MFS-IP Follow up Survey-Fathers

Evaluation of The Marriage and Family Strengthening Grants

0990-evalmarriageAppendix C Male FU

MFS-IP Follow up Survey-Fathers

OMB: 0990-0331

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Appendix C: Male Follow-up Survey Instrument

MFS-IP Instrument (Male FOLLOW-UP: ALL WAVES)

Table of Contents

PART ONE LIFETIME EXPERIENCES AND FAMILY STRUCTURE 2

Domain A: Demographics 2

Domain B: Incarceration Characteristics 2

Domain D: Genogram 4

Domain F: Relationship Status 5

Domain G: Family Structure 7

PART THREE EXPERIENCES SINCE INCARCERATION 9

Domain L: Social Support 9

Domain Q: Impact of Incarceration on Relationship with Partner 9

Domain R: Impact of Incarceration on Relationship with Children 14

PART FOUR EXPERIENCES SINCE PREVIOUS INTERVIEW 19

Domain H: Street Time 19

Domain S: Service Need and Receipt 20

Domain N: Parenting 29

PART FIVE EXPERIENCES SINCE RELEASE 30

Domain U: First 24 Hours 30

Domain I: Employment Status 31

Domain K: Income 34

Domain J: Housing 36

Domain L: Social Support 39

Domain M: Intimate Partner Violence 42

Domain V: Partner Relationship Quality 46

Domain N: Parenting 48

Domain O: Substance Use 51

Domain P: Physical and Mental Health 54

Domain W: Criminal Behavior 55

Domain X: Reincarceration Characteristics 58

Domain T: Community Involvement 60

PART SIX PERSONAL CHARACTERISTICS/CURRENT FEELINGS 61

Domain Z: Personal Traits 61

Domain P: Mental and Physical Health 66

Domain V: Partner Relationship Quality 70

Domain N: Parenting and Child Well-Being 77

Domain L: Social Support 84

ACASI SEGMENT 85

Domain J: Housing 85

Domain O: Substance Use 86

Domain V: Partner Relationship Quality 88

Domain M: Intimate Partner Violence 89

PART SEVEN EXPECTATIONS FOR POST-RELEASE PERIOD 94

Domain W: Criminal Behavior 94

Domain O: Substance Use 95

Domain L: Social Support 95

Domain K: Income 96

Domain I: Employment 97

Domain J: Housing 97

Domain V: Partner Relationship Quality 98

Domain N: Parenting 100

Locator information 102



MFS-IP MALE FOLLOW-UP INSTRUMENT DRAFT


{Y_bconBEGIN}


BCON1

[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, AND ARE YOU CONFIDENT THE INTERVIEW SETTING IS PRIVATE?


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.]:YES NO


{if BCON1=yes, go on with existing interview; if=no, go to BCON2}


BCON2

[INTERVIEWER: BECAUSE YOU HAVE INDICATED THAT 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.]

{go to Y_bconEND}


{if BCON1=yes}

BCON3

[HAND R INTERVIEW CONSENT FORM. USE THE FACILITY CONSENT FORM FOR INCARCERATED RESPONDENTS AND THE COMMUNITY CONSENT FOR ALL OTHER RESPONDENTS.]


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


[READ THE CONSENT FORM TO THE RESPONDENT.]


BCON4

[IF R AGREES TO PARTICIPATE IN THE INTERVIEW, HAND R PEN AND INSTRUCT R TO SIGN THE INTERVIEW CONSENT FORM. THEN YOU SHOULD SIGN THE CONSENT FORM.


GIVE R AN {bold}UNSIGNED{normal} COPY OF THE INTERVIEW CONSENT FORM. RETURN YOUR COPY OF THE CONSENT FORM TO YOUR INTERVIEWING MATERIALS FOR LATER SHIPMENT TO YOUR FS.]


[DID R CONSENT TO THE INTERVIEW OR DID R REFUSE THE INTERVIEW?]

(Consent “R CONSENTED TO THE INTERVIEW,”

Refused “R REFUSED THE INTERVIEW”)

IS R CURRENTLY INCARCERATED?

YES

NO

WHAT IS R’S GENDER?

Male

Female

Transgendered

PART ONE
LIFETIME EXPERIENCES AND FAMILY STRUCTURE

Domain A: Demographics

First, I’d like to get some updated information about your education and citizenship.

Educational attainment

NSAF (modified)

1. What is the highest grade or level of school you have ever completed?

None

8th grade or less

Some high school

GED

High school diploma

Vocational/tech/business certificate or diploma

Some college

Associate’s degree (AA, AS)

Bachelor’s degree (BA, BS)

Graduate/professional degree (MA, MS, PhD, EdD, medicine/MD,
dentistry/DDS, law/JJ/LLB, etc.)

2. (If answer is high school diploma): PROBE: Do you have a high school diploma or GED?

Citizenship

3. Are you a U.S. citizen?

YES

NO

Domain B: Incarceration Characteristics

(If R is not incarcerated, skip to next domain)


The next set of questions is about your current incarceration. [REFER TO REFERENCE CALENDAR.]

Incarceration duration

Created

4. Please tell me the date you were admitted for this term of incarceration. I’m asking for the date you entered incarceration this time, not the date of your sentencing. [REFER TO REFERENCE CALENDAR.]

___________ (MM/DD/YYYY)

5. That means you have been incarcerated for {calculated length of incarceration based on current date and response to above item}. Is this correct?

YES

NO

Created

6. Do you expect to be released from this incarceration?

YES

NO



7. (If yes) When do you expect to be released from this incarceration?

___________ (MM/DD/YYYY)

Instant offense

8. Are you currently serving time because of a parole or probation violation?

YES

NO


9. (If yes to either parole or probation violation) Was the [parole/probation] violation for a technical violation, like failing to report or having a dirty analysis, or for a new crime? [ALLOW BOTH.]

Technical violation

New crime

10. (If yes to new crime) What crime were you charged with for the new crime? Select all that apply. [USE SHOWCARD.]

Homicide

Rape

Other sex offense (not rape)

Robbery

Assault

Burglary

Theft

Car theft

Fraud or forgery

Weapons offense

Drug dealing

Drug possession

DWI or DUI

Other (SPECIFY)

11. (If no to parole/probation violation) What crimes were you convicted of for this prison term? Select all that apply. [USE SHOWCARD.]

Homicide

Rape

Other sex offense (not rape)

Robbery

Assault

Burglary

Theft

Car theft

Fraud or forgery

Weapons offense

Drug dealing

Drug possession

DWI or DUI

Other (SPECIFY)

Disciplinary actions

Created

12. During this term of incarceration, how many disciplinary infractions have you received?

_______ (# infractions)

13. During this term of incarceration, how many days have you served in administrative segregation?

This is sometimes referred to as spending time “in the hole.”

_________ (# TIMES)

Institutional transfers

Created

14. During this incarceration, how many times have you been transferred? By transferred I mean moved from one correctional facility to another or between a jail and a correctional facility. Do not include times you were transferred out for court or medical appointments and returned to the same facility after less than 7 days.

______ (# TRANSFERS)


Domain D: Genogram

15. REFER TO GENOGRAM. Since we last interviewed you, has anything changed in terms of who is in your family?

YES

NO


(If yes): UPDATE GENOGRAM TO REFLECT ANY CHANGES.

Domain F: Relationship Status

Marital history and current relationship status

Next, I’d like to ask you about some of the relationships you’ve had in your life, using our drawing as a starting point. [REFER TO GENOGRAM.]

Created

16. So, just to confirm, have you ever been married?

YES

NO

17. (If ever married) How many times? _____

18. (If ever married) And just to confirm, are you currently married?

YES

NO

19. (If currently married) How long have you been married to your current spouse? [REFER TO REFERENCE CALENDAR.]

|___|___| |___|___|
MONTHS YEARS

20. (If ever married) Just to confirm, have you ever been divorced?

YES

NO

21. (If ever divorced) How many times have you been divorced? _____

22. (If currently married) Are you currently romantically involved with your spouse? That is, do you still consider yourselves to be a couple?

YES

NO

23. (If not romantically involved with spouse) Are you legally separated?

YES

NO

24. (If romantically involved with spouse) And this person’s name is (NAME), correct? [RECORD.] For the rest of the interview, I will use the term “spouse” to refer to this person.

[IF PRELOADED, CONFIRM THAT THIS PERSON IS THE OTHER STUDY PARTICIPANT.]

25. (If other than married or separated, or report not being in a romantic relationship with the spouse) And just to confirm, are you in a romantic relationship with anyone? (Do you have a partner, or someone you are in a serious relationship with?)

YES

NO

26. (If in romantic relationship) And this person’s name is (NAME), correct? [RECORD.] For the rest of the interview, I will use the term “partner” to refer to this person.

[IF PRELOADED, CONFIRM THAT THIS PERSON IS THE OTHER STUDY PARTICIPANT.]

Duration of current relationship

27. (If in romantic relationship with spouse or someone else) Were you in a relationship with (SPOUSE/PARTNER) before you were incarcerated this time?

YES

NO

28. (If in romantic relationship) How long have you and (SPOUSE/PARTNER) been together? [REFER TO REFERENCE CALENDAR.]

|___|___| |___|___|

MONTHS YEARS

SVORI (modified)

29. During the 6 months before your incarceration, were you living with (SPOUSE/PARTNER) at any point? [REFER TO REFERENCE CALENDAR.]

YES

NO



Reasons for ending relationship with partner

30. (If R reports divorce, breakup or separation with original spouse/partner) What are the main reasons you and (SPOUSE/PARTNER) split up?

You had conflicts or disagreements you could not work out

(If R is not incarcerated) You did not feel close to one another after you

were released

You just drifted apart or lost interest in the relationship

She became involved with someone else during your incarceration

You become involved with someone else during your incarceration

(If R is not incarcerated) She became involved with someone else after

you were released

(If R is not incarcerated) You become involved with someone else after

you were released


Co-parenting relationships

31. (If R has any children) How many adults do you share parenting responsibilities with for any of your children? This could include ex-spouses or ex-partners who are fathers of your children, or another adult such as a grandparent with whom you are raising one of your children.

_______ (# COPARENTS)




Domain G: Family Structure

Now, I’m going to ask you some questions about your family life. You were asked many of these questions during your last interview, and I’d like to see if there have been any changes.

[QUESTIONS IN FOLLOWING SECTION MAY BE SKIPPED AT FI DISCRETION IF R BECOMES TOO DISTRESSED.]

Detailed child characteristics (all children) – gender, age, relationship to child, relationship with mother, residence with child, financial support, frequency of contact

32. (If R has children) First, I’m going to ask you some questions about each of the children you have, using our drawing as a starting point. For these questions, we’ll include all children that you are parenting in some way. [REFER TO GENOGRAM.] That would be {number] child(ren) total, correct? [ENTER TOTAL NUMBER OF CHILDREN FROM GENOGRAM.]

___________ (# CHILDREN)

Let’s start with your oldest child.

33. The child’s name is (state name from genogram), correct? [FILL IN FIRST NAME.]

34. What is the child’s age? (PROBE IF NEEDED: Your best estimate is fine.)

___________ (AGE IN YEARS)

35. And (fill child name) is (male/female), correct?

Male

Female

36. And just to confirm, (fill child name) is (SELECT RELATIONSHIP FROM BELOW), correct?

Your biological child

A child of your spouse or ex-spouse

A child of your spouse/partner or ex-partner

A child of another blood relative

A child of a non-relative

A legally adopted child

37. (If other than “child of your spouse”) And just to confirm, what is your relationship to (fill child name)’s mother?

You’ve never been married

You’re divorced or separated

You’re currently married

38. (If other than “child of your spouse/partner” or “child of your spouse”) And you (are/are not) currently in a committed romantic relationship with (fill child name)’s mother, correct?

In a committed relationship

Not in a committed relationship

39. Did you live with this child at any point since your last interview? [REFER TO REFERENCE CALENDAR.]

YES

NO

40. (If not living with child) Since your last interview, how far away from (fill child name) were you living? Please tell me about how long it would take for you to travel from the place you were primarily living to (fill child name)’s home.

__________(# MINUTES)

More than a 12-hour drive

[REPEAT QUESTIONS ABOVE FOR ALL CHILDREN.]

(If R has children under 18): Child support payments (any children)

BSF

41. Are you required by a court to pay child support for any of your children? [REFER TO REFERENCE CALENDAR.]

Yes

No

42. (If R is required to pay child support) How many children were you required to pay child support for?

_____(# of children)

43. (If R is required to pay child support) Since your last interview, how many of those court-ordered child support payments did you make?

All required payments

Some required payments

No required payments

SVORI

44. (If R is required to pay child support) Has the court order for child support been changed since your last interview?

Yes

No

45. (If R is required to pay child support) Do you owe back child support?

Yes

No



PART THREE
EXPERIENCES SINCE INCARCERATION

(If R is incarcerated)

Next, I’m going to ask you about your experiences since you were incarcerated.

Domain L: Social Support

In-prison contact with other family members

SVORI (modified)

1. How often do you currently receive personal visits from family members other than (SPOUSE/PARTNER) and child(ren)? [REFER TO REFERENCE CALENDAR.]

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never


Domain Q: Impact of Incarceration on Relationship with Partner

Importance of partner contact during incarceration

The next set of questions is about keeping in touch with your spouse/partner during this incarceration. First, I’d like to know how much you agree or disagree with each of the following statements.

2. Keeping in touch with (SPOUSE/PARTNER) during this incarceration is very important to you.

Strongly agree

Agree

Disagree

Strongly disagree

Institutional support for partner contact during incarceration

3. You are satisfied with the amount of help you’ve received with staying in touch with (SPOUSE/PARTNER) during this incarceration. This could be help from outside programs or agencies, program staff at your facility, clergy, correctional officers, or other staff.

Strongly agree

Agree

Disagree

Strongly disagree

Contact with partner during incarceration

Now, I’d like to ask about specific contact you may have had. [REFER TO REFERENCE CALENDAR.] [USE SHOWCARD.]

SVORI (modified)

4. About how often do you currently talk on the phone with (SPOUSE/PARTNER)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never

5. (If R currently talks on the phone with SPOUSE/PARTNER) About how long is your average phone call with (SPOUSE/PARTNER)?

_______ (# MINUTES)

6. How often do you currently send mail to your (SPOUSE/PARTNER)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never

7. How often do you currently receive mail from your (SPOUSE/PARTNER)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never

8. How often do you currently receive personal visits from your (SPOUSE/PARTNER)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never

9. (If R has received any personal visits from SPOUSE/PARTNER) About how much time do you spend visiting with (SPOUSE/PARTNER) on an average visit?

_______ (# MINUTES)


Barriers to contact with partner during incarceration

Returning Home (modified)

Thinking about your time in prison, please tell me how much you agree or disagree with each of the following statements.

10. The prison is located too far away for (SPOUSE/PARTNER) to make regular visits or is too hard to get to because of transportation issues.

Strongly agree

Agree

Disagree

Strongly disagree

11. Visitor admission rules (such as background checks, dress codes, searches, metal detectors) are hard for (SPOUSE/PARTNER) to deal with.

Strongly agree

Agree

Disagree

Strongly disagree

12. The cost of visiting makes it hard for (SPOUSE/PARTNER) to visit as often as she would like to.

Strongly agree

Agree

Disagree

Strongly disagree

13. Schedule issues, like limited visiting hours and (SPOUSE/PARTNER)’s work schedule, make it hard for her to find time for visits.

Strongly agree

Agree

Disagree

Strongly disagree

14. The cost of receiving calls is too high for (SPOUSE/PARTNER), or you do not have access to a phone.

Strongly agree

Agree

Disagree

Strongly disagree

15. The prison is not a pleasant place to visit, or not a place you want (SPOUSE/PARTNER) to see you.

Strongly agree

Agree

Disagree

Strongly disagree

16. (SPOUSE/PARTNER) does not want to maintain close contact with you while you are incarcerated.

Strongly agree

Agree

Disagree

Strongly disagree

17. You do not want to maintain close contact with (SPOUSE/PARTNER) while you are incarcerated.

Strongly agree

Agree

Disagree

Strongly disagree

18. What would you say are the two biggest difficulties in staying in touch with (SPOUSE/PARTNER) during your incarceration? [SHOW ONLY ITEMS FOR WHICH R ANSWERED “STRONGLY AGREE” OR “AGREE” ABOVE.]

The prison is located too far away for (SPOUSE/PARTNER) to make
regular visits or is too hard to get to because of transportation issues

Visitor admission rules (such as background checks, dress codes,
searches, metal detectors) are hard for (SPOUSE/PARTNER)
to deal with

The cost of visiting makes it hard for (SPOUSE/PARTNER) to visit as
often as she would like to.

Schedule issues, like limited visiting hours and (SPOUSE/PARTNER)’s
work schedule, make it hard for her to find time for visits.

The cost of receiving calls is too high for (SPOUSE/PARTNER), or you
do not have access to a phone.

The prison is not a pleasant place to visit, or not a place you want
(SPOUSE/PARTNER) to see you.

(SPOUSE/PARTNER) does not want to maintain close contact with
you while you are incarcerated.

You do not want to maintain close contact with (SPOUSE/PARTNER)
while you are incarcerated.

Impact of incarceration on partner relationship

19. (If R was with partner prior to this incarceration) How has your time in prison changed your relationship with (SPOUSE/PARTNER), if at all? Has it made you closer, has it made you drift apart, or has there been no change?

Made you closer

Made you drift apart

No change

20. What concerns or worries do you have about your relationship with (SPOUSE/PARTNER) during your incarceration? Mark all that apply.

Your time in prison will make you drift apart

It is hard for you to know what your place in her life is when you’re in
prison

You don’t know whether she will accept collect charges for your calls or
be at home when you call

She is concerned about your lifestyle in prison

She won’t forgive you for problems or conflicts you’ve had

Being in prison makes it hard to open up to her or let yourself get
close to her

You don’t know whether she will get involved with someone else while
you’re in prison

Or some other concern that I haven’t mentioned (SPECIFY) _____________________________________

21. Of the concerns you mentioned, which one is your biggest concern? Mark one only. [SHOW ONLY RESPONSE OPTIONS THAT WERE SELECTED ABOVE.]

Your time in prison will make you drift apart

It is hard for you to know what your place in her life is when you’re in
prison

You don’t know whether she will accept collect charges for your calls or
be at home when you call

She is concerned about your lifestyle in prison

She won’t forgive you for problems or conflicts you’ve had

Being in prison makes it hard to open up to her or let yourself get close
to her

You don’t know whether she will get involved with someone else while
you’re in prison

Or some other concern that I haven’t mentioned (SPECIFY) _____________________________________


Domain R: Impact of Incarceration on Relationship with Children

Importance of child contact during incarceration

The next set of questions is about keeping in touch with your child(ren) during this incarceration. First, I’d like to know how much you agree or disagree with each of the following statements.

22. Keeping in touch with your child(ren) during your incarceration is very important to you. Do you...

Strongly agree

Agree

Disagree

Strongly disagree

Institutional support for child contact during incarceration

23. You are satisfied with amount of help you’ve received with staying in touch with your child(ren) during this incarceration. This could be help from outside programs or agencies, program staff at your facility, clergy, correctional officers, or other staff. Do you...

Strongly agree

Agree

Disagree

Strongly disagree

Contact with children during incarceration & Contact with focal child during incarceration

Now, I’d like to ask about specific contact you may have had. [REFER TO REFERENCE CALENDAR.] [USE SHOWCARD.]

SVORI (modified)

24. How often do you currently talk on the phone with (your child/any of your children)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never

(If never, skip to question about sending mail.)

25. (If R has more than 1 child) How many of your children do you currently talk on the phone with?

[RECORD NUMBER.] ______________

26. (If R has more than 1 child) Do you currently talk on the phone with (FOCAL CHILD)?

YES

NO

27. (If R currently talks on the phone with any children) About how long is your average phone call with (your child/any of your children)?

_______ (# MINUTES)

28. How often do you currently send mail to (your child/any of your children)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never

(If never, skip to question about sending audiotapes.)

29. (If R has more than 1 child) How many of your children do you currently send mail to?

_______ (# of children)

30. (If R has more than 1 child) Do you currently send mail to (FOCAL CHILD)?

YES

NO

31. Have you been able to send any audiotapes to (your child/any of your children)?

YES

NO

32. How often do you currently receive mail from (your child/any of your children)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never

(If never, skip to question about receiving photographs.)

33. (If R has more than 1 child) How many of your children do you currently receive mail from?

_______ (# of children)

34. (If R has more than 1 child) Do you currently receive mail from (FOCAL CHILD)?

YES

NO

35. Have you received any photographs or audiotapes of (your child/any of your children)?

YES

NO

36. How often do you currently receive personal visits from (your child/any of your children)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never

(If never, skip to next construct.)

37. (If R has more than 1 child) How many of your children do you currently receive personal visits from?

_______ (# of children)

38. (If R has more than 1 child) Do you currently receive personal visits from (FOCAL CHILD)?

YES

NO………………………………………………………………………………..


Barriers to contact with children during incarceration

Returning Home (modified)

Thinking about your time in prison, please tell me how much you agree or disagree with each of the following statements.

39. The prison is located too far away for your child(ren) to have regular visits, or is too hard for the child(ren)’s mother or caretaker to get to because of transportation issues.

Strongly agree

Agree

Disagree

Strongly disagree

40. Visitor admission rules (such as background checks, dress codes, searches, metal detectors) are hard for your child(ren) to deal with.

Strongly agree

Agree

Disagree

Strongly disagree

41. The cost of visiting is too high for the child(ren)’s mother or caretaker to bring them as often as she would like to.

Strongly agree

Agree

Disagree

Strongly disagree

42. Schedule issues, like limited visiting hours and the child(ren)’s mother’s or caretaker’s work schedules, make it hard to find time for visits.

Strongly agree

Agree

Disagree

Strongly disagree

43. The cost of calling or receiving calls is too high, or you do not have access to a phone.

Strongly agree

Agree

Disagree

Strongly disagree

44. The prison is not a pleasant place to visit, or not a place you want your child(ren) to see you.

Strongly agree

Agree

Disagree

Strongly disagree

45. Your child(ren)’s mother or caretaker does not want (him/her/them) to maintain close contact with you while you are incarcerated.

Strongly agree

Agree

Disagree

Strongly disagree

46. You do not want to maintain close contact with your child(ren) while you are incarcerated.

Strongly agree

Agree

Disagree

Strongly disagree

47. Your child(ren)(do/does) not want to maintain close contact with you.

Strongly agree

Agree

Disagree

Strongly disagree

48. You were not in close contact with your child(ren) before this incarceration.

Strongly agree

Agree

Disagree

Strongly disagree

49. What are the two biggest challenges in staying in touch with your child(ren) while you are incarcerated? [MARK TWO ONLY.] [SHOW ONLY OPTIONS FOR WHICH THE R ANSWERED “Yes” ABOVE, PLUS THE “OTHER, SPECIFY” OPTION.]

The prison is located too far away for your child(ren) to have regular visits,
or is too hard for the child(ren)’s mother or caretaker to get to because of
transportation issues

Visitor admission rules (such as background checks, dress codes,
searches, metal detectors) are hard for your child(ren) to deal with.

The cost of visiting is too high for the child(ren)’s mother or caretaker
to bring them as often as she would like to. .

Schedule issues, like limited visiting hours and the child(ren)’s mother’s
or caretaker’s work schedules, make it hard to find time for visits.

The cost of calling or receiving calls is too high, or you do not have
access to a phone

The prison is not a pleasant place to visit, or not a place you want
your child(ren) to see you

Your child(ren)’s mother or caretaker does not want (him/her/them)
to maintain close contact with you while you are incarcerated

You do not want to maintain close contact with your child(ren) while
you are incarcerated

Your child(ren) (do/does) not want to maintain close contact with you

You were not in close contact with your child(ren) before the
incarceration

Some other reason (SPECIFY) _______________________________

Impact of incarceration on relationship with focal child

50. How has your time in prison changed your relationship with (FOCAL CHILD), if at all? Has it made you closer, has it made you drift apart, or has there been no change?

Made you closer

Made you drift apart

No change

51. What concerns or worries do you have about (FOCAL CHILD) during your incarceration? MARK ALL THAT APPLY. [USE SHOWCARD.]

Concerns about there being enough money to support him/her

Concerns about how s/he is doing in school

Concerns about his/her happiness

Concerns about him/her getting teased or threatened by peers

Concerns that you will not be as close emotionally as you were before
this incarceration

Concerns that s/he won’t have a male role model

Concerns that s/he will get in trouble

Or some other concern that I haven’t mentioned (SPECIFY)

52. What is your biggest concern or worry about (FOCAL CHILD) during your incarceration? MARK ONE ONLY. [(SHOW ONLY RESPONSE OPTIONS THAT WERE SELECTED ABOVE.]

Concerns about there being enough money to support him/her

Concerns about how s/he is doing in school

Concerns about his/her happiness

Concerns about him/her getting teased or threatened by peers

Concerns that you will not be as close emotionally as you were before
this incarceration

Concerns that s/he won’t have a male role model

Concerns that s/he will get in trouble

Other (SPECIFY)



PART FOUR
EXPERIENCES SINCE PREVIOUS INTERVIEW

Domain H: Street Time

Street time

(If R has not been released at any point since previous interview, skip to next domain.)

1. In the time since we last interviewed you, how many days were you incarcerated in a prison, jail or juvenile facility?

_____ (# DAYS)

2. Since we last interviewed you, how many days were you hospitalized?

_____ (# DAYS)

3. Since we last interviewed you, how many days were you in a residential treatment program?

_____ (# DAYS)



Domain S: Service Need and Receipt

Now, I’m going to ask you about services you might have received and programs you might have participated in since your last interview. [REFER TO REFERENCE CALENDAR.] I will also ask you which services you might have wanted or needed. We are asking these questions for research purposes only; your answers will not affect the services you receive.

Marriage education (need, receipt, attendance with partner, duration, completion, reasons for not completing)

Created

4. Since your last interview, have you attended any group classes or workshops on healthy marriage or romantic relationships? These sessions would have included other people, not just you or your (SPOUSE/PARTNER).

YES

NO

5. Have you wanted or felt that you needed to attend any group classes or workshops on healthy marriage or romantic relationships?

YES

NO

6. (If received marriage education) How many times have you attended any group classes or workshops on healthy marriage or romantic relationships during this incarceration?

# TIMES |___|___|

7. (If received marriage education and R is not incarcerated) Did you attend these classes or workshops...

While you were still incarcerated,

Since you have been released,

Or both?

Created

8. (If received marriage education) Since your last interview, how many times have you and (SPOUSE/PARTNER) gone together to any group classes or workshops on healthy marriage or romantic relationships?

# TIMES |___|___|

BSF

9. (If received marriage education) About how long did each class, workshop, or group session usually last?

PROBE: In other words, for how many hours did you meet each time?

# HOURS |___|___|

(FI confirmation: So, you had about X sessions each lasting about Y hours?)

Created

10. (If received marriage education) Did you attend some or all of the classes or workshops that were offered or did you stop attending before the classes were over?

Attended all

Attended most

Attended a few

11. (If other than “attended all”) Why did you stop attending the classes or workshops?
MARK ALL THAT APPLY. [USE SHOWCARD.]

You were not interested in the classes/workshops

The classes/workshops were not helpful

(SPOUSE/PARTNER) objected

(SPOUSE/PARTNER) lacked transportation, child care, or had conflicts
with her work schedule and couldn’t attend with you

The location of the classes was not convenient

You or (SPOUSE/PARTNER) had a conflict with the instructor

You or (SPOUSE/PARTNER) had a conflict with participants

You or (SPOUSE/PARTNER) did not agree with discussions/message

You got released or transferred to another institution

You got kicked out

Some other reason (SPECIFY) _____________________________

Marriage and relationship counseling (need, receipt, attendance with partner, duration)

BSF/SMH

12. Since your last interview, have you met with a counselor, therapist, or social worker to work on your relationship with (SPOUSE/PARTNER) in sessions that were not part of a workshop, class, or group? In other words, individual or couple’s counseling sessions that did not include other people besides you or (SPOUSE/PARTNER).

YES

NO

13. Have you wanted or felt that you needed to participate in individual or couple’s counseling sessions to work on your relationship with (SPOUSE/PARTNER)?

YES

NO

BSF

14. (If received marriage counseling) Since your last interview, about how many times have you had these counseling sessions to work on your (marriage/relationship)?

# TIMES |___|___|

15. (If received service and R is not incarcerated) Did you receive this counseling...

While you were still incarcerated,

Since you have been released,

Or both?

Created

16. (If received marriage counseling) Since your last interview, about how many times have you and (SPOUSE/PARTNER) attended these counseling sessions together?

# TIMES |___|___|

BSF

17. (If received marriage counseling) About how long did each session usually last?

# HOURS |___|___|

(FI confirmation: So, you had about X sessions each lasting about Y hours?)

How heard of relationship strengthening services

Created

18. (If received any marriage education or counseling) How did you hear about the relationship strengthening activities in which you participated? PROBE: Who told you about the classes?
MARK ALL THAT APPLY.

Heard about it at an orientation or information session

Heard about it from a friend or fellow inmate

Heard about it from PARTNER/SPOUSE

Saw poster, brochure, or other ad

Referred by case manager or other staff member

Referred by other service agency

Other (SPECIFY) ____________________________________

Skills learned from relationship strengthening services

CHMI

19. (If received any marriage education or counseling) What knowledge or skills did you learn in relationship classes or relationship counseling that helped you improve your relationship with (SPOUSE/PARTNER)? Please select all that apply. [USE SHOWCARD.]

How to talk with (SPOUSE/PARTNER) about things that matter

How to work through problems calmly and fairly

How to calm down when things get heated

How to work together on caring for the child(ren)

How to build and keep each other’s trust

How to work with each other’s feelings about other family members,
ex-partners, and friends

How to deal with stress and life changes together

Other (SPECIFY) ___________________________________

20. (If R selects more than 1 response above) What would you say is the most important skill you learned in your relationship classes or relationship counseling?

How to talk with (SPOUSE/PARTNER) about things that matter

How to work through problems calmly and fairly

How to calm down when things get heated

How to work together on caring for the child(ren)

How to build and keep each other’s trust

How to work with each other’s feelings about other family members,

ex-partners, and friends

How to deal with stress and life changes together

Other (SPECIFY) ___________________________________

Created

21. (If received any marriage education or counseling) How much has your relationship with (SPOUSE/PARTNER) improved as a result of the classes or workshops? Would you say…

A lot

A little

Not at all

Parenting education (need, receipt, duration)

Modified from BSF

22. Since your last interview, have you attended any classes, groups, or workshops to help you improve your parenting skills or learn to be a better parent?

YES

NO

23. Have you wanted or felt that you needed this service?

YES

NO

24. (If received parenting) How many times have you attended any parenting classes, groups, or workshops during this incarceration?

# TIMES |___|___|

25. (If received service and R is not incarcerated) Did you attend these classes/groups/workshops...

While you were still incarcerated,

Since you have been released,

Or both?

BSF

26. (If received parenting) About how long did each class, workshop, or group session usually last? PROBE: In other words, for how many hours did you meet each time?

# HOURS |___|___|

(FI confirmation: So, you had about X sessions each lasting about Y hours?)

Case management (need, receipt, duration, referrals, follow-up)

SVORI

27. Since your last interview, have you met with a staff member who talks with you about issues or needs you have, tries to get you into services or programs, helps you get benefits or assistance, and/or monitors your progress? These services are called case management and the person might be called a case manager, case worker, social worker, transition coordinator, or systems navigator.

YES

NO

28. Have you wanted or felt that you needed this service?

YES

NO

29. (If received case management) How many sessions of case management have you received during this incarceration?

___( # SESSIONS)

30. (If received service and R is not incarcerated) Did you receive this case management...

While you were still incarcerated,

Since you have been released,

Or both?

31. (If received case management) Has a case manager referred you to any of the following kinds of services or benefits? Please select all that apply. [USE SHOWCARD.]

Marriage or relationship education

Parenting education

Job training or employment readiness

Money management training

Other life skills training

Support groups

Marriage or relationship counseling

Mental health treatment

Substance abuse treatment

Other counseling

Housing program

Health benefits program

Public assistance, such as TANF or food stamps

Legal services

32. (If received case management) Has a case manager followed up to make sure you received those services?

YES

NO

Substance abuse and mental health treatment (need, receipt)

Modified from BSF

33. Since your last interview, have you received counseling, therapy, or other treatment to help you deal with an emotional or mental health problem?

YES

NO

34. Have you wanted or felt that you needed this service?

YES

NO

35. (If received service and R is not incarcerated) Did you receive this counseling/therapy/treatment...

While you were still incarcerated,

Since you have been released,

Or both?

36. Since your last interview, have you received counseling, self-help groups, group sessions, or other treatment to help you deal with alcohol or substance abuse?

YES

NO

37. Have you wanted or felt that you needed this service?

YES

NO

38. (If received service and R is not incarcerated) Did you receive this alcohol or substance abuse treatment...

While you were still incarcerated,

Since you have been released,

Or both?

Other support services (need, receipt)

BSF modified

39. Since your last interview, have you received services or taken a course to help you manage anger?

YES

NO

40. Have you wanted or felt that you needed this service?

YES

NO

41. (If received service and R is not incarcerated) Did you participate in anger management services...

While you were still incarcerated,

Since you have been released,

Or both?

Created

42. Since your last interview, have you received services or taken a course for men to learn how to avoid hurting or abusing their partners?

YES

NO

43. Have you wanted or felt that you needed this service?

YES

NO

44. (If received service and R is not incarcerated) Did you participate in these services...

While you were still incarcerated,

Since you have been released,

Or both?

Created

45. Since your last interview, have you participated in any GED, adult basic education, or college courses?

YES

NO

46. Have you wanted or felt that you needed this service?

YES

NO

47. (If received service and R is not incarcerated) Did you participate in these courses...

While you were still incarcerated,

Since you have been released,

Or both?

SVORI

48. Since your last interview, have you participated in any employment readiness, vocational or job training programs?

YES

NO

49. Have you wanted or felt that you needed this service?

YES

NO

50. (If received service and R is not incarcerated) Did you participate in this training...

While you were still incarcerated,

Since you have been released,

Or both?

Created

51. Since your last interview, have you participated in any money management or financial planning programs?

YES

NO

52. Have you wanted or felt that you needed this service?

YES

NO

53. (If received service and R is not incarcerated) Did you participate in money management or financial planning classes...

While you were still incarcerated,

Since you have been released,

Or both?

54. Since your last interview, have you participated in any other life skills education?

YES

NO

55. Have you wanted or felt that you needed this service?

YES

NO

56. (If received service and R is not incarcerated) Did you participate in other life skills education...

While you were still incarcerated,

Since you have been released,

Or both?

57. Since your last interview, have you received any help finding housing or paying for housing for when you are released?

YES

NO

58. Have you wanted or felt that you needed this service?

YES

NO

59. (If received service and R is not incarcerated) Did you receive this housing-related help...

While you were still incarcerated,

Since you have been released,

Or both?

60. Since your last interview, have you received any assistance with retaining your parental rights or changing child custody arrangements?

YES

NO

61. Have you wanted or felt that you needed this service?

YES

NO

62. (If received service and R is not incarcerated) Did you receive this assistance...

While you were still incarcerated,

Since you have been released,

Or both?

63. Since your last interview, have you participated in any family group conferencing or family mediation? We mean meetings with your family members, such as your (SPOUSE/PARTNER), child(ren), or other family members to discuss issues and set goals for the future.,

YES

NO

64. Have you wanted or felt that you needed this service?

YES

NO

65. (If received service and R is not incarcerated) Did you participate in family group conferencing/family mediation...

While you were still incarcerated,

Since you have been released,

Or both?

66. Since your last interview, have you participated in any support groups? We mean a group of individuals who meet regularly to discuss personal or interpersonal issues.

YES

NO

67. Have you wanted or felt that you needed this service?

YES

NO

68. (If received service and R is not incarcerated) Did you participate in support groups...

While you were still incarcerated,

Since you have been released,

Or both?

69. Since your last interview, have you received spiritual or religious assistance from any faith-based organizations or people? For example, this would include meeting with a chaplain, minister, or other clergy member.

YES

NO

70. Have you wanted or felt that you needed this service?

YES

NO

71. (If received service and R is not incarcerated) Did you receive this spiritual or religious assistance...

While you were still incarcerated,

Since you have been released,

Or both?


Domain N: Parenting

Financial support for focal child

72. Since your last interview, have you financially supported (FOCAL CHILD) in any way?

YES

NO

73. (If yes) In what way or ways have you provided financial support for (FOCAL CHILD) since your last interview? Please include support you provided to the child directly as well as support you provided to the child’s other parent or caretaker. [USE SHOWCARD.]

Giving (FOCAL CHILD) birthday or holiday gifts

Taking (FOCAL CHILD) shopping for clothing, school supplies, or other

things s/he needs

Helping out occasionally with bills, rent or other expenses in the child’s

household

Providing steady, regular financial support of up to $100 per month

Providing steady, regular financial support of $100-$200 per month

Providing steady, regular financial support of $200-$300 per month

Providing steady, regular financial support of over $300 per month



PART FIVE
EXPERIENCES SINCE RELEASE


(If R has not yet been released, skip to Part 4: Expectations for Release)


The next set of questions deal with your experiences since you were released from prison for the term during which we first interviewed you. [REFER TO REFERENCE CALENDAR]

Domain U: First 24 Hours

First 24 hours

First, I’m going to ask you about things that happened to you during the first 24 hours after you were released.

SVORI

1. On the day that you were released from incarceration, was anyone at the institution to meet you when you were released?

YES

NO

2. (If yes) Who was there to meet you? Please indicate all that apply.

(SPOUSE/PARTNER)

Your child/children

Other family member(s)

A friends/friends

A parole or probation officer

A case worker or case manager

A mentor

Some other type of person (SPECIFY:)

3. On the day that you were released from incarceration, did you report to a parole or probation officer?

YES

NO

4. On the day that you were released from incarceration, did you see or talk to anyone from a service agency?

YES

NO

5. Where did you sleep the first night out of incarceration? Please indicate all that apply.

In your own house or apartment, meaning your name is on the title,
mortgage, or lease

In someone else’s house or apartment

In a transitional housing building or halfway house

In a motel/hotel or rooming house

In a residential treatment facility

In a shelter

On the street

In an outdoor location where you camped out

In an abandoned building or vacant unit

In some other place

6. At the time of release, did you have a photo ID?

YES

NO

7. (If no) Have you gotten a new photo ID since your release from prison?

YES

NO

8. Overall, in the first 24 hours after your release from incarceration, how prepared did you feel to live on the outside?

Very prepared

Prepared

Unprepared

Very unprepared



Domain I: Employment Status

NSAF

Next, I’d like to ask a few questions about your employment.

9. At any point since you were released from incarceration, have you worked at a job? [REFER TO REFERENCE CALENDAR.] (IF R HAD A JOB BUT WAS TEMPORARILY NOT WORKING BECAUSE OF SICKNESS, VACATION, STRIKE, BAD WEATHER, ETC, COUNT AS EMPLOYED.)

YES

NO

10. (If R has had a job and is not reincarcerated) Are you currently working at a job?

YES

NO


Employment duration

11. (If R has had a job) How many months have you worked since your release from prison?

_____ (# MONTHS)

Full/part time

SVORI

12. (If R has had a job) Is your current/most recent job…

Part time

Full time

Type of employment

SVORI

13. (If R has had a job) Is your current/most recent job…

Formal pay (a job that has a pay stub)

Self-employment

Casual pay (a job that is “under the table” or “off the books”)

Earnings

SVORI

14. (If R has had a job) How much do/did you earn from your current/most recent job before taxes including any tips, bonuses, and commissions? Responses could be per hour, per day, per week, per two weeks, per month, or per year.

___________ dollars

per hour

per day

per week

every 2 weeks

per month

per year

Benefits

SVORI

15. (If R has had a job) Does your current/did your most recent job provide health insurance coverage?

YES

NO

SVORI

16. (If R has had a job) Are/were you entitled to any fully paid leave, such as sick leave, paid holidays or vacation leave from your employer?

YES

NO

Difficulty finding/keeping a job

17. How easy or hard (if R is currently working: was it) has it been to get a job?

Very easy

Pretty easy

Pretty hard

Very hard

18. (If R has had a job since release) How easy or hard has it been to keep a job?

Very easy

Pretty easy

Pretty hard

Very hard

Barriers to employment

19. Please tell me whether any of the following factors have made it difficult for you to look for a job, get a job or keep a job. Select all that apply.

Not having work experience

Not having child care

Lack of transportation

Not speaking English well

Lack of reading skills

Lack of vocational training or certification

Lack of educational background

Having a disability or serious medical condition

Lack of jobs in the neighborhood

Having a drug or alcohol problem

The job required drug tests

Having a criminal record

Discrimination other than having a criminal record

Being on parole or community supervision

Some other reason, specify: __________________________

Number of employer contacts/interviews

20. How many employers have you contacted since your release?

None

1

2-5

6-10

More than 10

21. How many job interviews have you had since your release?

None

1

2-5

6-10

More than 10

Unemployment insurance

22. Have you collected any Unemployment Insurance since your release?

YES

NO

Domain K: Income

Difficulty supporting oneself

Returning Home

23. How easy or hard has it been to make enough money to support yourself?

Very easy

Pretty easy

Pretty hard

Very hard

Income sharing with partner

24. Do you and your partner share income and expenses with each other? This could include sharing rent, splitting bills or other expenses, or sharing assets like a bank account. [REFER TO REFERENCE CALENDAR.]

YES

NO

Sources of support

BSF (modified)

Next I’m going to read a list of income sources. For each, tell me if you have received income from this source since your release from incarceration. [REFER TO REFERENCE CALENDAR.] [USE SHOWCARD.]

25. Cash welfare, also known as TANF? You may have received this benefit as an electronic transfer, a check or on a bank or debit card. PROBE: TANF is Temporary Assistance for Needy Families.

YES

NO

26. (If partner shares expenses with R) Has (SPOUSE/PARTNER) received income from this source since your release?

YES

NO

27. Other public assistance, such as food stamp benefits, support from the Indian Health Service, disability insurance such as Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), or unemployment insurance benefits (UI)? You may have received these benefits as coupons, electronic transfer, or as an EBT or debit card.

YES

NO

28. (If partner shares expenses with R) Has (SPOUSE/PARTNER) received income from this source since your release?

YES

NO

29. Child support payments?

YES

NO

30. (If partner shares expenses with R) Has (SPOUSE/PARTNER) received income from this source since your release?

YES

NO

31. Money from friends or relatives who do not live with you?

YES

NO

32. (If partner shares expenses with R) Has (SPOUSE/PARTNER) received income from this source since your release?

YES

NO

33. Formal employment? By “formal,” we mean a job that you received a pay stub for, and for which taxes were taken out of your pay.

YES

NO

34. (If partner shares expenses with R) Has (SPOUSE/PARTNER) received income from this source since your release?

YES

NO

35. “Under the table” or casual work. By “under the table,” we mean work that you did not receive a pay stub for, for which taxes were not taken out of your pay. This could include things you were paid in cash for, like babysitting or mowing lawns.

YES

NO

36. (If partner shares expenses with R) Has (SPOUSE/PARTNER) received income from this source since your release?

YES

NO

37. Illegal activities, such as selling drugs, breaking and entering , etc.

YES

NO

38. (If partner shares expenses with R) Has (SPOUSE/PARTNER) received income from this source since your release?

YES

NO

Domain J: Housing

Type of housing

Multi-Site Adult Drug Court Study

39. At any point since your release from incarceration, have you lived in these places? [REFER TO REFERENCE CALENDAR.] [USE SHOWCARD.] (SELECT ALL THAT APPLY.)

In your own house or apartment, meaning your name is on the title, mortgage, or lease

In someone else’s house or apartment

In a transitional housing building or halfway house

In a motel/hotel or rooming house

In a residential treatment facility

In a shelter

On the street

In an outdoor location where you camped out

In an abandoned building or vacant unit

In some other place

40. (if R lived in more than one place) Since your release, where have you mostly lived? (SELECT ONE.)

In your own house or apartment, meaning your name is on the title, mortgage, or lease

In someone else’s house or apartment

In a transitional housing building or halfway house

In a motel/hotel or rooming house

In a residential treatment facility

In a shelter

On the street

In an outdoor location where you camped out

In an abandoned building or vacant unit

In some other place

41. (If R only lived OR mostly lived in own home or someone else’s home) Is the (house/apartment) public housing? Public housing is defined as a unit in a building owned by a public housing authority.

YES

NO

42. (if no) Is the (house/apartment) Section 8? Section 8 housing is where a section 8 voucher is being used to pay for part or all of your rent for a privately owned unit.

YES

NO

Number of places lived

43. Since your release, how many different places have you lived?

______ (NUMBER)

People living with & Living with partner

44. Since your release, have you lived with (SPOUSE/PARTNER)?

YES

NO

45. (If yes) Are you currently living with (SPOUSE/PARTNER)?

YES

NO

46. Since your release, have you lived with (FOCAL CHILD)?

YES

NO

47. (If yes) Are you currently living with (FOCAL CHILD)?

YES

NO



Ask for each of R’s remaining children:

48. Since your release, have you lived with (CHILD)?

YES

NO

49. Who else have you lived with since your release? Please list everyone who has lived with you at some point since your release. [SELECT ALL THAT APPLY.]

NO ONE ELSE

SPOUSE OR ROMANTIC PARTNER

EX-SPOUSE OR ROMANTIC PARTNER

MOTHER/STEPMOTHER

FATHER/STEPFATHER

Sister/stepsister

Brother/stepbrother

Aunt/Uncle, Great Aunt/Uncle

Cousin

Grandparent

other Children/stepchildren

Friend OF R

FRIEND OF R’S PARTNER

SOME Other PERSON, NOT A FRIEND OR FAMILY MEMBER

(SPECIFY) _____________________________________________

Barriers to housing

50. Since your release, have you had trouble finding a place to live?

YES

NO

51. (If yes to above): Why did you have trouble finding a place to live? (SELECT ALL THAT APPLY.)

You were unable to obtain public housing or a Section 8 voucher

You were unable to stay with friends or family who live in public housing
or a Section 8 unit

You were unable to obtain a lease on a non-public housing home
or apartment

You were unable to stay with friends or family in a non-public housing
home or apartment

You were unable to find a bed in a long-term shelter or supportive
housing

You had no money for a housing deposit

There were no public housing vouchers available

It was too expensive in your neighborhood

Some other reason, specify: ____________________

Neighborhood characteristics

SVORI/Returning Home

52. Please tell me whether you strongly disagree, disagree, agree, or strongly agree with the following statements about the neighborhood where you mainly live (if reincarcerated: lived).

    1. It is hard to stay out of trouble in your neighborhood or community.

Strongly agree

Agree

Disagree

Strongly disagree

    1. Drug selling is a major problem in your neighborhood or community.

Strongly agree

Agree

Disagree

Strongly disagree

    1. Your neighborhood or community is a good place to live.

Strongly agree

Agree

Disagree

Strongly disagree

    1. Your neighborhood or community is a good place to find a job.

Strongly agree

Agree

Disagree

Strongly disagree


Domain L: Social Support

This next set of questions deals with the kinds of support you have received from your friends and family since your release.

Number of friends

Social Capital Community Benchmark Survey

First, I will ask about your friends. Please do not count any family members as you answer these questions.

53. How many close friends do you have? These are people you feel at ease with, can talk to about private matters, or can call on for help. Would you say you have no close friends, one or two, 3-5, 6-10, or more than that?

No close friends

One or two

Three to five

Six to ten

More than ten

Negative/positive peer exposure

Returning Home/SVORI (modified)

Think about the people you have spent time with since your release, other than your partner and other family members.

54. Of the people you spend time with, how many have ever been in prison? [USE SHOWCARD.]

All

Most

Some

None

55. Of the people you spend time with, how many are employed full time?

All

Most

Some

None

56. Of the people you spend time with, how many can you hang out with and know that you won’t get in trouble?

All

Most

Some

None

57. Of the people you spend time with, how many use illegal drugs?

All

Most

Some

None

Created

58. How often do the people you spend time with convince you to do things you know you shouldn’t be doing?

Often

Sometimes

Rarely

Never


Support from friends

59. Do you have a friend who will loan you money if you need it?

YES

NO

60. Do you have a friend who will provide you with a place to live if you need it?

YES

NO

61. Do you have a friend who will help you with transportation to work or other appointments if you need it?

YES

NO

62. Have your friends been as helpful as you hoped they would be after your release from incarceration?

YES

NO

Number of close family members

Next, I’d like to know about family members other than your spouse/partner or children.

63. How many close family members do you currently have? These are people you feel at ease with, can talk to about private matters, or can call on for help. Would you say you have no close family members, one or two, 3-5, 6-10, or more than that?

No close family members

One or two

Three to five

Six to ten

More than ten

Support from “other family members”

Created

64. Do you have a family member who will loan you money if you need it?

YES

NO

65. Do you have a family member who will provide you with a place to live if you need it?

YES

NO

66. Do you have a family member who will help you with transportation to work or other appointments if you need it?

YES

NO

67. Have your family been as helpful as you hoped they would be after your release from incarceration?

YES

NO


Domain M: Intimate Partner Violence

(If R is incarcerated)

Now, I’m going to ask you some questions about your romantic relationship since your release (If reincarcerated: but before your reincarceration). [REFER TO REFERENCE CALENDAR.] Please remember that your answers cannot be shared with your family, friends or acquaintances under any circumstances.

Psychological abuse

Thinking about the time since your release, please tell me how much of the time each of these statements was true.

68. How often have you felt safe in your relationship with your spouse/partner? Would you say…

Often

Sometimes

Rarely

Never

TX HM

69. Your spouse/partner has become jealous or possessive. Would you say…

Often

Sometimes

Rarely

Never

TX HM

70. Your spouse/partner has made you feel like you were not good enough. Would you say…

Often

Sometimes

Rarely

Never


Conflict tactics

SMH/BSF (Modified from Conflict Tactics Scale)

No matter how well a couple gets along, there are times when they disagree or have fights. I am going to read a list of things that might happen when you have differences. First, tell me how many times since your release from incarceration (If reincarcerated: but prior to your reincarceration) you have done the following. Then I’ll ask you how many times (SPOUSE/PARTNER) has done the following. [REFER TO REFERENCE CALENDAR.] [USE SHOWCARD.]

71. Since your release from incarceration, how many times have you thrown something at your spouse/partner?

None

1 time

2 times

3-5 times

6 or more times

72. Since your release from incarceration, how many times has your spouse/partner thrown something at you?

None

1 time

2 times

3-5 times

6 or more times

73. Since your release from incarceration, how many times have you pushed, shoved, hit, slapped, or grabbed your spouse/partner?

None

1 time

2 times

3-5 times

6 or more times

74. Since your release from incarceration, how many times has your spouse/partner pushed, shoved, hit, slapped, or grabbed you?

None

1 time

2 times

3-5 times

6 or more times

75. Since your release from incarceration, how many times have you used a knife or gun on your spouse/partner?

None

1 time

2 times

3-5 times

6 or more times

76. Since your release from incarceration, how many times has your spouse/partner used a knife or gun on you?

None

1 time

2 times

3-5 times

6 or more times

77. Since your release from incarceration, how many times have you choked, slammed, kicked, burned, or beat your spouse/partner?

None

1 time

2 times

3-5 times

6 or more times

78. Since your release from incarceration, how many times has your spouse/partner choked, slammed, kicked, burned, or beat you?

None

1 time

2 times

3-5 times

6 or more times

79. Since your release from incarceration, how many times have you used force to make your spouse/partner have sex? (PROBE: Force means things like hitting, holding down, or using a weapon)

None

1 time

2 times

3-5 times

6 or more times

80. Since your release from incarceration, how many times has your spouse/partner used force to make you have sex? (PROBE: Force means things like hitting, holding down, or using a weapon)

None

1 time

2 times

3-5 times

6 or more times

81. Since your release from incarceration, how many times have you threatened to hurt your spouse/partner?

None

1 time

2 times

3-5 times

6 or more times

82. Since your release from incarceration, how many times has your spouse/partner threatened to hurt you?

None

1 time

2 times

3-5 times

6 or more times

83. Since your release from incarceration, how many times have you threatened to hurt your spouse/partner’s children, family members, or other loved ones?

None

1 time

2 times

3-5 times

6 or more times

84. Since your release from incarceration, how many times has your spouse/partner threatened to hurt your children, family members, or other loved ones?

None

1 time

2 times

3-5 times

6 or more times

85. Since your release from incarceration, how many times have you tried to keep your spouse/partner from seeing or talking with her friends or family?

None

1 time

2 times

3-5 times

6 or more times

86. Since your release from incarceration, how many times has your spouse/partner tried to keep you from seeing or talking with your friends or family?

None

1 time

2 times

3-5 times

6 or more times

87. Since your release from incarceration, how many times have you kept money from your spouse/partner, made her ask for money, or taken money from her?

None

1 time

2 times

3-5 times

6 or more times

88. Since your release from incarceration, how many times has your spouse/partner tried to keep money from you, made you ask for money, or taken money from you?

None

1 time

2 times

3-5 times

6 or more times


Domain V: Partner Relationship Quality

Difficulty establishing/re-establishing relationship with partner

Returning Home

89. How easy or hard has it been to have a good relationship with SPOUSE/PARTNER since your release?

Very easy

Pretty easy

Pretty hard

Very hard

90. Since your release, what have been the biggest challenges in your relationship with your partner? [MARK ALL THAT APPLY.]

Finding her

Being able to feel close to her again after the time in prison

Being able to trust her after the time in prison

Problems or new situations that came up during your incarceration

Having missed out on so much that happened in her life while you were

incarcerated

Trying to meet her expectations for you related to finding a job, staying clean,
helping her financially

Being angry at her or not wanting to see her

Her being angry at you or not wanting to see you

Some other challenge (SPECIFY):___________________________

Support to/from partner

Please tell me whether you strongly agree, agree, disagree, or strongly disagree with the following statements about you and (SPOUSE/PARTNER) have treated one another since your release.

91. Since your release, you have stood by (SPOUSE/PARTNER) no matter what.

Strongly agree

Agree

Disagree

Strongly disagree

92. You have loved (SPOUSE/PARTNER) and made her feel wanted.

Strongly agree

Agree

Disagree

Strongly disagree

93. You have helped (SPOUSE/PARTNER) with problems she has faced.

Strongly agree

Agree

Disagree

Strongly disagree

94. Since your release, (SPOUSE/PARTNER) has stood by you no matter what.

Strongly agree

Agree

Disagree

Strongly disagree

95. (SPOUSE/PARTNER) has loved you and made you feel wanted.

Strongly agree

Agree

Disagree

Strongly disagree

96. (SPOUSE/PARTNER) has helped you with problems you have faced.

Strongly agree

Agree

Disagree

Strongly disagree

Domain N: Parenting

This next set of questions is about your experiences with parenting (FOCAL CHILD) since your release from incarceration.

Co-parental conflict about focal child

97. (If spouse/partner is coparent to focal child) How often have you and (SPOUSE/PARTNER) stood by a discipline or parenting decision, even if one of you did not like the decision? [REFER TO REFERENCE CALENDAR.]

Often

Sometimes

Rarely

Never

98. Have you and (SPOUSE/PARTNER) often, sometimes, hardly ever, or never had arguments about (FOCAL CHILD)?

Often

Sometimes

Rarely

Never

Decision-making about focal child

99. Who has made major decisions about things such as child care and health care for (FOCAL CHILD)? Would you say...

You and the child's mother or main caretaker have made most decisions

together

The child's mother or main caretaker has made most decisions herself

You have made most decisions yourself

(If R is not incarcerated, and has any children whom he does not live with))

The next set of questions is about keeping in touch with your child(ren) since you have been released.

Importance of contact with non-resident children

Thinking about your child(ren) who do(es) not live with you, I’d like to know how much you agree or disagree with the following statement.

100. Keeping in touch with your child(ren) is very important to you. Do you...

Strongly agree

Agree

Disagree

Strongly disagree

Post-release contact with non-resident children

Now, I’d like to ask about specific contact you may have had with the child(ren) of yours who do(es) not live with you. [REFER TO REFERENCE CALENDAR.] [USE SHOWCARD.]

SVORI (modified)

101. How often do you currently talk on the phone with this child/any of these child(ren)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

A couple of times a year or less

Never

(If never, skip to question about sending mail.)

102. (If R has more than 1 child) How many of your children do you currently talk on the phone with?

[RECORD NUMBER.] ______________

103. (If focal child is non-resident) Do you currently talk on the phone with (FOCAL CHILD)?

YES

NO

104. How often do you currently send mail to your child(ren)?

One or more times a week

A couple of times a month

About once a month

Every couple of months

A couple of times a year or less

Never

(If never, skip to question about receiving mail.)

105. (If R has more than 1 child) How many of your children do you currently send mail to?

_______ (# of children)

106. (If focal child is non-resident) Do you currently send mail to (FOCAL CHILD)?

YES

NO

107. How often do you see your child(ren) in person?

One or more times a week

A couple of times a month

About once a month

Every couple of months

A couple of times a year or less

Never

(If never, skip to next domain.)

108. (If R has more than 1 child) How many of your children do you currently see in person?

_______ (# CHILDREN)

109. (If R does not live with focal child): How often do you see (FOCAL CHILD) in person?

One or more times a week

A couple of times a month

About once a month

Every couple of months

Only a couple of times

Never


Frequency of eating meals with focal child

110. (If R lives with focal child, or sees focal child one or more times a week) In a typical week since your last interview, how many days did you eat at least one meal with (FOCAL CHILD)? [REFER TO REFERENCE CALENDAR.]

ONE DAY

TWO DAYS ……….

THREE DAYS

FOUR DAYS

FIVE DAYS ……….

SIX DAYS

SEVEN DAYS


Difficulty establishing/re-establishing relationship with focal child

111. How easy or hard has it been to have a good relationship with (FOCAL CHILD) since your release?

Very easy

Pretty easy

Pretty hard

Very hard

Created

112. What have been the biggest challenges in your relationship with (FOCAL CHILD) since your release? [MARK ALL THAT APPLY.]

Finding him/her

Having missed out on so much that happened with him/her while you were
incarcerated

Getting (FOCAL CHILD) to trust you or open up to you after the time apart

Finding transportation for visits or activities with (FOCAL CHILD)

Dealing with people who don’t want you to see (FOCAL CHILD)

Not being in a stable enough housing and financial situation to be able to
spend time with (FOCAL CHILD)

Your lifestyle not being a healthy one for kids

(FOCAL CHILD) being angry at you or not wanting to see you

Some other challenge (SPECIFY)___________________________



Impact of incarceration on relationship with focal child

113. How has your relationship with (FOCAL CHILD) changed since you were released? Has being released made you closer, has it made you drift apart, or has there been no change?

Made you closer

Made you drift apart

No change


Domain O: Substance Use

(If R is incarcerated)

Substance use

114. Please tell me which of the following substances you have used since your release, even just once. [REFER TO REFERENCE CALENDAR.] [SELECT ALL THAT APPLY.] [USE SHOWCARD.]

Alcohol

Marijuana or hashish

Powder cocaine

Crack cocaine

Heroin (this includes smoking, sniffing, snorting, and injecting heroin)

Methamphetamine

Other amphetamines, such as monster, crank, or ice

Hallucinogens or designer drugs, such as ecstasy, LSD or acid, mushrooms, mescaline,
peyote, green, PCP, or angel dust

Prescription medication without a prescription or for other reasons than were prescribed,
or in larger amounts, or more often than your doctor ordered. This includes sedatives,
tranquilizers, stimulants, pain relievers, opiates, or anabolic steroids.

Methadone without a prescription or for other reasons than were prescribed, or in larger
amounts, or more often than your doctor ordered.

Did not use any alcohol or drugs

(If R reports no alcohol or drug use since release, skip to Physical and Mental Health domain.)

115. Which of the following have you used the most since your release? (SELECT ONE.) READ LIST OUT LOUD. (Show only response categories that were selected by the R in the prior question.)

Alcohol

Marijuana or hashish

Powder cocaine

Crack cocaine

Heroin (this includes smoking, sniffing, snorting, and injecting heroin)

Methamphetamine

Other amphetamines, such as monster, crank, or ice

Hallucinogens or designer drugs, such as ecstasy, LSD or acid, mushrooms, mescaline,
peyote, green, PCP, or angel dust

Prescription medication without a prescription or for other reasons than were prescribed,
or in larger amounts, or more often than your doctor ordered. This includes sedatives,
tranquilizers, stimulants, pain relievers, opiates, or anabolic steroids.

Methadone without a prescription or for other reasons than were prescribed, or in larger
amounts, or more often than your doctor ordered.

Addiction severity

CAGE

116. Since your release from incarceration, [REFER TO REFERENCE CALENDAR.]



  1. (If R reported any alcohol use) Have you felt you should cut down on your drinking?

YES

NO

  1. (If R reported any alcohol use) Have people complained about your drinking?

YES

NO

  1. (If R reported any alcohol use) Have you felt bad or guilty about your drinking?

YES

NO

  1. (If R reported any alcohol use) Have you had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?

YES

NO

  1. (If R reported any drug use) Have you felt you should cut down on your drug use?

YES

NO

  1. (If R reported any drug use) Have people annoyed you by complaining about your drug use?

YES

NO

  1. (If R reported any drug use) Have you felt bad or guilty about your drug use?

YES

NO

Anger and addiction

117. (If R reported any AOD use) Since your release from incarceration, how often have you experienced problems with anger when you have been drinking or using drugs? [REFER TO REFERENCE CALENDAR.]

Often

Sometimes

Rarely

Never

118. (If R reported any AOD use) Since your release from incarceration, how often have you physically hurt or gotten rough with your (SPOUSE/PARTNER) or other family members when you have been drinking or using drugs?

Often

Sometimes

Rarely

Never

Binge drinking

National Survey on Drug Use and Health

119. (If R reported any alcohol use) Since your release from incarceration, how often have you had 5 or more drinks of beer, wine, or liquor on the same occasion? By "drink," we mean a bottle or can of beer, a wine cooler or a glass of wine, a shot of liquor, or a mixed drink or cocktail. By "occasion," we mean at the same time or within a couple of hours of each other. [REFER TO REFERENCE CALENDAR.]

Often

Sometimes

Rarely

Never

Domain P: Physical and Mental Health

The next questions are about your experiences with health care and health insurance during your incarceration and since you were released.

Continuity of medication use

120. During your most recent incarceration, were you taking prescription medications on a regular basis?

YES

NO

121. Did the prison give you a supply of medications or a prescription to take with you upon your release?

YES

NO

122. Are you still taking all of the same type of medication(s) you had been taking in prison?

YES

NO

123. (If no) What is the main reason you stopped taking the medication(s) you were taking in prison? Of these, which best describes the main reason.

You couldn’t afford it

You couldn’t afford to see a doctor to get a prescription

You decided you don’t need it

You didn’t like the side effects

You forgot about it

Something else (SPECIFY)

Health insurance

124. Since your release from incarceration, have you been covered by Medicaid, (CA: Medi-Cal), Medicare, Champus, Indian Health Services, or any other government program that pays for medical care? [REFER TO REFERENCE CALENDAR.]

YES

NO

125. Since your release from incarceration, have you been covered by health insurance through your or someone else’s employer, or insurance you purchased directly from a private insurance company?

YES

NO

Unmet need

126. Since your release from incarceration, have you, your spouse/partner or your child(ren) ever needed to see a doctor or go to the hospital but couldn’t go because of the cost?

YES

NO



Domain W: Criminal Behavior

Supervision status

127. At any point since your release, have you been on probation or parole?

Yes, probation

Yes, parole

Neither probation nor parole

128. (If R has been on probation or parole, ask) Are you currently on probation/parole?

YES

NO



Duration of supervision

129. (If currently on probation/parole) How much more of your supervision term do you have left to serve?

_____ (# MONTHS)

Compliance with supervision

130. (If R has been on probation or parole, ask) Since you were released from incarceration (if reincarcerated: the term of incarceration you were serving when we first interviewed you), have you ever failed to comply with any conditions of your supervision?

YES

NO

Criminal behavior

131. Now, I would like to ask you about any illegal activity you may have participated in since your release from prison. Since your release, have you committed any of the following? (CHECK ALL THAT APPLY.)

Burglary

Robbery

Assault

Car theft

Theft

Fraud or forgery

Drug dealing

Drug possession

Other crime types (specify)

Arrests

132. Since your release, have you been arrested? Please count all arrests, not just those that led to a conviction.

YES

NO

133. (If arrested) How many times have you been arrested since your release?

_____ (# ARRESTS)



Reincarceration

134. Since your release, have you been back in a jail or prison for more than 24 hours at one time?

YES

NO

135. (If yes) How many separate times have you been sent to prison or jail since your release?

_____ (# TIMES)



Factors associated with desistance

136. (If R has not been back in jail/prison) What do you think has made the most difference in terms of keeping you out of trouble since being released from incarceration? Select all that apply.

You found a good job

Your spouse/partner is supportive

Other family members are supportive

You wanted to change for your children’s sake

You stopped associating with friends that got you into trouble

You found a good place to live

You live in a safe neighborhood where it is easy to stay out of trouble

You stopped using drugs or alcohol

You got the services you needed

You learned how to deal with the stress or pressure in your life

Your religion or spirituality has helped you stay out of trouble

137. (If R has not been back in jail/prison) Of the reasons that you just indicated, which three do you think have made the most difference in terms of keeping you out of trouble since being released from incarceration?

You found a good job

Your spouse/partner is supportive

Other family members are supportive

You wanted to change for your children’s sake

You stopped associating with friends that got you into trouble

You found a good place to live

You live in a safe neighborhood where it is easy to stay out of trouble

You stopped using drugs or alcohol

You got the services you needed

You learned how to deal with the stress or pressure in your life

Your religion or spirituality has helped you stay out of trouble



Factors associated with recidivism

138. (If R has been back in jail/prison) What would you say are the main reasons that you got in trouble and went back to a correctional facility? Select all that apply.

You could not find a good job

You experienced problems with your spouse/partner

You experienced problems with other family members

You associated with friends that got you into trouble

You could not find a place to live

You lived in a neighborhood where it was easy to get in trouble

You were using drugs or alcohol

You couldn’t get the services you needed

You were under too much stress or pressure

139. (If R has been back in jail/prison) Of the reasons that you just indicated, what would you say are the three main reasons that you got in trouble and went back to a correctional facility?

You could not find a good job

You experienced problems with your spouse/partner

You experienced problems with other family members

You associated with friends that got you into trouble

You could not find a place to live

You lived in a neighborhood where it was easy to get in trouble

You were using drugs or alcohol

You couldn’t get the services you needed

You were under too much stress or pressure

Readiness for change regarding criminal behavior

SVORI

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

140. You are tired of the problems caused by the crimes you committed.

Strongly agree

Agree

Disagree

Strongly disagree

141. You want to get your life straightened out.

Strongly agree

Agree

Disagree

Strongly disagree

142. You will give up friends and hangouts that get you into trouble.

Strongly agree

Agree

Disagree

Strongly disagree

143. You are willing to accept help to not commit crimes.

Strongly agree

Agree

Disagree

Strongly disagree


Domain X: Reincarceration Characteristics

Incarceration duration

144. (If reincarcerated) Please tell me the date you were incarcerated for this term of incarceration. I’m asking for the date you entered incarceration this time, not the date of your sentencing.

___________________(MM/DD/YYYY)


145. (If reincarcerated) That means you have been incarcerated for {calculated length of incarceration based on current date and response to above item}. Is this correct?

YES

NO

Created

146. (If reincarcerated) Do you expect to be released from this incarceration?

YES

NO

147. (If yes) When do you expect to be released from this incarceration?

___________ (MM/DD/YYYY)



Instant offense

148. (If reincarcerated) Are you currently serving time because of a parole or probation violation?

YES

NO

149. (if yes to either parole or probation violation) Was the [parole/probation] violation for a technical violation, like failing to report or having a dirty analysis, or for a new crime? (ALLOW BOTH)

Technical violation

New crime

150. (If yes to new crime) What crime were you charged with for the new crime? Select all that apply. [USE SHOWCARD.]

Homicide

Rape

Other sex offense (not rape)

Robbery

Assault

Burglary

Theft

Car theft

Fraud or forgery

Weapons offense

Drug dealing

Drug possession

DWI or DUI

Other (specify)

151. (If no to parole/probation violation) What crimes were you convicted of for this prison term? Select all that apply. [USE SHOWCARD.]

Homicide

Rape

Other sex offense (not rape)

Robbery

Assault

Burglary

Theft

Car theft

Fraud or forgery

Weapons offense

Drug dealing

Drug possession

DWI or DUI

Other (specify)


Disciplinary actions

152. (If reincarcerated) During this term of incarceration, how many disciplinary infractions have you received?

_______ (# INFRACTIONS)

153. (If reincarcerated) During this term of incarceration, how many days have you served in administrative segregation? This is sometimes referred to as spending time “in the hole.”

_________ (# TIMES IN SEGREGATION)



Domain T: Community Involvement

Community involvement

154. Since your release, have you done any of the following? (CHECK ALL THAT APPLY.)

a. Attended a church, mosque, synagogue or any other type of religious
service?

b. Participated in any community volunteer work?

c. Voted in any political election, such as a general election, primary
election or special referendum?

d. Taken part in any local organizations like clubs, sports teams, ethnic or
racial pride groups, political organizations, or other community groups?

155. Do you belong to a church, synagogue, mosque, or other religious organization?

YES

NO



PART SIX
PERSONAL CHARACTERISTICS/CURRENT FEELINGS

Domain Z: Personal Traits

These next questions deal with your feelings, attitudes, and how things are going for you currently.

Locus of control

1. How often do you feel that you are not able to control the important things in your life? [USE SHOWCARD.]

Often

Sometimes

Rarely

Never

Anger management

Created

2. How often do you feel angry or mad? Would you say...

Often

Sometimes

Rarely

Never

3. In general, how much of the time does your anger cause problems in your relationships?

Often

Sometimes

Rarely

Never

4. How much of the time does your anger cause problems in your job or work life?

Often

Sometimes

Rarely

Never

Emotional reactivity

Reactive Responding Measure

For each of the following items, please tell me how much you agree or disagree. There are no correct or incorrect answers. [USE SHOWCARD.]

5. You often respond quickly and emotionally when something happens.

Strongly agree

Agree

Disagree

Strongly disagree

6. You let your emotions cool before you act.

Strongly agree

Agree

Disagree

Strongly disagree

Spirituality

These next questions are about the role that religion or spirituality plays in your life. Please tell me how much you agree or disagree with each of these statements.

SVORI

7. You find strength in your religion or spirituality.

Strongly agree

Agree

Disagree

Strongly disagree

8. You pray or meditate regularly.

Strongly agree

Agree

Disagree

Strongly disagree

9. You read the Bible, Koran, or other religious books regularly.

Strongly agree

Agree

Disagree

Strongly disagree

10. The religious services or groups you participate in matter a great deal to you.

Strongly agree

Agree

Disagree

Strongly disagree

Not applicable

Self-efficacy

SVORI

The next questions are about how you currently feel about your life.

11. You can do just about anything you really set your mind to.

Strongly agree

Agree

Disagree

Strongly disagree

12. Sometimes you feel like you’re being pushed around in your life.

Strongly agree

Agree

Disagree

Strongly disagree

13. You often feel helpless dealing with the problems of life.

Strongly agree

Agree

Disagree

Strongly disagree

Goal orientation

Shelley Taylor

14. It’s important for you to take time to plan out where you’re going in life.

Strongly agree

Agree

Disagree

Strongly disagree

15. You have many goals that you will work to achieve.

Strongly agree

Agree

Disagree

Strongly disagree

Attachment

Collins & Read 1991, partial

For each of the following statements, please tell me how much you agree or disagree when it comes to close relationships.

16. You find it difficult to allow yourself to depend on others.

Strongly agree

Agree

Disagree

Strongly disagree

17. You find it difficult to trust others completely.

Strongly agree

Agree

Disagree

Strongly disagree

18. You are nervous when anyone gets too close to you emotionally.

Strongly agree

Agree

Disagree

Strongly disagree

Cooperation

Cloninger Temperament Scale

19. You often consider another person’s feelings as much as your own.

Strongly agree

Agree

Disagree

Strongly disagree

20. People involved with you have to learn how to do things your way.

Strongly agree

Agree

Disagree

Strongly disagree

Relationship skills/knowledge

These next questions are about your opinions about romantic relationships. Please tell me how much you agree or disagree.

21. Once a couple starts to have problems, it usually is not possible to fix them.

Strongly agree

Agree

Disagree

Strongly disagree

22. Couples should not have to work on their relationships in order to have a happy relationship.

Strongly agree

Agree

Disagree

Strongly disagree

23. Most people can learn to communicate better with their spouse.

Strongly agree

Agree

Disagree

Strongly disagree

24. When one spouse says something mean or hurtful, it is OK for the other spouse to say something mean or hurtful back.

Strongly agree

Agree

Disagree

Strongly disagree

25. When wives and husbands have very different views about important things in the family, it is best to not talk about those things.

Strongly agree

Agree

Disagree

Strongly disagree

26. People can learn to avoid situations where they might be tempted to cheat on their spouse/partner.

Strongly agree

Agree

Disagree

Strongly disagree

27. It is sometimes OK for couples to get a little rough physically, like pushing or hitting.

Strongly agree

Agree

Disagree

Strongly disagree


Domain P: Mental and Physical Health

Now I’d like to ask you some questions about your health and how you have been feeling over the last 1 month. [REFER TO REFERENCE CALENDAR.]

Overall physical health

CIDI-SF WHO Composite International Diagnostic Interview Short Form–edited

28. In general, how is your health? Would you say it is . . .

Excellent

Very good

Good

Fair

Poor

Physical health limitations

CIDI-SF WHO Composite International Diagnostic Interview Short Form–edited

29. Do you have a serious health problem that limits the amount or kind of work you can do?

YES

NO

Overall mental health

Created

30. In general, would you say your current emotional or psychological health is excellent, very good, good, fair, or poor?

Excellent

Very good

Good

Fair

Poor

ADHD

Copeland Symptom Checklist for Attention Deficit Disorders

Thinking about the past 1 month, please tell me how much you agree or disagree with each of the following statements.

31. You are easily distracted.

Strongly agree

Agree

Disagree

Strongly disagree

32. You get frustrated easily.

Strongly agree

Agree

Disagree

Strongly disagree

33. You do not think before acting.

Strongly agree

Agree

Disagree

Strongly disagree

PTSD

PC-PTSD

34. In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past 1 month, you have had nightmares about it or thought about it when you did not want to?

YES

NO

35. In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past 1 month, you tried hard not to think about it or went out of your way to avoid situations that reminded you of it?

YES

NO

36. In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past 1 month, you were constantly on guard, watchful, or easily startled?

YES

NO

37. In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past 1 month, you felt numb or detached from others, activities, or your surroundings?

YES

NO

Depression

CES-D Short

Below is a list of ways you might have felt or behaved recently. Please tell me how often you have felt this way during the past week. [USE SHOWCARD.] [REFER TO REFERENCE CALENDAR.]

During the past week….

38. You were bothered by things that don’t usually bother you.

All of the time

Most of the time

Some of the time

A little of the time

None of the time

39. You had trouble keeping your mind on what you were doing.

All of the time

Most of the time

Some of the time

A little of the time

None of the time

40. You felt depressed.

All of the time

Most of the time

Some of the time

A little of the time

None of the time

41. You felt that everything you did was an effort.

All of the time

Most of the time

Some of the time

A little of the time

None of the time

42. You felt hopeful about the future.

All of the time

Most of the time

Some of the time

A little of the time

None of the time

43. You felt fearful.

All of the time

Most of the time

Some of the time

A little of the time

None of the time

44. Your sleep was restless.

All of the time

Most of the time

Some of the time

A little of the time

None of the time

45. You were happy.

All of the time

Most of the time

Some of the time

A little of the time

None of the time

46. You felt lonely.

All of the time

Most of the time

Some of the time

A little of the time

None of the time


Domain V: Partner Relationship Quality

Now, I’m going to ask you some questions about your romantic relationship with (SPOUSE/PARTNER). Please remember that all information you provide will be kept strictly confidential.

Happiness with relationship

DAS-8

47. On a scale from 1 to 10 where 1 means not at all happy and 10 means perfectly happy, which number best describes your happiness with your relationship? [USE SHOWCARD.]

_______ [ALLOW 1-10.]

Dyadic adjustment

DAS-8

48. How often do you and (SPOUSE/PARTNER) agree on displays of affection? By displays of affection, I mean holding hands, hugging, kissing, or other kinds of physical affection. [USE SHOWCARD.]

Often

Sometimes

Rarely

Never

49. How often have you discussed or considered divorce, separation, or ending your current relationship?

Often

Sometimes

Rarely

Never

50. In general, how often do you think that things between you and (SPOUSE/PARTNER) are going well?

Often

Sometimes

Rarely

Never

51. Do you confide in (SPOUSE/PARTNER)? By confide, I mean share secrets or personal, sensitive information.

Often

Sometimes

Rarely

Never

52. Do you ever regret getting into your current relationship?

Often

Sometimes

Rarely

Never

53. How often do you and (SPOUSE/PARTNER) calmly discuss something?

Often

Sometimes

Rarely

Never

54. How often do you and (SPOUSE/PARTNER) work together on something?

Often

Sometimes

Rarely

Never

Communication

BSF

55. Even when arguing, you and (SPOUSE/PARTNER) can keep a sense of humor. Would you say…

Often

Sometimes

Rarely

Never

56. Your arguments get very heated. Would you say…

Often

Sometimes

Rarely

Never

BSF

57. Small issues suddenly become big arguments. Would you say…

Often

Sometimes

Rarely

Never

58. You are good at working out your differences with each other. Would you say…

Often

Sometimes

Rarely

Never

Communication skills

Stanley and Markman

59. When discussing issues, you repeat back what (SPOUSE/PARTNER) says to make sure you understand her. Would you say…

Often

Sometimes

Rarely

Never

60. When your talks begin to get out of hand, you agree to stop them and talk later. Would you say…

Often

Sometimes

Rarely

Never

61. When discussing issues you allow (SPOUSE/PARTNER) to finish talking before you respond. Would you say…

Often

Sometimes

Rarely

Never

62. (SPOUSE/PARTNER) interrupts you when you are talking. Would you say…

Often

Sometimes

Rarely

Never

Forgiveness

KY BHMP

63. You are usually able to forgive (SPOUSE/PARTNER). Would you say…

Often

Sometimes

Rarely

Never

Relationship fidelity

(If R is incarcerated)

CHMI (modified)

64. How often are you tempted to have sexual or romantic contact with someone other than your spouse/partner?

Often

Sometimes

Rarely

Never

Created

65. During your relationship with your spouse/partner, was there ever a time when you had sexual or romantic contact with someone else?

Yes

No

Maybe

How much do you agree or disagree with the following statements?

66. You know you can count on your spouse/partner to remain faithful to you. By faithful, we mean never having sexual contact with anyone except you.

Strongly agree

Agree

Disagree

Strongly disagree

67. You know how to avoid situations where you might be tempted to cheat on your spouse/partner.

Strongly agree

Agree

Disagree

Strongly disagree

Relationship commitment

BSF

Here are some statements about your relationship with (SPOUSE/PARTNER). For each one, please tell me if you strongly agree, agree, disagree, or strongly disagree.

68. It is very important to you to be completely faithful to your spouse/partner. By faithful, we mean never having sexual contact with anyone except your spouse/partner.

Strongly agree

Agree

Disagree

Strongly disagree

69. It is very important to you that your spouse/partner be completely faithful to you.

Strongly agree

Agree

Disagree

Strongly disagree

70. You may not want to be with your spouse/partner a few years from now.

Strongly agree

Agree

Disagree

Strongly disagree

Positive connections, bonding, friendship

Stanley and Markman

71. You and (SPOUSE/PARTNER) have fun together. Would you say…

Strongly agree

Agree

Disagree

Strongly disagree

Stanley and Markman

72. You believe you and (SPOUSE/PARTNER) can handle whatever conflicts will arise in the future. Would you say…

Strongly agree

Agree

Disagree

Strongly disagree

73. You feel good about your chances to make this relationship work for a lifetime.

Strongly agree

Agree

Disagree

Strongly disagree

Intimacy and support

BSF

74. Your (SPOUSE/PARTNER) encourages or helps you to do things that are important to you.

Strongly agree

Agree

Disagree

Strongly disagree

BSF

For this next question, I’d like you to tell me how often the following is true for you.

75. When you have problems, (SPOUSE/PARTNER) really understands what you’re going through. [USE SHOWCARD.] Would you say…

Often

Sometimes

Rarely

Never

Attitudes about marriage

The next questions are about your opinions on marriage. Please tell me how much you agree or disagree with this statement.

76. (If R is unmarried or no longer romantically involved with spouse) Getting and staying married is an important goal for you.

Strongly agree

Agree

Disagree

Strongly disagree

77. (If R is married and still romantically involved with spouse) Staying married to your spouse for the rest of your life is an important goal for you.

Strongly agree

Agree

Disagree

Strongly disagree


The next questions are about your thoughts on what could happen in your relationship with (SPOUSE/PARTNER) in the future. No one knows what the future holds, but we would like your best guess about what you expect. Please answer based on your realistic expectations, rather than what you wish for or hope will happen.

Marriage plans

78. (If R is in a romantic relationship with someone other than a spouse): What do you think the chances are that you will marry (PARTNER) in the future? Would you say…

No chance

A little chance

A 50–50 chance

A pretty good chance

An almost certain chance

Perceived life changes if split up

NSFH-90, Sec. SE-7, Q.13-14 (modified)

Even though it may be very unlikely, think for a moment about how various areas of your life might be different if you and (SPOUSE/PARTNER) split up. Then, I’ll ask how you think things might be different for (SPOUSE/PARTNER). For each of the following areas, please tell me whether you would you expect it to get better, worse, or stay the same if you split up? Let’s start with you.

79. How would your financial situation change if you split up? Would it get....

Better

Worse

Stay the same

CAN’T PREDICT

80. How would your overall happiness change if you split up? Would it get...

Better

Worse

Stay the same

CAN’T PREDICT

Now, let’s think about (SPOUSE/PARTNER).

81. How would her financial situation change if you split up? Would it get...

Better

Worse

Stay the same

CAN’T PREDICT

82. How would her overall happiness change if you split up? Would it get...

Better

Worse

Stay the same

CAN’T PREDICT

83. (If R has any children) Next, let’s think about your child(ren). How would your child(ren)’s overall happiness change if you and (SPOUSE/PARTNER) split up? Would it get...

Better

Worse

Stay the same

CAN’T PREDICT

Perceptions of support from R’s parents for continuing the relationship

Created

Please tell me how much you agree or disagree with the following statements about your parents’ feelings about your relationship with (SPOUSE/PARTNER).

84. Your parents want you and (SPOUSE/PARTNER) to stay together as a couple.

Strongly agree

Agree

Disagree

Strongly disagree

85. (SPOUSE/PARTNER)’s parents want you and (SPOUSE/PARTNER) to stay together as a couple.

Strongly agree

Agree

Disagree

Strongly disagree


Domain N: Parenting and Child Well-Being

Residence of focal child

The next items ask about your relationship with (FOCAL CHILD).

86. With whom does (FOCAL CHILD) currently live? [USE SHOWCARD.]

The child’s mother

The child’s maternal grandparent(s)

The child’s paternal grandparent(s)

The child’s step-grandparent(s)

Other blood relatives of the child

The child’s stepparent

Other non-blood relatives

The child is in custody of social services

Other (SPECIFY)

Parental efficacy (focal child)

Fragile Families

87. Please think about how you feel about yourself as a parent to (FOCAL CHILD). Would you say you are...

An excellent parent

A very good parent

A good parent

Not a very good parent

Quality of relationship with focal child

Parent-Child Relational Quality Scale (Umbersome, 1989)

88. Would you say your current relationship with (FOCAL CHILD) is excellent, good, fair, or poor?

Excellent

Good

Fair

Poor

Does focal child know R is incarcerated

(If R is incarcerated)

89. Does (FOCAL CHILD) know that you are incarcerated?

YES

NO

Co-parental conflict about focal child

ECLS-B, 9 and 24-Month Surveys Resident Father Questionnaires

Parenting with another person can be challenging.

90. Do you and (SPOUSE/PARTNER) have arguments about (FOCAL CHILD) often, sometimes, rarely, or never?

Often

Sometimes

Rarely

Never

Shared decision making about focal child

NLSY-97

91. Who makes major decisions about things such as child care and health care for (FOCAL CHILD)? .

You and the child's mother or main caretaker make most decisions
together

The child's mother or main caretaker makes most decisions herself/
himself

You make most decisions yourself

Focal child’s relationship with mother

92. Please rate (FOCAL CHILD)’s relationship with his/her mother or main caretaker. Would you say it is...

Excellent

Good

Fair

Poor

Partner’s role as coparent to focal child

93. Does (SPOUSE/PARTNER) coparent (FOCAL CHILD) with you? By coparent, we mean that (SPOUSE/PARTNER) is involved in raising (FOCAL CHILD).

YES

NO

Focal child’s school attendance & performance

94. (If focal child is 4 years or older) Does (FOCAL CHILD) attend school? ( By school I mean kindergarten through college.)

YES

NO

Created

95. (If focal child does attend school) What grade is (FOCAL CHILD) in?

KINDERGARTEN

1st GRADE

2nd GRADE

3RD GRADE

4TH GRADE

5TH GRADE

6TH GRADE

7TH GRADE

8TH GRADE

9TH GRADE

10TH GRADE

11TH GRADE

12th GRADE

COLLEGE

OTHER, SPECIFY: _________________________________

96. (If focal child does attend school) Based on your knowledge of (FOCAL CHILD)’s school work, including (HIS/HER) most recent report cards, how is (HE/SHE) doing in school overall? Would you say...

Well below average

Below average

Average

Above average

Well above average

Focal child’s extracurricular participation

97. (If focal child does attend school) Based on your knowledge, does (HE/SHE) participate in any sports, clubs, organizations, or programs after school or on weekends?

YES

NO

Focal child’s social skills/behavior

NSCH

I’m going to read a list of behaviors that sometimes describe children. For each item, please tell me how often this is true for (FOCAL CHILD) during the past 1 month. [REFERENCE CALENDAR] [USE SHOWCARD.]

98. (If focal child is older than 4 years) (FOCAL CHILD) bullies, or is cruel or mean to others. Would you say…

Always

Usually

Sometimes

Never

Don’t know

99. (If focal child is older than 4 years) (FOCAL CHILD) shows respect for teachers and neighbors

Always

Usually

Sometimes

Never

Don’t know

100. (If focal child is older than 4 years) …gets along well with other children

Always

Usually

Sometimes

Never

Don’t know

101. (If focal child is older than 4 years) …is disobedient

Always

Usually

Sometimes

Never

Don’t know

102. (If focal child is older than 4 years) …is stubborn, sullen, or irritable

Always

Usually

Sometimes

Never

Don’t know

103. (If focal child is older than 4 years) …feels worthless or inferior

Always

Usually

Sometimes

Never

Don’t know

104. (If focal child is older than 4 years) …is unhappy, sad, or depressed

Always

Usually

Sometimes

Never

Don’t know

105. (If focal child is older than 4 years) …is withdrawn, and does not get involved with others

Always

Usually

Sometimes

Never

Don’t know

New Hope (modified)

Raising children can be difficult these days. Has (FOCAL CHILD) ever had any of the following problems?

106. (If focal child does attend school) Being suspended or expelled from school?

YES

NO

107. (If focal child does attend school) Needing to repeat a grade in school?

YES

NO

108. (If focal child is 10 or older) Running away?

YES

NO

109. Being placed in foster care, or being sent to live with a friend or relative?

YES

NO

110. (If focal child is 10 or older) Getting into trouble for using alcohol or drugs?

YES

NO

111. (If focal child is 10 or older) Getting into trouble with the police?

YES

NO

Parental warmth

(If R is incarcerated and reports no contact with focal child during this incarceration, skip this subsection)

For the next set of questions, I’d like you to think about what things are like when you see or communicate with (FOCAL CHILD) (If R is incarcerated, add: now, during this incarceration.)

On average, how often do you do each of the following with (FOCAL CHILD) when you communicate with him/her? [USE SHOWCARD.]

112. (If R is incarcerated and reports no visits with focal child, skip this question) Hug or show physical affection to your child?

Always

Usually

Sometimes

Never

Physical contact is not permitted during visits at your facility

113. Tell (FOCAL CHILD) that you love (him/her)?

Always

Usually

Sometimes

Never

114. Communicate with (FOCAL CHILD) about things (he/she) is interested in?

Always

Usually

Sometimes

Never

115. Praise (FOCAL CHILD)? By praise, we mean tell the child that s/he is good in some way or that s/he has done something well.

Always

Usually

Sometimes

Never

Attitudes about children and fatherhood

Here are some statements that men have made about their role as fathers. For each of the following statements, please indicate how strongly you agree or disagree.

CHMI (ECLS-B Fathers SAQ Q16)

116. It’s hard for men to act loving toward children.

Strongly agree

Agree

Disagree

Strongly disagree

117. Fathers should spend as much time taking care of their children as mothers.

Strongly agree

Agree

Disagree

Strongly disagree

118. The way a father treats his child will affect the child later in life.

Strongly agree

Agree

Disagree

Strongly disagree

119. The activities a father does with his children don’t matter. What matters more is whether he supports them financially.

Strongly agree

Agree

Disagree

Strongly disagree

120. It is sometimes OK for fathers to physically discipline their children, such as hitting or spanking them.

Strongly agree

Agree

Disagree

Strongly disagree

Created

121. Incarcerated fathers can still be good role models for their children.

Strongly agree

Agree

Disagree

Strongly disagree

122. Incarcerated fathers can still be involved in making decisions about their children’s lives.

Strongly agree

Agree

Disagree

Strongly disagree



Domain L: Social Support

Emotional support from extended family

SVORI/Returning Home (modified)

Now I’d like to ask about how you currently feel about your relationships with your family members other than (SPOUSE/PARTNER) or children. This would mean your parents, siblings, cousins, or other family members. Please tell me whether you strongly agree, agree, disagree, or strongly disagree with the following statements.

123. You feel close to your family.

Strongly agree

Agree

Disagree

Strongly disagree

124. You have family members who will stand by you no matter what.

Strongly agree

Agree

Disagree

Strongly disagree

125. You want your family to be involved in your life.

Strongly agree

Agree

Disagree

Strongly disagree

126. You are criticized a lot or put down by your family.

Strongly agree

Agree

Disagree

Strongly disagree

127. You have someone in your family to talk to about yourself or your problems.

Strongly agree

Agree

Disagree

Strongly disagree

128. You have someone in your family to love you and make you feel wanted.

Strongly agree

Agree

Disagree

Strongly disagree


ACASI SEGMENT

(If R is not incarcerated)


Domain J: Housing

Criminal/AOD behavior of people living with

129. Has anyone you are currently living with ever been to jail, prison, or some other correctional institution?

Yes

No

130. Do any of the people you are currently living with use illegal drugs?

Yes

No


Domain O: Substance Use

Addiction severity

CAGE

131. Now, I’d like you to think about your current drug and alcohol use. [REFER TO REFERENCE CALENDAR.]

a. (If R reported any alcohol use) Do you feel you should cut down on your drinking?

YES

NO

b. (If R reported any alcohol use) Do people ever annoy you by complaining about your drinking?

YES

NO

c. (If R reported any alcohol use) Do you ever feel bad or guilty about your drinking?

YES

NO

d. (If R reported any alcohol use) Do you ever have a drink first thing in the morning to steady your nerves or get rid of a hangover (“eye-opener”)?

YES

NO

e. (If R reported any drug use) Do you ever feel you should cut down on your drug use?

YES

NO

f. (If R reported any drug use) Do people ever annoy you by complaining about your drug use?

YES

NO

g. (If R reported any drug use) Do you ever feel bad or guilty about your drug use?

YES

NO

Anger and addiction

138. How often do you experience problems with anger when you have been drinking or using drugs? [REFER TO REFERENCE CALENDAR.]

Often

Sometimes

Rarely

Never

139. How often do you physically hurt or get rough with your spouse/partner or other family members when you have been drinking or using drugs?

Often

Sometimes

Rarely

Never

Binge drinking

National Survey on Drug Use and Health

140. How often do you have 5 or more drinks of beer, wine, or liquor on the same occasion? By "drink," we mean a bottle or can of beer, a wine cooler or a glass of wine, a shot of liquor, or a mixed drink or cocktail. By "occasion," we mean at the same time or within a couple of hours of each other. [REFER TO REFERENCE CALENDAR.]

Often

Sometimes

Rarely

Never

Substance use

141. Please tell me which of the following substances you have used since your last interview, even just once. [REFER TO REFERENCE CALENDAR.] [SELECT ALL THAT APPLY.] [USE SHOWCARD.]

Alcohol

Marijuana or hashish

Powder cocaine

Crack cocaine

Heroin (this includes smoking, sniffing, snorting, and injecting heroin)

Methamphetamine

Other amphetamines, such as monster, crank, or ice

Hallucinogens or designer drugs, such as ecstasy, LSD or acid, mushrooms, mescaline,
peyote, green, PCP, or angel dust

Prescription medication without a prescription or for other reasons than were prescribed,
or in larger amounts, or more often than your doctor ordered. This includes sedatives,
tranquilizers, stimulants, pain relievers, opiates, or anabolic steroids

Methadone without a prescription or for other reasons than were prescribed, or in larger
amounts, or more often than your doctor ordered

Did not use any alcohol or drugs

(If R reports no alcohol or drug use since last interview, skip to next domain.)

142. Which of the following have you used the most since your last interview? (SELECT ONE.) READ LIST OUT LOUD. (Show only response categories that were selected by the R in the prior question.)

Alcohol

Marijuana or hashish

Powder cocaine

Crack cocaine

Heroin (this includes smoking, sniffing, snorting, and injecting heroin)

Methamphetamine

Other amphetamines, such as monster, crank, or ice

Hallucinogens or designer drugs, such as ecstasy, LSD or acid, mushrooms, mescaline,
peyote, green, PCP, or angel dust

Prescription medication without a prescription or for other reasons than were prescribed,
or in larger amounts, or more often than your doctor ordered. This includes sedatives,
tranquilizers, stimulants, pain relievers, opiates, or anabolic steroids.

Methadone without a prescription or for other reasons than were prescribed, or in larger
amounts, or more often than your doctor ordered.



Domain V: Partner Relationship Quality

Relationship fidelity

CHMI (modified)

143. How often are you tempted to have sexual or romantic contact with someone other than your spouse/partner?

Often

Sometimes

Rarely

Never

Created

144. During your relationship with your spouse/partner, was there ever a time when you had sexual or romantic contact with someone else?

Yes

No

Maybe

How much do you agree or disagree with the following statements?

145. You know you can count on your spouse/partner to remain faithful to you. By faithful, we mean never having sexual contact with anyone except you.

Strongly agree

Agree

Disagree

Strongly disagree

146. You know how to avoid situations where you might be tempted to cheat on your spouse/partner.

Strongly agree

Agree

Disagree

Strongly disagree


Domain M: Intimate Partner Violence

Now, I’m going to ask you some questions about your romantic relationship since you were released (If reincarcerated: but before you were reincarcerated). [REFER TO REFERENCE CALENDAR.] Please remember that your answers cannot be shared with your family, friends or acquaintances under any circumstances.

Psychological abuse

Thinking about the time since your spouse/partner was released, please tell me how much of the time each of these statements was true.

147. How often have you felt safe in your relationship with your spouse/partner? Would you say…

Often

Sometimes

Rarely

Never

TX HM

148. Your spouse/partner has become jealous or possessive. Would you say…

Often

Sometimes

Rarely

Never

TX HM

149. Your spouse/partner has made you feel like you were not good enough. Would you say…

Often

Sometimes

Rarely

Never

Conflict tactics

SMH/BSF (Modified from Conflict Tactics Scale)

No matter how well a couple gets along, there are times when they disagree or have fights. I am going to read a list of things that might happen when you have differences. First, tell me how many times since your spouse/partner was released from incarceration (If reincarcerated: but prior to his reincarceration) you have done the following. Then I’ll ask you how many times your spouse/partner has done the following. [REFER TO REFERENCE CALENDAR.] [USE SHOWCARD.]

150. Since your spouse/partner was released from incarceration, how many times have you thrown something at him?

None

1 time

2 times

3-5 times

6 or more times

151. Since your spouse/partner was released from incarceration, how many times has he thrown something at you?

None

1 time

2 times

3-5 times

6 or more times

152. Since your spouse/partner was released from incarceration, how many times have you pushed, shoved, hit, slapped, or grabbed him?

None

1 time

2 times

3-5 times

6 or more times

153. Since your spouse/partner was released from incarceration, how many times has he pushed, shoved, hit, slapped, or grabbed you?

None

1 time

2 times

3-5 times

6 or more times

154. Since your spouse/partner was released from incarceration, how many times have you used a knife or gun on him?

None

1 time

2 times

3-5 times

6 or more times

155. Since your spouse/partner was released from incarceration, how many times has he used a knife or gun on you?

None

1 time

2 times

3-5 times

6 or more times

156. Since your spouse/partner was released from incarceration, how many times have you choked, slammed, kicked, burned, or beat him?

None

1 time

2 times

3-5 times

6 or more times

157. Since your spouse/partner was released from incarceration, how many times has he choked, slammed, kicked, burned, or beat you?

None

1 time

2 times

3-5 times

6 or more times

158. Since your spouse/partner was released from incarceration, how many times have you used force to make him have sex? (PROBE: Force means things like hitting, holding down, or using a weapon)

None

1 time

2 times

3-5 times

6 or more times

159. Since your spouse/partner was released from incarceration, how many times has he used force to make you have sex? (PROBE: Force means things like hitting, holding down, or using a weapon,)

None

1 time

2 times

3-5 times

6 or more times

160. Since your spouse/partner was released from incarceration, how many times have you threatened to hurt him?

None

1 time

2 times

3-5 times

6 or more times

161. Since your spouse/partner was released from incarceration, how many times has he threatened to hurt you?

None

1 time

2 times

3-5 times

6 or more times

162. Since your spouse/partner was released from incarceration, how many times have you threatened to hurt his children, family members, or other loved ones?

None

1 time

2 times

3-5 times

6 or more times

163. Since your spouse/partner was released from incarceration, how many times has he threatened to hurt your children, family members, or other loved ones?

None

1 time

2 times

3-5 times

6 or more times

164. Since your spouse/partner was released from incarceration, how many times have you tried to keep him from seeing or talking with his friends or family?

None

1 time

2 times

3-5 times

6 or more times

165. Since your spouse/partner was released from incarceration, how many times has he tried to keep you from seeing or talking with your friends or family?

None

1 time

2 times

3-5 times

6 or more times

166. Since your spouse/partner was released from incarceration, how many times have you kept money from him, made him ask for money, or taken money from him?

None

1 time

2 times

3-5 times

6 or more times

167. Since your spouse/partner was released from incarceration, how many times has he tried to keep money from you, made you ask for money, or taken money from you?

None

1 time

2 times

3-5 times

6 or more times


PART SEVEN
EXPECTATIONS FOR POST-RELEASE PERIOD


(If R is incarcerated.)

(If R reported serving a life sentence with no expectation of release, skip to end)


The next set of questions deals with your release from prison and transition back into the community. No one knows what the future holds, but we would like your best guess about what you expect. Please answer based on your realistic expectations, rather than what you wish for or hope will happen.


IF NEEDED, REPEAT THIS STATEMENT (We would like your best guess about what you expect. Please answer based on your realistic expectations.) AS A PROBE FOR ITEMS IN THIS SECTION.


Domain W: Criminal Behavior

Post-release supervision

(If R is incarcerated)

Created

1. When you are released from this incarceration, will you be on some type of post-release supervision, such as parole?

YES

NO

Readiness for change regarding criminal behavior

(If R is incarcerated)

SVORI

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

2. You will give up friends and hangouts that get you into trouble after you are released.

Strongly agree

Agree

Disagree

Strongly disagree

3. You are willing to accept help to not commit crimes after you are released.

Strongly agree

Agree

Disagree

Strongly disagree

Expectations about reincarceration

4. Do you think you will ever be sent back to jail or prison again, after you are released from this incarceration?

YES

NO


Domain O: Substance Use

(If R is incarcerated)

Expectations about substance use

5. How likely is it that you will use any illegal drugs after release?

Very likely

Likely

Unlikely

Very unlikely


Domain L: Social Support

Expectations about support from “other family members”

The next set of questions are about your expectations for your relationships with family members other than your spouse/partner or child(ren) after your release from prison.

Created

6. Do you have a family member who will loan you money if you need it?

YES

NO

7. Do you have a family member who will provide you with a place to live if you need it?

YES

NO

8. Do you have a family member who will help you with transportation to work or other appointments if you need it?

YES

NO

Expectations about support from friends

Next, I’d like to know about your expectations for your relationships with friends after your release from prison.

Created

9. Do you have a friend who will loan you money if you need it?

YES

NO

10. Do you have a friend who will provide you with a place to live if you need it?

YES

NO

11. Do you have a friend who will help you with transportation to work or other appointments if you need it?

YES

NO


Domain K: Income

Next, I’d like to know more about your plans for your financial and living situation when you are released.

Expectations about sources of financial support

Returning Home

12. What sources of financial support do you expect to have in the first 1 month following your release? [USE SHOWCA RD.]

None

Pay from a job

Your own savings

Money from your spouse/partner’s job or savings

Money from other family members

Money from your friends

Public assistance

Money from illegal sources

Some other source (SPECIFY______________)

Perceived difficulty supporting oneself

13. How easy or hard do you think it will be to make enough money to support yourself?

Very easy

Pretty easy

Pretty hard

Very hard


Domain I: Employment

Perceived difficulty finding/keeping a job

14. Based on past experience, how easy or hard do you think it will be to find a decent job?

Very easy

Pretty easy

Pretty hard

Very hard

15. Based on past experience, how easy or hard do you think it will be to keep a job?

Very easy

Pretty easy

Pretty hard

Very hard


Domain J: Housing

Expectations about living with partner

Created

16. Do you expect to live with (SPOUSE/PARTNER) after release?

YES

NO


Expectations about living with focal child and other children

Created

17. Do you expect to live with (FOCAL CHILD) after release?

YES

NO

18. (Ask for each child): Do you plan to live with (CHILD) after you are released?

YES

NO

Unsure


Expectations about living with anyone else

Created

19. Do you expect to live with anyone else after you are released?

YES

NO


Domain V: Partner Relationship Quality

Intentions for continuing relationship

20. Do you want to remain in a committed romantic relationship with (SPOUSE/PARTNER) after you are released? Would you say...

Yes

No

Don’t know

21. Do you think (SPOUSE/PARTNER) wants to remain in a committed romantic relationship with you after you are released? Would you say...

Yes

No

Don’t know

Perceived difficulty establishing/re-establishing relationship with partner

Returning Home

22. (If R answers “yes” or “don’t know” to intentions for continuing relationship) How easy or hard do you think it will be to have a good relationship with (SPOUSE/PARTNER) after you get out?

Very easy

Pretty easy

Pretty hard

Very hard

23. (If R answers “yes” or “don’t know” to intentions for continuing relationship) Thinking about when you are released, what do you expect will be the biggest challenges in your relationship with your partner? MARK ALL THAT APPLY.

Finding her

Being able to feel close to her again after the time in prison

Being able to trust her after the time in prison

Problems or new situations that have come up since you were incarcerated

Having missed out on so much that happened in her life while you were
incarcerated

Trying to meet her expectations for you related to finding a job, staying clean,
helping her financially

Being angry at her or not wanting to see her

Her being angry at you or not wanting to see you

Some other challenge (SPECIFY)___________________________

Expectations about support to/from partner

(If R answers “yes” or “don’t know” to intentions for continuing relationship)

Please tell me whether you strongly agree, agree, disagree, or strongly disagree with the following statements about your expectations about how you and (SPOUSE/PARTNER) will treat one another after you are released.

24. After you are released, you will stand by (SPOUSE/PARTNER) no matter what.

Strongly agree

Agree

Disagree

Strongly disagree

25. You will love (SPOUSE/PARTNER) and make her feel wanted.

Strongly agree

Agree

Disagree

Strongly disagree

26. You will help (SPOUSE/PARTNER) with whatever problems she faces.

Strongly agree

Agree

Disagree

Strongly disagree

27. After you are released, you think (SPOUSE/PARTNER) will stand by you no matter what.

Strongly agree

Agree

Disagree

Strongly disagree

28. You think (SPOUSE/PARTNER) will love you and make you feel wanted.

Strongly agree

Agree

Disagree

Strongly disagree

29. You think (SPOUSE/PARTNER) will help you with whatever problems you face.

Strongly agree

Agree

Disagree

Strongly disagree


Domain N: Parenting

Expectations about interaction with focal child

30. (If R does not plan to live with focal child) How often do you think you will see (FOCAL CHILD) in person after you are released?

One or more times a week

A couple of times a month

About once a month

Every couple of months

A couple of times a year or less

Never

Expectations about financial support for focal child

31. (If R does not plan to live with focal child) Do you expect to financially support (FOCAL CHILD) in any way after you are released?

YES

NO

32. (If yes) In what way or ways do you expect to provide financial support for (FOCAL CHILD)? Please include support you expect to provide to the child directly as well as support you will provide to the child’s other parent or caretaker. [USE SHOWCARD]

Giving (FOCAL CHILD) birthday or holiday gifts

33. Taking (FOCAL CHILD) shopping for clothing, school supplies, or other

things s/he needs

34. Helping out occasionally with bills, rent or other expenses in the child’s

household

Providing steady, regular financial support of up to $100 per month

Providing steady, regular financial support of $100-$200 per month

Providing steady, regular financial support of $200-$300 per month

Providing steady, regular financial support of over $300 per month

Expectations about decision-making about focal child

35. Who will make major decisions about things such as child care and health care for (FOCAL CHILD)? Would you say...

You and the child's mother or main caretaker will make most decisions

together

The child's mother or main caretaker will make most decisions herself/

himself

You will make most decisions yourself

Perceived difficulty establishing/re-establishing relationship with children

Returning Home

36. How easy or hard do you think it will be to have (a) good relationship(s) with your child(ren) after you get out?

Very easy

Pretty easy

Pretty hard

Very hard

Created

37. Thinking about when you are released, what do you expect will be the biggest challenges in your relationship(s) with your child(ren)? (If R has more than one child) Please consider only the child(ren) you were in contact with before you were incarcerated. MARK ALL THAT APPLY.

Finding them

Having missed out on so much that happened with him/her/them while you
were incarcerated

Getting them to trust you or open up to you after the time apart

Finding transportation for visits or activities

Dealing with people who don’t want you to see your kids

Not being in a stable enough housing and financial situation to be able to
spend time with your kids

Your lifestyle not being a healthy one for kids

Your child(ren) being angry at you or not wanting to see you

Some other challenge (SPECIFY)___________________________



Locator information

SVORI

(If R is incarcerated) BHOU1

So that we can contact you once you are released, please tell me where you are going to stay immediately after release. Where is the very first place you will go as you are getting back on your feet?


INTERVIEWER: PROBE FOR DETAILS:
WHAT CITY WILL THEY LIVE IN?

WHERE WILL THEY LIVE, MORE SPECIFICALLY?

WHO WILL THE R LIVE WITH?

WHAT TYPE OF STRUCTURE WILL THEY LIVE IN?

HOW LONG WILL THEY STAY?


(If R is incarcerated) BHOU2

DOES THE R HAVE A SPECIFIC ADDRESS?

Yes-> RECORD ADDRESS, CITY, STATE, PHONE

NO-> SKIP TO BHOU3


(If R is incarcerated) BHOU3

Do you think you will stay there indefinitely, or will that be a temporary situation?

STAY-> SKIP TO BHOU6

ONLY TEMPORARY->GO TO BHOU4


(If R is incarcerated) BHOU4

Where do you think you will live next?

INTERVIEWER: PROBE FOR DETAILS:
WHAT CITY WILL THEY LIVE IN?

WHERE WILL THEY LIVE, MORE SPECIFICALLY?

WHO WILL THE R LIVE WITH?

WHAT TYPE OF STRUCTURE WILL THEY LIVE IN?

HOW LONG WILL THEY STAY?


(If R is incarcerated) BHOU5

DOES THE R HAVE A SPECIFIC ADDRESS?

Yes-> RECORD ADDRESS, CITY, STATE, PHONE

NO-> SKIP


(If R is not incarcerated) BHOU1

So that we can contact you for follow-up interviews, please tell me where you expect to be living 9 months from now.


INTERVIEWER: PROBE FOR DETAILS:
WHAT CITY WILL THEY LIVE IN?

WHERE WILL THEY LIVE, MORE SPECIFICALLY?

WHO WILL THE R LIVE WITH?

WHAT TYPE OF STRUCTURE WILL THEY LIVE IN?

HOW LONG WILL THEY STAY?

(If R is not incarcerated) BHOU2

DOES THE R HAVE A SPECIFIC ADDRESS?

YES-> RECORD ADDRESS, CITY, STATE, PHONE

NO-> SKIP TO BHOU3

(If R is not incarcerated) BHOU4

Where else might you be living 9 months from now?

INTERVIEWER: PROBE FOR DETAILS:
WHAT CITY WILL THEY LIVE IN?

WHERE WILL THEY LIVE, MORE SPECIFICALLY?

WHO WILL THE R LIVE WITH?

WHAT TYPE OF STRUCTURE WILL THEY LIVE IN?

HOW LONG WILL THEY STAY?

(If R is not incarcerated) BHOU5

DOES THE R HAVE A SPECIFIC ADDRESS?

YES-> RECORD ADDRESS, CITY, STATE, PHONE

NO-> SKIP


(If R is employed) Where do you work?  In other words, what is the name of the company or organization you work for? We will not contact you at work unless we cannot get in touch with you at your home.

{allow 30}

(If R is not incarcerated) BHOU11i2

And in what city is that?

{allow 30}

(If R is not incarcerated) BHOU11i3

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}

(If R is not incarcerated) BHOU11i4

Do you have a work phone number?

YNDKRF

{if BHOU11i4=yes, ask BHOU11i5}

(If R is not incarcerated) BHOU11i5

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE ‘DON’T KNOW’.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}


BHOU9a

In the event that you are not living where you expect to live, I need to collect contact information on three people who would know your whereabouts and who could help us contact you to be interviewed, if necessary. 

@/@/@/

What is the name of the first person who would know how to reach you?

@/@/@/

{green}ENTER FIRST NAME{normal}

{allow 30}

{if BHOU9a=dk or rf, go to BHOU12}


BHOU9b

{green}ENTER MIDDLE NAME{normal}

{allow 30; not a required response}


BHOU9c

{green}ENTER LAST NAME{normal}

{allow 30}      

                       

BHOU9d                                

What is this person's address?  If you don’t know the exact address, please tell me a street name or a neighborhood.

@/@/@/

{green)INTERVIEWER: BE SURE TO PROBE FOR A BLDG AND/OR APT NUMBER.{normal}

{allow 100}

                       

BHOU9e

And in what city is that?

{allow 30}



BHOU9f

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}


BHOU9g

Does this person have a phone number?

YNDKRF

{if BHOU9g=yes, ask BHOU9g1; if=no, dk, or rf, go to BHOU9i}


BHOU9g1

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}

           

BHOU9h

{if BHOU9g=yes, ask BHOU9h} Does this person have a second phone number, such as a cell phone?

YNDKRF

{if BHOU9h=yes, ask BHOU9h1}


BHOU9h1

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}


BHOU9i

Does this person work outside of the home?

YNDKRF

{if BHOU9i=yes, ask BHOU9i1; else ask BHOU9j}


BHOU9i1

Where does this person work?  In other words, what is the name of the company or organization this person works for?  We will not contact them at work unless we’ve tried all other possible means of locating you.

{allow 30}


BHOU9i2

And in what city is that?

{allow 30}


BHOU9i3

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}


BHOU9i4

Does this person have a work phone number?

YNDKRF

{if BHOU9i4=yes, ask BHOU9i5; if no, dk, or rf, go to BHOU9j}


BHOU9i5

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}


BHOU9j

What is this person's relationship to you?

RELATION

{if BHOU9j=Other, ask BHOU9j1}


BHOU9j1

{green}DESCRIBE THE RELATIONSHIP OF THE PERSON TO R, RECORDING THE R’S ANSWER VERBATIM.{normal}

{allow 100}


BHOU9k

Thank you. Please let this person know that you would like them to tell me where I can find you when it is time for your next interview.



BHOU10a

What is the name of another person who would know how to reach you?

@/@/@/

{green}ENTER FIRST NAME{normal}

{allow 30}

{if BHOU10a=dk or rf, go to BHOU12}


BHOU10b

{green}ENTER MIDDLE NAME{normal}

{allow 30; not a required response}


BHOU10c

{green}ENTER LAST NAME{normal}

{allow 30}      

                       

BHOU10d                              

What is this person's address?  If you don’t know the exact address, please tell me a street name or a neighborhood.

@/@/@/

{green)INTERVIEWER: BE SURE TO PROBE FOR A BLDG AND/OR APT NUMBER.{normal}

{allow 100}

                       

BHOU10e

And in what city is that?

{allow 30}


BHOU10f

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}



BHOU10g

Does this person have a phone number?

YNDKRF

{if BHOU10g=yes, ask BHOU10g1; if=no, dk, or rf, go to BHOU10i }


BHOU10g1

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}

           

BHOU10h

{if BHOU10g=yes, ask BHOU10h} Does this person have a second phone number, such as a cell phone?

YNDKRF

{if BHOU10h=yes, ask BHOU10h1}


BHOU10h1

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}


BHOU10i

Does this person work outside of the home?

YNDKRF

{if BHOU10i=yes, ask BHOU10i1 else ask BHOU10j }


BHOU10i1

Where does this person work?  In other words, what is the name of the company or organization this person works for? Remember, we will not contact them at work unless we’ve tried all other possible means of locating you.

{allow 30}


BHOU10i2

And in what city is that?

{allow 30}


BHOU10i3

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}


BHOU10i4

Does this person have a work phone number?

YNDKRF

{if BHOU10i4=yes, ask BHOU10i5}


BHOU10i5

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}



BHOU10j

What is this person's relationship to you?

RELATION

{if BHOU10j=Other, ask BHOU10j1}


BHOU10j1

{green}DESCRIBE THE RELATIONSHIP OF THE PERSON TO R, RECORDING THE R’S ANSWER VERBATIM.{normal}

{allow 100}


BHOU10k

Thank you. Please let this person know that you would like them to tell me where I can find you when it is time for your next interview.



BHOU11a

What is the name of a third person who would know how to reach you?

@/@/@/

{green}ENTER FIRST NAME{normal}

{allow 30}

{if BHOU11a=dk or rf, go to BHOU12}


BHOU11b

{green}ENTER MIDDLE NAME{normal}

{allow 30; not a required response}


BHOU11c

{green}ENTER LAST NAME{normal}

{allow 30}      

                       

BHOU11d                              

What is this person's address?  If you don’t know the exact address, please tell me a street name or a neighborhood.

@/@/@/

{green)INTERVIEWER: BE SURE TO PROBE FOR A BLDG AND/OR APT NUMBER.{normal}

{allow 100}

                       

BHOU11e

And in what city is that?

{allow 30}


BHOU11f

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}


BHOU11g

Does this person have a phone number?

YNDKRF

{if BHOU11g=yes, ask BHOU11g1; if=no, dk, or rf, go to BHOU11i }


BHOU11g1

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}

           

BHOU11h

{if BHOU11g=yes, ask BHOU11h} Does this person have a second phone number, such as a cell phone?

YNDKRF

{if BHOU11h=yes, ask BHOU11h1}


BHOU11h1

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}


BHOU11i

Does this person work outside of the home?

YNDKRF

{if BHOU11i=yes, ask BHOU11i1; else ask BHOU11j}


BHOU11i1

Where does this person work?  In other words, what is the name of the company or organization this person works for? Again, we will not contact them at work unless we’ve tried all other possible means of locating you.

{allow 30}


BHOU11i2

And in what city is that?

{allow 30}


BHOU11i3

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}


BHOU11i4

Does this person have a work phone number?

YNDKRF

{if BHOU11i4=yes, ask BHOU11i5}


BHOU11i5

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}

     

BHOU11j

What is this person's relationship to you?

RELATION

{if BHOU11j=Other, ask BHOU11j1}


BHOU11j1

{green}DESCRIBE THE RELATIONSHIP OF THE PERSON TO R, RECORDING THE R’S ANSWER VERBATIM.{normal}

{allow 100}


BHOU11k

Thank you. Please let this person know that you would like them to tell me where I can find you when it is time for your next interview.


Now, if you are still okay with providing it, I’d like to get your (PARTNER/SPOUSE)’s name and contact information so that we can contact her and ask whether she would like to participate in the partner interview.


BHOU12a

What is your (PARTNER/SPOUSE)’s name?


IBHOU12d                            

What is your (PARTNER/SPOUSE)'s address?  If you don’t know the exact address, please tell me a street name or a neighborhood.

@/@/@/

{green)INTERVIEWER: BE SURE TO PROBE FOR A BLDG AND/OR APT NUMBER.{normal}

{allow 100}

                       

BHOU12e

And in what city is that?

{allow 30}


BHOU12f

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}


BHOU12g

Does your (PARTNER/SPOUSE) have a phone number?

YNDKRF

{if BHOU11g=yes, ask BHOU11g1; if=no, dk, or rf, go to BHOU11i }


BHOU12g1

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}

           

BHOU12h

{if BHOU11g=yes, ask BHOU11h} Does your (PARTNER/SPOUSE) have a second phone number, such as a cell phone?

YNDKRF

{if BHOU11h=yes, ask BHOU11h1}


BHOU12h1

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}


BHOU12i

Does your (PARTNER/SPOUSE) work outside of the home?

YNDKRF

{if BHOU11i=yes, ask BHOU11i1; else ask BHOU11j}


BHOU12i1

Where does your spouse/partner work?  In other words, what is the name of the company or organization (she) works for? Again, we will not contact her at work unless we’ve tried all other possible means of locating her.

{allow 30}


BHOU12i2

And in what city is that?

{allow 30}


BHOU12i3

And in what state is that?

@/@/@/

{green}INTERVIEWER:  CODE THE STATE USING THE LookUp TABLE BY EITHER PRESSING <BACKSPACE> OR STARTING TO TYPE THE NAME OF THE STATE.{normal}

{lookup list of states}


BHOU12i4

Does your (PARTNER/SPOUSE) have a work phone number?

YNDKRF

{if BHOU11i4=yes, ask BHOU11i5}


BHOU12i5

What is that phone number, starting with the area code?

@/@/@/

{green}INTERVIEWER:  IF R DOES NOT KNOW THE NUMBER, CODE “DON’T KNOW”.{normal}

{three separate numeric fields presented together: field1, allow 3; field2, allow 3; field3, allow 4}


BHOU12k

Thank you. Please let your (PARTNER/SPOUSE) know that you would like them to tell me where I can find you when it is time for your next interview.



BHOU13

If I’m really having difficulty finding where you live, can you tell me where you spend your time when you are not at home and not at work? What local places do you like to spend time at?



___________________________________________________________(description of places)

Social security number

1. What is your social security number?

___-__-____

Name



2. And just to confirm, do you still go by (R FIRST AND LAST NAME)?

YES

NO



3. (If no) What name or names do you go by?



_________________(FIRST)

_________________(LAST)



_________________(FIRST)

_________________(LAST)



Other info R would like to share



4. Finally, is there anything else you think we should know about how incarceration has affected you or your family?



That was our last question. Thank you for your participation in this study! Someone from RTI might contact you by phone or by mail to briefly verify the quality of my work.


We will also contact you again in 9 months to invite you to participate in a follow-up interview. You can decide at that time whether or not you wish to participate.


Before I leave, I want to give you this card with toll-free helpline numbers. Some people have found these to be useful.


I also need to give you your incentive payment, and I need to ask you to initial a receipt.




Incentive


5. WAS THE R ELIGIBLE FOR THE $5 BONUS?

YES
NO



6. HOW WAS THE INCENTIVE PAID?

1. INMATE ACCOUNT

2. DESIGNEE

3. INCENTIVE NOT PERMITTED BY FACILITY

4. OTHER (SPECIFY)


INTERVIEWER OBSERVATIONS


BFIO1

HOW COOPERATIVE WAS THE RESPONDENT?”

(Verycoop “VERY COOPERATIVE,”

 Faircoop “FAIRLY COOPERATIVE,”

 Notcoop “NOT VERY COOPERATIVE,”

 Hostile “OPENLY HOSTILE”)


BFIO2

ESTIMATE THE RESPONDENT’S LEVEL OF UNDERSTANDING OF THE INTERVIEW QUESTIONS.”

(Nodiff “NO DIFFICULTY UNDERSTANDING QUESTIONS,”

 Litdiff “JUST A LITTLE DIFFICULTY UNDERSTANDING QUESTIONS,”

 Fairdiff “A FAIR AMOUNT OF DIFFICULTY UNDERSTANDING QUESTIONS,”

 Alotdiff “A LOT OF DIFFICULTY UNDERSTANDING QUESTIONS”)


BFIO3

HOW MUCH TROUBLE DID THE RESPONDENT HAVE REMEMBERING PAST EVENTS?”

(Notrob “NO TROUBLE,”

 Littrob “JUST A LITTLE TROUBLE,”

 Fairtrob “A FAIR AMOUNT OF TROUBLE,”

 Alottrob “A LOT OF TROUBLE”)

           

BFIO4

ESTIMATE THE RESPONDENT’S LEVEL OF TRUTHFULNESS/MISPRESENTATION.”

(Verytrth “VERY TRUTHFUL,”

 Fairtrth “FAIRLY TRUTHFUL,”

 Nottrth “NOT VERY TRUTHFUL,”

 Lying “OPENLY LYING”)


BFIO5

IN GENERAL, HOW ENGAGED/INTERESTED WAS THE RESPONDENT DURING THE INTERVIEW?”

(Veryengd “VERY ENGAGED AND INTERESTED,”

 Fairengd “FAIRLY ENGAGED AND INTERESTED,”

 Notengd “NOT VERY ENGAGED AND INTERESTED,”

 Totuneng “TOTALLY UNENGAGED AND DISINTERESTED”)


BFIO6

IN GENERAL, HOW IRRITABLE OR MOODY WAS THE RESPONDENT DURING THE INTERVIEW?”

(Veryengd “VERY IRRITABLE/MOODY,”

 Fairengd “FAIRLY IRRITABLE/MOODY,”

 Notengd “NOT VERY IRRITABLE/MOODY”

 Totuneng “NOT AT ALL IRRITABLE/MOODY”)


BFIO7

INDICATE THE DEGREE OF DISTRACTIONS OR INTERRUPTIONS DURING THE INTERVIEW.”

(None “NO DISTRACTIONS OR INTERRUPTIONS,”

 Afew “JUST A FEW DISTRACTIONS OR INTERRUPTIONS,”

 Fairnumb “A FAIR NUMBER OF DISTRACTIONS OR INTERRUPTIONS,”

 Alot “A LOT OF DISTRACTIONS OR INTERRUPTIONS”)


BFIO8

HOW MUCH EYE CONTACT DID THE RESPONDENT USE DURING YOUR INTERACTION?”

(“R MOSTLY AVOIDED EYE CONTACT,”

 “R OCCASIONALLY MADE EYE CONTACT,”

R MOSTLY MADE EYE CONTACT.”




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