1124 Attachment C-Questionnaire-English

National Survey of Speeding, Driving While Distracted and other Unsafe Driving Behaviors

Attachment C - Questionnaire - English version - revised

National Survey of Speeding, Driving While Distracted and other Unsafe Driving Behaviors

OMB: 2127-0613

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OMB Control No. 2127-xxxx

Expiration Date xx/xx/xx/xxxx



Attachment C – revised


English Questionnaire


2011 National Survey of Speeding Attitudes and Behavior

National Highway Traffic Safety Administration



Paperwork Reduction Act Burden Statement


A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-XXXX. Public reporting for this collection of information is estimated to be approximately 20 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Washington, DC, 20590






4548C: CELL SAMPLE

SC1 Hello, I am _____ calling on behalf of the U.S. Department of Transportation. We are conducting a national study on traffic safety. I know I’m calling you on your cell phone, but we are conducting a brief survey and we would like to send you $10 for answering some questions.


[IF NEEDED: Any answers you give are kept strictly private. It will only take about 20 minutes. The OMB number for this solicitation is XXXXXXXXX]


Are you currently driving?


1 Yes THANK & END, CALLBACK

2 No

9 Refused THANK AND END



SC1a Are you in a safe place to talk right now?


1 Yes

2 No, call me later SCHEDULE CALLBACK

3 No, CB on land-line RECORD NUMBER, schedule call back

4 Cell phone for business only THANK & END - BUSINESS#

9 Refused THANK AND END – Soft Refusal



SC2 Are you 16 years old or older?


1 Yes

2 Yes, no time SCHEDULE CALLBACK

3 No SCREEN OUT

9 Refused THANK AND END - SOFT REFUSAL


Qualified Level 1


SC2a How many persons, age 16 and older, live in your household?


[ENTER NUMBER 1-10]

98 NONE SCREEN OUT

99 Don’t know/Refused SCREEN OUT


SC3 Do any other people age 16 or older regularly ANSWER your cell phone, or just you?


[INTERVIEWER: THIS QUESTION REFERS TO THE PHYSICAL PHONE AND NOT TO THEIR CALLING PLAN]


1 Yes, others

2 No, just respondent SKIP TO SC4

9 Don’t know/Refused SKIP TO SC4


SC3b How many other people age 16 or older regularly answer your cell phone?


[ENTER NUMBER 1-10]

99 Don’t know/Refused


SC4 Not counting any that are used strictly for business purposes, are there other cell phones that you use regularly, or is it just the one?


1 Yes, use other cell phones

2 No SKIP TO SC5

9 Don’t know/Refused SKIP TO SC5


SC4b How many other cell phones do you use regularly, excluding those used only for business purposes?

[ENTER NUMBER 1-10]

99 Don’t know/Refused


SC5 Not counting (this/these) cell phones, do you also have a regular land-line phone at home?


1 Cell is only phone SKIP TO SA3

2 Has regular phone at home SKIP TO SA3

9 Don’t know/Refused THANK AND END, soft refusal


[CELL PHONE MOSTLY QUESTIONS ARE AT THE END OF THE DEMOGRAPHICS SECTION]


4548L: LAND LINE SAMPLE

SL1 Hello, I am _____ calling on behalf of the U.S. Department of Transportation. We are conducting a national study on traffic safety.

[IF NEEDED: If you would like to learn more about the survey, you can call our toll-free number at 1-888-772-4269 or visit the DOT website at www.nhsta.dot.gov. Any answers you give are kept strictly private. It will only take about 20 minutes. The OMB number for this solicitation is XXXXXXXXX]


How many persons, age 16 and older, live in this household?


[ENTER NUMBER 1-10]

98 NONE SCREEN OUT

99 Don’t know/Refused SCREEN OUT


Qualified Level 1

ASK IF SL1=1.

SL1b May I speak with that person?


1 Rspn on line SKIP TO SA3

2 Rspn called to phone GO TO SL1d

3 Rspn unavailable SCHEDULE CALLBACK

9 Refused THANK AND END – Soft Refusal


ASK IF SL1>1

SL1c In order to select just one person to interview, may I please speak to the person in your household, age 16 or older, who (has had the most recent/will have the next) birthday?


1 Rspn on line GO TO SA3

2 Rspn called to phone

3 Rspn unavailable SCHEDULE CALLBACK

9 Refused THANK AND END – Soft Refusal


SL1d Hello, I am _____ calling on behalf of the U.S. Department of Transportation We are conducting a national study on traffic safety. Could I please confirm that you are a household member age 16 or older?


1 Yes

2 No SCHEDULE CALLBACK

9 Refused THANK AND END – Soft Refusal


SKIP TO SA3


4548O: LANDLINE OVERSAMPLE

SO1 Hello, I am _____ calling on behalf of the U.S. Department of Transportation. We are conducting a national study on traffic safety.

[IF NEEDED: If you would like to learn more about the survey, you can call our toll-free number at 1-888-772-4269 or visit the DOT website at www.nhsta.dot.gov. Any answers you give are kept strictly private. It will only take about 20 minutes. The OMB number for this solicitation is XXXXXXXXX]


How many persons, age 16 to 34, live in this household?

[ENTER NUMBER 1-10]

98 NONE SCREEN OUT

99 Don’t know/Refused SCREEN OUT


Qualified Level 1


ASK IF SO1=1.

SO1b May I speak with that person?


1 Rspn on line SKIP TO SA3

2 Rspn called to phone GO TO SO1d

3 Rspn unavailable SCHEDULE CALLBACK

9 Refused THANK AND END – Soft Refusal

ASK IF SO1>1

SO1c In order to select just one person to interview, may I please speak to the person in your household, age 16 to 34, who (has had the most recent/will have the next) birthday?


1 Rspn on line GO TO SA3

2 Rspn called to phone

3 Rspn unavailable SCHEDULE CALLBACK

9 Refused THANK AND END – Soft Refusal



SO1d Hello, I am _____ calling on behalf of the U.S. Department of Transportation We are conducting a national study on traffic safety. Could I please confirm that you are a household member age 16 to 34?


1 Yes

2 No SCHEDULE CALLBACK

9 Refused THANK AND END – Soft Refusal


SA3 Record gender from observation. (Ask only if Necessary)


1 Male

2 Female


Qualified Level 2


General Driving Information


1. How often do you usually drive a car or other motor vehicle? Would you say that you usually drive . . . (NOTE: Motorcycle counts as a motor vehicle)

1 Every day, or almost every day

2 Several days a week

3 Once a week or less

4 Only certain times a year, OR

5 Never SKIP TO D1

6 (VOL) Don’t Know SKIP TO D1

7 (VOL) Refused SKIP TO D1


2. What kind of vehicle do you drive most often? Is it a car, van or minivan, motorcycle, SUV, pickup truck or something else?
(
NOTE: IF RESPONDENT DRIVES MORE THAN ONE VEHICLE OFTEN, ASK: "What kind of vehicle did you LAST drive?")

1 Car

2 Van or minivan

3 SUV

4 Pickup truck

5 Other truck

6 Motorcycle

7 Other (SPECIFY)

8 (VOL ) Don’t Know

9 (VOL) Refused

Speed Behavior


3. Which of the following statements best describes your driving? READ AND ROTATE 1&2

1 I tend to pass other cars more often than other cars pass me OR

2 Other cars tend to pass me more often then I pass them

3 (VOL) Both/About equally

4 (VOL) Don’t Know

5 (VOL) Refused


4. When driving I tend to . . . READ AND ROTATE 1&2

1 Stay with slower moving traffic, or

2 Keep up with the faster traffic

3 (VOL) Both/About Equally

4 (VOL) Don’t Know

5 (VOL) Refused



Speed Behavior on Various Road Types


We want to find out how people may change the way they drive on different types of roads, such as multi-lane highways, rural routes, or residential streets. These next questions are about how you drive on some of these different kinds of roads.


First, I am going to ask about your driving on Multi-Lane, Divided Highways. These are roads which include interstates, freeways and other highways and have a barrier or a median separating traffic in opposite directions.


Multi-Lane, Divided Interstate-type Highways

5a. How often do you drive on Multi-Lane, Divided Highways? Do you drive on this type of road . . . ?

1 Frequently

2 Sometimes

3 Rarely

4 Never SKIP TO Q6a

5 (VOL) Don’t Know SKIP TO Q6a

6 (VOL) Refused SKIP TO Q6a


5b. During the past seven days, approximately how many miles did you drive on Multi-Lane Divided Highways? [IF NEEDED: Your best guess is fine.]


_________ Miles

9998 Don’t Know

9999 Refused

5c. What do you consider to be a safe speed limit for (most) Multi-Lane, Divided Highways in good weather on roads with no congestion during the day?


____MPH


998 (VOL) Don’t Know

999 (VOL) Refused


5d. When driving on Multi-Lane, Divided Highways in good weather during the day, how fast do you normally drive?


____MPH


998 (VOL) Don’t Know

999 (VOL) Refused


5e. How often would you say you drive 15 miles an hour over the speed limit on Multi-Lane, Divided Highways?

1 Often

2 Sometimes

3 Rarely

4 Never

5 (VOL) Don’t Know

6 (VOL) Refused


5f. How many miles per hour over the speed limit do you think the average driver can go on Multi-Lane, Divided Highways, before he or she will receive a ticket?


____MPH over the speed limit


998 (VOL) Don’t Know

999 (VOL) Refused


For this next set of questions I am going to ask you about your driving behavior on Two-Lane Highways which are not divided. This means there is only one lane traveling in each direction and no median or barrier separating traffic traveling in opposite directions.


Two-Lane Highways, one lane in each direction


6a. How often do you drive on Two Lane Highways, one lane in each direction? Do you drive on this type of road . . . ?

1 Frequently

2 Sometimes

3 Rarely, or

4 Never SKIP TO Q7a

5 (VOL) Don’t Know SKIP TO Q7a

6 (VOL) Refused SKIP TO Q7a


6b. During the past seven days, approximately how many miles did you drive on Two Lane Highways, one lane in each direction? [IF NEEDED: Your best guess is fine.]


_________ Miles

9998 Don’t Know

9999 Refused


6c. What do you consider to be a safe speed limit for (most) Two-Lane Highways, one lane in each direction in good weather during the day?


____MPH


998 (VOL) Don’t Know

999 (VOL) Refused



6d. When driving on Two-Lane Highways, one lane in each direction in good weather during the day, how fast do you normally drive?


____MPH


998 (VOL) Don’t Know

999 (VOL) Refused



6e. How often would you say you drive 15 miles an hour over the speed limit on Two-Lane Highways, one lane in each direction?

1 Often

2 Sometimes

3 Rarely

4 Never

5 (VOL) Don’t Know

6 (VOL) Refused




6f. How far above the speed limit do you think the average driver can go on Two-Lane Highways, one lane in each direction, before he or she will receive a ticket?


____MPH over the speed limit


998 (VOL) Don’t Know

999 (VOL) Refused


Now I am going to ask you about your driving behavior on streets in neighborhoods and residential areas. .

Neighborhood or Residential Streets


7a. How often do you drive on Neighborhood or Residential streets? Do you drive on this type of road . . . ?

1 Frequently

2 Sometimes

3 Rarely, or

4 Never SKIP TO Q10

5 (VOL) Don’t Know SKIP TO Q10

6 (VOL) Refused SKIP TO Q10


7b. During the past seven days, approximately how many miles did you drive on Neighborhood or Residential streets? [IF NEEDED: Your best guess is fine.]


_________ Miles

9998 Don’t Know

9999 Refused


7c. What do you consider to be a safe speed limit for (most) Neighborhood or Residential streets in good weather during the day?


____MPH


998 (VOL) Don’t Know

999 (VOL) Refused


7d. When driving on Neighborhood or Residential streets in good weather during the day, how fast do you normally drive?


____MPH


998 (VOL) Don’t Know

999 (VOL) Refused


7e. How often would you say you drive 10 miles an hour over the speed limit on Neighborhood or Residential streets?

1 Often

2 Sometimes

3 Rarely

4 Never

5 (VOL) Don’t Know

6 (VOL) Refused


7f. How far above the speed limit do you think the average driver can go on Neighborhood or Residential streets, before he or she will receive a ticket?


____MPH over the speed limit


998 (VOL) Don’t Know

999 (VOL) Refused



Norms/Factors on Speeding


8. Now I'm going to read a few statements about driving and speed limits. After I read each one, please tell me whether you agree, disagree, or neither. (READ ITEM). Would you say you strongly (AGREE/DISAGREE) or somewhat (AGREE/DISAGREE)?

a. Everyone should obey the speed limits because it’s the law.

b. People should keep pace with the flow of traffic.

c. Speeding tickets have more to do with raising money than they do with reducing speeding.

d. Driving over the speed limit is not dangerous for skilled drivers.

e. There is no excuse to exceed the speed limits.

f. It is unacceptable to exceed speed limits by more than 20mph.

g. If it is your time to die, you’ll die, so it doesn’t matter whether you speed.


1 Strongly agree

2 Somewhat agree

3 Neither

4 Somewhat disagree

5 Strongly disagree

6 (VOL) Don’t Know

7 (VOL) Refused


9. Now I'm going to read a few statements. After I read each one, please tell me whether you agree, disagree, or neither. (READ ITEM). Would you say you strongly (AGREE/DISAGREE) or somewhat (AGREE/DISAGREE)?

a. I enjoy the feeling of driving fast.

b. The faster I drive, the more alert I am.

c. I often get impatient with slower drivers.

d. I try to get where I am going as fast as I can.

e. I worry a lot about having a crash.

f. I consider myself a risk taker while driving.

g. Speeding is something I do without thinking.

1 Strongly agree

2 Somewhat agree

3 Neither

4 Somewhat disagree

5 Strongly disagree

6 (VOL) Don’t Know

7 (VOL) Refused


10. People sometimes go faster than the speed limit for different reasons. On those occasions when you do, what do you think are the main reasons you drive faster than the speed limit? Anything else? MULTIPLE RECORD. DO NOT READ.

1 I’m late

2 I am unlikely to have a crash

3 It’s a habit

4 I’m alone in the car

5 I’m unlikely to get a ticket

6 People I am with encourage it

7 I’m comfortable driving fast

8 Other, Specify

9 (VOL) I never speed

10 (VOL) Don’t Know

11 (VOL) Refused


11. Now I'm going to read a few statements. After I read each one, please tell me whether you agree, disagree, or neither. (READ ITEM). Would you say you strongly (AGREE/DISAGREE) or somewhat (AGREE/DISAGREE)?


Driving at or near the speed limit . . .

a. Reduces my chances of an accident

b. Makes it difficult to keep up with traffic

c. Makes me feel annoyed

e. Makes it easier to avoid dangerous situations

f. Uses less fuel

1 Strongly agree

2 Somewhat agree

3 Neither

4 Somewhat disagree

5 Strongly disagree

6 (VOL) Don’t Know

7 (VOL) Refused


Attitudes Towards Enforcement


12. How important is it that something be done to reduce speeding by drivers? Is it . . .?

1 Very important

2 Somewhat important

3 Not too important

4 Not at all important

5 (VOL) Don’t Know

6 (VOL) Refused


13. How often do you think police should enforce the speed limit? Should they enforce it . . .

1 All the time

2 Often

3 Sometimes

4 Rarely, or

5 Never

6 (VOL) Don’t Know

7 (VOL) Refused


14. How often do you see motor vehicles that have been pulled over by police on the streets and roads you normally drive? Do you see motor vehicles pulled over . . . READ LIST

1 All the time

2 Often

3 Sometimes

4 Rarely

5 Never

6 (VOL) Don’t Know

7 (VOL) Refused























Automated Photo Enforcement Devices


The next questions are about speed cameras. These are cameras set up at intersections or other locations to take pictures of speeding vehicles. A traffic ticket is mailed to the owner of the vehicle along with a photograph and information about the location and time.


15. Before today, have you ever heard of speed cameras being used to ticket drivers that speed?

1 Yes

2 No

3 (VOL) Don’t Know

4 (VOL) Refused


16. Thinking about locations where speed cameras might be useful, would you find it acceptable to use them . . . ? READ AND ROTATE A-F

A. Where it could be hazardous for a police officer to stop a driver

B. Where stopping a vehicle could cause traffic congestion

C. Where there have been many accidents

D. In a school zone

E. In a construction zone

F. On all roads


1 Yes

2 No

3 (VOL) Don’t Know

4 (VOL) Refused


IF Q15 DOES NOT EQ 1, SKIP TO Q19


17. Along the routes you normally drive, are there speed cameras in use?

1 Yes, they are being used

2 No, there are no speed cameras along these routes

3 (VOL) Don’t Know

4 (VOL) Refused


18. Have you ever received a ticket in the mail for a speed violation, identified by a speed camera?

1 Yes

2 No

3 (VOL) Don’t Know

4 (VOL) Refused


19. Now I'm going to read a few statements. After I read each one, please tell me whether you agree, disagree, or neither. (READ ITEM). Would you say you strongly (AGREE/DISAGREE) or somewhat (AGREE/DISAGREE)?

a. Speed cameras are used to prevent accidents

b. Speed cameras are used to generate revenue


1 Strongly agree

2 Somewhat agree

3 Neither

4 Somewhat disagree

5 Strongly disagree

6 (VOL) Don’t Know

7 (VOL) Refused



Attitudes Toward Speeding Countermeasures


20. How would you feel about using the following measures in your community to reduce speeding? Please tell me whether you think each of the following is a good idea or a bad idea.

a. More frequent ticketing for speeding

b. Issuing higher fines for speeding tickets

c. Increasing public awareness of the risks of speeding

d. Road design changes, like speed humps and traffic circles, to slow down traffic

e. Electronic signs by the road that warn drivers that they are speeding and should slow down

f. Increased use of speed cameras in dangerous or high crash locations


1 Good idea

2 Neither a good or bad idea

3 Bad idea

4 (VOL) Don’t Know

5 (VOL) Refused


There are a number of new technologies in use to reduce the amount of speeding on our nation’s roads. These next questions ask what you think about the use of these technologies to reduce speeding.


21. A speed governor is a device which does not allow the vehicle to go above a certain speed. Do you think the mandatory use of a speed governor is a good idea or a bad idea for . . . . ?

a. Truck drivers

b. Drivers 18 years or younger

c. Drivers with multiple speeding tickets in one year

d. All drivers

1 Good idea

2 Neither a good or bad idea

3 Bad idea

4 (VOL) Don’t Know

5 (VOL) Refused


22. Please tell me whether you think each of the following is a good idea or a bad idea to help reduce speeding?

a. A device in your motor vehicle that notifies you with a buzzer or a flashing light when you drive faster than the speed limit

b. A device in your motor vehicle which records your speed data and gives you the option to provide the information to your insurance company to lower your premiums, if you obey the speed limits

c. A device in your motor vehicle, which slows the motor vehicle down when it senses another car or object is too close to your motor vehicle

1 Good idea

2 Neither a good or bad idea

3 Bad idea

4 (VOL) Don’t Know

5 (VOL) Refused


22a. Would it prevent you from speeding?

1 Yes

2 No

3 Not sure

4 (VOL) Refused


23. Now I'm going to read a few statements. After I read each one, please tell me whether you would be likely, unlikely, or neither to use the following devices in your own vehicle(s). (READ ITEM). Would you say you would be very (LIKELY/UNLIKELY) or somewhat (LIKELY/UNLIKELY) to use this device?

A. A device in your motor vehicle that does not allow you to drive faster than 10 miles over the posted speed limit.

B. A device in your motor vehicle that you can switch on or off, that prevents you from driving faster than the speed limit

C. A device in your motor vehicle which allows parents to limit the maximum speed of the motor vehicle, when the teenager drives the motor vehicle

1 Very likely

2 Somewhat likely

3 Neither

4 Somewhat unlikely

5 Very unlikely

6 (VOL) Don’t Know

7 (VOL) Refused


24. Some roadways use digital signs to change the speed limit on a section of road based on traffic or weather conditions. Do you think it is a good idea or a bad idea to use these signs in the following situations: :

A. Construction zones

B. School zones

C. Bad weather

D. Congested Roadways

1 Good idea

2 Neither a good or bad idea

3 Bad idea

4 (VOL) Don’t Know

5 (VOL) Refused

Crash Experience


25. How many times have you been in a speeding related accident in the past five years?


__________ TIMES

RANGE: 0-30

98 (VOL) Don’t Know

99 (VOL) Refused


IF Q25=0, SKIP TO Q30


26. How long ago was the most recent accident?


__________

98 (VOL) Don’t Know

99 (VOL) Refused


1 Days

2 Weeks

3 Months

4 Years


27. Did you receive any injuries as a result of the most recent speeding related accident?

1 Yes

2 No SKIP TO Q30

3 (VOL) Don’t Know SKIP TO Q30

4 (VOL) Refused SKIP TO Q30



28. Did your injuries require you to go to the hospital?

1 Yes

2 No SKIP TO Q30

3 (VOL) Don’t Know SKIP TO Q30

4 (VOL) Refused SKIP TO Q30


29. How long did you stay in the hospital?


__________ DAYS

0=Less than 1 day

RANGE 0-97

98 (VOL) Don’t Know

99 (VOL) Refused


Personal Sanctions


30. In the past TWELVE MONTHS have you been STOPPED for speeding by the police?

1 Yes

2 No SKIP TO Q34

3 (VOL) Don’t Know SKIP TO Q34

4 (VOL) Refused SKIP TO Q34


31. How many times have you been stopped for speeding in the past twelve months?


_______ TIMES STOPPED

7 Seven or more times

8 (VOL) Don’t Know

9 (VOL) Refused


32a. Did you receive a ticket during the last time you were stopped for speeding?

1 Yes SKIP TO Q33

2 No

3 (VOL) Don’t Know

4 (VOL) Refused)


32b. Did you receive a warning the last time you were stopped for speeding?

1 Yes

2 No SKIP TO Q34

3 (VOL) Don’t Know SKIP TO Q34

4 (VOL) Refused) SKIP TO Q34


33. Did you change your driving behavior as a result of receiving the (TICKET/WARNING) for speeding?

1 Yes

2 No

3 (VOL) Don’t Know

4 (VOL) Refused


Other Risky Behaviors


34. When driving your primary vehicle how often do you wear your seatbelt?

1 All of the time

2 Most of the time

3 Some of the time

4 Rarely

5 Never

6 (VOL) Don’t Know

7 (VOL) Refused


35. In the past 30 days, have you driven a vehicle when you thought you might have consumed too much alcohol to drive safely?

1 Yes

2 No

3 (VOL) Don’t Know

4 (VOL) Refused


Use of Cell Phone Behaviors


36. When you drive a motor vehicle, do you usually have a cell phone or wireless phone of some type in the vehicle with you?


1 Yes

2 No SKIP TO D1

8 (VOL) Don’t Know

9 (VOL) Refused



37. How often do you talk on the phone while you are driving? Would you say you talk on the phone while driving during . . . ?


1 All trips

2 Most trips

3 About half your trips

4 Fewer than half your trips, or

5 None of your trips SKIP TO Q39

8 (VOL) Don’t Know

9 (VOL) Refused


38. When you are talking on the phone while driving, do you tend to …?


1 Hold the phone in your hand

2 Squeeze the phone between your ear and shoulder

3 Use a hands–free earpiece

4 Use a built-in-car system (OnStar, Sync, or built-in Bluetooth)

5 Use the cellular phone’s speakerphone feature

6 Varies

8 (VOL) Don’t Know

9 (VOL) Refused


39. How often do you read OR send text messages while you are driving and the vehicle is moving? Would you say you read OR send text messages while driving during ...?


1 All trips

2 Most trips

3 About half your trips

4 Fewer than half your trips, or

5 None of your trips

8 (VOL) Don’t Know

9 (VOL) Refused



Demographics


Now, a few last questions for statistical purposes . . .


D1. How old are you?

AGE IN YEARS: ________

99 Refused (VOL)


D2. Are you currently employed full time, part time, unemployed and looking for work, retired, going to school, a homemaker, or something else? SINGLE RECORD

1 Employed full time

2 Employed part time

3 Unemployed and looking for work

4 Retired

5 Going to school

6 Homemaker

7 (VOL) Disabled

8 Other (SPECIFY)

9 (VOL) Not sure

10 (VOL) Refused


D3. What is highest grade or year of regular school you have completed? DO NOT READ

1 No formal schooling

2 First through 7th grade

3 8th grade

4 Some high school

5 High school graduate

6 Some college

7 Four-year college graduate

8 Some graduate school

9 Graduate degree

10 (VOL) Refused


D4. Are you currently married, divorced, separated, widowed, or single?

1 Married

2 Divorced

3 Separated

4 Widowed

5 Single

6 (VOL) Don’t Know

7 (VOL) Refused


D5. Do you consider yourself to be Hispanic or Latino?

1 Yes

2 No

3 (VOL) Don’t Know

4 (VOL) Refused


D6. Which of the following racial categories describes you? You may select more than one.
READ LIST AND MULTIPLE RECORD

1 American Indian or Alaska Native

2 Asian

3 Black or African‑American

4 Native Hawaiian or Other Pacific Islander

5 White

6 (VOL) Hispanic/Latino

11 (VOL) Other (SPECIFY)

12 (VOL) Refused


ASK IF D5=2 AND D6=6

D6a. Just to confirm, do you consider yourself to be Hispanic or Latino?

1 Yes

2 No

3 (VOL) Don’t Know

4 (VOL) Refused


D7a. How many persons live in your household?


______ persons

98 (VOL) Don’t Know

99 (VOL) Refused



D7b. How many persons live in your household who are under 16 years old?


______ persons under 16

00 None

98 (VOL) Don’t Know

99 (VOL) Refused


D8. Do you own or rent your home?

1 Own

2 Rent

3 Some other arrangement

4 (VOL) Don’t Know

5 (VOL) Refused


D9. Which of the following categories best describes your total household income before taxes in 2009? Your best estimate is fine. READ LIST

1 Less than $5,000

2 $5,000 to $14,999

3 $15,000 to $29,999

4 $30,000 to $49,999

5 $50,000 to $74,999

6 $75,000 to $99,999

7 $100,000 or more

8 (VOL)Not sure

9 (VOL)Refused

D10. Let me just confirm that the number I reached you at was: [qphone] READ PHONE NUMBER

1 Yes

2 No

3 (VOL) Refused


D10a. May I please have your zip code?


ENTER ZIP CODE:

98 (VOL) Don’t Know

99 (VOL) Refused


IF DK OR REF IN D10a, ASK D10b

D10b. Do you live in a rural, suburban, or urban area?

1 Rural

2 Suburban

3 Urban

4 (VOL) Other (Specify)

5 (VOL) Don’t Know

6 (VOL) Refused


ASK ONLY FOR LANDLINE SAMPLE

D11. Is this the only telephone number for this household?

1 Yes, this is the only number

2 No, there is more than one number

9 (Don’t Know/Refused)


ASK ONLY FOR LANDLINE SAMPLE

D12. Do you have a cell phone in addition to the line we are speaking on right now?

1 This is only phone

2 Also has cell phone

9 (Don’t Know/Refused)


ASK ONLY IF (SC5=2) OR (D12=2)

D13. Of all the telephone calls that you or your family receives, are . . . (Read List)

1 All or almost all calls received on cell phones

2 Some received on cell phones and some on regular phones

3 Very few or none on cell phones

8 (VOL) Don’t know

9 (VOL) Refused


ASK ONLY IF (SC5=2) OR (D12=2)

D14. Thinking about just your LAND LINE home phone, NOT your cell phone, if that telephone rang when someone was home, under normal circumstances, how likely is it that the phone would be answered? Would you say it is … (Read List)

1 Very likely the land line phone would be answered,

2 Somewhat likely,

3 Somewhat unlikely,

4 Very Unlikely, or

5 Not at all likely the land line phone would be answered

8 (VOL) Don’t know

9 (VOL) Refused


IF CELL SAMPLE SKIP TO C1.


Those are all the questions I have for you. Thank you for your participation.


FOR CELL SAMPLE ONLY

C1. May I please have your street address, city, and state so I can send you your $10 incentive check?


ENTER ADDRESS:

ENTER CITY:

ENTER STATE:


Those are all the questions I have for you. Thank you for your participation.


NHTSA Form 1124 Page 49


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Authorrandolph.atkins
File Modified0000-00-00
File Created2021-02-01

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