Appendix
B
Household Outcomes Survey – Non-Experimental
Version
OMB Control Number _____
Omb Expiration Date _____
Hello, my name is ______________ and I work for Abt Associates. We are assisting the U.S. Department of Housing and Urban Development (HUD) to evaluate the Alternative Housing Pilot Program (AHPP). One way in which we are studying the AHPP is to talk to people that are living in AHPP units to see how things are going for them since they moved in. We’ll ask them some questions about how they like the unit itself, how it compares to other places that they have lived, and how the family likes the unit. I’d like to know if you are willing to take a few minutes to complete this study with me now. The survey is voluntary and will take approximately 45 minutes to complete. The collection of this information has been approved by OMB. The results from these surveys will be used to determine what types of alternative housing would be best to use after future disasters.
SC1. Are you willing to participate in a survey for me now? The interview will take about 45 minutes to do.
YES, 1 ASK SC2
NO, 2
SC1a. Would you be willing to participate in an interview at another time, maybe later today or tomorrow?
YES, 1 ASK SC2
NO THANK RESPONDENT AND TERMINATE 2
Thank you for agreeing to participate in this interview. First, I would like to make sure that I am speaking to the right person.
SC2. My records show that your address at the time that you applied for an AHPP unit was READ ADDRESS BACK TO RESPONDENT:
[BASE STREET ADDRESS] [BASE CITY] [BASE STATE] [BASE ZIP]
2a. Is that correct?
YES,
REPONDENT CONFIRMED
BASE ADDRESS IN OUR RECORDS 1 ASK
SC4
NO, RESPONDENT INDICATES BASE
ADDRESS IS INCORRECT 2 ASK SC3
SC3. Where were you living at the time you applied for the AHPP unit in [BASELINE MONTH/YEAR]?
STREET
CITY: STATE: ZIP:
IF RESPONDENT DATA DO NOT VERIFY:
Since your address at [BASELINE] does not match what I have in my records, I’m going to verify the information in our records with my supervisor. I may [come back/call you back] at a later date to conduct the interview. Thank you for your time.
IF RESPONDENT DATA VERIFY:
You were selected for the interview because you received an AHPP unit. Your answers are important. We will ask you a series of questions about your neighborhood, housing, health, family, friendships, employment, and household composition. Your answers will not be traced back to you and your name will never be used in any report about this survey. Participating in this survey cannot affect any housing assistance you may be receiving.
Now I’d like to go over this form that says you agree to take part in the survey, and record your consent.
IF IN-PERSON INTERVIEW: GO OVER CONSENT FORM, AND OBTAIN SIGNATURE
IF TELEPHONE INTERVIEW: GO OVER CONSENT FORM, AND ASK RESPONDENT TO VERBALLY INDICATE THEIR CONSENT.
SURVEY CONSENT FORM: AHPP Household Outcomes Study I (PRINT NAME:________________________________________________________) acknowledge that by participating in this survey, I understand the following statements:
YES, This information has been read to me and I want to complete this survey. I agree to let the researchers studying this program get information about me and my family from FEMA, HUD, or other agencies. I understand that this information will be kept private, except as required by law, and that my name will not be used in any study report.
NO, I have read this form and have decided not to complete this survey.
_______________________________________________ ____/____/____ Signature Date
_______________________________________________ Name: Please Print
If you have questions about your rights as a participant in this study call Marianne Beauregard at 617-249-2852, which may be a toll call. |
PROGRAMMER NOTE: CAPI WILL CONTAIN A CHECK TO INDICATE THE FOLLOWING:
PRE-KATRINA ADDRESS KNOWN:PKADD=1 if known from survey or application data
Throughout the interview, we will ask questions about your housing at different points in time. Before we begin the interview, I want to make sure I understand your housing situations at different times between the hurricane and now.
Intro1. [IF PRE-KATRINA ADDRESS IS KNOWN SKIP TO Intro2, IF NOT AVAILABLE ASK:] Where were you living immediately before the hurricane hit, that is before August 29, 2005?
STREET
CITY: STATE: ZIP:
Intro2. At the time that you applied for AHPP housing, were you living in:
A FEMA mobile home (SKIP TO Intro3b) 1
A FEMA travel trailer (SKIP TO Intro3b) 2
A Non-FEMA travel trailer 3
A Non-FEMA mobile home 4
A rental unit you leased 5
In a housing unit with others, not paying part of the rent 6
In a housing unit with others, paying part of the rent 7
In A Homeless shelter OR OTHER HOMELESS SITUATION 8
Some other location (SPECIFY:_________________________________) 96
Intro3. [IF Intro2 equal 3-8 or 96 ASK:] Did you ever live in a FEMA travel trailer or mobile home, after the hurricane Katrina or Rita?
Yes 1
No (SKIP TO Intro4) 2
[IF Intro3=1] When you lived in FEMA housing, did you live in a FEMA travel trailer, a FEMA mobile home, or both?
Travel Trailer 1
Mobile Home 2
Both 3
REFUSED 7
DON’T KNOW 8
On what kind of site was your FEMA unit located? Was it…
On a private site you owned? 1
On a private site someone let you use? 2
On a private site you rented from someone else? 3
In a commercial park? 4
In a park developed specifically for the AHPP? 5
In a park developed by FEMA for temporary housing? 6
Some other location (SPECIFY:_________________________________)? 96
How long did you live in your FEMA trailer and/or mobile home? Would you say you lived in your FEMA trailer and/or mobile home for….
Less than one month? 1
One to six months? 2
Seven to twelve months? 3
Between one and two years? 4
Two years or more? 5
REFUSED 7
DON’T KNOW 8
Intro4. Now, I’d like to confirm your current address and phone number. My records show that your current address is READ ADDRESS BACK TO RESPONDENT:
[CURRENT STREET ADDRESS] [CURRENT CITY] [CURRENT STATE] [CURRENT ZIP]
Is that correct?
YES, ADDRESS CONFIRMED (SKIP TO Intro4e) 1
NO, ADDRESS INCORRECT 2
4a. What is your current street address and apartment number?
STREET ADDRESS APT OR UNIT #
4b. In what city do you live?
CITY
4c. In what state?
STATE
4d. What is your zip code?
ZIP
4e. What is your current home phone number?
HOME PHONE NUMBER
4f. What is your cell phone number?
CELL PHONE NUMBER
4g. What is your email address?
What is the main reason that you applied for an AHPP unit?
To have a LARGER place to live 1
To have a SAFER place to live 2
To be CLOSER TO HOME 3
To have a NEWER place to live 4
To have a PERMANENT house 5
Some other reason (specify) __________________________________ 96
REFUSED 97
DON’T KNOW 98
In what month and year did you move in to your AHPP unit?
__________________/_______________________
MONTH YEAR
REFUSED 97
DON’T KNOW 98
Are you currently living in your AHPP unit?
Yes (SKIP TO A12) 1
No 2
REFUSED (SKIP TO A12) 7
DON’T KNOW (SKIP TO A12) 8
On what type of site was your AHPP unit located? Was it…
On a private site you owned? 1
On a private site someone let you use for free? 2
On a private site you rented from someone else? 3
In a commercial park? 4
In a park developed specifically for the AHPP? 5
In a park developed by FEMA for temporary housing (i.e., a FEMA park)? 6
Some other place (SPECIFY:_________________________________)? 96
REFUSED 97
DON’T KNOW 98
In what month and year did you move out of the AHPP unit?
__________________/_______________________
MONTH YEAR
REFUSED 97
DON’T KNOW 98
We know that there may be more than one reason why you moved out of your AHPP unit. I’m going to read you a list of reasons why people move. We are interested in knowing which of these reasons is the main reason you moved out of your AHPP unit. Was the main reason you moved because…
Your permanent housing was ready? (GO TO A7) 1
The land that your AHPP unit was on was no longer available? (GO TO A7) 2 [Note to Interviewer: This category would include such things as losing a permit or landlord refusing to renew a lease]
Your entire family could not live in your AHPP unit? (ASK A6a) 3
You were not satisfied with the AHPP unit itself? (ASK A6b) 3
You were not satisfied with the location of your AHPP unit? (ASK A6c) 4
You could not afford it? (ASK A6d) 5
Of a personal or family problem? (ASK A6e) 6
Of some other reason (SPECIFY:________________________) (GO TO A7) 96
REFUSED (GO TO A7) 97
DON’T KNOW (GO TO A7) 98
A6a. What was the main reason your entire family could not live in your AHPP unit? Was it because…
A family member was not eligible for AHPP housing 1
The unit didn’t accommodate the disability of a family member 2
There were not enough room for all my family members 3
Family member did not like AHPP unit 4
Family member did not like location of AHPP unit 5
REFUSED 6
DON’T KNOW 7
SKIP TO A7
A6b. What was the main reason you were dissatisfied with your AHPP unit? [INTERVIEWER: DO NOT READ LIST]
There were not enough bedrooms 1
There was not enough storage space 2
The bedrooms were too small 3
There was not enough space to entertain family and friends 4
The unit was built poorly 5
The unit was not accessible for a person with a disability 6
There was no place for my children to play outside 7
There were leaks or other problems in the unit 8
the costs of utility payment? 9
difficulty scheduling utility hook-ups? 10
the location of the unit on your property? 11
Some other problem with unit (SPECIFY_______________________) 96
REFUSED 97
DON’T KNOW 98
SKIP TO A7
A6c. What was the main reason you were dissatisfied with the location of your AHPP unit?
Problems with your neighbors 1
It was too far away from your work 2
It was too far away from school 3
It was too far away from where your family and friends live 4
It was too far away from stores and services 5
It was too far away from your church 6
You thought the neighborhood was unsafe 7
There were no parks or playgrounds nearby 8
Some other reason (SPECIFY_______________________) 96
REFUSED 97
DON’T KNOW 98
SKIP TO A7
A6d. What was the main reason you could not afford to live in your AHPP unit?
The cost of the rent or mortgage each month 1
The cost of utilities 2
The cost of pad rental—the cost of the land on which the AHPP unit was located 3
Transportation costs to get to and from places like work or school 4
Other costs (SPECIFY_______________________________) 96
REFUSED 97
DON’T KNOW 98
SKIP TO A7
A6e. What was the main personal reason you had for moving out of the AHPP unit?
A divorce or separation (ASK A6e1) 1 An employment opportunity 2
To care for a relative/friend in their home 3
Health reasons that made it impossible to live in the unit 4
Because you were asked to leave or evicted for non-compliance with program requirements 5
Other reason (SPECIFY_______________________________) 96
REFUSED 97
DON’T KNOW 98
A6e.1. Did the entire family leave the AHPP unit because of the divorce/separation or were you the only one to leave?
I left the unit but others stayed 1
I left with some members of the family, but others stayed 2
The entire family left the unit 3
REFUSED 97
DON’T KNOW 98
NOTE TO PROGRAMMER:
A7 - A11 are asked only about the AHPP unit for those who are not currently living in their AHPP unit.
At any time while you were living in the AHPP unit…
|
Yes |
No |
REFUSED |
DON’T KNOW |
a. Was there mildew, mold, or water damage on any wall, floor, or ceiling? |
1 |
2 |
97 |
98 |
b. Were there any floor problems such as boards, tiles, carpeting or linoleum that were missing, curled, or loose? |
1 |
2 |
97 |
98 |
c. Were there any holes or large cracks where outdoor air or rain could come in? |
1 |
2 |
97 |
98 |
d. Did you smell bad odors such as sewer, natural gas, etc. in your home? |
1 |
2 |
97 |
98 |
e. Were any bathroom floors covered by water because of a plumbing problem? |
1 |
2 |
97 |
98 |
f. Had your toilet not worked for 6 hours or more? |
1 |
2 |
97 |
98 |
g. Had your electricity not worked for 2 hours or more? |
1 |
2 |
97 |
98 |
h. In cold weather, did you ever need to use your oven to heat your home? |
1 |
2 |
97 |
98 |
i. Did all outside doors and windows have locks that worked? |
1 |
2 |
97 |
98 |
Not including bathrooms and hallways, how many rooms were in your AHPP unit?
One 1
Two 2
Three 3
Four 4
Five 5
Six or more 6
refuSED 97
dON’T kNOW 98
How many of the rooms in the AHPP unit were bedrooms?
One 1
Two 2
Three or more 3
refuSED 97
dON’T kNOW 98
When you were living in the AHPP unit, did anyone in the household regularly sleep in a room other than a bedroom?
Yes 1
No (SKIP TO A11) 2
REFUSED (SKIP TO A11) 97
DON’T KNOW (SKIP TO A11) 98
A10a. Was this because there were not enough bedrooms in the AHPP unit?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
When you were living in the AHPP unit, did anyone in the household have to leave your AHPP unit to go someplace else to sleep?
Yes 1
No (SKIP TO A12) 2
REFUSED (SKIP TO A12) 97
DON’T KNOW (SKIP TO A12) 98
A11a. Was this because there was not enough space in the AHPP unit for everyone to sleep there?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
What feature(s) of the AHPP units [are/were] attractive to you? For each feature listed, please tell me if it was one of the features that attracted you to the AHPP unit.
|
Yes |
No |
REFUSED |
DON’T KNOW |
a. Was the amount of living space an attractive feature to you? |
1 |
2 |
97 |
98 |
b. Was the number of bedrooms an attractive feature to you? |
1 |
2 |
97 |
98 |
c. Were the kitchen appliances (stove, dishwasher etc.) attractive features to you? |
1 |
2 |
97 |
98 |
d. Were the bathroom facilities (tub, shower, size) attractive features to you? |
1 |
2 |
97 |
98 |
e. Was the room design and layout an attractive feature to you? |
1 |
2 |
97 |
98 |
h. Was the accessibility of the unit for people with disabilities an attractive feature to you? |
1 |
2 |
97 |
98 |
j. Was the amount of privacy in the unit an attractive feature to you? |
1 |
2 |
97 |
98 |
k. Was the amount of storage space in the unit an attractive feature to you? |
1 |
2 |
97 |
98 |
l. Was there any other feature that was attractive to you? (SPECIFY________________________) |
1 |
2 |
97 |
98 |
NOTE TO PROGRAMMER: A13 and A14 ARE TO BE COMPLETED ONLY IF THE RESPONDENT LIVED IN A FEMA TRAVEL TRAILER OR MOBILE HOME.
If INTRO2 = 3-96 OR INTRO3=2 GO TO PART B, OTHERWISE ASK A13
[INTRO2=1, 2 OR INTRO3=1] 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 the FEMA unit? Would you say your AHPP unit [is/was] in better condition, worse condition, or about the same condition as the FEMA unit?
AHPP unit in better condition 1
AHPP unit about the same 2
AHPP unit in worse condition 3
REFUSED 97
DON’T KNOW 98
I'd like to learn more about how your AHPP unit compare(s/d) to your FEMA unit. I'm going to read a list of unit features. For each feature I read, 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 as in your FEMA unit.
|
Better in AHPP unit |
Worse in AHPP unit |
About the same in both places |
A14a. Was the amount of living space in your AHPP unit better than, worse than, or about the same as in your FEMA unit? |
1 |
2 |
3 |
A14b. Was the accessibility of your AHPP unit for people with disabilities better than, worse than, or about the same as in your FEMA unit? |
1 |
2 |
3 |
A14c. Was the amount of privacy in your AHPP unit better than, worse than, or about the same as in your FEMA unit? |
1 |
2 |
3 |
A14d. Would you say that your feelings of personal safety from high winds in your AHPP unit was better than, worse than, or about the same as in your FEMA unit? |
1 |
2 |
3 |
A14e. Would you say that your feelings of personal safety from floods in your AHPP unit better than, worse than, or about the same as in your FEMA unit? |
1 |
2 |
3 |
Now I’d like to ask you some questions about your current housing situation.
[IF CURRENT HOUSING = AHPP, SKIP TO B1a] I’d like to ask you some questions about where you live right now. Are you…
Renting your home or apartment? 1
Living in a home you own? 2
Living with family or friends and pay part of the rent? 3
Living with family or friends and do not pay rent? 4
Living in a group shelter? 5
Living in some other arrangement...
Homeless (SKIP TO B6) 6
Incarcerated 7
Living in a Group Home, Dorm Or Barracks 8
Living in a Hospital/Nursing Home/Special School 9
Other (SPECIFY_______________________) 96
refuSED 97
dON’T kNOW 98
B1a. [IF CURRENT HOUSING=AHPP UNIT] Do you currently rent or own your AHPP unit?
RENT 1
OWN 2
refuSED 97
dON’T kNOW 98
How many years have you lived at your current address?
Number of Years __________ (SKIP TO B3) 1-96
Less Than One Year 0
DON’T KNOW (SKIP TO B3) -1
REFUSED (SKIP TO B3) -2
B2a. How many months have you lived at your current address?
Number of Months __________ 1-12
DON’T KNOW -1
REFUSED -2
Was there ever a time during the past 12 months when you did not have your own place to stay? For this question you should consider living in your FEMA or AHPP unit as having your own place.
Yes 1
No (SKIP TO B5) 2
REFUSED (SKIP TO B5) 97
DON’T KNOW (SKIP TO B5) 98
During the past 12 months when you did not have your own place to stay, we would like to know about any places where you stayed. Did you…
|
Yes |
No |
REFUSED |
DON’T KNOW |
a. Stay with a relative |
1 |
2 |
7 |
8 |
b. Stay with a friend |
1 |
2 |
7 |
8 |
c. Stay in a shelter [INTERVIEWER: A SHELTER IS A HOMELESS SHELTER, EMERGENCY SHELTER, OR DOMESTIC VIOLENCE SHELTER BUT NOT A GROUP HOME] |
1 |
2 |
7 |
8 |
d. Stay on the streets or in some other place that is not generally used for housing |
1 |
2 |
7 |
8 |
We’d like to know a few things about the quality of your current housing and neighborhood.
Overall, how would you describe the condition of your current house/apartment/living space? Would you say it is in excellent, good, fair, or poor condition?
Excellent 1
Good 2
Fair 3
Poor 4
refuSED 97
dON’T kNOW 98
In your current housing...
|
Yes |
No |
REFUSED |
DON’T KNOW |
a. Is there mildew, mold, or water damage on any wall, floor, or ceiling? |
1 |
2 |
7 |
8 |
b. Are there any floor problems such as boards, tiles, carpeting or linoleum that are missing, curled, or loose? |
1 |
2 |
7 |
8 |
c. Are there any holes or large cracks where outdoor air or rain can come in? |
1 |
2 |
7 |
8 |
d. Do you smell bad odors such as sewer, natural gas, etc. in your home? |
1 |
2 |
7 |
8 |
e. Have any bathroom floors been covered by water because of a plumbing problem? |
1 |
2 |
7 |
8 |
f. Has your toilet not worked for 6 hours or more? |
1 |
2 |
7 |
8 |
g. Has your electricity not worked for 2 hours or more? |
1 |
2 |
7 |
8 |
h. In cold weather, do you ever need to use your oven to heat your home? |
1 |
2 |
7 |
8 |
i. Do all outside doors and windows have locks that work? |
1 |
2 |
7 |
8 |
Not including bathrooms and hallways, how many rooms are there in your current house/apartment/ living space?
One 1
Two 2
Three 3
Four 4
Five 5
Six or more 6
refuSED 97
dON’T kNOW 98
B7a. How many of the rooms in your house/apartment/living space are bedrooms? [NOTE: an efficiency unit or travel trailer should be coded as zero]
Zero (including efficiency unit or travel trailer) 0
One 1
Two 2
Three or more 3
refuSED 97
dON’T kNOW 98
Does anyone in the household regularly sleep in a room other than a bedroom?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B8a. Was this because there were not enough bedrooms in the AHPP unit?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Does anyone in the household ever leave your current unit to go someplace else to sleep at night?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B9a. Was this because there was not enough space in the AHPP unit for everyone to sleep there?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Do you agree or disagree with the following statement: “Living in my current unit makes me feel more at home, like I did before the hurricane, than living in a FEMA trailer did”?
Agree 1
Neither Agree nor Disagree 2
Disagree 3
REFUSED 97
DON’T KNOW 98
Is your current unit your permanent address? By permanent, we mean you have moved into another home or unit and no longer consider yourself as living in temporary housing.
Yes (SKIP TO B14) 1
No 2
REFUSED 97
DON’T KNOW 98
What is your permanent or long-term housing plan? Do you plan to….
Continue to live in current housing 1
Move into repaired or rebuilt pre-storm home 2
Buy a different home 3
Return to the home I [rented/ owned] before the storm 4
Rent a different home 5
Other (SPECIFY______________________________) 96
REFUSED 97
DON’T KNOW 98
When do you expect to be in your permanent housing?
In less than six months 1
In six months to just under one year 2
In one to three years 3
In more than three years 4
REFUSED 97
DON’T KNOW 98
B13a. What is the main reason you have not been able to complete your permanent housing plans? Would you say it is…
A lack of affordable rental housing in the area? 1
A lack of affordable homes to buy? 2
Poor credit or criminal background checks? 3
Lack of funds for security deposit? 4
Lack of funds to complete the repairs on my pre-disaster unit? 5
Other (SPECIFY________________________)? 96
REFUSED 97
DON’T KNOW 98
Now I’d like to talk about any housing related payments you may have.
ASK IF B1=2 or B1a=2; ELSE SKIP TO B16
What is the monthly amount you pay for owning this (condo/house)? We are interested in the payment you make to the bank or mortgage company.
Per Month $__ __ __ __ 0-9999
DON’T KNOW -1
REFUSED -2
B14a. I have recorded that you pay [AMOUNT] monthly to own this unit, is that correct?
Yes 1
No (REPEAT B14 and B14a UNTIL CORRECT) 2
REFUSED 97
DON’T KNOW 98
During the past 12 months, were you ever more than 15 days late paying your mortgage?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
IF B1=2 or B1a=2 SKIP to B23
[ASK IF B1=1 or 3, OR B1a=1; ELSE SKIP TO B23] Altogether in the month just past, what did you pay as rent? We are interested only in knowing your part of the payment. Please include rent costs for the unit as well as any pad rentals required.
Per Month $__ __ __ __ 0-9999
DON’T KNOW -1
REFUSED -2
B16a. I have recorded that you pay [AMOUNT] monthly in rent, is that correct?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
What is the total current monthly rent payment on this (apartment/house)? By total current monthly rent, I mean the amount that you and anyone else pay to pay to rent this unit.
Per Month $__ __ __ __ 0-9999
DON’T KNOW -1
REFUSED -2
B17a. I have recorded [AMOUNT] as the total amount of monthly rent for this unit, is that correct?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Do you currently receive any governmental housing assistance in paying rent, such as through public housing or Section 8 or Housing Choice Voucher?
Yes (SKIP TO B20) 1
No 2
REFUSED 97
DON’T KNOW 98
Is your rent amount lower because you are in a Federal, State, or local government housing program?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
During the past 12 months, were you ever more than 15 days late paying your rent?
Yes 1
No 2
Not Applicable 3
REFUSED 97
DON’T KNOW 98
During the last 12 months, have you been evicted from a home for any reason?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Do you pay utilities separately from rent? By utilities, we mean the electric, gas or water bill.
Yes 1
No (SKIP to B24) 2
REFUSED (SKIP to B24) 97
DON’T KNOW (SKIP to B24) 98
People sometimes have trouble paying their utility bills on time. During the past 12 months, were you ever more than 15 days late paying your electric, gas, or water bill?
Yes 1
No (SKIP TO B24) 2
Not applicable (SKIP TO B24) 3
Utilities included in rent/condo fees (SKIP TO B24) 4
REFUSED (SKIP TO B24) 97
DON’T KNOW (SKIP TO B24) 98
B23a. In the past 12 months, was your gas, water, or electricity ever shut off for nonpayment?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
The next set of questions asks about problems you may have had in your unit in the past six months, that is since (month/year). Were any of the following items broken during the last six months?
|
Yes |
No |
NOT APPLICABLE |
REFUSED |
DON’T KNOW |
a. Your stove or refrigerator? |
1 |
2 |
4 |
7 |
8 |
b. Your bathroom or kitchen plumbing? |
1 |
2 |
4 |
7 |
8 |
c. Electric outlets or light switches? |
1 |
2 |
4 |
7 |
8 |
d. The air conditioning? |
1 |
2 |
4 |
7 |
8 |
e. The heating system? |
1 |
2 |
4 |
7 |
8 |
f. Something else on the inside of the house? |
1 |
2 |
4 |
7 |
8 |
g. Something on the outside of your house like the roof or exterior walls or the stairs or porch? |
1 |
2 |
4 |
7 |
8 |
[REPEAT FOR EACH YES ITEM IN B24] Have you called to have [B24ITEM] repaired in the last six months, that is since (month/year)?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Thinking about the most recent time you called to have something repaired, how many days did it take for someone to come repair it?
0-7 days 1
8-14 days 2
15-30 days 1
>30 days 2
NO ONE HAS COME YET 97
REFUSED 97
DON’T KNOW 98
Still thinking about the most recent time you called to have something repaired, were you satisfied with how quickly the broken item was repaired
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Were you satisfied with the quality of the repair?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
[If respondent has reported something broken and didn’t call OR Reported nothing broken]
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?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
ALL renters
In general, how satisfied are you with the quality of routine repairs?
Very satisfied 1
Satisfied 2
Neither satisfied nor dissatisfied 1
Dissatisfied 2
Very Dissatisfied 97
REFUSED 97
DON’T KNOW 98
B30a. In general, how satisfied are you with the quality of routine maintenance?
Very satisfied 1
Satisfied 2
Neither satisfied nor dissatisfied 1
Dissatisfied 2
Very Dissatisfied 97
REFUSED 97
DON’T KNOW 98
In general, how satisfied are you with the promptness of emergency repairs?
Very satisfied 1
Satisfied 2
Neither satisfied nor dissatisfied 1
Dissatisfied 2
Very Dissatisfied 97
REFUSED 97
DON’T KNOW 98
Now we would like to learn more about who currently lives with you.
How many people do you live with now? Please include all adults and children who live with you and consider this their primary residence. This total number excludes yourself.
|
DON’T KNOW -1
REFUSED -2
B32a. What is your marital status? Are you currently…
Single, never married 1
Married or living in a marriage like situation 2
Widowed 3
Separated/Divorced 4
REFUSED 97
DON’T KNOW 98
[CAPI WILL USE TEXT SUBSTITUTIONS TO CHANGE AHPP Unit to CURRENT UNIT FOR PEOPLE WHO MOVED OUT OF AHPP UNIT]
Now, I’d like you think back to just before the hurricane and the people you were living with at that time. How many of them are currently living with you? Would you say that all of them are living with you, some of them are living with you, or none of them are living with you.
ALL LIVING WITH R (SKIP TO B37) 1
SOME LIVING WITH R 2
NONE LIVING WITH R 3
R LIVED ALONE AT TIME OF HURRICANE (SKIP TO B37) 4
REFUSED (SKIP TO B37) 97
DON’T KNOW (SKIP TO B37) 98
Is the reason that these people are not living with you now related to the AHPP unit itself or is it for a reason that is personal to you or the other person?
RELATED TO AHPP UNIT 1
PERSONAL REASON (SKIP TO B36) 2
REFUSED (SKIP TO B36) 97
DON’T KNOW (SKIP TO B36) 98
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….
|
Yes |
No |
REF |
DK |
a. The program did not allow them to live in an AHPP unit? |
1 SKIP TO B36 |
2 |
7 |
8 |
b. The unit does not accommodate their disability? |
1 SKIP TO B36 |
2 |
7 |
8 |
c. The unit is too small? |
1 SKIP TO B36 |
2 |
7 |
8 |
d. They do not like the AHPP unit? |
1 SKIP TO B36 |
2 |
7 |
8 |
e. They do not like the location of the AHPP unit? |
1 |
2 |
7 |
8 |
Does your AHPP unit allow more, less, or the same number of your family members to live together than the place you lived in just before your AHPP unit?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Now, I’d like you to 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 these people for a period of 30 days or more, at any time since Hurricane Katrina or Rita?
Yes 1
No (SKIP TO C1) 2
REFUSED 97
DON’T KNOW 98
Did receiving your AHPP unit allow you to live together once again?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
The next set of questions have to do with your health.
In general, would you say your health is excellent, very good, good, fair, or poor?
Excellent 1
Very good 2
Good 3
Fair 4
Poor 5
REFUSED 97
DON’T KNOW 98
Do you or anyone in the household have a physical disability or condition that limits one or more basic activity such as walking, climbing stairs, reaching, lifting, or carrying?
Yes 1
No (SKIP TO C5) 2
REFUSED (SKIP TO C5) 97
DON’T KNOW (SKIP TO C5) 98
C2a. Is anyone in a wheelchair or otherwise unable to climb stairs at all?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
[IF C2 or C2a=YES ASK: CAPI set skip patterns for which units to ask about:] I’d like to ask some questions about how the needs of this person were addressed in your FEMA housing, your AHPP housing, and your current housing. Could the person with the physical disability or condition:
|
FEMA Unit |
AHPP unit |
Current Unit (if not AHPP unit) |
a. Get into and out of their [FEMA/AHPP/ CURRENT] unit by themselves |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
b. Move around from room to room within the unit by themselves |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
c. Get into and out of the bathroom by themselves |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Now I’d like to talk about some specific health conditions.
Has a doctor or other health professional ever told you that you had asthma?
Yes 1
No (SKIP TO C7) 2
REFUSED (SKIP TO C7) 97
DON’T KNOW (SKIP TO C7) 98
C4a. Do you still have asthma symptoms? (coughing, wheezing, shortness of breath)
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
C4b. When were you first diagnosed with asthma? Was it….
Before the hurricane 1
After the hurricane but before your AHPP unit 2
Since moving into your AHPP unit 3
REFUSED 97
DON’T KNOW 98
During the past 6 months, that is since [MONTH/YEAR6MO], have you had an episode of asthma or an asthma attack?
Yes 1
No (SKIP TO C7) 2
REFUSED (SKIP TO C7) 97
DON’T KNOW (SKIP TO C7) 98
During the past 6 months, that is since [MONTH/YEAR6MO], did you have to visit an emergency room or urgent care center because of asthma?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Have you ever been told by a doctor or other health professional that you have…
|
|
If Yes: When were you diagnosed with [condition]? Was it before the hurricane, after the hurricane but before you received your AHPP unit, or since you received your AHPP unit? |
a. Emphysema? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
b. Allergies? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
c. Other respiratory or breathing problems? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
[IF C7a-c=Yes ASK C8; ELSE SKIP TO C9] We are interested in knowing if living in the AHPP unit affected your breathing problems in any way. While living in the AHPP unit, do you think that your breathing problems got better, worse, or stayed about the same?
Better 1
Worse 2
Stayed about the same 3
REFUSED 97
DON’T KNOW 98
[IF R LIVES ALONE, SKIP TO C13] Has another ADULT member of your household ever been diagnosed with… [INTERVIEWER: If more than one adult was diagnosed, ask follow-up question for the ‘most recent’ diagnosis.]
|
|
If Yes: When was the other adult diagnosed with [condition]? Was it before the hurricane, after the hurricane but before you received your AHPP unit, or since you received your AHPP unit? |
a . Asthma? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
b. Allergies? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
c. Other respiratory or breathing problems? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
[IF C9a-c=Yes ASK C10; ELSE SKIP TO C11] We are interested in knowing if living in the AHPP unit affected the breathing problems of any other adult in any way. While living in the AHPP unit, do you think that the other adults breathing problems got better, worse, or stayed about the same?
Better 1
Worse 2
Stayed about the same 3
REFUSED 97
DON’T KNOW 98
Has any CHILD member of your household under the age of 18 ever been diagnosed with …[INTERVIEWER: If more than one child diagnosed, ask follow-up question for the ‘most recent’ diagnosis.]
|
|
If Yes: When was child diagnosed with [condition]? Was it before the hurricane, after the hurricane but before you received your AHPP unit, or since you received your AHPP unit? |
a . Asthma? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
b. Allergies? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
c. Other respiratory or breathing problems? |
Yes 1 No 2 N/A 3 REF 97 DK 98 |
Before hurricane 1 After hurricane, before AHPP unit 2 After AHPP unit 3 REF 97 DK 98 |
[IF C11a-c=Yes ASK C12; ELSE SKIP TO C13] We are interested in knowing if living in the AHPP unit affected the breathing problems of children in your household in any way. While living in the AHPP unit, do you think that the breathing problems of the children living in your household got better, worse, or stayed about the same?
Better 1
Worse 2
Stayed about the same 3
REFUSED 97
DON’T KNOW 98
The next few questions ask about smoking.
Have you smoked at least 100 cigarettes in your entire life?
Yes 1
No (SKIP TO C17) 2
REFUSED (SKIP TO C17) 97
DON’T KNOW 98
C13a. Have you smoked at least 100 cigarettes since Hurricane Katrina, that is since August 2005?
Yes 1
No (SKIP TO C17) 2
REFUSED (SKIP TO C17) 97
DON’T KNOW 98
On how many of the past 30 days did you smoke a cigarette?
Zero days (SKIP TO C15b) 0
_____ Number of days 1-30
DON'T KNOW -1
REFUSED -2
C14a. On the average when you smoked in the last 30 days, about how many cigarettes did you smoke per day?
_____ Number of cigarettes 1-99
DON'T KNOW -1
REFUSED -2
Do you smoke cigarettes inside your home?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
C15a. [IF EVER LIVED IN A FEMA TRAILER OR MOBILE HOME] Thinking back to when you lived in a FEMA trailer or mobile home. Did you smoke cigarettes inside your FEMA trailer or mobile home?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
C15b. (IF C14=zero days) Did you quit smoking before you moved into your AHPP unit?
Yes (SKIP TO C17) 1
No 2
REFUSED 97
DON’T KNOW 98
[Since living/when you lived] in the AHPP unit, do you think that you smoke(d) more, less, or about the same amount as before you lived in the AHPP unit?
More 1
Less 2
About the same amount 3
REFUSED 97
DON’T KNOW 98
The next set of questions help us learn more about how you are feeling.
How much of the time during the past month have you felt ...
|
All of the time |
Most of the time |
Some of the time |
A little of the time |
None of the time |
Refused |
Don’t Know |
a. So sad that nothing could cheer you up? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
b. Nervous? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
c. Restless or fidgety? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
d. Hopeless? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
e. That everything was an effort? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
f. Worthless? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
g. Calm and peaceful? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
Now I’m going to read you a list of problems and complaints that people sometimes have in response to stressful life experiences. As I read each item, please think about the last month and indicate how much you have been bothered by that problem.
In the last month, how much were you bothered by [READ ITEM]? Would you say you were bothered not at all, a little bit, moderately, quite a bit, extremely?
|
Not at all |
A little bit |
Moderately |
Quite a bit |
Extremely |
Refused |
Don’t Know |
a. Repeated, disturbing memories, thoughts, or images of the hurricanes? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
b. Repeated, disturbing dreams of the hurricanes? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
c. Suddenly acting or feeling as if the hurricanes were happening again (as if you were reliving it)? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
d. Feeling very upset when something reminded you of the hurricanes? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
e. Having physical reactions (e.g., heart pounding, trouble breathing, or sweating) when something reminded you of the hurricanes? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
f. Avoid thinking about or talking about the hurricanes or avoid having feelings related to it? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
g. Avoid activities or situations because they remind you of the hurricanes? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
h. Trouble remembering important parts of the hurricanes? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
i. Loss of interest in things that you used to enjoy? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
j. Feeling distant or cut off from other people? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
k. Feeling emotionally numb or being unable to have loving feelings for those close to you? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
l. Feeling as if your future will somehow be cut short? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
m. Trouble falling or staying asleep? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
n. Feeling irritable or having angry outbursts? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
o. Having difficulty concentrating? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
p. Being “super alert” or watchful on guard? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
q. Feeling jumpy or easily startled? |
1 |
2 |
3 |
4 |
5 |
7 |
8 |
The next questions ask about moderate physical activity and your height and weight. As noted earlier, these data will be used for this study only and averaged with other respondents. Your individual responses will be kept private.
In a usual week, do you do moderate activities on three or more days for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that cause small increases in breathing or heart rate?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
About how tall are you without shoes?
|
|
Feet |
|
Inches |
About how much do you weigh without shoes?
|
|
Pounds |
The next set of questions asks about your income in the past month and generally what resources you are depending on to support yourself.
Are you currently:
Employed full-time (30 hours of work per week or more) (SKIP TO C24) 1
Employed part-time (less than 30 hours per week) (SKIP TO C24) 2
Self-employed (SKIP TO C24) 3
Unemployed looking for work 4
Not working for pay (retired, disabled, taking care of family, etc...) 5
REFUSED 97
DON’T KNOW 98
What is the main reason that you are not working for pay?
Employer no longer in business since hurricane 1
Employer is too far from home to retain job 2
Unable to work for health reasons 3
Has job but temporarily absent /seasonal work 4
Couldn’t find any work 5
Child care problems 6
Family responsibilities 7
In school or other training 8
Waiting for a new job to begin 9
Retired 10
Disabled 11
Other (SPECIFY___________________________) 96
REFUSED 97
DON’T KNOW 98
Did you have to leave a job in order to move to where your AHPP unit was located?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
IF C22=4 THEN SKIP TO C28
Are you currently working for the same employer that you worked for before you moved into your AHPP unit?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
[IF EMPLOYED and STILL LIVING IN AHPP UNIT] Now, I’d like to ask a few questions about how where you live affect your ability to work. Compared to where you lived before you moved into your AHPP unit, since moving into you AHPP unit is it easier, harder, or about the same to….
|
Easier |
Harder |
Same |
Refused |
Don’t Know |
a. Travel to work? |
1 |
2 |
5 |
7 |
8 |
b. Work extra hours? |
1 |
2 |
5 |
7 |
8 |
c. Find a higher paying job? |
1 |
2 |
5 |
7 |
8 |
d. Spend more time with your family? |
1 |
2 |
5 |
7 |
8 |
e. Find quality child care? |
1 |
2 |
5 |
7 |
8 |
How many of the people in your household (including yourself) are employed full-time or part-time?
|
DON’T KNOW -1
REFUSED -2
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. During the past month, did anyone in your household receive income from…?
|
Yes |
No |
No INCOME IN PAST MONTH |
REFUSED |
DON’T KNOW |
a. Wages, salary, commissions, bonuses or tips from a job |
1 |
2 |
2 |
7 |
8 |
b. Self-employment income |
1 |
2 |
2 |
7 |
8 |
c. Interest, dividends, net rental income, royalty income, or income from estates and trust |
1 |
2 |
2 |
7 |
8 |
d. Social Security or Railroad Retirement |
1 |
2 |
2 |
7 |
8 |
e. Supplemental Security Income (SSI) |
1 |
2 |
2 |
7 |
8 |
f. Alimony or Child Support |
1 |
2 |
2 |
7 |
8 |
g. Any public assistance or welfare payments from the state or local welfare office (including TANF, but NOT including Food Stamps) |
1 |
2 |
2 |
7 |
8 |
h. Food Stamps |
1 |
2 |
2 |
7 |
8 |
i. Retirement, survivor, or disability pensions (NOT including Social Security) |
1 |
2 |
2 |
7 |
8 |
j. Unemployment Compensation |
1 |
2 |
2 |
7 |
8 |
k. Other (SPECIFY_______________________) |
1 |
2 |
2 |
7 |
8 |
What is your household’s total monthly income last month from all of the sources checked above. Please include income from all family members.
Monthly Household Income $________________ 0-99999
DON’T KNOW -1
REFUSED -2
C29a. I have recorded that your total monthly household income is [AMOUNT], is that correct?
Yes 1
No (REPEAT C29 and C29a UNTIL CORRECT) 2
REFUSED 97
DON’T KNOW 98
C29b. [IF C29=0 AND ANY ITEM IN C28=NO INCOME LAST MONTH ASK:] I just want to confirm that you had no income at all from any of the above sources last month. Is that correct?
Yes 1
No (REPEAT C29 and C29a UNTIL CORRECT) 2
REFUSED 97
DON’T KNOW 98
Was your total household income last month what you would receive in a typical month?
Yes (SKIP TO C32) 1
No 2
REFUSED 97
DON’T KNOW 98
In a typical month, what would your household’s total monthly income from all of the sources checked above be? Please include income from all family members.
Typical Monthly Household Income $________________ 0-99999
DON’T KNOW -1
REFUSED -2
C31a. I have recorded that your total monthly household income in a typical month is [AMOUNT], is that correct?
Yes 1
No (REPEAT C31 and C31a UNTIL CORRECT) 2
REFUSED 97
DON’T KNOW 98
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.
Did you use… |
Yes |
No |
REFUSED |
DON’T KNOW |
a. Money from your savings (by savings I mean money that you put aside for a later date) |
1 |
2 |
7 |
8 |
b. Insurance proceeds from your homeowner or renters policy |
1 |
2 |
7 |
8 |
c. Money from a state grants program for hurricane victims |
1 |
2 |
7 |
8 |
d. A new credit card or other debt (that you did not pay off this month) |
1 |
2 |
7 |
8 |
In the past month, have you lived in housing or received financial assistance from family, friends, or a charitable organization?
In the past month… |
Yes |
No |
REFUSED |
DON’T KNOW |
a. Were you living with friends or family or in a house provided by friends or family? |
1 |
2 |
7 |
8 |
b. Did your friends or family provide some financial help? |
1 |
2 |
7 |
8 |
c. Were you living in housing provided by charitable organization? (Note: includes a homeless shelter) |
1 |
2 |
7 |
8 |
d. Did a charitable organization, such as a church or the Red Cross, provide some financial help? |
1 |
2 |
7 |
8 |
[ASK C34 ONLY IF NOT ON BASELINE] Now I’d like to ask a few questions about your education and that of your children.
What is the highest degree or level of school you have completed? (select only one)
Nursery School to 6th grade or no schooling 1
7th to 12th grade - NO DIPLOMA 2
High School Graduate or Equivalent (for example, GED) 3
Some College 4
Associates Degree 5
Bachelors Degree 6
Masters Degree, Doctorate Degree, or other Professional Degree
(for example, MD, DDS, DVM, LLB, JD) 7
REFUSED 97
DON’T KNOW 98
We’d like to learn more about how your children are doing since you received your AHPP unit.
Of the [# IN B32] people living with you, are any of them children age 17 or under?
Yes 1
No (SKIP TO C38) 2
REFUSED 97
DON’T KNOW 98
How many children in your household are 5 years old or under?
|
DON’T KNOW -1
REFUSED -2
How many children in your household are between 6 and 11 years of age?
|
DON’T KNOW -1
REFUSED -2
How many children in your household are between 12 and 17 years of age?
|
DON’T KNOW -1
REFUSED -2
Now I’d like to learn a little more about your opinion on how the AHPP program may have affected your children age 17 and under. For each topic, I will ask whether you think there has been a change for the better or a change for the worse or no change at all while you have been living in the AHPP unit. [Note: If >1 child and not the same affect, we want to which was the most common affect on the children in the household. ]
|
A13b. Child(ren)’s [WELLBEINGATTRIBUTE] has… |
||
|
Improved |
Same |
Worse |
C36a. Since moving into your AHPP unit would you say that your children’s emotional health has improved, stayed the same or gotten worse?
|
|
|
|
C36b. Since moving into your AHPP unit, would you say that the behavior of your children has improved, stayed the same, or gotten worse?
|
|
|
|
C36c. Since moving into your AHPP unit, would you say that your children’s enthusiasm to go to school has improved, stayed the same, or gotten worse?
|
|
|
|
C36d. Since moving into your AHPP unit, would you say that your children's desire to do well in school has improved, stayed the same, or gotten worse?
|
|
|
|
Since moving into your AHPP unit, have you or another adult in your household …
|
Yes |
No |
REFUSED |
DON’T KNOW |
a. attended a general school meeting such as back to school night? |
1 |
2 |
7 |
8 |
b. volunteered to serve on a committee or help out in the school? |
1 |
2 |
7 |
8 |
c. attended any school activities your child has participated in such as a sporting event, school play, or science fair? |
1 |
2 |
7 |
8 |
d. met with your child’s teacher to discuss their progress in school |
1 |
2 |
7 |
8 |
e. met with child’s teacher to discuss any behavior problems he/she has had in school? |
1 |
2 |
7 |
8 |
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 you moved into your AHPP unit?
More Likely 1
Less Likely 2
Equally Likely 3
REFUSED 97
DON’T KNOW 98
Are you living on the same property, or lot, as you were before the hurricane hit?
Yes (SKIP TO C40) 1
No 2
REFUSED 97
DON’T KNOW 98
C39a. Thinking about your neighborhood now, are you living in the same neighborhood as when the hurricane hit when you lived at [HURRICANE ADDRESS] or living in a different neighborhood?
Same 1
Different 2
REFUSED 97
DON’T KNOW 98
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?
Same 1
Different 2
REFUSED 97
DON’T KNOW 98
Now, please tell us how satisfied you are with the following neighborhood features for your current housing...
|
Satisfied |
Neither satisfied or unsatisfied |
Unsatisfied |
NOT APPLICABLE |
Ref |
Don’t know |
a. Distance to your job? |
1 |
2 |
3 |
4 |
7 |
8 |
b. Distance to your child/children’s school? |
1 |
2 |
3 |
4 |
7 |
8 |
c. Quality of your child/children’s school? |
1 |
2 |
3 |
4 |
7 |
8 |
d. Garbage pick-up? |
1 |
2 |
3 |
4 |
7 |
8 |
e. Police response? |
1 |
2 |
3 |
4 |
7 |
8 |
f. Quality of outdoor space, such as parks? |
1 |
2 |
3 |
4 |
7 |
8 |
g. Distance to grocery store? |
1 |
2 |
3 |
4 |
7 |
8 |
h. Friendliness of your neighbors? |
1 |
2 |
3 |
4 |
7 |
8 |
i. Availability of child care? |
1 |
2 |
3 |
4 |
7 |
8 |
j. Availability of health care? |
1 |
2 |
3 |
4 |
7 |
8 |
Now we’d like to get a sense of how safe you think the area is where you currently live.
How safe do you feel…
|
Very safe |
Safe |
Unsafe |
Very unsafe |
Refused |
Don’t know |
a. On the streets near your home during the day? |
1 |
2 |
3 |
4 |
7 |
8 |
b. On the streets near your home at night? |
1 |
2 |
3 |
4 |
7 |
8 |
C42a. Think back to when you lived in a FEMA unit. Do you feel more safe, less safe, or equally safe in your current unit than you did in your FEMA unit?
MORE SAFE 1
LESS SAFE 2
EQUALLY SAFE 3
REFUSED 97
DON’T KNOW 98
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.
In the past 6 months… |
Yes |
No |
REFUSED |
DON’T KNOW |
a. Was anyone’s purse, wallet, or jewelry snatched from them? |
1 |
2 |
7 |
8 |
b. Was anyone threatened with a knife or a gun? |
1 |
2 |
7 |
8 |
c. Was anyone beaten or assaulted? |
1 |
2 |
7 |
8 |
d. Did someone try to break into your home or property? |
1 |
2 |
7 |
8 |
e. Was anyone stabbed or shot? |
1 |
2 |
7 |
8 |
Now, still thinking about the area that you consider your neighborhood, please tell me if the following items are - a big problem, a small problem, or no problem at all
In your neighborhood [is/are] … |
Big problem |
small problem |
no problem at all |
a. People being attacked or robbed a... |
1 |
2 |
3 |
b. People selling drugs a… |
1 |
2 |
3 |
f. Shootings and violence a… |
1 |
2 |
3 |
I am now going to ask you some questions about different types of help that may have been or may be available to you if you need it.
In the six months before the hurricanes, if you needed help, please tell me if the following types of support were available to you.
If you needed help now, please tell me if the following types of support would be available to you.
|
C45. Available in 6 months prior to hurricane? |
C46.
|
||
|
Yes |
No |
Yes |
No |
a. Someone available to help you if you were confined to bed. |
1 |
2 |
1 |
2 |
b. Someone available to give good advice about a crisis or problem you have. |
1 |
2 |
1 |
2 |
c. Someone available to get together with for relaxation. |
1 |
2 |
1 |
2 |
d. Someone available to confide in or talk about your problems. |
1 |
2 |
1 |
2 |
e. Someone available to love you and make you feel wanted. |
1 |
2 |
1 |
2 |
Think about the unit and the neighborhood you live in now. How safe do you feel…
|
Very safe |
Safe |
Unsafe |
Very unsafe |
Refused |
Don’t know |
a. From flooding? |
1 |
2 |
3 |
4 |
7 |
8 |
b. From high winds? |
1 |
2 |
3 |
4 |
7 |
8 |
c. From hurricanes? |
1 |
2 |
3 |
4 |
7 |
8 |
In what ways do you think that AHP program has affected your quality of life?
___________________________________________________________________________________-_
Thank you very much for your time today. To help us be able to get back in touch with you in the future, we would like to collect the names, telephone numbers and addresses of two people who will always know how to reach you. Please tell me about people who live at a different address than you. This information will be kept strictly confidential and will only be used if we are unable to contact you.
Could you tell us the name of a primary person who does not live with you and will always know how to contact you?
Yes 1
No (SKIP TO C57) 2
REFUSED (SKIP TO C57) 97
DON’T KNOW (SKIP TO C57) 98
What is his/her first name?
C50a. What is his/her middle name?
C50b. What is his/her last name?
C50c. Does his/her name have a suffix?
What is (his/her) street address?
C51a. Is there a complex/building name?
C51b. Is there an apartment number?
C51c. In what city?
C51d. In what state?
C51e. What is the zip code?
What's the best phone number to reach (him/her) at starting with the area code?
Telephone # with area code: (_______) ________-________
C52a. Is
she/he a friend or a relative, or what is (his/her) relationship to
you?
ACCEPT ONE RESPONSE ONLY.
Friend 1
Relative 2
Other (SPECIFY______________________________) 96
REFUSED 97
DON’T KNOW 98
Could you tell us the name of a second person who does not live with you and will always know how to contact you?
Yes 1
No (SKIP TO C57) 2
REFUSED (SKIP TO C57) 97
DON’T KNOW (SKIP TO C57) 98
What is the name of someone else who keeps in contact with you?
C54a. What is his/her first name?
C54b. What is his/her middle name?
C54c. What is his/her last name?
C54d. Does his/her name have a suffix?
What is (his/her) street address?
C55a. Is there a complex/building name?
C55b. Is there an apartment number?
C55c. In what city?
C55d. In what state?
C55e. What is the zip code?
What's the best phone number to reach (him/her) at starting with the area code?
Telephone # with area code: (_______) ________-________
C56a. Is
she/he a friend or a relative, or what is (his/her) relationship to
you?
ACCEPT ONE RESPONSE ONLY.
Friend 1
Relative 2
Other (SPECIFY______________________________) 96
REFUSED 97
DON’T KNOW 98
Thank you for taking the time to speak with me today. This brings us to the end of the survey. What you’ve told us is very important, and it will help us help others after disasters. I have just a few more questions about the survey itself.
Were any of the survey questions emotionally upsetting to you?
Yes 1
No (SKIP TO END) 2
REFUSED (SKIP TO END) 97
DON’T KNOW (SKIP TO END) 98
Are you still feeling emotionally upset, or are you feeling okay now?
Still feeling upset 1
Feeling okay now (SKIP TO END) 2
REFUSED (SKIP TO END) 97
DON’T KNOW (SKIP TO END) 98
If you would like to talk to someone about how you are feeling, you can call someone at the [NAME OF LOCAL SUPPORT AGENCY SUCH AS SAMARITANS]? The phone number for this organization is on this card. [Interviewer will provide a card to the respondent with toll-free number for the Samaritans or a local help group.]
Would you like to take this card and speak to someone about how you are feeling now?
Yes 1
No (SKIP TO END) 2
[INTERVIEWER RECORD YES IF RESPONDENT TOOK CARD AND THEN COMPLETE AN ADVERSE EVENT REPORT.]
Yes 1
No 2
AHPP
Questionnaire –Non-Experimental Version
| File Type | application/msword |
| File Title | Rehabilitation Program Application Form |
| Author | Authorized Gateway 2000 Licensee |
| Last Modified By | BuronL |
| File Modified | 2008-05-16 |
| File Created | 2008-05-15 |