Attachment 2b. Reinterview Questionnaire
Attachment 2b
Hello, This is ..... from the U.S.Census Bureau.
Our records show that one of our interviewers, (interviewer name), recently contacted your
household.
We're doing a short quality control check to make sure that our interviewers are
following correct procedures.
As for the original interview, all information collected will be kept strictly confidential.
Can you or another household member answer a few questions to help us evaluate the
interviewer's work?
1 Yes
2 No
3 Inconvenient time. Try again later
__________________________________________________
We expect this interview to take about five minutes. We have limited questions
in this survey to those essential to current policy initiatives. If you have
any comments about this survey, please send them to :
Associate Director for Administration
Paperwork Reduction Project
Room 3104, FOB3
Bureau of the Census
Washington, DC 20233-0001
OR
Office of Management and Budget
Paperwork Reduction Project
Washington, DC 20503
__________________________________________________
TOLL FREE (800) TELEPHONE NUMBER to confirm
To verify that I am calling from the Census Bureau, you may call my regional office
(PROVIDE RESPONDENT WITH THE TELEPHONE NUMBER OF THE REGIONAL OFFICE).
When you call, please provide your name and the following identification number:
0000015.
READ IF NECESSARY:
To verify that the toll free number is legitimate, you may call Directory Assistance on:
1-800-555-1212.
__________________________________________________
Reinterview Help Menu
Press F8 to proceed with reinterview.
1 Why are you calling me again?
2 Are you calling everyone or am I just lucky?
3 Don't you have anything better to do with my tax dollars? I'm too busy to answer your questions again.
4 Are you "checking up" on me? I told you the truth the first time you called.
5 Do I have to answer your questions?
6 Who sees my answers?
7 Return to Reinterview.
__________________________________________________
Why are you calling me again?
Like any business, we're interested in maintaining the quality of our product, so each
month we reinterview a few households who are in the survey to ensure we are
efficiently and accurately collecting data.
__________________________________________________
Are you calling everyone or am I just lucky?
We are able to get a reliable measure of data quality by reinterviewing only a small
percentage of the total households interviewed in the survey.
__________________________________________________
Don't you have anything better to do with my tax dollars?
I'm too busy to answer your questions again.
The National Center for Health Statistics, other federal agencies, and businesses will
use the data to assess the health services people receive. The Census Bureau
feels a strong need for an independent measure of its quality. As a result, we feel
that the results from our reinterview are a wise use of our tax dollars.
__________________________________________________
Are you "checking up" on me?
I told you the truth the first time you called
The purpose of reinterview is not to check up on respondents. In order to ensure that
we are efficiently and accurately collecting data, we reinterview a few households
who are in the survey.
__________________________________________________
Do I have to answer all your questions?
Your participation in this survey is voluntary. However, the information you provide
will help us to ensure the efficiency and accuracy of our data collection procedures.
Like any business, we're interested in maintaining the quality of our product.
__________________________________________________
Who sees my answers?
We want to reassure you that your confidentiality is completely protected. We conduct
this survey under the authority of Title 13, United States Code, Sections 8 and 9. As
required by Title 13, only sworn Census Bureau employees who have taken an oath to
protect your confidentiality will see the actual responses. The penalties for violating
this oath include jail and substantial fines.
__________________________________________________
Choose one of the following options to continue:
1 Telephone Reinterview
2 Personal Visit Reinterview
3 Quit - Attempt later
4 Reinterview Noninterview
5 RO/HQ Discretion - Type A (Contact Supervisor)
__________________________________________________
Contact your supervisor for authorization before conducting a personal visit.
1 Personal visit reinterview authorized
2 Quit - Attempt later
__________________________________________________
May I speak to (respondent’s name)?
1 This is correct person, or correct person called to the phone.
2 Person not available now. Call back later.
3 Person can not be reached. Speak with another household member.
4 Person unknown at this number.
5 Person no longer lives there.
6 Person deceased.
7 Person can be reached at another number.
8 Reinterview Noninterview.
__________________________________________________
Have I reached area code (number)?
1 Yes
2 No
3 Refused to verify
__________________________________________________
I'm sorry, I'll dial again to be sure I've dialed correctly.
1 After several attempts, wrap up case.
2 Redial
__________________________________________________
This case was a Type A in the original interview.
Please use any available resource to check that the original outcome was:
1 Original outcome was correct.
2 Original outcome was incorrect.
3 Reinterview Noninterview.
4 Quit - Attempt later.
__________________________________________________
Is your address:
(households’s address)
1 Yes
2 No
3 Refused to verify Address
__________________________________________________
Did the interviewer visit in person or call on the telephone?
1 Personal visit only
2 Telephone call only
3 Both - Interviewer visited and called
__________________________________________________
Was the interviewer polite and professional?
1 Yes
2 No
__________________________________________________
Enter comments from the reinterview respondent here.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________
__________________________________________________
About how long did the interview last?
Answer must be in the range from 0 up to 9:
__________________________________________________
Did the interviewer use a laptop computer?
1 Yes
2 No
__________________________________________________
Our records indicate that (names from roster) was/were living or staying at:
(households’s_address)
on (interview date).
Is this correct?
1 Yes
2 No
__________________________________________________
Enter the line number of the household member(s) (line number on roster)
who wasn't/weren't living or staying at the household on (interview date).
__________________________________________________
Have I missed any household member who was living or staying at:
(households’s_address)
On (interview date).
1 Yes
2 No
__________________________________________________
Enter the name of each missing household member who was living or staying at:
(households’s_address)
on (interview date).
__________________________________________________
Were you present during the original interview?
1 Yes
2 No
__________________________________________________
A non-household member (proxy) was used in the original interview.
Probe to determine if there were any household members able to respond to
the survey at the time the interview was conducted (i.e., they were not
hospitalized, institutionalized, seriously ill, or deceased.)?
1 Yes
2 No
__________________________________________________
Did an interviewer ask you or someone in your household if anyone in
the household was INJURED or POISONED seriously enough that they got
medical advice or treatment between (Date1) and (Date2)?
A 'NO' in the reinterview could indicate that not all questions
were asked in the original interview. The reinterview disposition codes
should reflect this discrepancy.
1 Yes
2 No
__________________________________________________
DURING THE PAST 12 MONTHS, prior to (interview date), did an interviewer ask you or
someone in your household if anyone in the household was covered by health insurance or some
other kind of health care plan?
A 'NO' in the reinterview could indicate that not all questions
were asked in the original interview. The reinterview disposition codes
should reflect this discrepancy.
1 Yes
2 No
__________________________________________________
DURING THE PAST 12 MONTHS, prior to (interview date), was there any time when you or someone in family needed medical care, but did not get it because you or the family couldn't afford it?
1 Yes
2 No
__________________________________________________
As of (interview date), what is the HIGHEST level of school
you completed or the highest degree you had received?
0 Never attended, preschool, kindergarten
1 1st grade
2 2nd grade
3 3rd grade
4 4th grade
5 5th grade
6 6th grade
7 7th grade
8 8th grade
9 9th grade
10 10th grade
11 11th grade
12 12th grade, no diploma
13 GED or equivalent
14 HIGH SCHOOL GRADUATE
15 Some college, no degree
16 Associates degree: occupational, technical, or vocational program
17 Associate's degree: Academic program
18 Bachelor's degree (Example: BA, AB, BS, BBA)
19 Master's degree (Example: MA, MS, MEng, MEd, MBA)
20 Professional School Degree (Example: MD, DDS, DVM, JD)
21 Doctorate degree (Example: PhD, EdD)
__________________________________________________
Is (FULL NAME) national ancestry Puerto Rican, Cuban,
Mexican/Mexicano, Mexical American, Chicano, other Latin American,
or other Spanish?
1 Yes
2 No
__________________________________________________
What is (FULL NAME)’s race?
Interviewer: READ IF NECESSARY: White, Black, American Indian, Eskimo,
Aleut, Asian or Pacific Islander.
1 Black
2 NonBlack
__________________________________________________
Could the interviewer have spoken to another person at
(households’s_address)?
1 Yes
2 No
__________________________________________________
May I speak to her/him?
1 Yes
2 No
__________________________________________________
Hello. I'm ... from the U.S. Census Bureau.
Our records show that one of our interviewers, (interviewer name), recently contacted this
location to verify the status of:
(households’s_address)
We're doing a short quality control check to make sure that our interviewers are following
correct procedures.
Was
(households’s_address)
vacant on (interview date)?
1 Yes
2 No
__________________________________________________
What was the status of
(households’s_address)
on or about (interview date)?
Enter reported status.
Explain any discrepancy between reported status and original outcome.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________
__________________________________________________
This case is not completed.
Make several attempts to contact respondent/contact person before selecting reinterview
noninterview.
1 Quit - Complete later
2 Reinterview Noninterview
__________________________________________________
Was the original outcome correct?
1 Yes
2 No
3 Reinterview Noninterview
__________________________________________________
Which outcome describes this reinterview case?
1 Type A Noninterview.
2 Type B Noninterview.
3 Type C Noninterview.
4 Type D Noninterview - Household replaced by new household since the original interview.
__________________________________________________
Which Type A outcome describes this reinterview case?
1 Unable to complete, bad telephone number.
2 Unable to locate.
3 No one home.
4 Temporarily absent.
5 Refused.
6 Language problem.
7 Respondent can't remember.
8 Insufficient partial.
9 Other Type A - Specify in the Reinterview Notes.
__________________________________________________
Which Type B outcome describes this reinterview case?
1 Vacant, regular.
2 Vacant, seasonal.
3 Vacant, storage of household furniture.
4 Converted to temporary business or storage.
5 Unoccupied tent or trailer site.
6 Unfit, to be demolished.
7 HH institutionalized or temporarily ineligible.
8 Entire HH under age ^MIN_AGE.
9 Temporarily occupied by persons with Usual Residence Elsewhere (URE), regular.
10 Temporarily occupied by persons with Usual Residence Elsewhere (URE), seasonal.
11 Other Type B - Specify in the Reinterview Notes.
__________________________________________________
Which Type C outcome describes this reinterview case?
1 Demolished.
2 House or trailer moved.
3 Converted to permanent business or storage.
4 Condemned.
5 Deceased.
6 Moved out of country.
7 Other Type C - Specify in the Reinterview Notes.
__________________________________________________
Which of the following options describes the misclassification of the original Type B case?
1 Should have been an Interview or Type A.
2 Should have been a vacant interview.
3 Should have been another Type B.
4 Should have been a Type C.
5 Type D3
__________________________________________________
Which of the following options describes the misclassification of the original Type C case?
1 Should have been an Interview or Type A.
2 Should have been a vacant interview.
3 Should have been a Type B.
4 Should have been another Type C.
5 Type D4
__________________________________________________
Which of the following options describes the misclassification of the original vacant interview case?
1 Should have been an Interview or Type A.
2 Should have been a Type B or C.
__________________________________________________
Do you suspect falsification?
1 Yes
2 No
3 Unable to determine
__________________________________________________
Explain why you do not suspect falsification in the Reinterview Notes now.
Press Ctrl-F7 to access Reinterview Notes.
Enter 1 when done with your explanation in the Reinterview Notes.
__________________________________________________
Your reinterview detected multiple discrepancies:
Enter the code of the detected discrepancy below which best describes this case.
1 ^DISCREP_DESCRP[1]
2 ^DISCREP_DESCRP[2]
3 ^DISCREP_DESCRP[3]
4 ^DISCREP_DESCRP[4]
5 ^DISCREP_DESCRP[5]
6 ^DISCREP_DESCRP[6]
7 ^DISCREP_DESCRP[7]
8 ^DISCREP_DESCRP[8]
9 ^DISCREP_DESCRP[9]
10 ^DISCREP_DESCRP[10]
11 ^DISCREP_DESCRP[11]
12 ^DISCREP_DESCRP[12]
13 ^DISCREP_DESCRP[13]
14 ^DISCREP_DESCRP[14]
15 ^DISCREP_DESCRP[15]
16 ^DISCREP_DESCRP[16]
17 ^DISCREP_DESCRP[17]
18 ^DISCREP_DESCRP[18]
19 ^DISCREP_DESCRP[19]
20 ^DISCREP_DESCRP[20]
__________________________________________________
Caution: Obtain supervisor's permission before seleting an option below.
Which of the following options describes this reinterview case?
1 Hard to interview original case
2 More than 50 miles from nearest reinterviewer and no phone number
3 Observed during the original interview
4 Personal visit needed, but not authorized
5 Case management or ROSCO problems - Obtain HQ approval
6 Sample adjustment - Obtain HQ approval
7 Other RO discretion - Specify in the Reinterview Notes
__________________________________________________
Explain why you suspect falsification in the Reinterview Notes now.
Press Ctrl-F7 to access Reinterview Notes.
Enter 1 when done with your explanation in the Reinterview Notes.
__________________________________________________
Your reinterview detected multiple discrepancies:
Enter the code of the detected discrepancy below which best describes the primary reason you suspect
falsification.
1 ^DISCREP_DESCRP[1]
2 ^DISCREP_DESCRP[2]
3 ^DISCREP_DESCRP[3]
4 ^DISCREP_DESCRP[4]
5 ^DISCREP_DESCRP[5]
6 ^DISCREP_DESCRP[6]
7 ^DISCREP_DESCRP[7]
8 ^DISCREP_DESCRP[8]
9 ^DISCREP_DESCRP[9]
10 ^DISCREP_DESCRP[10]
11 ^DISCREP_DESCRP[11]
12 ^DISCREP_DESCRP[12]
13 ^DISCREP_DESCRP[13]
14 ^DISCREP_DESCRP[14]
15 ^DISCREP_DESCRP[15]
16 ^DISCREP_DESCRP[16]
17 ^DISCREP_DESCRP[17]
18 ^DISCREP_DESCRP[18]
19 ^DISCREP_DESCRP[19]
20 ^DISCREP_DESCRP[20]
__________________________________________________
I'm sorry, I have the wrong address/telephone number. Thank you for your help.
Attempt to contact the correct household now or at a later time.
__________________________________________________
Thank you for your cooperation. You've been very helpful.
__________________________________________________
Thank you for your help, but I need to speak to a household member. I'll try back later.
__________________________________________________
I'd like to schedule a date to complete/conduct the quality check. What date AND time would
be best to call/visit?
Enter date AND time
Enter (1) if you don't intend to follow up on this case.
_________________________
What date AND time would be best to contact
(respondent’s name) in order to conduct the quality check?
Enter date AND time.
Enter (1) if you don't intend to follow up on this case.
__________________________________________________
Thank you for your help.
We will call/visit again at the time suggested.
Enter 1 to continue
__________________________________________________
Enter reinterview notes about this case now, or view and edit existing notes.
Press Ctrl-F7 to access Reinterview Notes.
Press SHIFT-F11 to access Abbreviation List.
Press SHIFT-F12 to view Original CAPI Notes.
Enter 1 to continue after completing reinterview notes.
__________________________________________________
This case is ready to be wrapped up. After exiting, the case will be
deleted from your case list.
_________________________________________________
THIS CASE IS NOT COMPLETED
Enter 1 to continue
| File Type | application/msword |
| File Title | Attachment 2a |
| Author | hcr8 |
| Last Modified By | Howard Riddick |
| File Modified | 2006-09-29 |
| File Created | 2006-09-29 |