Various Demographic Pretesting Activities

Generic Clearence for Questionnaire Pretesting Research

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Various Demographic Pretesting Activities

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Household Roster (Page 1 of 3)

Line #

1. NAME

2. AGE

2b. REL

34. ASTHWHO

67. HEARDIFF

68. HEARLEN

70. SEEDIFF

71. SEELEN

73. MEMDIFF

74. MEMLEN

76. WALKDIFF

77. WALKLEN

1













2













3













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12













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14













15



















Household Roster (Page 2 of 3)



Line #

79. CAREDIFF

80. CARELEN

82. ERRNDIFF

83. ERRLEN

85. BATHWHO

86. BATHLEN

88. KITWHO

89. KITLEN

91. FEEDWHO

92. FEEDLEN

94. HWRKWHO

1












2












3












4












5












6












7












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9












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Household Roster (Page 3 of 3)



Line #

95. HWRKLEN

97. SPLEDWHO

98. SPLEDWHAT

99. SPELLEN

1





2





3





4





5





6





7





8





9





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15







Housing Modifications Table (Page 1 of 1 )

Feature

Feature in Home

Follow-up Q.


101. Ramps inside your home?


124


102. An elevator inside your home?


126


103. Bedroom on the entry level?


128


104. Bathroom on the entry level?


130


105. Handrails or grab bars on both sides of the stairs or steps inside your home?


132


106. Handrails or grab bars in your bathroom, such as in the shower or bathtub area?


134


107. Handrails or grab bars in other areas of your home?


136


108. Built-in seats in the shower area of your home?


138


109. Raised toilets?


140


110. Door handles instead of knobs?


141


111. Handles or levers for all sink faucets instead of knobs?


142


112. Extra wide doors or hallways?


143


113. Electrical outlets positioned slightly higher than standard?


144


114. Electrical switches positioned slightly lower than standard?


145


115. Kitchen cabinets positioned lower than standard?


146


116. Kitchen cabinets with rollout trays and lazy susans?


147


117. Easy to use climate controls?


148


118. Bathroom designed to allow wheelchair access?


149


119. Kitchen designed to allow wheelchair access?


150


120. Wheelchair accessible countertops?


151


121. Areas on the same level or no steps between rooms?


152a


122. Audible or visual strobe light system to indicate doorbell, telephone, smoke, or carbon monoxide detectors?


152b




Mortgage Table Mortgage of f

159. MGTYPE

160. MATBUY

161. YRMOR

162. MNMOR

163. PMT

164. UNPBAL

165. INTW

166. INTF

167. REFI

168.

REFNREAS

169. OTRFSP













170. LNFNBR

171. CASH

172. ADDTNS

173. PERUS1

174. TERM2

175. AMRTZ

176. PMTPARTS

177. PMIAMT

178. OTHPMT

179. OTHPMTSP

180. AMTM

181. PMTF














182. PMTFSP

183. PMTCHYR

184. WHYPMTCH

185. VARMSP

186. PMTINC

187. PMTCHAMT

188. SHOCK

189. RULEINTRO

190. MORTIN

191. SUBMOR

192. BANK

193. DOC














194. SELL

195. MORGTYPE1

196. MORGTYPE3

200. MORGCHK1

201. MORGCHK2

202. MORGCHK3

203. MORGCHK4

204. MORGCHK5

205. MORGCHK6

206. MORGCHK7












207. MORGCHK8

208. MORGCHK9

209. MORGCHK13

210. MORGCHK14

210b. MORGTYPE4

211. MRGTYPSP

212.

BALLNTRM

213.

BALLNAMT

214.

AMMORT1

215.

TERM1











216.

AMMORT2

217.

MGREAS

218.

MGREASSP

219. FRSTTERM

220. ADJCHNG

221. ADJDPEND

222.

ADJDPNSP

223. ADJRATEF

224. ADJRATEO

225. MAXADJ











226. MAXADJTM

227. ADJFIX

228. ORIGINTW

229. ORIGINTF

230. MAXINTW

231. MAXINTF

232.

HECR

233. HEBAL

234. IMPROV














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