Violence and Victimization Experiences of Indian Women L

Thanks for agreeing to participate in this survey. Before we begin, I want to remind you that the answers you give us will be kept confidential. No information that could personally identify you will be given to anyone outside of this study. The answers you provide will be combined with answers from hundreds of others and analyzed together to describe aspects of your community. You can skip any question or stop the survey at any time. May we begin?

YES {go to RC1}
NO {go to BREAKOFF}

Section RC: Respondent Characteristics

{DK and RF options allowed on every screen unless otherwise specified}

RC1

What month and year were you born?

[ELIGIBLE YEARS OF BIRTHS ARE: ]

[if DK or RF is selected} {INTERVIEWER: IF DK or RF, SAY: I’m sorry, but we’re only speaking with people age 18 and older so I need to confirm your age. If you are not able to answer this question, we will have to end the interview now. Thank you for your interest, and have a nice day / evening.]

[INTERVIEWER: IF YEAR OF BIRTH IS OUTSIDE ELIGIBLE RANGE, SAY: I’m sorry, but we’re only speaking with people age 18 and older. I will have to end the interview now. Thank you for your interest, and have a nice day / evening.]

RC2

With what racial groups do you identify? You may choose more than one. Would you say…

[SHOWCARD #1]

[CODE ALL THAT APPLY]

1 White,

2 Black or African American,

3 Asian,

4 Native Hawaiian or other Pacific Islander,

5 American Indian,

6 Alaska Native, or

7 Some other race or ethnicity {OTHER, SPECIFY max 25 characters}

[INTERVIEWER NOTE: PROBE “Any others?”]

[if DK or RF is selected} {INTERVIEWER: IF DK or RF, SAY: I’m sorry, but we’re only speaking with people who are American Indian or Alaska Native. If you are not able to answer this question, we will have to end the interview now. Thank you for your interest, and have a nice day / evening.]

[INTERVIEWER: IF RC2 does not include 5 or 6, SAY: I’m sorry, but we’re only speaking with people who are American Indian or Alaska Native. I will have to end the interview now. Thank you for your interest, and have a nice day / evening.]

RC3

Are you of Hispanic or {if female: Latina; ~~if male:~~ ~~Latino~~} origin?

1 YES

2 NO

RC3a

{if RC3 = 1}

What is your ethnic background? Are you…

1 Mexican, Mexican American, or Chicano/a?

2 Puerto Rican?

3 Cuban?

4 Some other ethnicity?

RC3b

{if RC2 = more than one category, or if RC2 and RC3 are endorsed}

{only display response categories endorsed at RC2 or RC3}

Do you primarily consider yourself:

1 White

2 Black or African American

3 Asian

4 Native Hawaiian or other Pacific Islander

5 American Indian

6 Alaska Native

7 Hispanic or Latino

8 Other [SPECIFY] {fill with category specified at RC2}

RC4

{if RC2 = 5 or RC2 = 6}

What is your main tribal or village affiliation?

[DROP DOWN LIST OF TRIBES AND NATIVE CORPORATIONS]

RC5

{if RC2=5}

Are you enrolled with your affiliated tribe?

1 YES

2 NO

RC6

{if RC2 = 6}

Are you a shareholder or a descendant of a shareholder in an Alaska Native corporation?

1 YES

2 NO

RC7

{if RC2 = 5 or RC2 = 6}

Have you ever lived {fill: within reservation or tribal jurisdictional boundaries / in an Alaska Native village}?

1 YES {go to RC7a}

2 NO {go to RC8}

RC7a

Have you lived {fill: within reservation or tribal jurisdictional boundaries / an Alaska Native village} at any time during the past 12 months?

1 YES

2 NO

RC8

Next, you will be asked some general questions about your relationships.

Are you currently married, divorced, separated, widowed, or have you never been married?

1 MARRIED

2 DIVORCED

3 SEPARATED

4 WIDOWED

5 NEVER MARRIED

6 OTHER, SPECIFY {max 25 characters}

RC9

How many people live in your household?

ENTER NUMBER {RANGE 1 – 30}

RC10

How many children under the age of 18 currently live in your household? Please include all children who live with you, whether you are their parent or legal guardian or not.

ENTER NUMBER {RANGE 0 – 30}

RC11a

Next, please tell me which of the following resources you currently have in your home.

A telephone? By this we mean cell phones or home phones or “land lines” that are currently in service.

1 YES

2 NO

RC11b

A home computer with Internet access?

1 YES

2 NO

RC11c

A two-way radio or VHF? We mean a radio that can be used to communicate back and forth with other radio users.

1 YES

2 NO

RC12

If you really needed to get somewhere, such as in an emergency, what forms of transportation do you have access to?

[CODE ALL THAT APPLY]

1 CAR, TRUCK, MOTORCYCLE, MOTOR SCOOTER OR BOAT OWNED BY R OR SOMEONE IN HIS/HER HH

2 CAR, TRUCK, MOTORCYCLE, MOTOR SCOOTER OR BOAT OWNED BY A RELATIVE OR NEIGHBOR

3 BICYCLE, SNOW MACHINE, ALL TERRAIN VEHICLE (ATV) OR DOGSLED

4 SHUTTLE BUS

5 TRAIN

6 AIRPLANE

7 SCHOOL VEHICLE

8 MEDI-VAC

9 TAXI

10 WALKING

11 1-800-SAFE-RIDE

12 HITCHHIKING

13 POLICE RIDE

14 RENTAL CAR

15 OTHER, SPECIFY {allow 50 characters}

RC13

How long does it take you to get to the nearest hospital, using the form of transportation you would normally use to get there? Please count time spent getting from your home to the door of the hospital, and do not include health clinics in your answer.

[RECORD NUMBER, THEN RECORD MINUTES / HOURS]

RC14

How long does it take you to get to the nearest health clinic, using the form of transportation you would normally use to get there? Please count time spent getting from your home to the door of the health clinic.

[RECORD NUMBER, THEN RECORD MINUTES / HOURS]

NOT APPLICABLE

RC15

What is the highest level of education you have completed?

1 NO SCHOOLING

2 1st‑8th GRADE

3 SOME HIGH SCHOOL

4 HIGH SCHOOL GRADUATE

5 TECHNICAL OR VOCATIONAL SCHOOL (ATTENDED OR GRADUATED)

6 SOME COLLEGE

7 4-YEAR COLLEGE DEGREE

8 POSTGRADUATE

RC16

Are you currently employed or working a job for which you get paid?

1 YES {go to RC17}

2 NO {go to RC18}

98 (VOL) DK {go to RC21}

99 (VOL) RF {go to RC21}

RC17

Are you currently employed full-time or part-time?

EMPLOYED FULL-TIME (FI Note: Please select this option for Rs who are working at one full-time job and also for Rs who are working at more than one part-time job with total hours of 40 hours per week or more)
EMPLOYED PART-TIME

98 (VOL) DK

99 (VOL) RF

{go to RC19}

RC18

Why are you currently not employed?

HOMEMAKING / STAY-AT-HOME PARENTING
GOING TO SCHOOL
RETIRED
DISABLED
UNABLE TO WORK FOR OTHER HEALTH REASONS
LOOKING FOR WORK
LAID OFF
ENGAGED IN SUBSISTENCE LIVING
NO JOBS AVAILABLE WHERE R LIVES
SEASONAL WORKER (DOES NOT WORK IN “OFF” SEASON)
OTHER

98 (VOL) DK

99 (VOL) RF

RC19

Now please think about your employment status or work situation over the past 12 months, that is since {fill date 12 months ago}.

What were you doing for most of the past 12 months?

EMPLOYED FULL-TIME {go to RC20}
EMPLOYED PART-TIME {go to RC20}
HOMEMAKING / STAY-AT-HOME PARENTING {go to RC21}
GOING TO SCHOOL {go to RC21}
RETIRED {go to RC21}
DISABLED {go to RC21}
UNABLE TO WORK FOR OTHER HEALTH REASONS {go to RC21}
LOOKING FOR WORK {go to RC21}
LAID OFF {go to RC21}
ENGAGED IN SUBSISTENCE LIVING
OTHER {go to RC21}

98 (VOL) DK {go to RC21}

99 (VOL) RF {go to RC21}

RC20

How are you generally paid for the work you do? Are you….

1 Paid by salary,

2 Paid by the hour,

3 Paid by the job or task, or

4 Paid some other way?

98 (VOL) DK {go to RC21}

99 (VOL) RF {go to RC21}

RC21

What was the total income from ALL household members during {fill: most recently ended calendar year}, before taxes. Include income from all sources such as work, investments, dividends, child support and public assistance. Was it…

RC21a Less than $25,000? {If RC21a=2, go to RC21e; if RC21a=1, go to RC21b}

($20,000 to less than $25,000)

RC21b Less than $20,000? {if RC21b=2, go to RC22; if RC21b=1 go to RC21c}

($15,000 to less than $20,000)

RC21c Less than $15,000? {if RC21c=2, go to RC22; if RC21c=1 go to RC21d}

($10,000 to less than $15,000)

RC21d Less than $10,000? {go to RC22}

RC21e Less than $35,000? {If RC21e=2, go to RC21f; if RC21e=1, go to RC22}

($25,000 to less than $35,000)

RC21f Less than $50,000? {If RC21f=2, go to RC21g; if RC21f=1, go to RC22}

($35,000 to less than $50,000)

RC21g Less than $75,000? {If RC21g=2, go to RC21h; if RC21g=1, go to RC22}

($50,000 to less than $75,000)

RC21h $75,000 or more?

98 (VOL) DK

99 (VOL) RF

[TI NOTE: STUDENTS SHOULD NOT INCLUDE THEIR PARENTS’ INCOME.]

RC22

What was your personal income during {fill: most recently ended calendar year}, before taxes. Include income from all sources such as work, investments, dividends, child support and public assistance. Was it…

RC22a Less than $25,000? {If RC22a=2, go to RC22e; if RC22a=1, go to RC22b}

($20,000 to less than $25,000)

RC22b Less than $20,000? {if RC22b=2, go to Section H; if RC22b=1 go to RC22c}

($15,000 to less than $20,000)

RC22c Less than $15,000? {if RC22c=2, go to Section H; if RC22c=1 go to RC22d}

($10,000 to less than $15,000)

RC22d Less than $10,000? {go to Section H }

RC22e Less than $35,000? {If RC22e=2, go to RC22f; if RC22e=1, go to Section H }

($25,000 to less than $35,000)

RC22f Less than $50,000? {If RC22f=2, go to RC22g; if RC22f=1, go to Section H }

($35,000 to less than $50,000)

RC22g Less than $75,000? {If RC22g=2, go to RC22h; if RC22g=1, go to Section H}

($50,000 to less than $75,000)

RC22h $75,000 or more?

98 (VOL) DK

99 (VOL) RF

[TI NOTE: STUDENTS SHOULD NOT INCLUDE THEIR PARENTS’ INCOME.]

RC23

Have you ever served in any branch of the military?

1 YES {go to RC124}

2 NO {go to Section H}

98 (VOL) DK {go to Section H}

99 (VOL) RF {go to Section H}

RC24

Have you served in any branch of the military in the past 12 months?

1 YES

2 NO

98 (VOL) DK

99 (VOL) RF

Section H: Health

H_INTRO

The next questions ask about ways you might have felt or behaved recently. Some respondents may find them upsetting or uncomfortable. Remember that you can skip any questions you do not wish to answer.

In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past one month, you have had nightmares about it or thought about it when you did not want to?

1 YES

2 NO

In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past 1 month, you tried hard not to think about it or went out of your way to avoid situations that reminded you of it?

1 YES

2 NO

In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past 1 month, you were constantly on guard, watchful, or easily startled?

1 YES

2 NO

In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past 1 month, you felt numb or detached from others, activities, or your surroundings?

1 YES

2 NO

Would you say that in general your physical health is…

1 Excellent,

2 Very good,

3 Good,

4 Fair, or

5 Poor

Section CCS: Community Crime and Safety

CCS1

Next, I’d like to know about the community where you live.

In the past 12 months, have you seen any of the following things happening? Please do not include anything you heard about on the radio or from someone else, saw on television, or read in the newspaper. Please do include anything you saw, whether or not it happened to you or someone else.

[SHOWCARD #4]

[CODE ALL THAT APPLY]

1 Someone hitting or deliberately hurting their spouse, romantic partner or someone they were dating

2 Someone hitting or deliberately hurting a member of their family, such as their child, parent, or someone else in their family

3 Someone hitting or deliberately hurting a stranger

4 Someone killing or trying to kill their spouse, romantic partner or someone they were dating

5 Someone killing or trying to kill a member of their family, such as their child, parent, or someone else in their family

6 Someone killing or trying to kill a stranger

7 None of these

CCS2

On a scale from 1 to 10, where 1 is no impact and 10 is a major impact on your quality of life, how much has YOUR OWN quality of life been affected by crime in the past 12 months?

[SHOWCARD #3]

[ENTER 1 – 10]

CCS3

Thinking about the last 12 months, how big of a problem do you think the following public safety issues are in your community? Please rate them from 1-10, where 1 means not a problem at all and 10 means a very big problem.

[SHOWCARD #5]

[ENTER 1 – 10]

[INTERVIEWER: WE ARE INTERESTED IN R’S OPINION ABOUT HOW BIG A PROBLEM EACH OF THESE ITEMS REPRESENTS IN THEIR COMMUNITY, WHETHER OR NOT THEY HAVE EXPERIENCED IT THEMSELVES IN THE PAST 12 MOS.]

CCS3a

Break-ins or attempted break-ins, also known as burglary?

[ENTER 1 – 10]

CCS3b

Theft of personal property?

[ENTER 1 – 10]

CCS3c

Mugging or robbery?

[ENTER 1 – 10]

CCS3d

Driving under the influence of alcohol or drugs?

[ENTER 1 – 10]

CCS3e

Alcohol abuse?

[INTERVIEWER: THIS INCLUDES ABUSE OF ANY ALCOHOL, WHETHER IT IS A TYPE OF ALCOHOL INTENDED FOR CONSUMPTION OR NOT.]

[ENTER 1 – 10]

CCS3f

Illegal use of drugs including prescription drugs?

[ENTER 1 – 10]

CCS3g

How big a problem is boot legging of alcohol in your community?

[ENTER 1 – 10]

CCS3h

Drug dealing?

[ENTER 1 – 10]

CCS3i

Child abuse, neglect and maltreatment? This could include physical abuse, sexual abuse, emotional abuse or neglect of a child.

[ENTER 1 – 10]

CCS3j

Youth violence or youth gangs?

[ENTER 1 – 10]

CCS3k

How big a problem is violent crime in your community? Violent crime includes things like robbery, rape, assault, fighting, physical threats, and murder.

[ENTER 1 – 10]

CCS3l

Violence against women?

[ENTER 1 – 10]

CCS3m

Elder abuse?

[ENTER 1 – 10]

CCS3n

Homicide of a family member?

[ENTER 1 – 10]

Section T: ACASI Tutorial

You will complete the next part of this interview on your own using the computer and headphones. Before you start, we’ll go through a short practice session together so you can learn how to use this computer to answer the interview questions. After this introduction, I will move away from the computer and will not be able to see your answers so that you can take the interview in privacy. Remember, this is not a test and there are no right or wrong answers. We are interested in your experiences and opinions. Please take as much time as you need. If you need assistance at any point, just let me know.

You do not need the mouse or keyboard to answer questions. You can simply touch the buttons on the screen using your finger.

[MOVE COMPUTER SO RESPONDENT CAN SEE THE SCREEN]

For each question, the answers will appear as buttons on the screen, like these yes and no buttons. To choose an answer you will need to use your finger to touch the button for your answer on the computer screen, like this.

[PRESS YES BUTTON]

After you choose your answer, you must touch the NEXT button at the bottom of the screen.

[TOUCH THE NEXT BUTTON]

If you want to go back to the previous question, this is the BACK button.

Now I will show you how to use the back button to go back to the previous question and

change the answer to no.

You can also use the back button to see your previous answer without changing it.

If you don’t know the answer to the question, touch the DON’T KNOW button at the bottom of the screen and you will go on to the next question.

If you don’t want to answer the question, you can touch the REFUSE button and you will go on to the next question.

If you want the computer to read the question again, you can press the REPEAT button.

You can adjust the volume here. Or if you want to turn the volume off you can adjust it on your headphones or take your headphones off.

Please put on your headphones. When you are ready, let me know.

[SELECT NEXT]

{PLAY AUDIO FOR ALL FOLLOWING SCREENS}

This screen will play while you adjust the volume in your headphones. When you have adjusted the volume to a level that is comfortable to you, touch the NEXT button on the bottom of your screen to continue with the practice session.

T10

Welcome to RTI’s self-interviewing system, which lets you control the interview and answer in complete privacy. In this system, you can read the questions on the computer screen and hear them read through the headphones. Nobody, not even your interviewer, will know how you answer the questions.

First, you will learn how to use the system and complete some practice questions. You will learn how to enter answers and how to back up if you make a mistake and want to change an answer.

If you would like to just see the questions on the screen, you can turn off the voice on your headphones or take them off.

Touch the large NEXT button on the bottom of your screen.

T11

After you hear the question, you will hear the possible answers. Each answer will be highlighted as it is read. To answer the question, you simply use your finger to touch the button on the screen with your answer on it and then touch the NEXT button.

Do you like ice cream?

Yes

T12

The last question was a Yes-No question. Other questions will have more answers to choose from, and you will pick your answer from a list.

What is your favorite color? Touch the answer button on the screen that best fits you and then touch the NEXT button.

Blue

Red

Yellow

Green

Some other color

T13

For some questions you will enter your answer using a keypad like the one shown below. Try using the keypad to answer the question below. If you need to change your answer touch the ‘Clear’ button to remove what you have already entered and then put in a new answer.

How many brothers and sisters do you have?

NUMBER: __________ [RANGE: 0 – 99]

T14

Sometimes there will be more than one question to answer on a screen like the example shown below. For these questions the answer choices and the Refused and Don’t Know buttons are shown to the right of each question. Try answering the questions below and then press the NEXT button to go to the next screen.

Has a doctor or other health care provider ever told you that you are allergic to…

Pollen? Y/N/DK/REF

Dust? Y/N/DK/REF

Mold? Y/N/DK/REF

T15

You can tell the computer to repeat a question by touching the REPEAT button. Try this now.

How many times did you listen to this question?

I have listened to this screen more than once.

I have only listened to this screen one time.

T16

If you have any questions, ask your interviewer now. If not, tell the interviewer you are ready to begin and she will move away from the computer. You can still ask her for help at any time. Touch the NEXT button when you are ready to begin.

Section VIC: Violent Victimization Intro

Programming note: Please make all of the violent victimization intro text appear on a single screen.

VIC_INTRO

The next set of questions asks about experiences that may or may not have happened to you. There will be some questions about physical injuries, harassing behaviors, and unwanted sexual activity. Remember, you don’t have to answer any question that you don’t want to.

[ENTER 1 TO CONTINUE]

VIC_INTROa

Do you have any questions?

1 YES {go to VIC_INTROb}

2 NO {go to PV_INTRO}

VIC_INTROb

Please let your interviewer know that you have some questions. She will answer them for you.

[GO TO PV_INTRO]

Section PA: Psychological Aggression

Please think about any romantic or sexual partners you have had in the past 12 months. When thinking about romantic or sexual partners, think about anybody you have been involved with romantically or sexually, which might include spouses, boyfriends, girlfriends, people you have dated, people you were seeing, or people you hooked up with.

PA1

In your lifetime, how many romantic or sexual partners have ever acted very angry towards you in a way that seemed dangerous?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA1a

{if PA1 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA2

In your lifetime, how many romantic or sexual partners have ever told you that you were a loser, a failure, or not good enough?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA2a

{if PA2 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA3

In your lifetime, how many romantic or sexual partners have ever called you names like ugly, fat, crazy, or stupid?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA3a

{if PA3 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA4

In your lifetime, how many romantic or sexual partners have ever insulted, humiliated, or made fun of you in front of others?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA4a

{if PA4 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA5

In your lifetime, how many romantic or sexual partners have ever told you that no one else would want you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA5a

{if PA5 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PA6

You indicated that you have been {fill with PA behavior(s) endorsed for lifetime} in your lifetime.

PA7

How old were you the first time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

PA8

How old were you the most recent time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

Section CCE: Coercive Control and Entrapment

CCE1

In your lifetime, how many romantic or sexual partners have ever tried to keep you from seeing or talking to your family or friends?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE1a

{if CCE1 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE2

In your lifetime, how many romantic or sexual partners have ever made decisions for you that should have been yours to make, such as the clothes you wear, things you eat, or the friends you have?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE2a

{if CCE2 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE3

In your lifetime, how many romantic or sexual partners have ever kept track of you by demanding to know where you were and what you were doing?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE3a

{if CCE3 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE4

In your lifetime, how many romantic or sexual partners have ever threatened to hurt him or herself or commit suicide when he or she was upset with you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE4a

{if CCE4 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE5

In your lifetime, how many romantic or sexual partners have ever threatened to hurt a pet or threatened to take a pet away from you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE5a

{if CCE5 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE6

In your lifetime, how many romantic or sexual partners have ever threatened to hurt someone you love?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE6a

{if CCE6 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE7

In your lifetime, how many romantic or sexual partners have ever hurt someone you love?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE7a

{if CCE7 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE8

{if RC10=1}

In your lifetime, how many romantic or sexual partners have ever threatened to take your children away from you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE8a

{if CCE8 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE9

In your lifetime, how many romantic or sexual partners have ever kept you from leaving the house when you wanted to go?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE9a

{if CCE9 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE10

In your lifetime, how many romantic or sexual partners have ever kept you from having money for your own use?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE10a

{if CCE10 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE11

In your lifetime, how many romantic or sexual partners have ever destroyed something that was important to you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE11a

{if CCE11 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE12

In your lifetime, how many romantic or sexual partners have ever said things like “If I can’t have you, then no one can”?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE12a

{if CCE12 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE13

In your lifetime, how many romantic or sexual partners have ever tried to get you pregnant when you did not want to become pregnant or tried to stop you from using birth control?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE13a

{if CCE13 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE14

In your lifetime, how many romantic or sexual partners have ever refused to use a condom when you wanted them to use one?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE14a

{if CCE14 ≥ 1}

How many romantic or sexual partners have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

CCE15

You indicated that you have been {fill with CCE behavior(s) endorsed for lifetime} in your lifetime.

How old were you the first time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

CCE16

How old were you the most recent time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

Section PV: Physical Violence

PV_INTRO

I’m going to ask you some questions about times when people have done things to you physically. When answering, please think about anyone who may have done these things to you, including romantic or sexual partners, relatives, other people you knew, or strangers.

{for each item, insert logic check on “a” items against PV items, so that # of people cannot be greater at past 12 months than ever}

PV1

In your lifetime, how many people have ever made threats to physically harm you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV1a

{if PV1 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV2

In your lifetime, how many people have ever slapped you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV2a

{if PV2 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV3

In your lifetime, how many people have ever pushed or shoved you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV3a

{if PV3 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV4

In your lifetime, how many people have ever hit you with a fist or something hard?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV4a

{if PV4 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV5

In your lifetime, how many people have ever kicked you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV5a

{if PV5 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV6

In your lifetime, how many people have ever hurt you by pulling your hair?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV6a

{if PV6 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV7

In your lifetime, how many people have ever upset you by cutting your hair when you didn’t want them to?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV7a

{if PV7 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV8

In your lifetime, how many people have ever slammed you against something?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV8a

{if PV8 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV9

In your lifetime, how many people have ever forced you to engage in sexual activity?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV9a

{if PV9 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV10

In your lifetime, how many people have ever tried to hurt you by choking or suffocating you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV10a

{if PV10 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV11

In your lifetime, how many people have ever beaten you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV11a

{if PV11 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV12

In your lifetime, how many people have ever burned you on purpose?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV12a

{if PV12 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV13

In your lifetime, how many people have ever used a knife or gun on you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV13a

{if PV13 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

PV14

You indicated that you have been {fill with PV behavior(s) endorsed for lifetime} in your lifetime.

[ENTER NEXT]

PV15

How old were you the first time {fill: this / any of these things} happened to you? Your best guess is fine.

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

PV16

How old were you the most recent time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

Section SV: Sexual Violence

SV_INTRO

Women and men may experience unwanted and uninvited sexual situations by strangers or people they know well, such as a romantic or sexual partner, friend, teacher, coworker, supervisor, or family member. Your answers will help us learn how often these things happen. Some of the language we use is explicit, but it is important that we ask the questions this way so that you are clear about what we mean. The questions we ask are detailed and some people may find them upsetting. The information you are providing will be kept private. You can skip questions you don’t want to answer and you can stop at any time.

We are going to ask you about different types of unwanted sexual situations. In general, these are: unwanted sexual situations that did NOT involve touching and situations that DID involve touching. I will also ask you about situations in which you were unable to provide consent to sex because of alcohol or drugs, situations where you were sleeping and unable to provide consent to sex, and about your experiences with unwanted sex that happened when someone used physical force or verbal pressure.

SV1

In your lifetime, how many people have ever exposed their sexual body parts to you, flashed you, or masturbated in front of you when you didn’t want it to happen?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV1a

{if SV1 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV2

In your lifetime, how many people have ever made you show your sexual body parts to them when you didn’t want it to happen?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV2a

{if SV2 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV3

In your lifetime, how many people have ever made you look at or participate in sexual photos or movies?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV3a

{if SV3 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV4

In your lifetime, how many people have ever verbally harassed you while you were in a public place in a way that made you feel unsafe?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV4a

{if SV4 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV5

In your lifetime, how many people have ever kissed you in a sexual way when you didn’t want to happen?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV5a

{if SV5 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV6

In your lifetime, how many people have ever fondled, groped, grabbed, or touched you in a way that made you feel unsafe?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV6a

{if SV6 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV_INTRO2

Some people are threatened with harm or physically forced to have sex when they don’t want to, for example, by being pinned or held down, or by the use of violence.

SV7

In your lifetime, how many people have ever used physical force or threats to physically harm you to make you have vaginal sex? By vaginal sex, we mean that a man or boy put his penis in your vagina.

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV7a

{if SV7 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV8

In your lifetime, how many people have ever used physical force or threats to physically harm you to make you receive anal sex, meaning they put their penis into your anus?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV8a

{if SV8 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV9

In your lifetime, how many people have ever used physical force or threats to physically harm you to put their mouth on your vagina?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV9a

{if SV9 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV9_1

In your lifetime, how many people have used physical force or threats to physically harm you to put their mouth on your anus?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV9_1a

{if SV9_1 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV10

In your lifetime, how many people have used physical force or threats to physically harm you to make you put your mouth on their vagina or anus?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV10a

{if SV10 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV10_1

In your lifetime, how many people have used physical force or threats to physically harm you to make you put your mouth on their penis?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV10_1a

{if SV10_1 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV11

In your lifetime, how many people have used physical force or threats to physically harm you to put their fingers or an object in your vagina or anus?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV11a

{if SV11 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV12

In your lifetime, how many people have used physical force or threats to physically harm you to TRY to make you have vaginal sex with them, but sex DID NOT HAPPEN?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV12a

{if SV12 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV13

In your lifetime, how many people have used physical force or threats to physically harm you to TRY to make you have oral or anal sex with them, but sex DID NOT HAPPEN?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV13a

{if SV13 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV_INTRO3

Sometimes sex happens when a person is unable to consent to it or stop it from happening because the person is drunk, high, drugged, or passed out from alcohol, drugs, or medications. This can include times when the person voluntarily consumed alcohol or drugs or was given drugs or alcohol without their knowledge or consent. Please remember that even if someone uses alcohol or drugs, what happens to the person is not their fault.

SV14

In your lifetime, how many people have ever had vaginal sex with you when you were drunk, high, drugged or passed out and unable to consent?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV14a

{if SV14 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV15

In your lifetime, how many people have ever made you receive anal sex when you were drunk, high, drugged, or passed out and unable to consent?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV15a

{if SV15 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV16

In your lifetime, how many people have ever put their mouth on your vagina when you were drunk, high, drugged, or passed out and unable to consent?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV16a

{if SV16 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV16_1

In your lifetime, how many people have put their mouth on your anus when you were drunk, high, drugged, or passed out and unable to consent?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV16_1a

{if SV16_1 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV17

In your lifetime, how many people have ever made you put your mouth on their vagina or anus when you were drunk, high, drugged, or passed out and unable to consent?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV17a

{if SV17 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV17_1

In your lifetime, how many people have made you put your mouth on their penis when you were drunk, high, drugged, or passed out and unable to consent?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV17_1a

{if SV17_1 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV17_2

In your lifetime, how many people have put their fingers or an object in your vagina when you were drunk, high, drugged, or passed out and unable to consent?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV17_2a

{if SV17_2 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV18

In your lifetime, how many people have had vaginal, oral, or anal sex with you when you were sleeping and unable to consent?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV18a

{if SV18 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV_INTRO4

Sometimes unwanted sexual contact happens after a person is pressured in a nonphysical way.

SV19

In your lifetime, how many people have you had vaginal, oral, or anal sex with after they pressured you by doing things like telling you lies, making promises about the future they knew were untrue, threatening to end your relationship, or threatening to spread rumors about you?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV19a

{if SV19 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV20

In your lifetime, how many people have you had vaginal, oral, or anal sex with after they pressured you by wearing you down by repeatedly asking for sex, or showing they were unhappy?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV20a

{if SV20 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV21

In your lifetime, how many people have you had vaginal, oral, or anal sex with after they pressured you by using their influence or authority over you, for example, your boss or your teacher, clergy, medicine man or woman?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV21a

{if SV21 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

SV22

You indicated that in your lifetime people have {fill as appropriate:

{fill as appropriate: had vaginal sex with you, had anal sex with you, put their mouth on your sexual body part or made you put your mouth on theirs} when you were drunk, high, drugged, or passed out and unable to consent
used physical force or threats to physically harm you to {fill as appropriate: make you have vaginal sex, make you have anal sex, put their mouth on your sexual body part or made you put your mouth on theirs}
used physical force or threats of physical harm to TRY to have vaginal, oral, or anal sex with you, but sex did not happen
had vaginal, oral, or anal sex with you after they pressured you.

SV23

How old were you the first time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

SV24

How old were you the most recent time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

Section S: Stalking

S_INTRO

The next questions are about times when you may have been contacted, followed or harassed. When answering, please think about anyone who may have done these things to you, including romantic or sexual partners, other people you knew, or strangers. Please do not include bill collectors, telephone solicitors, or other sales people.

In your lifetime, how many people have ever watched or followed you from a distance, or spied on you with a listening device, camera, GPS, or global positioning system?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

S1a

{if S1 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

In your lifetime, how many people have ever approached you or showed up in places, such as your home, workplace, or school when you didn’t want them to be there?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

S2a

{if S2 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

In your lifetime, how many people have ever left strange or potentially threatening items for you to find?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

S3a

{if S3 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

In your lifetime, how many people have ever sneaked into your home or car and did things to scare you by letting you know they had been there?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

S4a

{if S4 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

In your lifetime, how many people have ever left you unwanted messages? This includes text or voice messages.

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

S5a

{if S5 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

In your lifetime, how many people have ever made unwanted phone calls to you? This includes hang-up calls.

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

S6a

{if S6 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

In your lifetime, how many people have ever sent you unwanted emails, instant messages, or sent messages through websites like MySpace or Facebook?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

S7a

{if S7 ≥ 1}

How many people have done this to you in the past 12 months?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

In your lifetime, how many people have ever left you cards, letters, flowers, or presents when they know you didn’t want them to?

0 0 people

1 1 person

2 2 people

3 3-5 people

4 6-10 people

5 11-20 people

6 More than 20 people

You indicated that you have been {fill with S behavior(s) endorsed for lifetime} in your lifetime.

S10

How old were you the first time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

S11

How old were you the most recent time {fill: this / any of these things} happened to you?

[ENTER AGE ON KEYPAD] {RANGE 0 – 99}

S12

{if respondent has endorsed S1a, S2a, S3a, S4a, S5a, S6a, or S7a, else skip to SV_PC}

You have indicated that in the past 12 months, that is since {insert date one year before today’s date}, you have been {fill with list of S behaviors endorsed for past 12 months}.

In the past 12 months, how many times altogether did {fill: this / any of these things} happen to you?

[ENTER NUMBER OF TIMES ON KEYPAD] {RANGE 1 – 500}

S13

Now please think about the people who did {fill: this / these things} to you in the past 12 months.

In the past 12 months, how many people altogether did {fill: this / these things} to you?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 1 – 50}

S14

{S14 – S16 = 1 stalking perpetrator only at S13}

{if S13 = 1}

In the past 12 months, did this person do more than one of these things to you?

1 YES

2 NO

S15

In the past 12 months, did this person do any of these things to you more than one time?

1 YES

2 NO

S16

{if S14 OR S15 = 1; else go to }

In the past 12 months, were you ever fearful when this person did {fill: this / these things} to you?

1 YES

2 NO

S17

{S17 – S19 = more than 1 stalking perpetrator at S13}

{if S13 > 1}

In the past 12 months, how many of these people did more than one of these things to you?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

S18

In the past 12 months, how many of these people did any of these things to you more than one time?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

S19

{if S17 or S18 = 1}

In the past 12 months, were you ever fearful when any of these people did {fill: this / these things} to you?

1 YES

2 NO

S20

{if respondent has endorsed S16 or S19; else skip to PV_PC}

Please remember the {fill: person/people} who made you fearful by doing these things to you in the past 12 months. The {fill: thing/things} {fill: this person/these people} did to you will be referred to as {fill: ‘this harassing thing’/’these harassing things’} in future questions. You will need to remember the {fill: person/people} who made you fearful by doing these harassing things.

Section S-PC: Perpetrator Characteristics

S_PCINTRO

{if respondent has endorsed S16 or S19; else skip to PV_PC}

Now please think about any romantic or sexual partners you have had in the past 12 months. When thinking about romantic or sexual partners, think about anybody you have been involved with romantically or sexually, which might include spouses, boyfriends, girlfriends, people you have dated, people you were seeing, or people you hooked up with. For these next questions, think about any romantic or sexual partners who made you fearful by doing {a harassing thing/ harassing things} to you in the past 12 months.

S_PC3

In the past 12 months, how many times altogether did your romantic or sexual partners do {fill: this harassing thing / these harassing things} to you?

[ENTER NUMBER OF TIMES ON KEYPAD] {RANGE 0 – 500}

{if S_PC3 = 0 go to S_PC21}

S_PC3a

Of the {fill: S_PC3} times that your romantic or sexual partners did {fill: this harassing thing / these harassing things} to you in the past 12 months, how many times did it occur {fill: ON tribal reservation land / IN your village}?

[ENTER NUMBER OF TIMES ON KEYPAD] {RANGE 0 – 500}

S_PC3b

{if S_PC3 > S_PC3a}

Of the {fill: S_PC3} times that your romantic or sexual partners did {fill: this harassing thing / these harassing things} to you in the past 12 months, how many times did it occur {fill: OFF tribal reservation land / OUTSIDE of your village}?

[ENTER NUMBER OF TIMES ON KEYPAD] {RANGE 1 – 500}

S_PC4

In the past 12 months, how many of your romantic or sexual partners did {fill: this harassing thing / these harassing things} to you?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 1 – 50}

S_PC15

{if S_PC4 = 1}

Was the romantic or sexual partner who made you fearful by doing {fill: this harassing thing / these harassing things} to you in the past 12 months male or female?

1 MALE

2 FEMALE

S_PC16

{if S_PC4 > 1}

How many of the romantic or sexual partners who made you fearful by doing {fill: this harassing thing / these harassing things} to you in the past 12 months were men?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

S_PC17

{if S_PC4 > 1 AND S_PC16 < S_PC4}

How many of the romantic or sexual partners who made you fearful by doing {fill: this harassing thing / these harassing things} to you in the past 12 months were women?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 1 – 50}

S_PC18

{if S_PC4 = 1, else go to S_PC19}

Was the romantic or sexual partner who made you fearful by doing {fill: this harassing thing / these harassing things} to you in the past 12 months…

1 White?

2 Black or African American?

3 Asian?

4 American Indian?

5 Alaska Native?

6 Native Hawaiian or Other Pacific Islander?

7 Hispanic or Latino?

8 Some other race or ethnicity?

S_PC19

{if S_PC4 > 1}

How many of the romantic or sexual partners who made you fearful by doing {fill: this harassing thing / any of these harassing things} to you in the past 12 months were…

1 White? [ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

2 Black or African American? [ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

3 Asian? [ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

4 American Indian? [ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

5 Alaska Native? [ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

6 Native Hawaiian or Other Pacific Islander? [ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

7 Hispanic or Latino? [ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

8 Some other race or ethnicity? [ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

S_PC20

{if S_PC4 ≥ 1}

In the past 12 months, what was your relationship to your romantic or sexual {if S_PC4 = 1, fill: partner; if S_PC4 ≥ 1, fill: partners} who made you fearful at the time they did {fill: this harassing thing / these harassing things} to you? Since relationships can change over time, it is possible that they did something to you when they were your boyfriend, for example, and when they were your husband, in which case we want you to choose both boyfriend and husband. Please mark all the relationship types that apply.

Current Husband/Wife
Current Live-In Partner
Ex-Husband/Ex-Wife
Former Live-In Partner
Current Boyfriend, Girlfriend, Dating Partner, or Fiancé
Former Boyfriend, Girlfriend, Dating Partner, or Fiancé
Someone you were out on a date with, seeing casually, or having sex with

S_PC21

Now please think about experiences you may have had with people who were NOT your romantic or sexual partners and who made you fearful by doing harassing things to you in the past 12 months.

S_PC22

In the past 12 months, how many times altogether did people who were NOT your romantic or sexual partners do {fill: this harassing thing / these harassing things} to you?

[ENTER NUMBER OF TIMES ON KEYPAD] {RANGE 0 – 500}

{if S_PC22 = 0 go to PV_PC}

S_PC22a

Of the {fill: S_PC22} times that people who were NOT your romantic or sexual partners did {fill: this harassing thing / these harassing things} to you in the past 12 months, how many times did it occur {fill: ON tribal reservation land / IN your village}?

[ENTER NUMBER OF TIMES ON KEYPAD] {RANGE 0 – 500}

S_PC22b

{if S_PC22 > S_PC22a}

Of the {fill: S_PC22} times that people who were NOT your romantic or sexual partners did {fill: this harassing thing / these harassing things} to you in the past 12 months, how many times did it occur {fill: OFF tribal reservation land / OUTSIDE of your village}?

[ENTER NUMBER OF TIMES ON KEYPAD] {RANGE 1 – 500}

S_PC23

In the past 12 months, how many people who were NOT your romantic or sexual partners did {fill: this harassing thing / these harassing things} to you?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 1 – 50}

S_PC24

{if S_PC23 = 1}

Was the person who was not your romantic or sexual partner and made you fearful by doing {fill: this harassing thing / these harassing things} to you in the past 12 months male or female?

1 MALE

2 FEMALE

S_PC25

{if S_PC23 > 1}

How many of the people who were NOT your romantic or sexual partners and who made you fearful by doing {fill: this harassing thing / these harassing things} to you in the past 12 months were men?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 0 – 50}

S_PC26

{if S_PC23 > 1 AND S_PC25 < S_PC23}

How many of the people who were NOT your romantic or sexual partners and who made you fearful by doing {fill: this harassing thing / these harassing things} to you in the past 12 months were women?

[ENTER NUMBER OF PEOPLE ON KEYPAD] {RANGE 1 – 50}

S_PC27

{if S_PC23 = 1 else go to S_PC28}

Was the person who was not your romantic or sexual partner and who made you fearful by doing {fill: this harassing thing / these harassing things} to you in the past 12 months…

1 White?

2 Black or African American?

3 Asian?

4 American Indian?

5 Alaska Native?

6 Native Hawaiian or Other Pacific Islander?

7 Hispanic or Latino?

8 Some other race or ethnicity?

S_PC28

{if S_PC23 >1}

How many of the people who were NOT your romantic or sexual partners and who made you fearful by doing {fill: this harassing thing / any of these harassing things} to you in the past 12 months were…