIRTH AND (15MO=0 OR 15MO_PA1=0, dk)

you IF MALE; FATHER IF FEMALE

are IF MALE; is IF FEMALE

My next questions are about the legal arrangements you and [MOTHER/FATHER] have regarding [CHILD].

Did you and [MOTHER/FATHER] ever sign a birth certificate or document that identifies [you/FATHER] as the legal father of [CHILD]? Or, has a court ruled that [you/FATHER] [are/is] [CHILD]’s father?

PROBE: You usually sign a birth certificate in the hospital shortly after the baby is born or sometimes a little bit later.

YES	1	PA1.1
NO	0	PA2 OR PA11.2 OR PA12
DK	d	PA1.1
REF	r	PA1.1

PA1.1

IF PA1=1

you IF MALE; FATHER IF FEMALE

Did you and [MOTHER/FATHER] voluntarily sign a document establishing [you/FATHER] as [CHILD]’s legal father? Or did this get handled through the courts?

VOLUNTARILY SIGNED DOCUMENT	1	PA2 OR PA11.2 OR PA12
HANDLED THROUGH THE COURT	2
DK	d
REF	r

PA2

FS42<>1,2 (not live with child all or most of the time)

Next I have some questions about the financial contribution you might make to support [CHILD].

Do you have a legal agreement or child support order that requires you to provide financial support for [CHILD]?

YES	1	PA7
NO	0	PA9
DK	d
REF	r

PA7

IF PA2=YES

In the past month, how much were you supposed to pay in child support for [CHILD] under this order?

PROBE: If your support order covers more than one child, tell me the total amount you were supposed to pay last month.

PROBE: Your best estimate is fine.

AMOUNT IN DOLLARS	FF	PA8 OR PA9
DK	d
REF	r

PA8

IF PA7<>0

And in the past month, how much of that amount did you actually pay in child support?

PROBE: Your best estimate is fine.

AMOUNT IN DOLLARS	FF	PA9 OR PA12
DK	d
REF	r

PA9

IF FS42<> 1,2 (not live with child all or most of the time)

extra IF PA8>0

(IF PA8>0) Not counting the child support you already told me about,

[In/in] the past month, did you give extra money to help out with the cost of raising [CHILD]?

YES	1	PA10
NO	0	PA11
DK	d
REF	r

PA10

IF PA9=YES

extra IF PA8>0

How much extra money did you provide in the past month to help support [CHILD]?

PROBE: Your best estimate is fine.

AMOUNT IN DOLLARS	FF	PA11
DK	d
REF	r

PA11

IF FS42<>1,2 (not live with child all or most of the time)

his IF CMALE; her IF CFEMALE

In the past month, did you buy things for [CHILD] that [he/she] needed like clothes, diapers, or medicine?

YES	1	PA11.2 OR PA12
NO	0
DK	d
REF	r

PA11.2

IF FS33<>1,2 (not live together with other parent all or most of the time) AND FS42=1,2 (live with child all or most of the time)

FATHER IF FEMALE; MOTHER IF MALE

Do you have a legal agreement or child support order that requires [FATHER/MOTHER] to provide financial support for [CHILD]?

YES	1	PA11.7
NO	0	PA11.9
DK	d
REF	r

PA11.7

IF PA11.2=YES

FATHER IF FEMALE; MOTHER

In the past month, how much was [FATHER/MOTHER] supposed to pay in child support for [CHILD] under that order?

PROBE: If the support order covers more than one child, tell me the total amount [he/she] was supposed to pay last month for all your children.

AMOUNT IN DOLLARS	FF	PA11.8 OR PA11.9
DK	d
REF	r

PA11.8

IF PA11.7<>0

FATHER IF FEMALE; MOTHER IF MALE

And in the past month, how much did [FATHER/MOTHER] actually pay in child support?

AMOUNT IN DOLLARS	FF	PA11.9
DK	d
REF	r

PA11.9

IF FS33<>1,2 (not live together with other parent all of the time) AND FS42=1,2 (live with child all or most of the time)

FATHER IF FEMALE; MOTHER IF MALE

extra IF PA11.8>0

(IF PA11.8>0) Not counting the child support you already told me about, in the past month, did [FATHER/MOTHER] give you [extra] money to help out with the cost of raising [CHILD]?

YES	1	PA11.10
NO	0	PA11.11
DK	d
REF	r

PA11.10

IF PA11.9=YES

FATHER IF FEMALE; MOTHER IF MALE

extra IF PA8>0

How much extra money did [FATHER/MOTHER] pay you in the past month to help support [CHILD]?

AMOUNT IN DOLLARS	FF	PA11.11
DK	d
REF	r

PA11.11

IF FS33<>1,2 (not live with other parent together all or most of the time) AND FS42=1,2 (live with child all or most of the time)

FATHER IF FEMALE; MOTHER IF MALE

he IF CMALE; she IF CFEMALE

In the past month, did [FATHER/MOTHER] buy things for [CHILD] that [he/she] needed like clothes, diapers, or medicine?

YES	1	PA12
NO	0
DK	d
REF	r

PA12

ONLY ASK IF FEMALE IS RESPONDENT

his IF CMALE; her IF CFEMALE

him IF CMALE; her IF CFEMALE

Parents deal with meeting the expenses of raising a child in different ways. When answering the next question, I’d like you to think about all the expenses associated with raising [CHILD] such as [his/her] food, clothing, medical expenses, diapers, and any other costs of raising [him/her].

How much of the cost of raising [CHILD] does [FATHER] cover? Would you say its…

All or almost all,	1	END OF SECTION
More than half,	2
About half,	3
Less than half, or	4
Little or none?	5
DK	d
REF	r

SECTION WW: FAMILY SELF-SUFFICIENCY

WW1

ALL

The next questions are about your work.

Have you worked for pay at any time during the past 12 months? Please include odd jobs and temporary jobs.

PROBE: You can include odd jobs, temporary jobs, self-employment, military service, or any other type of paid work.

YES	1	WW2
NO	0	WW13 OR WW8
DK	d
REF	r

WW2

IF WW1=YES

How many months did you work for pay in the past 12 months?

INSTRUCTION: IF LESS THAN 1 MONTH, ENTER 1 MONTH.

NUMBER OF MONTHS	FF (1 TO 12)	1 to 11=WW3 12=WW4
DK	d
REF	r

WW3

IF WW2<>12

Did you work for pay in the past month?

PROBE: You can include odd jobs, temporary jobs, self-employment, military service, or any other type of paid work.

YES	1	WW4
NO	0	WW7
DK	d
REF	r

WW4

IF WW3=1 OR WW2=12

What were your total earnings in the past month before taxes and other deductions? Please include tips, commissions, and overtime pay.

PROBE: If you held more than one job, include your total earnings from all your jobs during the past month.

PROBE: I can help you add it up if you want to think out loud.

INSTRUCTION: IF RESPONDENT CAN ONLY REPORT EARNINGS AFTER TAXES, ENTER THAT AMOUNT.

AMOUNT	FFF,FFF.FF	WW5.2
DK	d	WW5.1
REF	r	WW6

WW5.1

IF WW4=DK

I just need to know a range. Can you tell me if it was…

INSTRUCTION: YOU CAN STOP READING WHEN RESPONDENT PROVIDES RANGE.

Less than $500,	1	WW5.2
Between $500 and $750,	2
Between $750 and $1000,	3
Between $1000 and $1250,	4
Between $1250 and $1500,	5
Between $1500 and $1750,	6
Between $1750 and $2000,	7
Between $2000 and $2500,	8
Between $2500 and $3000,	9
Between $3000 and $3500,	10
Between $3500 and $4000,	11
Between $4000 and $4500,	12
Between $4500 and $5000,	13
Between $5500 and $6000,	14
$6000 or more?	15
DK	d	WW6
REF	r

WW5.2

IF WW4>0 OF IF WW5.1<>DK OR REF

PLEASE ENTER IF RESPONDENT PROVIDED THE AMOUNT…

BEFORE TAXES WITHOUT PROBING	1	WW6
BEFORE TAXES AFTER PROBING	2
AFTER TAXES	3
NOT SURE	4

WW6

IF WW3=1 OR WW2=12

How many hours per week did you typically work last month?

AMOUNT OF HOURS	FFF	WW13 OR WW8
DK	d
REF	r

WW7

IF WW3=NO

Thinking about the last month that you did work, what were your total earnings during that month before taxes and other deductions? Please include tips, commissions, and overtime pay.

PROBE: If you held more than one job during that month, include your total earnings from all your jobs you held that month.

PROBE: I can help you add it up if you want to think out loud.

INSTRUCTION: IF RESPONDENT CAN ONLY REPORT EARNINGS AFTER TAXES, ENTER THAT AMOUNT.

AMOUNT	FFF,FFF.FF	WW7.2
DK	d	WW7.1
REF	r	WW13 OR WW8

WW7.1

IF WW7=DK

I just need to know a range. Can you tell me if it was…

INSTRUCTION: YOU CAN STOP READING WHEN RESPONDENT PROVIDES RANGE.

Less than $500,	1	WW7.2
Between $500 and $750,	2
Between $750 and $1000,	3
Between $1000 and $1250,	4
Between $1250 and $1500,	5
Between $1500 and $1750,	6
Between $1750 and $2000,	7
Between $2000 and $2500,	8
Between $2500 and $3000,	9
Between $3000 and $3500,	10
Between $3500 and $4000,	11
Between $4000 and $4500,	12
Between $4500 and $5000,	13
Between $5500 and $6000,	14
$6000 or more?	15
DK	d	WW8 OR WW13
REF	r

WW7.2

IF WW7>0 OR WW7.1 <>DK, REF

PLEASE ENTER IF RESPONDENT PROVIDED THE AMOUNT…

BEFORE TAXES WITHOUT PROBING	1	WW13 OR WW8
BEFORE TAXES AFTER PROBING	2
AFTER TAXES	3
NOT SURE	4

WW8

IF FS25=1 OR FS33<3 OR FS40<3

he IF FEMALE; she IF MALE

FATHER IF FEMALE and FS33<3;

MOTHER IF MALE and FS33<3; CURRENT PARTNER IF FS40<3 OR FS38.1=1

he IF FEMALE; she IF MALE

The next questions are about jobs [FATHER/MOTHER/CURRENT PARTNER] had in the past month. Has [he/she] worked for pay in the past month?

PROBE: You can include odd jobs, temporary jobs, self-employment, military service, or any other type of paid work.

YES	1	WW8.1
NO	0	WW13
DK	d
REF	r

WW8.1

IF WW8=1

her IF FEMALE; his IF MALE

he IF FEMALE; she IF MALE

What were [his/her] total earnings in the past month before taxes and other deductions? Please include tips, commissions, and overtime pay.

PROBE: If [he/she] held more than one job, include total earnings from all [his/her] jobs during the past month.

PROBE: I can help you add it up if you want to think out loud.

INSTRUCTION: IF RESPONDENT CAN ONLY REPORT EARNINGS AFTER TAXES, ENTER THAT AMOUNT

AMOUNT	FFF,FFF.FF	WW8.3
DK	d	WW8.2
REF	r	WW13

WW8.2

IF WW8.1=DK

I just need to know a range. Can you tell me if it was…

INSTRUCTION: YOU CAN STOP READING WHEN RESPONDENT PROVIDES RANGE.

Less than $500,	1	WW8.3
Between $500 and $750,	2
Between $750 and $1000,	3
Between $1000 and $1250,	4
Between $1250 and $1500,	5
Between $1500 and $1750,	6
Between $1750 and $2000,	7
Between $2000 and $2500,	8
Between $2500 and $3000,	9
Between $3000 and $3500,	10
Between $3500 and $4000,	11
Between $4000 and $4500,	12
Between $4500 and $5000,	13
Between $5500 and $6000,	14
$6000 or more?	15
DK	d	WW13
REF	r

WW8.3

IF WW8.1>0 OR WW8.2<> DK, REF

PLEASE ENTER IF RESPONDENT PROVIDED THE AMOUNT…

BEFORE TAXES WITHOUT PROBING	1	WW13
BEFORE TAXES AFTER PROBING	2
AFTER TAXES	3
NOT SURE	4

WW13

ALL

FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; CURRENT PARTNER IF FS40<3 OR FS38.1=1

LOCAL NAME FOR TANF: NEEDS SITE SPECIFIC FILL

Now I’m going to read a list of income sources. For each, tell me whether you, [FATHER/MOTHER/CURRENT PARTNER], or the children who live with you received income from this source in the past month:

PROBE: Did you, [FATHER/MOTHER/CURRENT PARTNER], or the children who live with you receive income from this source in the past month?

			(IF YES) How much did you receive in [FILL INCOME SOURCE] in the past month?
Cash welfare which is also known as TANF, or [LOCAL NAME OF TANF]?	YES	1	FF,FFF.FF
			DK
			REF
	NO	0
Food stamp benefits	YES	1	FF,FFF.FF
			DK
			REF
	NO	0
Disability insurance such as Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)?	YES	1	FF,FFF.FF
			DK
			REF
	NO	0
Unemployment Insurance Benefits or UI	YES	1	FF,FFF.FF
			DK
			REF
	NO	0
Child support?	YES	1	FF,FFF.FF
			DK
			REF
	NO	0
Money from friends or relatives?	YES	1	FF,FFF.FF
			DK
			REF
	NO	0
	WW28

WW28

ALL

or FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

or MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; or CURRENT PARTNER

IF FS40<3 OR FS38.1=1

In the past month did you (or [FATHER/MOTHER/CURRENT PARTNER]) receive money from any other source, such as rent from boarders, other government benefits, or any other income we have not already talked about?

YES	1	WW30
NO	0	WW32
DK	d
REF	r

WW30

IF WW28=YES

or FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

or MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; or CURRENT PARTNER

IF FS40<3 OR FS38.1=1

How much money from these other sources did you (or [FATHER/MOTHER/CURRENT PARTNER]) receive in the past month?

AMOUNT	FFF,FFF.FF	WW32
DK	d
REF	r

WW32

ALL

and FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

and MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; and CURRENT PARTNER

IF FS40<3 OR FS38.1=1

or FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

or MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; or CURRENT PARTNER

IF FS40<3

The next questions are about bank accounts.

Do you (or [FATHER/MOTHER/CURRENT PARTNER]) have any bank accounts?

YES	1	WW33
NO	0	WW36
DK	d
REF	r

WW33

IF WW32=YES AND ((IF FS25=1) OR (IF FS33<3) OR (IF FS40<3 OR FS38.1=1))

his IF FEMALE; her IF MALE

Are any of these accounts in…

a	Both your names?	YES	NO	WW36
b	[His/Her] name only?	YES	NO
c	Your name only?	YES	NO
	DK	d
	REF	r

WW36

(IF FS25=1) OR (IF FS33<3) OR (IF FS40<3 OR FS38.1=1)

FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; and CURRENT PARTNER

IF FS40<3

People handle money differently. Which of the following best describes how you and [FATHER/MOTHER/CURRENT PARTNER] handle your money?

We put all our money together.	1	WW37
We put some of our money together but keep the rest separate, or	2
We keep all our money separate.	3
DK	d
REF	r

WW37

(IF FS25=1) OR (IF FS33<3) OR (IF FS40<3 OR FS38.1=1)

FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; CURRENT PARTNER IF FS40<3

People also make different arrangements for handling household expenses, such as paying for rent, food, or utilities. Which of the following best describes how you and [FATHER/MOTHER/CURRENT PARTNER] pay for household expenses?

We usually both contribute to household expenses.	1	WW38
I usually cover household expenses.	2
[FATHER/MOTHER/CURRENT PARTNER] usually covers household expenses.	3
Someone else covers most of our household expenses, or	4	WW37.1
We have some other kind of arrangement.	5	WW37.2
DK	d	WW38
REF	r

WW37.1

IFWW37=4

Who covers these household expenses?

INSTRUCTION: PROBE FOR RELATIONSHIP TO RESPONDENT.

DESCRIBE PERSON

STRING OF 50

WW38

WW37.2

IF WW37=5

What kind of arrangement do you have?

INSTRUCTION: DESCRIBE THE ARRANGEMENT.

DESCRIBE ARRANGEMENT

STRING OF 50

WW38

WW38

ALL

or FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

or MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; and/or CURRENT PARTNER

IF FS40<3 OR FS38.1=1

Do you (or [FATHER/MOTHER/CURRENT PARTNER]) own a car, truck or van?

YES	1	WW40
NO	0
DK	d
REF	r

WW40

ALL

FATHER/MOTHER/CURRENT PARTNER

or FATHER (IF FS25=1 OR IF FS33<3) AND FEMALE;

or MOTHER (IF FS25=1 OR IF FS33<3) AND MALE; or CURRENT PARTNER

IF FS40<3 OR FS38.1=1

Do you (and/or [FATHER/MOTHER/CURRENT PARTNER]) own the home you live in?

YES	1	WW53
NO	0
DK	d
REF	r

WW53

ALL

Now, I have some questions about financial difficulties you may have experienced in the past 12 months.

Please tell me if there has been a time during the past 12 months when…

		YES	NO	DK	REF
a	You could not pay the full amount of the rent or mortgage that you were supposed to pay?	1	0	d	r
b	You had service turned off by the water, gas or electric company, or the oil company would not deliver oil because you could not afford to pay the bill?	1	0	d	r
c	You were evicted from your home or apartment because you could not pay the rent or mortgage?	1	0	d	r
		WW54

WW54

IF FS5<>2 OR 4 OR FS7<>2,3,4,5 (child alive)

NOTE: NEED STATE/LOCAL FILL FOR MEDICAID

The next questions are about health insurance coverage.

Is [CHILD] currently covered by Medicaid, [STATE/LOCAL FILL], or any other government program that pays for medical care?

YES	1	WW55.1.1
NO	0
DK	d
REF	r

WW55.1.1

IF FS5<>2,4 OR FS7<>2,3,4,5 (child alive)

Is [CHILD] currently covered by health insurance through your or someone else’s employer, or insurance purchased directly from a private insurance company?

YES	1	WW55.2
NO	0
DK	d
REF	r

WW55.2

ALL

NOTE: NEED STATE/LOCAL FILL FOR MEDICAID.

Are you currently covered by Medicaid, [STATE/LOCAL FILL], or any other government program that pays for medical care?

YES	1	WW55.2.1
NO	0
DK	d
REF	r

WW55.2.1

ALL

Are you currently covered by health insurance through your or someone else’s employer, or insurance purchased directly from a private insurance company?

YES	1	WW55.3
NO	0
DK	d
REF	r

WW55.3

ALL

In general would you say your health is…

Excellent,	1	WW57.1
Very good,	2
Good,	3
Fair, or	4
Poor?	5
DK	d
REF	r

WW57.1

IF FS19<>3 AND FS25<>6,7

FATHER IF FEMALE; MOTHER IF MALE

Next I have some questions about people who are available to help you in an emergency

Would you be able to count on [FATHER/MOTHER] to take care of [CHILD] in an emergency?

YES	1	WW57
NO	0
DK	d
REF	r

WW57

ALL

Besides [FATHER/MOTHER], how many other people would you be able to count on to take care of [CHILD] in an emergency?

PROBE: Your best estimate is fine.

INSTRUCTION: IF MORE THAN 25 ENTER 25.

NUMBER OF PEOPLE	FF	WW57.1
DK	d
REF	r

WW58.1

IF FS19<>3 AND FS25<>6,7

FATHER IF FEMALE; MOTHER IF MALE

Could you turn to [FATHER/MOTHER] if you suddenly needed to borrow $100?

YES	1	WW58
NO	0
DK	d
REF	r

WW58

ALL

Besides [FATHER/MOTHER] how many other people could you turn to if you suddenly needed to borrow $100 in an emergency?

PROBE: Your best estimate is fine.

INSTRUCTION: IF MORE THAN 25 ENTER 25.

NUMBER OF PEOPLE	FF	WW58.1
DK	d
REF	r

WW60

IF FS19<>3 AND FS25<>6,7)

FATHER IF FEMALE; MOTHER IF MALE

Suppose you had a problem, and you were feeling depressed or confused about what to do.

Could you turn to [FATHER/MOTHER] for help or advice if you had a problem and felt like that?

YES	1	WW59
NO	0
DK	d
REF	r

WW59

Besides [FATHER/MOTHER], how many other people would you be able to turn to for help or advice if you had a problem and felt like that?

PROBE: Your best estimate is fine.

INSTRUCTION: IF MORE THAN 25 ENTER 25.

NUMBER OF PEOPLE	FF	END OF SECTION
DK	d
REF	r

SECTION WB: PARENTAL WELL BEING (II)

WB9

ALL

INSTRUCTION: IS RESPONDENT CURRENTLY IN PRISON OR JAIL?

YES	1	WB11.1
NO	0	WB11

WB11

IF WB9=NO

The next questions are about involvement you may have had with the police or the criminal justice system.

Have you ever been arrested? Please include all arrests whether you were guilty or not.

YES	1	WB11.1
NO	0	WB25.1 OR END OF SECTION
DK	d
REF	r

WB11.1

IF WB11=YES OR IF WB9=YES

IF 15MO=0 THEN [RA DATE], IF 15MO=1 THEN [15MO_SURV DATE]

(IF WB9=YES) The next questions are about involvement you may have had with the police and/or the criminal justice system.

(IF WB9=NO) Have you been arrested since [RA DATE]? That is about (three/two) years ago.

YES	1	WB11.2
NO	0	WB15
DK	d
REF	r

WB11.2

IF WB11.1=YES

How many times have you been arrested in the past three years?

NUMBER OF ARRESTS	FF	WB15 IF DID A 15M INTERVIEW THEN SKIP TO WB26
DK	d
REF	r

WB15

IF WB11.1<> NO or r, AND 15MO=0; IF 15MO=1 – GOTO WB30WB26

Now, I would like to ask you about the time before [RA DATE].

Before [RA DATE], were you ever in jail or prison?

YES	1	WB23
NO	0
DK	d
REF	r

WB23

15MO=0

I would also like to ask you about any convictions or sentences you may have received.

Before [RA DATE], were you ever convicted and sentenced to go to jail or prison? Please include any sentence you received, even if you did not serve any time.

YES	1	WB24
NO	0	WB25.1 OR END OF SECTION
DK	d
REF	r

WB24

If WB23=YES AND 15MO=0

Please think about the longest sentence you received before [RA DATE]. How long was that sentence? Please tell me the total length of the prison sentence, even if you did not serve all of it.

INSTRUCTION: IF LESS THAN 1 WEEK, ENTER 1 WEEK.

INSTRUCTION: FIRST ENTER IF RESPONSE IS WEEKS, MONTHS AND/OR YEARS. YOU WILL ENTER THE NUMBER OF YEARS AND/OR MONTH ON NEXT TWO SCREENS.

INSTRUCTION: ENTER ALL THAT APPLY

b	WEEKS	YES
		NO
c	MONTHS	YES
		NO
d	YEARS	YES
		NO
	DK	d	WB25.1
	REF	r

WB24.1

IF WW24b=YES AND 15MO=0

INSTRUCTION: ENTER NUMBER OF WEEKS

WEEKS

FF

WB24.2 OR WB24.3

WB24.2

IF WB24c=YES AND 15MO=0

INSTRUCTION: ENTER NUMBER OF MONTHS

MONTHS

FF

WB24.3

WB24.3

IF WB24d=YES AND 15MO=0

INSTRUCTION: ENTER NUMBER OF YEARS

YEARS

FF

WB25.1 OR WB31

WB25.1

IF FEMALE IS RESPONDENT AND 15MO=0

The next questions are about involvement [FATHER] may have had with the police or the criminal justice system.

Has [FATHER] ever been arrested? Please include all arrests whether he was guilty or not.

YES	1	WB26
NO	0	END OF SECTION
DK	d
REF	r

WB26

IF WB25.1=YES

IF 15MO=0 THEN [RA DATE] AND (that is about three years ago), IF 15MO=1 THEN [15MO-SURVDATE] AND (that is about two years ago)

(ONLY SAY THIS INTRO IF HAD A 15M INTERVIEW (AND FATHER WAS ALIVE THEN): The next questions are about involvement [FATHER] may have had with the police or the criminal justice system.)

Has [FATHER] been arrested since [RA DATE]? (That is about three years ago./That is about two years ago.)

NEW WORDING IF FATHER KNOWN TO HAVE DIED FROM 36M INTERVIEW: Was [FATHER] arrested after [RA DATE]? That is about three years ago.

YES	1	WB27
NO	0	WB30
DK	d
REF	r

WB27

IF WB26=YES

IF 15MO=0 THEN (three years), IF 15MO=1 THEN (two years)

How many times in the past (three years/two years) has [FATHER] been arrested?

NEW WORDING IF FATHER KNOWN TO HAVE DIED FROM 36M INTERVIEW: How many times in the past three years was [FATHER] arrested?

NUMBER OF ARRESTS	FF	WB30
DK	d
REF	r

WB30

IF WB27<>0

Is [FATHER] currently in prison or jail?

YES	1	CC1
NO	0
DK	d
REF	r

WB31

IF MALE IS RESPONDENT

IF 15MO=0 THEN [RATE DATE], IF 15MO=1 THEN [15MO_SURV DATE]

Since [RA DATE], have you been in jail or prison?

YES	1	WB32
NO	0
DK	d
REF	r

WB32

ALL

IF 15MO=0 THEN [RATE DATE], IF 15MO=1 THEN [15MO_SURV DATE]

Since [RA DATE], have you been convicted and sentenced to go to jail or prison? Please include any sentence you received, even if you did not serve any time.

YES	1	WB33
NO	0	END OF SECTION
DK	d
REF	r

WB33

IF WB32=1

IF 15MO=0 THEN [RATE DATE], IF 15MO=1 THEN [15MO_SURV DATE]

Please think about the longest sentence you received since [RA DATE]. How long was that sentence? Please tell me the total length of the prison sentence, even if you did not serve all of it.

INSTRUCTION: IF LESS THAN 1 WEEK, ENTER 1 WEEK.

INSTRUCTION: FIRST ENTER IF RESPONSE IS WEEKS, MONTHS AND/OR YEARS. YOU WILL ENTER THE NUMBER OF YEARS AND/OR MONTH ON NEXT TWO SCREENS.

INSTRUCTION: ENTER ALL THAT APPLY

a	WEEKS	YES
		NO
b	MONTHS	YES
		NO
c	YEARS	YES
		NO
	DK	d	END OF SECTION
	REF	r

WB33.1

IF WB33a=YES

INSTRUCTION: ENTER NUMBER OF WEEKS

WEEKS

FF

WB33.2 OR WB33.3

WB33.2

IF WB33b=YES

INSTRUCTION: ENTER NUMBER OF MONTHS

MONTHS

FF

WB33.3

WB33.3

IF WB23c=YES

INSTRUCTION: ENTER NUMBER OF YEARS

YEARS

FF

WB34

WB34

ALL

Are you currently on probation or parole?

YES	1	END OF SECTION
NO	0
DK	d
REF	r

SECTION BP: COUNTRY OF ORIGIN AND BIOLOGICAL PARENTS

CC1

IF 15MO=1, GO TO BP10

Next, I would like to ask you some questions about where you were born and about your childhood.

What country were you born in?

UNITED STATES	1	BP1
PUERTO RICO	2
CANADA	3	CC2
MEXICO	4
CUBA	5
DOMINICAN REPUBLIC	6
EL SALVADOR	7
HAITI	8
JAMAICA	9
GUATEMALA	10
NICARAGUA	11
OTHER COUNTRY	12	CC1.1
DK	d	CC2
REFUSED	r

CC1.1

CC1=12

INSTRUCTION:

SPECIFY OTHER COUNTRY

CC2

CC2

IF CC1>2

When did you first come to live in the United States?

INSTRUCTION: FIRST CODE IF ANSWER IS, ‘SPECIFIC YEAR’ OR ‘NUMBER OF YEARS AGO’…

INSTRUCTION: YOU WILL BE ABLE TO ENTER SPECIFIC YEAR OR NUMBER OF YEARS ON THE NEXT SCREEN.

SPECIFIC YEAR	1	CC2.1
NUMBER OF YEARS AGO	2	CC2.2
DK	d	BP1
REF	r

CC2.1

IF CC2=1

INSTRUCTION:

ENTER SPECIFIC YEAR

BP1

CI2.2

IF CC2=2

INSTRUCTION:

ENTER NUMBER OF YEARS AGO

BP1

BP1

ALL

When you were growing up—that is before you turned 18—did you live most of the time with…

PROBE: In which of these living situations did you spend most of your time before you turned 18?

Both your biological mother and your biological father,	1	BP2
Your biological mother only,	2	BP3
Your biological father only, or	3
Neither of your biological parents?	4
DK	d
REF	r

BP2

If BP1=1

Did you usually live with both your parents at the same time?

YES	1	BP3
NO	0
DK	d
REF	r

BP3

Were your biological parents ever married to each other?

INTERVIEWER: IF RESPONDENT ANSWERS DON’T KNOW DO NOT REPEAT THE QUESTION.

YES	1	BP7
NO	0
DK	d
REF	r

BP7

Before you turned 18, did anyone—a stranger, friend, date, relative, or someone else you knew—ever do or try to do something sexual to you or make you do something sexual to them against your wishes?

YES	1	BP8
NO	0
DK	d
REF	r

BP8

Before you turned 18, were you ever beaten up, burned, assaulted with a weapon, or had your life threatened by an adult in your family or household?

YES	1	BP9
NO	0
DK	d
REF	r

BP9

man IF FEMALE; woman IF MALE

I have a few more questions about your sexual relationships.

How old were you the first time you had sexual intercourse with a [man/woman]?

PROBE: By sexual intercourse I mean that you made love, had sex, or went all the way with a [man/woman].

AGE OF FIRST INTERCOURSE	FF	BP10
DK	d
REF	r

BP10

ALL

man IF FEMALE; woman IF MALE

male IF FEMALE; female IF MALE

In the past three years, how many [men/women] have you had sexual intercourse with? Please count every [male/female] sexual partner in the past three years even if you had sex only once.

PROBE: And that is since in the last three years?

NUMBER OF TIMES	FFF	END OF SECTION
DK	d
REF	r

SECTION LO: LOCATING INFORMATION

LO1

ALL

HIDE REFERENCE TO MONEY IF CELL PHONE COMP

We are almost done. We will be sending you a (check) for $25 within the next four weeks. We need to make sure we have your correct address and some information on other people in case you move.

What is your full address?

PROBE: Can you spell the street name for me please?

PROBE: Is there an apartment number?

PROBE: Besides the P.O. Box, do you have a street address?

ADDR LINE 1

STRING OF 20

LO1.1

LO1.1

INSTRUCTION:

ENTER ADDR LINE 2

LO1.2

LO1.2

INSTRUCTION:

ENTER CITY

LO1.3

LO1.3

INSTRUCTION:

ENTER STATE

LO1.3.1

LO1.3.1

INSTRUCTION:

ENTER ZIP CODE

LO2

LO2

ALL

What is your home phone number?

HOME PHONE NUMBER	FFF-FFF-FFFF	LO2.1
DOES NOT HAVE PHONE	1	LO3
DK	d	LO3
REF	r

LO2.1

LO2=phone number

Whose name is that phone number listed in?

ENTER NAME	STRING OF 20	LO3
LISTED IN SAMPLE MEMBER’S NAME	0
DK	d
REF	r

LO3

ALL

Is there (a/another) phone number where you can be reached?

HOME PHONE NUMBER	FFF-FFF-FFFF	LO3.1
NO OTHER PHONE	0	LO4
DK	d
REF	r

LO3.1

LO3=phone number

Whose name is that phone number listed in?

ENTER NAME	STRING OF 20	LO3.2
LISTED IN SAMPLE MEMBER’S NAME	0	LO4
DK	d
REF	r

LO3.2

LO3=NAME

What is their relationship to you?

RELATIONSHIP	STRING OF 20	LO4
DK	d
REF	r

LO4

ALL

Do you (also) have a cell-phone or pager number?

CELL-PHONE/ PAGER NUMBER	FFF-FFF-FFFF	LO17
DOES NOT HAVE PHONE	1
DK	d
REF	r

LO17

COMPLETES FROM SOC

Thank you very much for your time. Those are all the questions I have right now.

Is [FATHER/MOTHER] available? I’d like to interview [him/her] too, if (he/she) is around.

INSTRUCTION: IF [FATHER/MOTHER] IS AVAILABLE, ASK TO SPEAK TO [HIM/HER]. CLOSE THE CURRENT CASE AFTER LEAVING A NOTE ABOUT THIS CASE AND OPEN [FATHER/MOTHER]’S CASE.

INSTRUCTION: IF [FATHER/MOTHER] ISN’T AVAILABLE, ASK FOR THE BEST TIME TO REACH [HIM/HER] AND RECORD ON [FATHER/MOTHER]’S CONTACT SHEET.

LO18

COMPLETES WITH FIELD LOCATOR

Thank you very much for your time. Those are all the questions I have right now.

Is [FATHER/MOTHER] available? I’d like to interview [him/her] too, if [he/she] is around.

INSTRUCTION: IF [FATHER/MOTHER] IS AVAILABLE, ASK TO SPEAK TO HIM/HER. CLOSE THE CURRENT CASE AFTER LEAVING A NOTE ABOUT THIS CASE AND OPEN [FATHER/MOTHER]’S CASE.

INSTRUCTION: IF [FATHER/MOTHER] ISN’T AVAILABLE, ASK FOR THE BEST TIME TO REACH HIM/HER AND RECORD ON [FATHER/MOTHER]’S CONTACT SHEET.

Please hand the phone back to our field locator.

INTERVIEWER: CONFIRM WITH FIELD LOCATOR THAT SM HAS BEEN PAID.

YES	1	END
NO	0
DK	d
REF	r

MPR DOCUMENTATION:

/home/ec2-user/sec/disk/omb/icr/200803-0970-013/doc/6448302

(REV – 6/4/08)

BSF - 8935-144

Lynne revised for Shannon Monahan