Cognitive Interviews for the 2010 National Household Education Survey (NHES) Study Draft Questionnaires

OMB No. 1850-0768

Approval Expires 08/31/2010

U.S. Department of Education
National Center for Education Statistics

National Household Education Survey

The National Center for Education Statistics is authorized to conduct this survey under Section 9543, 20 US Code.
Your participation is voluntary. Your answers may be used only for statistical purposes and may not be disclosed, or
used, in identifiable form for any other purpose except as required by law (Section 9573, 20 US Code). The information
you provide will be combined with information from other participants to produce statistical summaries and reports.

National Household Education Survey
Start Here
Next we're interested in courses or training
that any adult in this household may have
taken in the past 12 months.

This survey should be filled out by an adult
household member living at this address.
Please use blue or black pen if available.

4. In the past 12 months, has any adult in this
household taken any courses or training
to find a new job?

These first questions are about your opinions
on the role of the federal government.

Yes

1. What do you feel should be the main
focus of federal government over the
next 12 months?

No
5. In the past 12 months, has any adult in this
household taken any courses or training
for a current job?

Mark X ONE only.
Economy
Health Care

Yes

Education

No

Defense/Security
Energy

6. In the past 12 months, has any adult in this
household taken courses or training on the
following topics?
Yes
No

Something else
Specify:
2. Do you think that the federal government
is spending too much money on
education, about the right amount of
money, or too little money on education?

a. Computer skills............................
b. Stress management.....................

Too much

c. Health or fitness...........................

About the right amount

d. Foreign language.........................

Too little

e. English as a second language......

3. Do you think the federal government
should play a major role, a minor role, or
no role at all in making policy decisions
for schools?

f.

Hobbies.......................................

g. Some other topic..........................

Major role
Minor role
No role at all
ENGASCN
1

These next questions are about your
opinions on schools nationally and in
your community.

Next we would like to know about where
you get reading materials, such as books
or magazines.

7. How would you rate the quality of public
schools nationally?

11. Where do people in this household look
for information about current events?

Excellent

Mark X all that apply.

Good

Television

Fair

Radio

Poor

Newspapers

Very poor

Magazines
Internet

8. How would you rate the quality of your
community's public schools?

Some other source

Excellent

12. Are there 10 or more books in your home right
now?

Good
Fair

Yes

Poor

No

Very poor

13. Are there a variety of magazines and other
reading materials in your home?

9. Do you agree or disagree with the following
statements about schools in your community?
Agree Disagree

Yes
No

Don't
know

14. In a typical week, how many hours do you
spend reading a book, magazine, or newspaper?

a. They are safe places
during the school day.....
b. They are safe places
during the evening.........

hours per week
15. How often does anyone in this household visit
a bookstore or library?

c. They maintain good
discipline among
students.........................

Daily

d. They maintain good
relationships with
the community...............

Weekly
Monthly
Once or twice a year

10. Overall, do you think the nation's public
schools are teaching students the skills they
will need to be competitive in the workplace?

Never
16. How many computers are in this household
that can access the internet?

Yes
No

number of computers

2

22. What is the best phone number to reach you if
we have more education questions about
someone in your household?

These next questions are about your home or
residence.
17. How many years have you lived at this address?
Write "0" if less than 1 year.

(

)

-

years at this address
Think about everyone who lives in this
household. Then answer the following
questions for all the female and male
household members.

18. Is this house…
Mark X ONE only.
Owned or being bought by someone in
this household,

23. How many females live in this household?

Rented by someone in this household, or

number of females

Occupied by some other arrangement?

24. How many males live in this household?

Please answer the following questions
about the adults who live in this household.

number of males

19. Are there any adults in this household who do
not speak English at home?
No

25. Of everyone in this household, how many
are age 20 or younger?

GO TO question 21.

Do not include those living in college housing.

Yes

number age 20 or younger

20. What language do they speak at home?
Spanish
Another language

If anyone age 20 or younger usually lives in
this household, then fill in the rest of this
survey. If no one in this household is age 20
or younger return this survey in the postage
paid envelope that came with the survey.

Specify:
21. What is the highest grade or level of school
completed among the adults in this household?
Mark X ONE only.
8th grade or less
Some high school, but did not graduate
High school graduate or GED
Some college or associate's degree
Four year college degree (BA or BS)
Some graduate or professional education
but no degree
Graduate or professional degree beyond
a bachelor's degree

3

YOUTH / CHILD 1

YOUTH / CHILD 2
Continue with the next youngest youth or
child who is age 20 or younger.

Start with the youngest youth or child
who is age 20 or younger.
1. What is his or her first name, initials, or
nickname?

1. What is his or her first name, initials, or
nickname?

First name/initials/nickname

First name/initials/nickname

2. How old is this child in years?

2. How old is this child in years?

Mark for babies less than 1 year old

Mark for babies less than 1 year old

age in years

age in years
3. What is this child's sex?

3. What is this child's sex?

Male

Male

Female

Female

4. Is this child currently in...

4. Is this child currently in...

Mark X ONE only.

Mark X ONE only.

Public or private school, or preschool,

Public or private school, or preschool,

Homeschool instead of school for some
or all classes, or
Not in school?
GO TO A AT BOTTOM.

Homeschool instead of school for some
or all classes, or
Not in school?
GO TO A AT BOTTOM.

5. What is this child's current grade or
equivalent?

5. What is this child's current grade or
equivalent?

Preschool

Preschool

Kindergarten

Kindergarten

write grade 1 through 12

write grade 1 through 12

College or vocational school

College or vocational school

None of these

None of these

A. Continue with youth or child 2. If no one
else age 20 or younger lives here return this
form in the postage paid envelope provided.

A. Continue with youth or child 3. If no one
else age 20 or younger lives here return this
form in the postage paid envelope provided.

Youth/child 3 through 6 continue on the next
pages.

4

YOUTH / CHILD 3

YOUTH / CHILD 4

1. What is his or her first name, initials, or
nickname?

1. What is his or her first name, initials, or
nickname?

First name/initials/nickname

First name/initials/nickname
2. How old is this child in years?

2. How old is this child in years?

Mark for babies less than 1 year old

Mark for babies less than 1 year old

age in years

age in years

3. What is this child's sex?

3. What is this child's sex?

Male

Male

Female

Female

4. Is this child currently in...

4. Is this child currently in...

Mark X ONE only.

Mark X ONE only.

Public or private school, or preschool,

Public or private school, or preschool,

Homeschool instead of school for some
or all classes, or
Not in school?
GO TO A AT BOTTOM.

Homeschool instead of school for some
or all classes, or
Not in school?
GO TO A AT BOTTOM.

5. What is this child's current grade or
equivalent?

5. What is this child's current grade or
equivalent?

Preschool

Preschool

Kindergarten

Kindergarten

write grade 1 through 12

write grade 1 through 12

College or vocational school

College or vocational school

None of these

None of these
A. Continue with youth or child 5. If no one
else age 20 or younger lives here return this
form in the postage paid envelope provided.

A. Continue with youth or child 4. If no one
else age 20 or younger lives here return this
form in the postage paid envelope provided.

5

YOUTH / CHILD 5

YOUTH / CHILD 6

1. What is his or her first name, initials, or
nickname?

1. What is his or her first name, initials, or
nickname?

First name/initials/nickname

First name/initials/nickname
2. How old is this child in years?

2. How old is this child in years?

Mark for babies less than 1 year old

Mark for babies less than 1 year old

age in years

age in years

3. What is this child's sex?

3. What is this child's sex?

Male

Male

Female

Female

4. Is this child currently in...

4. Is this child currently in...
Mark X ONE only.

Mark X ONE only.
Public or private school, or preschool,

Public or private school, or preschool,

Homeschool instead of school for some
or all classes, or
Not in school?
GO TO A AT BOTTOM.

Homeschool instead of school for some
or all classes, or
Not in school?
GO TO A AT BOTTOM.

5. What is this child's current grade or
equivalent?

5. What is this child's current grade or
equivalent?

Preschool

Preschool

Kindergarten

Kindergarten

write grade 1 through 12

write grade 1 through 12

College or vocational school

College or vocational school

None of these

None of these
A. Thank you. Please return this form in the
postage paid envelope provided or mail it to:

A. Continue with youth or child 6. If no one
else age 20 or younger lives here return this
form in the postage paid envelope provided.

National Household Education Survey
Westat
1600 Research Blvd. Room TB146F
Rockville, MD 20850-9973
Toll-free number for questions: 1-888-880-3033

6

Commonly Asked Questions
Q: How did you get my address?
A: Your address was randomly selected from among all of the home addresses in the nation. It was selected
using scientific sampling methods to represent other households in the U.S.
Q: If there are no children or anyone currently in school in my household, should I respond?
A: Yes, you should respond to the short survey that was sent to your address. Once you return the
questionnaire, the study will be able to see if anyone in your household is eligible for the next and final
survey. If no one is eligible you will not receive another survey.
Q: Why don’t you ask more questions about education in this questionnaire?
A: The purpose of this questionnaire is to find out if anyone in your household is eligible for the next stage of
the survey. If so we will send a second questionnaire that will ask about educational experiences of a
member of your household.
Q: Why should I take part in this study? Do I have to do this?
A: You represent thousands of other households like yours, and you cannot be replaced. Your answers and
opinions are very important to the success of this study. Your participation is voluntary. You may choose
not to answer any or all questions in this survey. There are no penalties should you choose not to
participate in this study. In order for the survey to be representative it is important that you complete and
return this questionnaire.
Q: How will the information I provide be used?
A: Your responses will be combined with those of others to produce statistical summaries and reports. Your
individual data will not be reported. Your answers may be used only for statistical purposes and may not
be disclosed, or used, in identifiable form for any other purpose except as required by law (Section 9573,
20 US Code).
Q: How much time will it take?
A: On average, it should take 8 minutes for you to respond, including the time for reviewing instructions, and
completing and reviewing the collection of information. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden, to:
Andrew Zukerberg National Center for Education Statistics, U.S. Department of Education, 1990 K Street
NW, Room 9036, Washington, DC 20006-5650. Do not return the completed form to this address.
Q: Who is sponsoring the study? Is this study conducted by the Federal Government?
A: The National Center for Education Statistics, within the Department of Education is authorized to conduct
this study (Section 9543, 20 US Code). Westat has been contracted to conduct this study. This study has
been approved by the Office of Management and Budget, the office that reviews all federally sponsored
surveys. The approval number assigned to this study is 1850-0768. You may send any comments about
this survey, including its length, to the Federal Government. Write to Andrew Zukerberg, National Center
for Education Statistics, U.S. Department of Education, 1990 K Street NW, Room 9036, Washington, DC
20006-5650. You may send e-mail to [email protected].
Q: Who is Westat?
A: Westat is a research company located in Rockville, Maryland. Westat is conducting this survey under
contract to the U.S. Department of Education. If you have any questions about the study contact Westat
toll-free at 1-888-880-3033.