Various Demographic Pretesting Activities

Generic Clearence for Questionnaire Pretesting Research

OMB1110acsinternetenc1_rev

Various Demographic Pretesting Activities

OMB: 0607-0725

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Questions will be modified to reflect the laboratory setting. The name fills for all questions will change. Any additional rewording will appear below the screen shot. Some questions have not been programmed to the Internet yet, so the question wording is listed instead. Other questions are similar to those below but the exact wording has not been programmed yet, so there is no screen shot.

**This question will only ask if the house has telephone service.

*Which FUEL is used MOST for heating your house?

*Please create a list of people living in your household. Begin with yourself. Enter one person on each line. Leave any extra lines blank. Enter names until you have listed everyone who lives or stays there, then click Next.



*What is the highest degree or level of school you have COMPLETED?

*“LAST WEEK, did you work for pay at a job (or business) or do ANY work for pay, even for as little as one hour?”

*During the PAST 12 MONTHS (52 weeks), did you work 50 or more weeks?



*Were you --

***This question will not include the bold text since the respondent will not be receiving the full series of questions







**Will ask how Jane N Doe is related to you

**New answer categories:

Opposite-sex husband/wife/spouse
Opposite-sex unmarried partner
Same-sex husband/wife/spouse
Same-sex unmarried partner
Biological son or daughter
Adopted son or daughter
Stepson or stepdaughter
Brother or sister
Father or mother
Grandchild
Parent-in-law
Son-in-law or daughter-in-law
Other relative
Roomer or boarder
Housemate or roommate
Foster child
Other nonrelative





**Answer categories changed to:

Now married
In a registered domestic partnership or civil union
Widowed
Divorced
Separated
Never married

The following questions are not yet programmed, so there are no screen shots:

How many people live or stay at your house?

1

2

3

4

5

6 or more



At your house, apartment, or mobile home – do you or any member of your household subscribe to the Internet using –

  1. Dial-up service?

  2. DSL service?

  3. Cable modem service?

  4. Fiber-optic service?

  5. Mobile broadband plan for a computer or a cell phone?

  6. Satellite service?

  7. Some other service
    Specify service



After each question, respondents will be asked to rate the difficulty of that question on a 5-point scale:



Please rate the difficulty of the previous question:

5 ---------------4 ---------------3 ---------------2 ---------------1

Very Somewhat Neutral Not very Not at all
Difficult Difficult Difficult Difficult

File Typeapplication/msword
Authornicho016
Last Modified Bydemai001
File Modified2011-06-03
File Created2011-06-03

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