CICPE Comments on Wave 1 Questionnaire

Census 2010 CICCE Questionnaire (REVISED 3/10/09)

SCREENER AND WAVE 1 QUESTIONNAIRE

***Annotations reflecting results of Cognitive Interviews conducted 03/17/09-03/23/09****

NOTE1 TO REVIEWERS: NORC computer-assisted questionnaires have designated reserve codes for Don’t Know and Refused options which would be activated for these questionnaires. These options are not noted explicitly in this draft except where their selection affects skip patterns, or where we propose alternative categories which would replace these options.

NOTE2 TO REVIEWERS: NORC has received instructions from the Bureau regarding specific language that must be used with respect to the Privacy Act, matching with Title 13 data, etc. This language will appear in the consent statement rather than the questionnaire.

NOTE3 TO REVIEWERS: There will be multiple modes of data collection (CATI, CAPI, and possibly web and mail) and this questionnaire is the CATI instrument to be administered by interviewers.

NOTE4 TO REVIEWERS: Cognitive interviews of the instrument haven’t been conducted. It will occur after this review.

NOTE5 TO REVIEWERS: Items regarding paid media messaging will be finalized after the paid media campaign is better developed (later in 2009). The Q19 series of items is therefore a placeholder rather than final content.

INTRODUCTION: Hello, I’m calling from the University of Chicago to ask people about their attitudes and experiences toward different government programs and how they can be improved.

SCREENER

First, I would like to ask you a few questions about how your household receives mail.

S1. Is your mail delivered to your home or to a post office box?

1. Home

2. Post office box

S2. How many adults currently live in your household?

_____ Number of people

/*SKIP INSTRUCTION: if S2=1, SKIP TO S9. ELSE, ASK S3.*/

S3. Are you one of the main people who usually opens the mail for this household?

1. Yes

2. No (ASK S4)

SKIP TO S9

S4. These next questions are about the person who usually handles the mail. Is that person male or female?

1 Male

2 Female

S5. Is (he/she) of Hispanic, Latino or Spanish origin?

1. Yes (Ask S5A)

2. No (SKIP TO S6)

S5a. Is (he/she)…

1 Mexican, Mexican American, Chicano;

2 Puerto Rican;

3 Cuban; or

4 or of another Hispanic, Latino, or Spanish origin; for example, Argentinean, Colombian,

Dominican, Nicaraguan, Salvadoran, Spaniard, and so on? (ASK S5B)

5 DO NOT READ: HISPANIC ORIGIN NOT SPECIFIED

SKIP TO S6

S5b. What is that origin? (For example, Argentinean, Colombian, Dominican, Nicaraguan,

Salvadoran, Spaniard, and so on.)

____________________________

S6. Please choose one or more of the following races that this person considers him/herself to be? (CODE ALL THAT APPLY)

1. White

2. Black or African American

3. Asian

4. Native Hawaiian or other Pacific Islander

5. American Indian or Alaska Native

6. DO NOT READ: OTHER

/*SKIP INSTRUCTION: IF S6=1 OR 2, SKIP TO INSTRUCTION BEFORE S7. ELSE SKIP TO INSTRUCTIONS ABOVE S6A.*/

/*SKIP INSTRUCTION: IF S6=3 THEN ASK S6A. ELSE SKIP TO INSTRUCTION ABOVE S6B*/

S6a. Is (he/she)…

1 Asian Indian

2 Chinese

3 Filipino

4 Japanese

5 Korean

6 Vietnamese

7 Or another Asian group, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on? (ASK S6A1)

/SKIP INSTRUCTION: IS S6A=7 ASK S6A1. ELSE SKIP TO INSTRUCTION ABOVE S6B*/

S6A1.What is the other Asian group? (For example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on)

_____________________

/*SKIP INSTRUCTION: IF S6=4, THEN ASK S6B. ELSE SKIP TO INSTRUCTION ABOVE S6C.*/

S6b. Is (he/she) …

1 Native Hawaiian

2 Guamanian or Chamorro

3 Samoan

4 Or another pacific Island group, for example, Fijian, Tongan, and so on (ASK S6B1)

/*SKIP INSTRUCTION: IF S6B=4 THEN ASK S6B1. ELSE SKIP TO INSTRUCTION ABOVE S6C.*/

s6b1. What is that other Pacific Islander group? (For example, Fijian, Tongan, and so on)

______________________________

/*SKIP INSTRUCTION: IF S6=5 ASK S6C. ELSE SKIP TO INSTRUCTION ABOVE S6D*/

S6C. What is his/her enrolled or principal tribe?

________________________________________

/*SKIP INSTRUCTION: IF S6=6 ASK S6D. ELSE SKIP TO INSTRUCTION ABOVE S7*/

S6D. What is his/her other race group?

______________________

/*SKIP INSTRUCTION: IS THIS HOUSEHOLD ELIGIBLE FOR INCLUSION IN THE STUDY BASED ON SAMPLING CRITERIA? IF YES, ASK S8. ELSE, READ S7.*/

S7. Thank you for speaking with me today, those are all of the questions that I have for you. TERMINATE INTERVIEW.

S8. May I speak with that person now?

1 SELECTED RESPONDENT AVAILABLE, SKIP TO Q1.

2 SELECTED RESPONDENT UNAVAILABLE, ASK S8A.

S8A. May I have the first name of that person so I can ask for them directly when I get back in touch? ________________________

CALLBACK TO INITIATE INTERVIEW WITH APPROPRIATE RESPONDENT, STARTING INTERVIEW AT Q1.

S9. CODE RESPONDENT SEX.

ASK IF NEEDED: I am required to ask if you are male or female.

1 Male

2 Female

S10. Are you of Hispanic, Spanish or Latino origin?

1. Yes (ASK S10A)

2. No (ASK S11)

S10a. Are you…

1 Mexican, Mexican American, Chicano;

2 Puerto Rican;

3 Cuban; or

4 of another Hispanic, Latino, or Spanish origin; for example, Argentinean, Colombian,

Dominican, Nicaraguan, Salvadoran, Spaniard, and so on? (ASK S10B)

5 DO NOT READ: HISPANIC ORIGIN NOT SPECIFIED

SKIP TO S11

S10b. What is that origin? (For example, Argentinean, Colombian, Dominican, Nicaraguan,

Salvadoran, Spaniard, and so on.)

____________________________

S11. Please choose one or more of the following races that you consider yourself to be. (CODE ALL THAT APPLY)

1. White

2. Black or African American

3. Asian

4. Native Hawaiian or other Pacific Islander

5. American Indian or Alaska Native

6. OTHER

/*SKIP INSTRUCTION: IF S11=1 OR 2, THEN ASK Q1. ELSE SKIP TO INSTRUCTION ABOVE S11A*/

/*SKIP INSTRUCTION: IF S11=3 THEN ASK S11A. ELSE SKIP TO INSTRUCTION ABOVE S11B*/

S11a. Are you …

1 Asian Indian

2 Chinese

3 Filipino

4 Japanese

5 Korean

6 Vietnamese

7 Or another Asian group, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on?

/SKIP INSTRUCTION: IS S11A=7 ASK S11A1. ELSE SKIP TO INSTRUCTION ABOVE S11B*/

S11A1.What is the other Asian group? (For example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on)

_____________________

/*SKIP INSTRUCTION: IF S11=4, THEN ASK S11B. ELSE SKIP TO INSTRUCTION ABOVE S11C.*/

S11b. Are you…

1 Native Hawaiian

2 Guamanian or Chamorro

3 Samoan

4 Or another Pacific Island group, for example, Fijian, Tongan, and so on (ASK S11B1)

/*SKIP INSTRUCTION: IF S11B=4 THEN ASK S11B1. ELSE SKIP TO INSTRUCTION ABOVE S11C.*/

s11b1. What is that other Pacific Islander group? (For example, Fijian, Tongan, and so on)

______________________________

/*SKIP INSTRUCTION: IF S11=5 ASK S11C. ELSE SKIP TO INSTRUCTION ABOVE S11D*/

S11C. What is your enrolled or principal tribe?

________________________________________

/*SKIP INSTRUCTION: IF S11=6 ASK S11D. ELSE SKIP TO Q1*/

S11D. What is your other race group?

______________________

WAVE 1 QUESTIONNAIRE (estimated fielding date: Summer/Fall 2009)

We expect the rest of this interview to take XXX minutes. Your answers will help improve government programs and how people living in the U.S. learn about those programs. You may choose not to answer any question for any reason. You do not have to reveal any specific information about your own experiences unless you choose to do so. You may stop participating at any time, and there are no consequences for you if you choose to stop.

This survey has been approved by U.S. Office of Management and Budget approval number XXXXXX. Without this number, we could not conduct this survey. If you have comments about the survey, you may send them to an address I will provide at the conclusion.

Shall we start?

1. I am going to read you a list of activities. Please tell me whether or not you participated in the activity in the last 12 months. [IF NEEDED: by participation, I mean attending meetings or working at sponsored events.]	2. How often did you participate in this type of activity in the past year?
1a. In the last 12 months —that is since [MONTH] of last year—have you attended any meetings or events of a school group, neighborhood, or community association such as PTA or neighborhood watch group? 1 YES  ask Q2 2 NO	1 Once a year 2 Several times a year 3 Once a month 4 Several times a month 5 Once a week 6 never
1b. How about a community service organization such as a food pantry or a tutoring program? 1 YES  ask Q2 2 NO	1 Once a year 2 Several times a year 3 Once a month 4 Several times a month 5 Once a week 6 never
1c. In the last 12 months have you attended services or any other events at a church, synagogue, mosque or other religious institution or organization? 1 YES  ask Q2 2 NO	1 Once a year 2 Several times a year 3 Once a month 4 Several times a month 5 Once a week 6 never
1d. Is there any other type of activity that you have attended meetings for or worked at sponsored events for that I have not mentioned? 1 YES  ask Q2 2 NO	1 Once a year 2 Several times a year 3 Once a month 4 Several times a month 5 Once a week 6 never
1e. Have you given blood in a blood drive in the last 12 months? 1 YES 2 NO

3. Would you say that you vote in elections always, almost always, usually, seldom or never?

5 ALWAYS

4 ALMOST ALWAYS

3 USUALLY

2 SELDOM

1 NEVER

6 DO NOT READ: R NOT ELIGIBLE TO VOTE.

READ LIST.

RECORD ONE ANSWER FOR EACH ITEM.

	I’m going to read you two statements that people might make about where they live.	Strongly agree	Agree	Disagree	Strongly disagree	[do not read] NEITHER / NO OPINION
3a.	The first one is, “I know many of my neighbors” Do you strongly agree, agree, disagree or strongly disagree with this statement?	4	3	2	1	97
3b.	The next statement is, “If I had to move away from my neighborhood, I would miss it.” [IF NEEDED: Would you say you strongly agree, agree, disagree or strongly disagree with this statement?]		3	2	1	97

4. Next I would like to ask you about three government programs.

4A. (Have you ever heard of ) The Medicare Part D prescription drug benefit?

1 YES

2 NO

4B. (Have you ever heard of ) The No Child Left Behind Act?

1 YES

2 NO

4C. (Have you ever heard of ) The Census?

1 YES (SKIP TO INSTRUCTION ABOVE Q6)

2 NO

5. The Census is the count of all the people who live in the United States. Have you ever heard of that before?

1 YES

2 NO

/*SKIP INSTRUCTION: IF Q4A=1, ASK Q6. ELSE, SKIP TO INSTRUCTION ABOVE Q7.*/

6. Have you heard or seen anything recently about the Medicare part D prescription drug benefit?

1 YES

2 NO

/*SKIP INSTRUCTION: IF Q4B=1, ASK Q7. ELSE, SKIP TO INSTRUCTION ABOVE Q8.*/

7. Have you heard or seen anything recently about the No Child Left Behind Act?

1 YES

2 NO

/*SKIP INSTRUCTION: IF Q4C=1 OR Q5=1, ASK Q8. ELSE, SKIP TO Q9.*/

8. Have you heard or seen anything recently about Census 2010?

1 YES

2 NO

/*SKIP INSTRUCTION: IF Q5=2 AND Q8=2 THEN SKIP TO Q25*/

9. If the Census were held today, how likely would you be to participate? By participate, we mean fill out and mail in a Census form. Would you say you…?

5 Definitely would

4 Probably would

3 Might or might not

2 Probably would not

1 Definitely would not

10. What about most of your friends and neighbors? If the Census were held today, how likely do you think they would be to participate? By participate, we mean fill out and mail in a Census form. Would you say they …?

5 Definitely would

4 Probably would

3 Might or might not

2 Probably would not

1 Definitely would not

11. How likely are you to recommend participating in the Census to a family member or friend? Would you say you…?

5 Definitely will

4 Probably will

3 Might or might not

2 Probably will not

1 Definitely will not

/*SKIP INSTRUCTION: IF QS2=1 THEN SKIP TO Q12*/

11a. Is there someone else in your household who disagrees with you about whether or not your household should complete and return a census form?

1 YES

2 NO

12. Overall, how would you describe your general feelings about the Census? Do you feel…?

5 Highly favorable

4 Moderately favorable

3 Neutral

2 Not too favorable

1 Rather unfavorable

12A. How sure are you about your general feelings about the census? Would you say very sure, somewhat sure, somewhat unsure, very unsure.

1 VERY SURE

2 SOMEWHAT SURE

3 SOMEWHAT UNSURE

4 VERY UNSURE

13. In general, how familiar are you with the way Census data impacts you and your community.
Would you say…?

4 Very familiar

3 Somewhat familiar

2 Not very familiar

1 Not familiar at all

14. So far as you know, does the law require you to answer the census questions?

1 YES

2 NO

15. People have different ideas about what the Census is used for. I am going to read some of them
to you. As I read each one, please tell me by indicating yes or no whether you think that the
Census is used for that purpose. Is the Census used…?

		YES	NO
a.	To decide how much money communities will get from the government?	1	2
b.	To decide how many representatives each state will have in Congress?	1	2
c.	To count both citizens and non-citizens.	1	2
d.	To determine property taxes?	1	2
e.	To help the police and FBI keep track of people who break the law?	1	2
f.	To help businesses and governments plan for the future?	1	2
g.	To locate people living in the country illegally?	1	2

16. Next, I’m going to read some opinions about the Census. As I read each one, tell me if you strongly agree, agree, disagree, strongly disagree with each of the statements:	Strongly agree	Agree	Disagree	Strongly disagree			DO NOT READ: NEITHER AGREE NOR DISAGREE /DON’T KNOW
16A. Filling out the Census will let the government know what my community needs.	4	3	2	1			97
16B. The Census is an invasion of privacy.	4	3	2	1			97
16C. The Census Bureau’s promise of confidentiality can be trusted.	4	3	2	1			97
16D I am concerned that the information I provide will be misused.	4	3	2		1		97
16E. Taking part in the Census shows I am proud of who I am.	4	3	2		1		97
16F. My answers to the Census could be used against me.	4	3	2		1		97
16G. Answering and sending back the Census matters for my family and community.	4	3	2		1		97
16H.The government already has my personal information, like my tax returns, so I don’t need to fill out a Census form.	4	3	2		1		97
16I. I just don’t see that it matters much if I personally fill out the Census form or not.	4	3	2			1	97
16J. It takes too long to fill out the Census information, I don’t have time.	4	3	2		1		97

PAID MEDIA CENSUS EXPOSURE

17A. How much have you seen about the census in magazine, or newspaper advertisement? Would you say you’ve seen a lot, a little, or nothing about the census in magazine or newspaper advertisements?

1 A LOT (ASK 18A)

2 A LITTLE (ASK 18A)

3 NOTHING (SKIP TO 17B)

18A. Did you see advertisements about the census in..

1) magazines YES NO

2) newspapers YES NO

17B. How much have you heard or seen about the Census in commercials or public service announcements on television or radio? Would you say you’ve heard or seen a lot, a little, or nothing about the census in TV commercials or radio ads?

1 A LOT (ASK 18B)

2 A LITTLE (ASK 18B)

3 NOTHING (SKIP TO 17C)

18B. Did you hear or see advertisements about the Census on..

1) television? YES NO

2) radio? YES NO

17C. How much have you heard or seen about the Census on the Internet or in outdoor advertising? Would you say you’ve heard or seen a lot, a little, or nothing about the census on the Internet or in other outdoor advertising?

1 A LOT (ASK 18B)

2 A LITTLE (ASK 18B)

3 NOTHING (SKIP TO 17C)

18C. Did you hear or see advertisements about the Census...

1) on the Internet? YES NO

2) outdoors, such as on billboards or park benches? YES NO

3) in other places such as on coffee cups or statues? YES NO

PAID MEDIA MESSAGING

/* IN WAVE 1, THERE WILL BE A SINGLE ‘AD’ ASKED ABOUT, A ‘FALSE’ AD THAT WILL CAPTURE ALLEGED REPORTS OF EXPOSURE TO AN AD THAT HAS NOT IN FACT RUN. IN WAVES 2 AND 3, THE SAME SET OF QUESTIONS WILL BE ASKED ABOUT THE INITIAL FALSE AD, AS WELL AS 2 OR 3 TRUE ADS. THESE ITEMS WILL BE SPECIFIED ONCE EXECUTIONS HAVE BEEN FINALIZED BY DRAFTFCB.*/

19A. Have you recently seen an [ad about the 2010 Census that shows….]?

1 YES

2 MAYBE, NOT SURE

3 NO [SKIP TO NEXT AD]

9 REFUSED [SKIP TO NEXT AD]

19B. What happens in this ad (DO NOT READ RESPONSE CATEGORIES AND

CODE ONE ONLY.)?

[code frame is detailed description of advertisement – play by play of the visuals and dialogue]

Other, specify _____________________

19C. During the past 30 days, how often have you seen this advertisement? Would you say…

1 OFTEN

2 SOMETIMES

3 RARELY

4 NEVER

19D. Where did you see this ad?

[code frame includes relevant media, such as television, radio, magazines, newspapers, billboards, internet, etc.]

19E. Tell me how much you agree or disagree with the following statement: This ad is convincing. Would you say you strongly agree, agree, disagree, or strongly disagree?

1 STRONGLY AGREE

2 AGREE

3 DISAGREE

4 STRONGLY DISAGREE

5 DO NOT READ: NEITHER AGREE NOR DISAGREE

19F. Would you say the ad grabbed your attention?

1 YES

2 NO

19G. Would you say the ad gave you good reasons [to mail back your Census form]?

1 YES

2 NO

19H. Did you talk to your friends, family, or other people you know about this ad?

1 YES

2 NO

19I. As I read each of the following statements, tell me if you strongly agree, agree, disagree, strongly disagree with them: Do you think [FILL IN MEMORABLE NAME OR PHRASE TO DESCRIBE CENSUS CAMPAIGN] is about:

19J. As I read each of the following statements, tell me if you strongly agree, agree, disagree, strongly disagree with them: When you think of the [FILL IN MEMORABLE NAME OR PHRASE TO DESCRIBE CENSUS CAMPAIGN] you think:

[sub-items are based on messaging of final DFCB executions, but might include items such as: Returning the Census form is the right thing to do, People in my community are all returning the Census form, This Census is about people like me, The Census is trying to improve lives of people in my community, Other (specify)]

19K. For the next series of questions, please tell me whether you agree or disagree with each statement. As I read each one, tell me if you strongly agree, agree, disagree, strongly disagree with each of the statements:

(RANDOMIZE ORDER OF 19K_1 AND 19K_2)

19K_1. I’d [FILL IN A RELEVANT BEHAVIOR, MAYBE ATTENDING AN EVENT, SHOWING SUPPORT FOR THE CENSUS, E.G. ‘wear a ‘It’s Up to Us’ t-shirt’].

Would you say you:

1 STRONGLY AGREE

2 AGREE

3 DISAGREE

4 STRONGLY DISAGREE

5 DO NOT READ: NEITHER AGREE NOR DISAGREE

19K_2. The people in [FILL IN MEMORABLE NAME OR PHRASE TO DESCRIBE CENSUS CAMPAIGN] ads are just like me.

Would you say you:

1 STRONGLY AGREE

2 AGREE

3 DISAGREE

4 STRONGLY DISAGREE

5 DO NOT READ: NEITHER AGREE NOR DISAGREE

PARTNERSHIP MESSAGING

20. Let me read you a list of possible places or sources where you might have learned about the Census. Please tell me whether you heard or saw a lot about the census from this source, heard or saw a little about the census from this source, or heard or saw nothing about the census from this source.

20A. Have you seen or heard anything about the Census at meetings of religious groups, activities of community organizations, or local events like festivals, or fairs? [IF NEEDED: Did you hear or see a lot about the census, a little about the census, or nothing about the census at meeting of religious groups, activities of community organizations, or local events like festivals or fairs? ]

1 A LOT (ASK 20A_F)

2 A LITTLE (ASK 20A_F)

3 NOTHING (ASK 20B)

20A_F. Have you seen or heard something about the Census…

1) at meetings of religious groups YES NO

2) activities of community organizations YES NO

3) local events like festivals or fairs YES NO

20B. How about at meetings sponsored by a state, local or tribal government or speeches by local leaders in another setting? [IF NEEDED: Did you hear or see a lot about the census, a little about the census, or nothing about the census at meetings sponsored by governments or speeches made by local leaders in other settings?]

1 A LOT

2 A LITTLE

3 NOTHING

20B_F. Have you seen or heard something about the Census…

1) meetings sponsored by state, local or tribal government YES NO

2) speeches by local leaders in other settings YES NO

20C. How about conversations with friends, family, or other people that you know, for example, at home, at work, or at a local shop? [IF NEEDED: Did you hear or see a lot about the census, a little about the census, or nothing about the census from conversations with friends, family, or other people that you know? ]

1 A LOT

2 A LITTLE

3 NOTHING

20E. How about signs, posters, conference exhibits, or billboards? [IF NEEDED: Did you hear or see a lot about the census, a little about the census, or nothing about the census at signs, posters, conference exhibits, or billboards?]

1 A LOT (ASK 20E_F)

2 A LITTLE (ASK 20E_F)

3 NOTHING (ASK 20F)

20E_F. Can you tell me where you heard or saw something about the Census?

1) Signs or posters inside buildings YES NO

2) Conference exhibits YES NO

3) Outside billboards or posters YES NO

20G. How about in paycheck or utility bill inserts? [IF NEEDED: Did you hear or see a lot about the census, a little about the census, or nothing about the census in paycheck or utility bill inserts?]

1 A LOT

2 A LITTLE

3 NOTHING

/*SKIP INSTRUCTION: IF R TALKED WITH SOMEONE IN THE COMMUNITY (q20C=1 OR 2), ASK q21a. ELSE, GO TO NEXT SKIP INSTRUCTION.*/

/*SKIP INSTRUCTION: IF R REPORTS EXPOSURE TO PARTNERSHIP ACTIVITIES FOR AT LEAST ONE CATEGORY (20a through 20g eq 1 or 2), ASK Q21. ELSE, SKIP TO Q21D.*/

21. Have you spoken to or heard someone in your community talk about the Census?

1 YES (ASK 21A)

2 NO

IF NOT YES, SKIP TO Q21D.

21A. Who in your community have you heard talk about the Census? DO NOT READ CATEGORIES EXCEPT TO PROBE. CODE ALL THAT APPLY.

1 Government official

2 Religious leader

3 Someone from my union or workplace

4 Someone from a community organization

5 A friend, relative or neighbor

6 Other

7 DON’T RECALL/DIDN’T KNOW THEM

21B. Would you say the messages you’ve heard about the Census in your community changed some of what you believe about the Census?

1 YES

2 NO

21C. Would you say the messages you’ve heard about the Census in your community gave you good reasons to mail back your Census form?

1 YES

2 NO

CENSUS IN SCHOOLS EXPOSURE

21D. Do you have children in your household who attend Kindergarten through 6^th grade in public, private or tribal school?

1. YES (ASK 21E)

2. NO (ASK 22a)

21E. Have the student(s) told you a lot, a little or nothing about the census 2010?

1. A LOT

2. A LITTLE

3. NOTHING

21F. Have the student (s) shown you printed materials or information about the census 2010?

1. YES

2. NO

EARNED MEDIA CENSUS EXPOSURE

22A. Did you hear or see a lot about the census, a little about the census, or nothing about the census in Census job announcements?

1 A LOT

2 A LITTLE

3 NOTHING

22B. How about stories you came across in newspapers, magazines, television, radio or internet news coverage? [IF NEEDED: Did you hear or see a lot about the census, a little about the census, or nothing about the census in stories you came across in news coverage?]

1 A LOT

2 A LITTLE

3 NOTHING

22C. How about internet blogs, internet social networking tools, regular web-sites? [IF NEEDED: Did you hear or see a lot about the census, a little about the census, or nothing about the census on internet blogs?]

1 A LOT (ASK 22C_F)

2 A LITTLE (ASK 22C_F)

3 NOTHING (ASK 22D)

22C_F. Can you tell me where on the internet you heard or saw something about the Census? (CHECK ALL THAT APPLY)

1. Internet blogs YES NO

2. Social networking (e.g., Facebook, Myspace) YES NO

3. Regular web sites YES NO

22D. How about anywhere else? Did you hear or see a lot about the census, a little about the census, or nothing about the census on anything else?

SPECIFY:_________________

<MODE SPECIFIC CUEING ITEMS – we will have a different ‘clip’ for each medium>

23A. Please (take a look at this card/take a look at this clip/listen to this clip) from an ad that is being run in some parts of the country. Do you recall seeing an ad like this one?

1 Yes

2 No

IF NOT YES, SKIP TO Q24.

23B. Did you remember the ad from radio, a newspaper, a magazine, a billboard or other outdoor sign, from TV or from somewhere else? CODE ALL THAT APPLY.

1 radio

2 newspaper

3 magazine

4 billboard or other outdoor sign

5 TV

6 Other (specify) ________________

23C. What do you recall as the most important message of the ad?

[code frame will be based on clip used, similar to 21C: civic participation, gathering important information for our country, helping people in my community, making sure everyone like me is counted in the Census, etc.]

23D. Did you find this ad convincing?

1 Yes

2 No

<End MODE SPECIFIC CUEING ITEMS>

24. Have you heard or seen anything about the Census in a language other than English?

1 YES

2 NO

GENERAL MEDIA USE

Now I have a few questions about how you spend your time in a typical seven day week.

25. How many hours per week do you usually spend working for pay?

Number of hours |__|__|__|

IF R UNABLE TO PROVIDE NUMBER, CODE INTO CATEGORIES:

1 NONE

2 ONE TO NINETEEN

3 TWENTY TO THIRTY-NINE

4 FORTY AND MORE

26. During a typical 7-day week, about how many hours do you usually spend watching television, including hours when you are doing something else at the same time?

Number of hours |__|__|__|

IF R UNABLE TO PROVIDE NUMBER, CODE INTO CATEGORIES:

1 NONE

2 ONE TO NINETEEN

3 TWENTY OR MORE

27. During a typical 7-day week, how many hours do you usually spend listening to the radio, either at home, in your car, through the internet, or elsewhere?

Number of hours |__|__|__|

IF R UNABLE TO PROVIDE NUMBER, CODE INTO CATEGORIES:

1 NONE

2 ONE TO NINETEEN

3 TWEENTY OR MORE

28. About how many hours in a typical 7 day week do you usually spend reading newspapers or magazines?

Number of hours |__|__|__|

IF R UNABLE TO PROVIDE NUMBER, CODE INTO CATEGORIES:

1 NONE

2 ONE TO TWO

3 THREE OR MORE

29. About how many hours in a typical 7 day week do you spend using social networking tools such as instant messaging, Facebook or Myspace?

Number of hours |__|__|__|

IF R UNABLE TO PROVIDE NUMBER, CODE INTO CATEGORIES:

1 NONE

2 ONE TO TWENTY

3 MORE THAN TWENTY

30. About how many hours in a typical 7 day week do you spend on the Internet doing other things such as checking email, looking for information, shopping or reading, writing or commenting on blogs?

Number of hours |__|__|__|

IF R UNABLE TO PROVIDE NUMBER, CODE INTO CATEGORIES:

1 NONE

2 ONE TO TWENTY

3 MORE THAN TWENTY

31. Do you regularly read newspapers or magazines or watch television that is produced locally for members of your neighborhood or for an ethnic or religious community that you belong to?

1 YES

2 NO

DEMOGRAPHICS

I just have a few questions left about you and your household.

32. Which of the following best describes your age?

1 18 to 29

2 30 to 44

3 45 to 64

4 65 or older

33. How long have you lived at your address?

READ LIST IF NECESSARY. RECORD ONE ANSWER.

1 Less than 1 year

2 1-3 years

3 4-7 years

4 8-10 years

5 More than 10 years but not whole life

6 All of my life

34. What is the highest grade or year of regular school you have completed?

1 Less than high school

2. Some high school, no diploma

3. High school diploma

4. Some college, no diploma

5. College degree

6. Graduate or professional studies after college

35.In the past six months, have you attended a class in an adult education program, including one in a,college or university?

1 YES

2 NO

36. Were you born in the United States?

1 YES

2 NO

37. What is your marital status?

1 Now married

2 Widowed

3 Divorced

4 Separated

5 Never married

38. Do you rent or own your home?

1 RENT

2 OWN

3 OTHER

39. What language is usually spoken in this household?

0 ENGLISH

1          ARABIC

2          CANTONESE

3          FRENCH CREOLE

4          HINDI

5          JAPANESE

6          KHMER

7          KOREAN

8          MANDARIN

9          POLISH

10        RUSSIAN

11        SPANISH

12        TAGALOG

13        VIETNAMESE

14 OTHER (SPECIFY)

40. I am going to read you a list of income categories. Please stop me when I reach the category that best describes the combined annual income of all members of this household in the last calendar year, including wages or salary, pensions, interest or dividends, and all other sources before taxes and other deductions?

1. Less than $25,000

2. $25,000 to $59,999

3. $60,000 to $119,999

4. $120,000 or more

CONTACT INFORMATION

41. I have your street address as {ADDRESS}. Is that correct?

1 YES (ASK 42)

2 NO (ASK 41A)

41A. What is your correct street address?

_______________________________________________

City ________________________ ZIP ________________

42. Thank you very much; you’ve given us some valuable information today. We will be recontacting some participants in this survey to make sure that we collected our data properly and to follow-up on some of the questions that we discussed today. May we contact you in the future?

1 YES (ASK 43)

2 NO (ASK42a)

42A. You always have the right in the future to refuse to speak to us further, or to receive additional information about the value of participating in this study. May I record your contact information so that we may approach you in the future?

1 YES (ASK 43)

2 NO (END)

43. Please tell me your full name.

First __________________ Last __________________________

44. What is the best telephone number for us to reach you?

(____) _______-_________

43A. Is this a home phone, a cell phone, a phone at your workplace, or another type of phone?

1 HOME

2 CELL/MOBILE

3 WORKPLACE

4 OTHER

44. Is there another telephone number where we may try to reach you?

(____) _______-_________

44A. Is this a home phone, a cell phone, a phone at your workplace, or another type of phone?

1 HOME

2 CELL/MOBILE

3 WORKPLACE

4 OTHER

45. Do you have an e-mail address where we may try to reach you?

_____________________@_____________________________________

46. Please tell me about someone who will always know how to find you. What is that person’s name?

First _________________Last __________________________

46a. Please tell me two ways that we may try to reach that person if we are unable to contact you, for example, a telephone number, an e-mail address, or a mailing address.

(____) _______-_________

_____________________@_____________________________________

Street _______________________________________________

City ________________________ ZIP ________________

END. Those are all of the questions I have for you today. Thank you very much for speaking with me.

Do you want the address where you can provide comments on this survey? IF NEEDED: Send comments regarding this burden estimate or any other aspect of this collection of information to: Paperwork Project 0607-0947, U.S. Census Bureau, 4600 Silver Hill Road, Room 3K138, Washington, DC 20233. You may e-mail comments to [email protected]; use "Paperwork Project xxxxxxx" as the subject.

ADDITIONAL COMMENTS ON DRAFT WAVES 2 AND 3 INSTRUMENTS

All wave 1 edits will be made in the waves 2 and 3 instruments as appropriate.

/*SKIP INSTRUCTION: IF INTERVIEW DATE IS ON OR AFTER CENSUS MAILOUT DATE, ASK W2_1. ELSE, SKIP TO GENERAL MEDIA USE.*/

W2_1. Did your household receive a census questionnaire delivered to you at your home in March of this year?

1 YES

2 NO

W2_1A. [IF W2_1=1, READ: Before the questionnaire arrived,] were you expecting to get one?

1 YES

2 NO

/*SKIP INSTRUCTION: IF W2_1=YES, SKIP TO W2_3. ELSE, ASK W2_1B.*/

W2_1B. If you received a Census form today, how likely would you be to participate? By participate, we mean fill out and mail in a Census form. Would you say you…?

5 Definitely would

4 Probably would

3 Might or might not

2 Probably would not

1 Definitely would not

W2_1C. What about most of your friends and neighbors? If they received Census forms today, how likely do you think they would be to participate? By participate, we mean fill out and mail in a Census form. Would you say they …?

5 Definitely would

4 Probably would

3 Might or might not

2 Probably would not

1 Definitely would not

/*SKIP INSTRUCTION: IF W2_1=NO, DON’T KNOW OR REFUSED, SKIP TO INSTRUCTION BEFORE GENERAL MEDIA USE.*/

W2_3. Did someone complete and mail back the questionnaire?

1 YES (SKIP TO GENERAL MEDIA USE)

2 NO

W2_4. Did anyone ever open the envelope?

1 YES

2 NO (SKIP TO W2_7A)

98. DON’T KNOW (SKIP TO W2_7A)

96. REFUSED

W2_5. Did anyone start to fill out the census form that was inside?

1 YES

2 NO

(READ BELOW)

98. DON’T KNOW

96. REFUSED

/*NOTE TO INTERVIEWER: IF W2_5 IS NO ASK W2_6 THEN SKIP TO W2_7A. IF W2_5 IS YES, DK OR REF, CONTINUE AS INDICATED. */

W2_6. When you first saw the questionnaire, did it look like it would be hard or easy to complete?

1 HARD

2 EASY

3 DO NOT READ: NEITHER

4 DO NOT READ: NEVER SAW IT

W2_7. Did someone finish filling out the form?

1 YES

2 NO (SKIP TO W2_7A)

W2_7A. Why not? What happened? (DO NOT READ CATEGORIES)

1 DOESN’T SPEAK ENGLISH

2 COULD NOT READ THE FORM

3 CONFIDENTIALITY CONCERNS

4 FORM WAS TOO LONG

5 FORM WAS TOO DIFFICULT

6 NEVER GOT A FORM

7 TOO BUSY

8 WANTED MORE INFO ON CENSUS (WHY NEED IT?) _____________________

9 OTHER (SPECIFY) _____________________

23