Household Outcomes Survey Item by Item Justification � Non-Experimental Version

Appendix D

Household Outcomes Survey Item by Item Justification – Non-Experimental Version

AHPP QOL Evaluation – Household Outcomes Survey Item by Item Justification for Non-Experimental Version

Q #	Question		Previous Survey Question Used on (if not new)	Domain(s)	Justification
Screener Confirmation of Respondent
SC1-SC3		Confirmation of respondent’s name, baseline address, and date of birth			These questions are necessary to ensure that 1) the respondent is the person of interest and 2) that the baseline information in our records is accurate.
Introduction
None		Informed Consent		Tracking	It is important to obtain renewed consent from study participants for the first and second household outcomes survey. The study participants are a vulnerable population and it is imperative that they understand what they are agreeing to and how we will protect them.
INTRO1-INTRO3		Where were you living immediately before the hurricane, that is, in August 2005? At the time that you applied, what type of housing were you living in? Did you ever live in a FEMA travel trailer or mobile home? On what kind of site was your FEMA unit located?	AHPP baseline (modified) New	Tracking Mobility	It is important for us to understand participant mobility in order to track participants, understand residential mobility, and identify subgroups for data analysis. These questions track key participant addresses and ask questions about the type of place they were living at the time. If a participant provided address information during the baseline survey, he/she will not be asked the questions again.
INTRO4		What is your current address and phone number?	Moving To Opportunity (MTO)	Tracking Mobility	Current address is critical to the tracking effort and also to understanding current neighborhood conditions and the residential patterns of AHPP participants.
Section A: AHPP Unit
A1		What is the main reason you applied for an AHPP unit?	AHPP baseline		A1 allows us to capture this data retrospectively for those participants in Mississippi who did not complete a baseline survey.
A2		In what month and year did you move into your AHPP unit?	New	Mobility	A2-A5 will be paired with address information so we can understand residential mobility and identify subgroups for data analysis.
A3		Are you currently living in your AHPP unit?	New
A4		On what type of site is/was your AHPP unit located?	New
A5		When did you move out of your AHPP unit?	New
A6-A6e1		What was the main reason that you moved out of your AHPP unit? What was the main reason you were dissatisfied with your AHPP unit?	MTO modified response categories	Housing quality Mobility	A6 is designed to get an overall sense of why participants choose to leave the AHPP units. A6a-A6e1 are intended to capture more specific feedback on reasons for leaving including issues with the AHPP unit (quality, location, or affordability) or personal issues that were unrelated to the unit.
A7		At any time while you were living in your AHPP unit, were any of the following conditions present?	AHPP baseline	Housing quality	This series of questions assesses quality of AHPP housing for program participants who moved out of their AHPP unit. (Section B repeats this series of questions for participants that are currently living in the AHPP unit.)
		a. Mildew, mold, or water damage on any wall floor, or ceiling?
		b. Floor problems such as boards, tiles, carpeting or linoleum that were missing, curled or loose?
		c. Any holes or large cracks where outdoor air or rain could come in?
		d. Did you smell bad odors such as sewer, natural gas, etc. in your home?
		e. Bathroom floors covered by water because of a plumbing problem?
		f. Had your toilet not worked for 6 hours or more?
		g. Had your electricity not worked for 2 hours or more?
		h. In cold weather, did you ever need to use your oven to heat your home?
		i. Did all outside doors and windows have locks that worked?
A8		Not including bathrooms and hallways, how many rooms were in your AHPP unit?	MTO (originally from 3City)		A9-A11 in combination with household composition data provide information on overcrowding for former AHPP participants. Section B captures this information for current AHPP participants.
A9		How many of the rooms in the AHPP unit were bedrooms?	New
A10 A10a		When you were living in the AHPP unit, did anyone in the household regularly sleep in a room other than a bedroom because there were not enough bedrooms? Was this because there were not enough bedrooms	New
A11 A11a		When you were living in the AHPP unit, did anyone in the household go somewhere else to sleep because there was not enough space in the AHPP unit? Was this because there was not enough space in the AHPP unit for everyone to sleep there?	New
A12		What feature(s) of the AHPP units are/were most attractive to your family?	New	Housing quality	This series of questions will help us understand what aspects of the AHPP units were most attractive to current and former program participants.
		a. Was the amount of living space an attractive feature to you?
		b. Was the number of bedrooms an attractive feature to you?
		c. Were the kitchen facilities (stove, dishwasher etc.) attractive features to you?
		d. Were the bathroom facilities (tub, shower, size) attractive features to you?
		e. Was the room design and layout an attractive feature to you?
		f. Was the furniture an attractive feature to you?
		g. Was the structural soundness, or way that the unit was built, an attractive feature to you?
		h. Was the accessibility of the unit an attractive feature to you?
		i. Was there any other feature that was attractive to you? (SPECIFY_____________________)
A13		I’d like you to think about your housing unit when you lived in a FEMA travel trailer/mobile home. How would you describe the overall condition of your AHPP unit as compared to your FEMA unit? Would you say your AHPP unit is/was in better condition, worse condition, or about the same condition as the FEMA unit?	MTO and HOPE VI modified	Housing quality	Asks participants to directly compare their FEMA unit and their AHPP unit. If AHPP units are an alternative to FEMA travel trailers, we need a direct comparison to judge the relative merit of each unit type.
A14		I’m going to read a list of housing features and I’d like you to tell me whether the feature was better in your AHPP unit, worse in your AHPP unit, or about the same in your AHPP unit.	AHPP baseline, modified	Housing quality	Allows participant to make direct comparisons between the FEMA unit and the AHPP unit in several key housing quality areas. If AHPP units are an alternative to FEMA travel trailers, we need a direct comparison to judge the relative merit of each unit type.
Section B: Current Housing and Housing Quality
B1 B1a.		[IF NOT IN AHPP UNIT] I’d like to ask you some questions about your current housing situation. Do you/Are you… Rent your home or apartment? Live in a home you own? Live with family or friends and pay part of the rent? Live with family or friends and do not pay rent? Live in a group shelter? Homeless Incarcerated Living in a group home, dorm or barracks Living in a hospital/nursing home or special school Living in some other arrangement Do you currently rent or own your AHPP unit?	MTO modified	Housing quality	Allows us to determine the current housing type/situation for all participants.
B2-B2a		How many years have you lived at your current address? How many months have you lived at your current address?	MTO	Housing security	[B2-B4] These questions (combined with B14-23) measure housing security. Are sample members able to maintain their own housing units? If not, are they doubling-up with other families and/or experiencing homelessness?
B3		Was there ever a time during the past 12 months when you did not have your own place to stay?	MTO
B4		During this time, did you stay: With a relative With a friend In a shelter On the streets or another place not generally used for housing	MTO
B5		Overall, how would you describe the condition of your current house/apartment/living space? Would you say it was in excellent, good, fair, or poor condition?	MTO baseline	Housing quality	Housing quality is both an outcome of interest in its own right and a mediating factor for other outcomes. Moves into AHPP units are likely to increase with the quality of housing. Better-quality housing may also reduce stress.
B6		Does your current housing have any of the following problems? [Categories for a-i are the same as A8]	AHPP baseline	Housing quality
B7		Not including bathrooms and hallways, how many rooms are there in your current house/apartment/living space?	MTO (originally from 3City)		B7-B9a in combination with household composition data provide information on overcrowding.
B7a.		How many of the rooms in your house/apartment/living space are bedrooms?	New
B8 B8a		Does anyone in the household regularly sleep in a room other than a bedroom because there are not enough bedrooms? Was this because there were not enough bedrooms in your unit?	New
B9 B9a		Does anyone in the household go somewhere else to sleep because there is not enough space in your house/apartment/unit? Was this because there was not enough space in the unit for everyone to sleep there?	New
B10		Do you agree or disagree with the following statement: “This place where I live now feels like home to me”?	New	Housing quality	Combined with BB5 this question measures housing satisfaction.
B11 B12 B13 B13a		Is your current residence your permanent unit? What is your permanent or long-term housing plan? When do you expect to be in your permanent housing? What is the main reason you have not been able to complete your permanent housing plans?	New	Permanent housing plans	B11-B13a define the participant’s permanent housing plans and serve as a benchmark to be measured against in the second household outcomes survey. It will help us understand how AHPP fits into the respondent’s permanent housing plan and allow us to compare outcomes for respondents who view AHPP as temporary and those who view it as permanent.
B14 B14a B15		What is the monthly amount you pay for owning this (condo/house)? I have recorded that you pay [amount] to own this unit is that correct? During the past 12 months, were you ever more than 15 days late paying your mortgage?	MTO and HOPE VI (modified)	Housing security Rent/mortgage payments and hardship Utility payments and hardship	This series, in connection with B2-B4 assess financial burden on the respondents with respect to rent/mortgage and utility payments. Most residents in FEMA housing are not paying rent or utilities. It will be important to determine if utility or other payments make living in AHPP units more burdensome for occupants. B14-B15 are asked of owners and B16--B22 are asked of renters; B23-B23a are asked of all.
B16 B16a B17 B17a B18 B19 B20 B21 B22		Altogether in the month just past, what did you pay as rent? I have recorded that you pay [amount] monthly in rent is that correct? What is the total current monthly rent payment on this apartment/house? I have recorded [amount] as the total current monthly rent for this unit, is that correct? Do you currently receive any governmental housing assistance in paying rent such as through public housing or a housing choice voucher? Is your rent lower because you are in a Federal, State or local government housing program? During the past 12 months were you ever more than 16 days late paying your rent? During the last 12 months, have you ever been evicted for any reason? Do you pay utilities separately from rent?	MTO and HOPE VI (modified)
B23 B23a		During the past 12 months, were you ever more than 15 days late paying your electric, gas, or water bill? In the past 12 months, was your gas, water, or electricity ever shut off?	MTO and HOPE VI (modified)
B24 B25 B26 B27 B28 B29 B30 B31		Were any of the following items broken during the last six months? [FOR EACH YES IN B24a-g] Have you called to have [B24item] repaired in the last six months? Thinking about the most recent time you called to have something repaired, how many days did it take for someone to come repair it? Still thinking about that time, were you satisfied with how quickly the broken item was repaired? Were you satisfied with the quality of the repair? Do you know the phone number or know where to find the phone number to call if you need the landlord to repair something in your house? In general, how satisfied are you with the quality of routine repairs and maintenance? In general, how satisfied are you with the promptness of emergency repairs?	New	Housing quality, maintenance quality	This series of questions is intended to capture issues around AHP unit maintenance and repair to measure if an item(s) required repair, it the repairs were done, and the respondent’s knowledge of who to contact with repair issues.
B32 B32a B33 B34 B35a-e B36 B37 B38		How many people do you live with now? What is your marital status? Now I’d like you to think back to the time when the hurricane hit and the people that were living with you then. Are all, some or none of them living with you now? Is the reason these people are not living with you now related to the AHPP unit or is it a personal reason? I’d like to learn a little bit more about why those people are no longer living with you. Are any of them no longer living with you because… Does your AHPP unit allow more, less, or the same number of you family members to live together than the place you lived in just before your AHPP unit? Now I’d like you think about all of the people that lived with you both at the time of the hurricane and now. Have you been separated from any of them for 30 days or more at any time since the hurricane? Did receiving your AHPP unit allow you to live together once again?	AHPP baseline	Household Composition	B32 – B38 measure whether or not receipt of an AHPP unit allows families to “reconnect.” For all current household members we ask if they were living with the respondent at the time of the hurricane. If yes, we ask if there was any period of separation lasting 30 days or more. For those who are not living with all pre-hurricane household we ask why they aren’t together
Section C: Quality of Life Measures
C1		Would you say your health is excellent, very good, good, fair, or poor?	SF-12v2	Physical health	The physical health questions [C1 – C10] have been modified to focus primarily on the aspects of physical health that are likely to be affected by a housing unit, particularly a trailer or other manufactured unit—physical disabilities and ease of accessibility and breathing problems, such as asthma. Questions are asked with regard to respondent’s health, the health of other adults in household, and the health of children in household.
C2 C2a		Do you or anyone in the household have a physical disability or condition that limits one or more basic activities such as walking, climbing stairs, reaching, lifting, or carrying? Is anyone in a wheelchair or otherwise unable to climb stairs at all?	AHPP baseline
C3		(IF C2 or C2a=YES) I’d like to ask some questions about how the needs of this person were/are addressed in your FEMA unit, your AHPP unit, and in your current housing. a. Could the person with the physical disability get in and out of their [FEMA/AHPP/CURRENT] unit by themselves? b. Could the person with the physical disability move around from room to room within the unit by themselves? c. Could the person with the physical disability or condition get in and out of the bathroom by themselves in the [FEMA/AHPP/CURRENT] unit?	New
C4 C4a C4b		Has a doctor or other health professional ever told you that you had asthma? Do you still have symptoms? When were you first diagnosed with asthma?	NHIS99 (MTO and HOPE VI modified)		These questions measure the incidence of asthma and emphysema in the study population. Asthma incidence is known to be higher in high-poverty communities and communities with older housing stock, possibly due to crowding, poor air quality, stress, and/or exposure to allergens from cockroaches, mites, mice, mold, and cigarette smoke. Unlike many other chronic health problems, asthma is highly sensitive to current environmental conditions. Breathing problems are of particular interest for AHPP recipients who lived in FEMA trailers because of formaldehyde concerns. Questions are asked of the adult respondent, other adults, and children.
C5 C6		During the past 6 months, have you had an episode of asthma or asthma attack? During the past 6 months did you have to visit an emergency room or urgent care center because of asthma?
C7		Have you ever been told by a doctor or other health professional that you have… Emphysema? If yes, when were you diagnosed? Allergies? ? If yes, when were you diagnosed? Other respiratory or breathing problems? If yes, when were you diagnosed?	New
C8		We are interested in knowing if living in the AHPP unit has affected your breathing problems in any way. While living in an AHPP unit, do you think that your breathing problems got better, worse or stayed the same?	New
C9		Has another adult in your household ever been told by a doctor or other health professional that he/she has… Emphysema? If yes, when were you diagnosed? Allergies? If yes, when were you diagnosed? Oher respiratory or breathing problems? If yes, when were you diagnosed?	New
C10		We are interested in knowing if living in the AHPP unit has affected any other adults breathing problems in any way. While living in an AHPP unit, do you think that any other adults breathing problems got better, worse or stayed the same?	New
C11		Has a child in your household ever been told by a doctor or other health professional that he/she has… Emphysema? If yes, when were you diagnosed? Allergies? If yes, when were you diagnosed? Other respiratory or breathing problems? If yes, when were you diagnosed?	New
C12		We are interested in knowing if living in the AHPP unit has affected a child in your household’s breathing problems in any way. While living in an AHPP unit, do you think that a child’s breathing problems got better, worse or stayed the same?	New
C13 C13a C14 C14a C15 C15a C15b C16		Have you smoked at least 100 cigarettes in your entire life? Have you smoked at least 100 cigarettes since Hurricane Katrina? On how many of the past 30 days did you smoke a cigarette? On average when you smoked in the past 30 days, about how many cigarettes did you smoke per day? Do you smoke cigarettes inside your home? Did you smoke cigarettes inside your FEMA trailer or mobile home? Did you quit smoking before you moved into your AHPP Unit? Since living in the AHPP unit, do you think that you smoke, more, less, or about the same?	NHIS99 (MTO and HOPE VI modified)	Physical health	C13 measures the prevalence and intensity of tobacco use among AHPP participants. People who experience natural disasters may suffer from depression, anxiety or post-traumatic stress disorder. Depression and stress are heightened in people that experience such adverse events and both are correlated with tobacco use. Participants who move to an AHPP unit may experience less depression and stress if they feel that their housing situation has stabilized. These changes may be reflected in tobacco use. C16 asks respondents to compare their smoking habits from before living in the AHPP unit to their current smoking habits.
C17		How much of the time during the past month have you felt… a. So sad that nothing could cheer you up? b. Nervous? c. Restless or fidgety? d. Hopeless? e. That everything was an effort? f. Worthless? g. Calm and Peaceful?	AHPP baseline [National Co-Morbidity Survey (K6 Scale)]	Emotional health	It is hypothesized that a move to better quality housing (like an AHPP unit) would have a positive impact on a participant’s emotional health. This scale allows a comparison of emotional health measures over time.
C18		In the lat month how much ere you bothered by [READ ITEM]? Would you say you were bothered not at all, a little bit, moderately, quite a bit, extremely?	PTSD PCL-Civilian checklist	Emotional health	We use the PTSD PCL module to measure Post Traumatic Stress Disorder. This 17 question module is the shortest module that yields reliable results. We use the full module to ensure that the results retain the high level of reliability and leave open the opportunity to compare results against national norms. The participants in this study may experience PTSD. This module will allow us to measure if they are more affected than the general population and also to measure differences between those who receive and AHPP unit and those who do not.
		a. Repeated, disturbing memories, thoughts, or images of a stressful experience from the past?
		b. Repeated, disturbing dreams of a stressful experience from the past?
		c. Suddenly acting or feeling as if a stressful experience were happening again (as if you were reliving it)?
		d. Feeling very upset when something reminded you of a stressful experience from the past?
		e. Having physical reactions (e.g., heart pounding, trouble breathing, or sweating) when something reminded you of a stressful experience from the past?
		f. Avoid thinking about or talking about a stressful experience from the past or avoid having feelings related to it?
		g. Avoid activities or situations because they remind you of a stressful experience from the past?
		h. Trouble remembering important parts of a stressful experience from the past?
		i. Loss of interest in things that you used to enjoy?
		j. Feeling distant or cut off from other people?
		k. Feeling emotionally numb or being unable to have loving feelings for those close to you?
		l. Feeling as if your future will somehow be cut short?
		m. Trouble falling or staying asleep?
		n. Feeling irritable or having angry outbursts?
		o. Having difficulty concentrating?
		p. Being “super alert” or watchful on guard?
		q. Feeling jumpy or easily startled?
C19 C20 C21		In a usual week, do you do moderate activities on three or more days for at least 10 minutes at a time? About how tall are you without shoes? About how much do you weigh?	AHPP baseline	Physical health	Obesity is an important indicator of overall health, and could play a role in breathing issues and emotional health.
C22		Are you currently… Employed full-time, part-time, self-employed, unemployed looking for work, not working for pay?	AHPP baseline	Employment, education, and income	Repeat of baseline measures. This will allow us to measure changes in employment, education, and income over time.
C23		[IF not working] What is the main reason you aren’t working for pay?	AHPP baseline		C23 – C34 will be used in conjunction with similar questions in other domain areas to build an index of quality of life measures affected by the hurricane.
C24		Did you have to leave a job in order to move to where your MAHP unit was located	New
C25		Are you currently working for the same employer that you worked for before you moved into your AHPP unit?	New
C26a-e		Compared to where you lived before you moved into your AHPP unit, is it easier, harder, or about the same to…	New
C27		How many people in your household (including yourself) are employed full-time or part-time?	AHPP baseline
C28		I’m going to read a list of possible income sources. For each one, please answer yes, if someone in your family had income from this source in the past month.	AHPP baseline
C29 C29a C29b		What is your household’s total monthly income? I have recorded that your total monthly household income is [Amount] is that correct? If C28=NO INCOME IN PAST MONTH: I‘ve recorded that you had no income in the past month. Is that correct	AHPP baseline modified
C30 C31 C31a		Was your total household income last month what you would receive in a typical month? In a typical month, what would your household’s total monthly income from all sources be? I have recorded your total monthly household income in a typical month as…	New
C32a-d		In the past month have you or anyone in your household had to use one of the following sources in order to cover your living expenses?	AHPP baseline
C33a-d		In the past month have you lived in housing or received financial assistance from family, friends, or a charitable organization?	AHPP baseline
C34	What is the highest degree or level of school that you have completed?		AHPP baseline		A more stable living situation may encourage a participant to further their education as a means to employment.
C35 C35a C35b C35c	Of the [# in B32] people living in your household, are any of them children age 17 or under? How many children in your household are age 5 or under? How many children in your household are between ages 6 to 11 years of age? How many children in your household are between ages 12 and 17		New		C35-C38 One of the expected quality of life changes we expect to see centers around children. It is expected that living in an AHPP unit is likely to help with strengthen the child’s connection to school. Improved living situations may also strengthen the parent’s ability to play a more active role in the child’s educational experiences.
C36	Now I’d like to learn a little more about your opinion on how the AHP program may have affected your children age 17 and under. Since moving into your MAHP unit would you say that your children’s emotional health has improved, stayed the same, or gotten worse? Would you say that your child’s behavior has improved? Would you say that your child’s enthusiasm to go to school has improved? Would you say that your child’s desire to go to school has improved?		New
C37	Since moving into your AHPP unit, have you or another adult… Attended a regular school meeting? Volunteered to serve on a committee or help out in the school? Attended any school activities? Met with your child’s teacher to discuss their progress? Met with child’s teacher to discuss any behavior problems he/she has?		MTO
C38	Are you or another adult more likely, less likely, or equally likely to do the types of events we just discussed now than you were before moving into your AHPP unit?		New
C39 C39a	Are you living on the same property or lot as you were before the hurricane hit? Thinking about your neighborhood now, are you living in the same neighborhood as when the hurricane hit when you lived at [PRE-Hurricane address] or living in a different neighborhood?		New HOPE VI modified	Neighborhood quality	Measures changes in neighborhood as perceived by the respondent. Can be compared against census and crime data for the neighborhood once addresses are geocoded.
C40	Thinking about your neighborhood now, are you living in the same neighborhood as when you lived at [BASELINE address] or living in a different neighborhood?		HOPE VI modified
C41	Now please tell us how satisfied you are with the following neighborhood amenities for your current housing… - Distance to your job? - Distance to your child’s school? - Quality of your child’s school? - Garbage pick-up? - Police response? - Outdoor space? - Distance to grocery store? - Friendliness of neighbors? - Availability of child care? - Availability of health care?		AHPP baseline		C41 allows direct comparison of satisfaction in current unit to baseline, or pre-AHPP, unit.
C42 C42a.	How safe do you feel … On the streets near your home during the day? On the streets near your home at night? Do you feel more, less, or equally safe in your current unit than you did in your FEMA unit?		MTO baseline/ HOPE VI	Neighborhood quality	These questions measure fear of crime and crime victimization in the current neighborhood. In prior research fear of crime and victimization were identified as factors with pervasive effects on families’ lives. Fear also contributes to stress. AHPP units in new neighborhoods may reduce stress and fear. Reduced stress and fear may also affect mental health (e.g., reduced anxiety and depression), with consequent impacts on employability. Thus, families’ sense of safety and exposure to crime and violence can be expected to act as mediating factors in a number of areas.
C43	Please tell me if any of the following things have happened to you or anyone who lives/lived with you in the past 6 months. Was anyone’s purse, wallet, or jewelry snatched from them? Was anyone threatened with a knife or a gun? Was anyone beaten or assaulted? Did someone try to break into your home? Was anyone stabbed or shot?		MTO baseline NCVS modified
C44	Now, still thinking about the area you consider your neighborhood, please tell me if the following items are a big problem, small problem or no problem at all. People being attached or robbed People selling drugs People using drugs Shootings and violence		HOPE VI
C45 C46	I am going to ask you about different types of help that may be available to you if you need it. First, I’d like you to think back to the time immediately before the hurricane. If you needed help in the following areas, was it available to you? Someone available to help you if you were confined to bed. Someone available to give good advice about a crisis. Someone available to get together with for relaxation. Someone available to confide in or talk about your problems. Someone available to love you and make you feel wanted. If you needed that help now, would it be available to you? Someone available to help you if you were confined to bed. Someone available to give good advice about a crisis. Someone available to get together with for relaxation. Someone available to confide in or talk about your problems. Someone available to love you and make you feel wanted.		Florida Hurricane Survey	Social interactions	Measures the social supports available to participants in the time prior to the hurricanes and now.
C47	Think about the unit and the neighborhood you live in now. How safe do you feel… from flooding? from high winds? from hurricances?		New	Neighborhood safety
C48	In what ways do you think that the AHP program has affected your quality of life?		New		This open end question allows us to capture information on what participants think the benefit of an AHP unit has been to their life.
Secondary Contact Information
C49-C56	Name, Address, Phone, Relationship to Respondent		MTO	Tracking	C50-C57a captures relevant contact data for up to two people who will always know how to reach the respondent for participant tracking purposes.
C57 C58 C59 C60	Debriefing Module: Were any of the survey questions upsetting to you? Are you still upset? Would you like to take this card and call the helpline? INTERVIEWER DID RESPONDENT ACCEPT CARD?		Florida Hurricane Survey		This module was incorporated to ensure that participating in the study does not pose any emotional trauma to AHP participants.

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Abt Associates Inc. Appendix D Household Outcomes Survey Item by Item Justification – Non-Experimental Version