Attachment A
ACS Internet Test Follow-up --- Behavioral Questions
for Nonrespondents, and Mail and Internet Respondents
Nonrespondents
I’m calling from the U.S. Census Bureau about a survey that was recently mailed to your address.
May I speak to someone at least 15 years old who usually handles the mail and is knowledgeable about the household at [fill: address] and the people in that household?
Once you have an eligible respondent:
I’m calling from the U.S. Census Bureau about the American Community Survey that was recently mailed to your address.
I am required by law to tell you that this survey is authorized by Title 13, Sections 141, 193, and 221 of the United States Code. The average interview takes about 15 minutes. This survey is mandatory and your cooperation is very important. All the information you provide will remain completely confidential
1. Do you remember receiving a large envelope from the Census Bureau in February or March?
❑ Yes
❑ No (probe for someone who opens the mail and may have seen the envelope and restart the interview)
(if nobody remembers it, skip to hypothetical questions, H1).
2. Did you open it?
❑ Yes -- skip to 3
❑ No -- go to 2a
❑ DK -- skip to hypothetical questions, H2
2a. Why didn't you open it? (Mark all that apply)
❑ Already completed the Census
❑ I am too busy
❑ Forgot to/Haven’t gotten to it (R implies they will)
❑ Looked too big/too much work
❑ Threw it away
❑ Didn’t look official/Looked like junk mail
❑ Not familiar with Census Bureau
❑ It wasn’t addressed to me (said “Resident”)
❑ Other_- Record main ideas___________________
Skip to hypothetical questions, H2
3. The Census Bureau wants to improve its mailing materials. What materials do you remember seeing in the envelope? (Mark all that apply)
❑ Form or Questionnaire
❑ Letter – (if marked, then go to 4.a)
❑ Questionnaire Guide
❑ FAQ Brochure
❑ Return Envelope
❑ Postcard
❑ Internet Instruction Card
❑ Other – Record Main ideas
❑ DK
4. If "Letter" NOT marked in question 3
Did you see a letter about the survey?
❑ Yes
❑ No - Skip to 5a if "Form or Questionnaire" marked in Question 3, Otherwise go to 5.
❑ DK - Skip to 5a if "Form or Questionnaire" marked in Question 3, Otherwise go to 5.
4a. Did you read the letter [Fill if "letter” marked in 3: that was in the large envelope]??
❑ Yes
❑ No - Skip to 5a if "Form or Questionnaire" marked in Question 3, Otherwise go to 5.
4b. What do you remember about what the letter said? (Mark all that apply)
❑ It provided response options – Internet or paper
❑ Listed uses of the data
❑ Randomly selected
❑ Required by law - mandatory
❑ Answers are kept confidential
❑ It provided phone number for help
❑ Signed by director
❑ Someone may call or visit
❑ Confusing
❑ Other- Record main ideas _______________________________
5. If "Form or Questionnaire" not marked in 3
Did you see a questionnaire or form to fill out?
❑ Yes
❑ No - Skip to 6
5a. Also ask if "Form or Questionnaire" marked in 3
What do you remember about the questionnaire or form? - Record main ideas
_________________________________________
There were several different ways to respond to the survey. As far as you recall, how could you have chosen to respond to the survey: by paper? by the Internet? or by another way?
❑ Paper – Mail/Send it in
❑ Internet (if marked then go to 7a)
❑ Other, _______________________
❑ Don't Remember
Internet Check
If "Internet” is marked in Q6, then ask this series beginning with 7a; otherwise Skip to Paper Check
7a. Did you consider answering over the Internet?
❑ Yes
❑ No - Skip to 7d.
❑ Don't Know
7b. Did you try to log on?
❑ Yes - Skip to 7e.
❑ No
7c. Why not? (Mark all that apply) If necessary: Any other reasons?
❑ I am too busy
❑ Forgot about it
❑ Haven’t gotten to it (R implies they will)
❑ The instruction card was too confusing
❑ Lost/misplaced the logon information
❑ Household id/pin logon problems
❑ Other – (Record main ideas) _______________
Skip to Paper Check
7d. Why didn't you want to answer over the Internet? (Mark all that apply)
❑ No access to Internet
❑ Inexperienced computer user
❑ Worried about security
❑ Convenience of the paper
❑ The instruction card was too confusing
❑ The survey was too long to do on the Internet
❑ No interest in the computer
❑ Other – (Record main ideas) ______________________
Skip to Paper Check
7e. Did you have any trouble with your User ID or PIN?
❑ Yes -- Can you tell me more about that? (Record main ideas)
❑ No.
7f. Did you start to answer the questions on the Internet?
❑ Yes
❑ No -- Why not? (Record main ideas and Skip to Paper Check)
7g. Did you finish answering the survey on the Internet?
❑ Yes
❑ No -- Why not? (Record main ideas and Skip to Paper Check)
7e. Did you submit the completed survey on the Internet?
❑ Yes – About when did you submit the survey?
❑ No -- Why not? (Record main ideas)
Paper Check: If "Paper” is marked in Q6, then ask this series beginning with 8a; otherwise Skip to Check Other
8a. Did you consider answering the survey on the paper form?
❑ Yes
❑ No -- Why not? Skip to Check Other
8b. Did you start to answer the questions on the paper form?
❑ Yes
❑ No -- Why not? (Record main ideas and Skip to Check Other)
8c. Did you finish answering the survey on the paper form?
❑ Yes
❑ No -- Why not? (Record main ideas and Skip to Check Other)
8d. Did you mail in the completed survey?
❑ Yes – About when did you mail the survey?
❑ No -- Why not? (Record main ideas)
Check Other: If "Paper” and “Internet" are marked in Q6, then Skip to Demographic Questions. Otherwise, ask Q9.
9. Some people were offered two options for responding to the survey - filling out the paper form or going to the Internet and filling out the survey there. Which of those two ways to answer the survey do you prefer? (Mark only one)
❑ Paper– Why do you prefer paper? (Record main ideas)
❑ Internet– Why do you prefer the Internet? (Record main ideas)
❑ Neither option
❑ Prefer both options about the same
❑ It depends - Please give some examples of when you would prefer to respond over the Internet (Record main ideas)
❑ DK
Go to INTERNET USE SECTION then go to DEMOGRAPHIC QUESTIONS
HYPOTHETICAL QUESTIONS
H1. If you had received a large envelope from the Census Bureau, do you think you would have opened it?
❑ Yes
❑ No -- Why not?
H2. If you had opened it and found a questionnaire to fill out, do you think you would have completed it?
❑ Yes
❑ No -- Why not?
H3. If you had a choice of answering on the Internet or answering on paper, which would you prefer?
❑ Paper– Why do you prefer paper? (Record main ideas)
❑ Internet– Why do you prefer the Internet? (Record main ideas)
❑ Neither option
❑ Prefer both options about the same
❑ It depends-- Please give some examples of when you would prefer to respond over the Internet (Record main ideas)
❑ DK
Go to INTERNET USE SECTION then go to DEMOGRAPHIC QUESTIONS
Mail respondents
This call is about a Census Bureau survey you recently completed. First we’d like to thank you for completing the questionnaire. Today, we’d like to collect some additional information.
1. If you recall, you recently received a large envelope from the U.S. Census Bureau. The Census Bureau wants to improve its mailing materials. What materials do you remember seeing in the envelope? (Mark all that apply)
❑ Form or Questionnaire
❑ Letter - If marked, skip to 2a.
❑ Questionnaire Guide
❑ FAQ Brochure
❑ Return Envelope
❑ Postcard
❑ Internet Instruction Card
❑ Other – Record Main ideas
❑ Don’t remember the envelope
❑ DK
2. If "Letter" NOT marked in question 1
Did you see a letter about the survey?
❑ Yes
❑ No - Skip to 3
❑ DK - Skip to 3
2a. Did you read the letter [Fill if "letter” marked in 1: that was in the large envelope]?
❑ Yes
❑ No - Skip to 3
2b. What do you remember about what the letter said?
❑ It provided response options – Internet or paper
❑ Listed uses of the data
❑ Randomly selected
❑ Required by law - mandatory
❑ Answers are kept confidential
❑ It provided phone number for help
❑ Signed by director
❑ Someone may call or visit
❑ Confusing
❑ Other- Record main ideas _______________________________
❑ Don’t remember anything
3. We received a completed form in the mail from you. As far as you recall, could you have chosen to respond by the Internet?
❑ Yes
❑ No - Go to 4b
If control panel (using a flag) skip to Q13; otherwise go to Q4.
4a. Why did you decide to use the paper form to complete the survey instead of the Internet ?
❑ No access to Internet
❑ Lost/misplaced internet log-in instructions
❑ Inexperienced computer user
❑ Worried about security
❑ Convenience of the paper / Prefer paper forms
❑ Other – (Record main ideas) ______________________
4b. If the paper form was not an option, would you have completed the survey on the Internet?
❑ Yes
❑ No.
❑ Maybe
5. Was there anything in the mailing materials that made you decide to use the paper form to complete the survey?
❑ Yes, - Please describe what in the materials motivated you to use the paper. (Record main ideas)
❑ No
❑ Don't know
6a. Did you consider answering over the Internet?
❑ Yes
❑ No - Skip to 6d.
❑ Don't Know
6b. Did you try to log on?
❑ Yes - Skip to 7.
❑ No
6c. Why not? (Mark all that apply)
❑ I am too busy
❑ Forgot to
❑ Haven’t gotten to it (R implies they will)
❑ The instruction card was too confusing
❑ Lost/misplaced the logon information
❑ User id/pin logon problems
❑ Other – (Record main ideas) _______________
SKIP to Internet Use
6d. Why didn't you want to answer over the Internet? (Mark all that apply)
❑ No access to Internet
❑ Inexperienced computer user
❑ Worried about security
❑ Convenience of the paper
❑ The instruction card was too confusing
❑ The survey was too long to do on the Internet
❑ No interest in the computer
❑ Other – (Record main ideas) ______________________
SKIP to Internet Use
7. Did you have any trouble with your User ID or PIN?
❑ Yes -- Can you tell me more about that? (Record main ideas)
❑ No.
8. Did you start to answer the questions on the Internet?
❑ Yes
❑ No -- Why not? (Record main ideas and Skip to end)
9. Did you have any difficulty using the Internet to answer the survey?
❑ Yes -- Can you tell me more about that?
(Mark all that apply.)
❑ Slow Internet connection
❑ Session timed-out
❑ Couldn’t get back in to the survey
❑ Power problems
❑ Other (Record main ideas)
❑ No
10. Did you finish answering the survey on the Internet?
❑ Yes
❑ No -- Why not? (Record main ideas and Skip to 12)
11. Did you submit the completed survey on the Internet?
❑ Yes – About when did you submit the survey?
❑ No -- Why not? (Record main ideas)
12. Did you complete the paper form before or after you went to the Internet?
❑ Completed paper BEFORE internet
❑ Completed paper AFTER internet
❑ Respondent indicated they completed the paper and Internet at the same time.
SKIP to Internet Use
13. The Census Bureau is considering offering the survey over the Internet, in addition to having the paper form. Which of those two ways to answer the survey do you prefer? (Mark only one)
❑ Paper– Why do you prefer paper? (Record main ideas)
❑ Internet – Why do you prefer the Internet? (Record main ideas)
❑ Neither option
❑ Prefer both options about the same
❑ It depends-- Please give some examples of when you would prefer to respond over the Internet (Record main ideas)
❑ DK
Go to Internet Use
Internet respondents
This call is about a Census Bureau survey you recently completed. First we’d like to thank you for completing the survey online. Today, we’d like to collect some additional information.
1. If you recall, you recently received a large envelope from the U.S. Census Bureau. The Census Bureau wants to improve its mailing materials. What materials do you remember seeing in the envelope? (Mark all that apply)
❑ Form or Questionnaire
❑ Letter – (if marked, then go to 2.a)
❑ Questionnaire Guide
❑ FAQ Brochure
❑ Return Envelope
❑ Postcard
❑ Internet Instruction Card
❑ Other – Record Main ideas
❑ Don’t remember the envelope
❑ DK
2. If "Letter" NOT marked in question 1
Did you see a letter about the survey?
❑ Yes
❑ No - Skip to 3
❑ DK - Skip to 3
2a. Did you read the letter [Fill if "letter marked in 1: that was in the large envelope]?
❑ Yes
❑ No - Skip to 3
2b. What do you remember about what the letter said?
❑ It provided response options – Internet or paper
❑ Listed uses of the data
❑ Randomly selected
❑ Required by law - mandatory
❑ Answers are kept confidential
❑ It provided phone number for help
❑ Signed by director
❑ Someone may call or visit
❑ Confusing
❑ Other- Record main ideas _______________________________
3. We received your completed survey over the internet. As far as you recall, could you have chosen to respond using a paper questionnaire? (Mark all that apply.)
❑ Yes
❑ No - Go to 5
4a. Why did you decide to use the Internet to complete the survey? (Mark all that apply)
❑ There was no paper form/ no other way to respond
❑ Easy
❑ I prefer the Internet/Do everything on the Internet (pay bills, shop, etc.)
❑ Secure
❑ Convenient
❑ Faster processing
❑ Saves money
❑ Other -- (Record main ideas)
4b. If the Internet was not an option, would you have completed a paper form?
❑ Yes
❑ No.
❑ Maybe
5. Was there anything in the mailing materials that made you decide to use the Internet to complete the survey?
❑ Yes, - Please describe what in the materials motivated you to use the Internet.
(Mark all that apply.)
❑ Message about conserving natural resources
❑ Message about saving money
❑ Message about processing data efficiently
❑ Uses of the data
❑ Randomly selected
❑ Required by law
❑ Answers are kept confidential
❑ Someone may call or visit
❑ Paper form looked too long
❑ Other, (Record main ideas)_______________________________
❑ No
❑ Don't know
6. Did you have any trouble with your User ID or PIN?
❑ Yes -- Can you tell me more about that? (Record main ideas)
❑ No.
7. Did you have any difficulty using the Internet to complete the survey?
❑ Yes -- Can you tell me more about that?
(Mark all that apply.)
❑ Slow Internet connection
❑ Session timed-out
❑ Couldn’t get back in to the survey
❑ Power problems
❑ Other (Record main ideas)
❑ No
8. Did you use the paper form as a guide while you filled out the survey on the Internet?
❑ Yes
❑ No
9. Did you complete the paper form?
❑ Yes
❑ No – skip to end
10. Was that before you started the survey on the Internet, while you were on the Internet, or after you completed the survey on the Internet?
❑ Before you started the survey on the Internet
❑ While you were on the Internet
❑ After you completed the survey on the Internet
END - GO TO INTERNET USE
INTERNET USE – For everyone
1. Do you use the Internet at home?
[] Yes
[] No
2a. Do you use the Internet at work?
[] Yes
[] No
2b. Do you use the Internet at some other place?
[] Yes
[] No – (If Q1=No and Q2a=No then go to closing)
If Internet responder, based on input flag: Where did you complete the survey?
❑ Home
❑ Work
❑ Library
❑ Other __________________________
If 'No" to question 1, skip to question 6.
What kind of Internet access do you have at home?
❑ Dial-up service
❑ DSL service
❑ Cable modem service
❑ Fiber-optic service
❑ Mobile broadband plan for a computer or cell phone
❑ Satellite service
❑ Some Other service, specify ___________________________
❑ Don’t know__________________________
What Internet browser do you typically use at home? Please tell me the version, if you can recall it.
❑ Internet explorer, ____________Version
❑ Firefox, ____________Version
❑ Chrome, ____________Version
❑ Safari, ____________Version
❑ Opera, ____________Version
❑ Other __________________________
On an average day, about how many hours do you use the Internet, either at home, work or somewhere else? If NECESSARY: Please include time you use the Internet on your phone or on a regular computer. (Do NOT read response categories)
❑ Less than 1 hour
❑ 1 hour
❑ 2 hours
❑ 3 hours
❑ 4 hours
❑ 5 hours
❑ 6 hours
❑ 7 hours
❑ 8 hours
❑ 9 hours
❑ 10 hour
❑ More than 10 hours
5. For the following activities or types of websites, please indicate how often you use or visit them. Is it very often, often, sometimes, rarely, or never?
a. News, map directions, job hunting, reviews or other information or research gathering. (Is it very often, often, sometimes, rarely, or never?)
5 Very often
4 Often
3 Sometimes
2 Rarely
1 Never
b. Facebook, MySpace, Twitter, blogging, or other social networking (Is it very often, often, sometimes, rarely, or never?)
5 Very often
4 Often
3 Sometimes
2 Rarely
1 Never
c. Paying bills, shopping or other financial transactions(Is it very often, often, sometimes, rarely, or never?)
5 Very often
4 Often
3 Sometimes
2 Rarely
1 Never
d. Emailing (Is it very often, often, sometimes, rarely, or never?)
5 Very often
4 Often
3 Sometimes
2 Rarely
1 Never
Instant messaging, telephone calls, or other means of communication besides email (Is it very often, often, sometimes, rarely, or never?)
5 Very often
4 Often
3 Sometimes
2 Rarely
1 Never
f. Viewing videos, downloading music or podcasts, or other forms of entertainment (Is it very often, often, sometimes, rarely, or never?)
5 Very often
4 Often
3 Sometimes
2 Rarely
1 Never
g. Filling out surveys (Is it very often, often, sometimes, rarely, or never?)
5 Very often
4 Often
3 Sometimes
2 Rarely
Never
If Nonrespondent, go to Demographic questions.
If Internet or Mail respondent, go to CRA questions.
Demographic Questions for Nonrespondents
Now I am going to ask you some questions regarding your demographic information.
1. Including yourself, how many people live in your household?
2. What is your age?
___ years old - If only 1 person in the household (from Q1) SKIP to question 4. Otherwise go to question 3.
98 DON'T KNOW - Go to 2a
99 REFUSED - Go to 2a
2a. In which of these age categories do you belong?
READ LIST.
18-24
25-34
35-44
45-54
55-64
65 or older
If only 1 person in the household (from Q1) SKIP to question 4.
3. Are there any children in school who are under 18 living at home with you?
❑ Yes
❑ No
4. What is the highest grade or year of regular school you completed?
READ LIST IF NECESSARY.
❑ Less than high school graduation
❑ High school graduate
❑ Some college
❑ College graduate
❑ Postgraduate
5. Are you of Hispanic, Latino or Spanish origin?
❑ Yes
❑ No
6. I’m going to read a list of race categories. You may choose one or more races.
(Fill if Q5 = ‘yes’: For this survey, Hispanic origin is not a race.)
Are you White; Black, African American, or Negro; American Indian
or Alaska Native; Asian; Native Hawaiian or Other Pacific Islander; or Some other race?
♦ Enter all that apply, separate with commas.
” 11. White
” 12. Black, African American, or Negro
” 13. American Indian or Alaska Native
” 14. Asian
” 15. Native Hawaiian or Other Pacific Islander
” 16. Some other race
7. Do you rent or own your house/apartment?
Rent
Own
OTHER
7b. Which best describes this building?
❑
a
mobile home
❑
a one-family house (attached or detached)
❑
a building with 2 or more units or apartments.
❑
Boat, RV, van, etc
8. ♦ Ask or verify. Are you male or female?
❑ Male
❑ Female
9. For last year - 2010 - what was the total income of your household BEFORE TAXES?
READ LIST IF NECESSARY
❑ Less than $25,000
❑ $25,000 to less than $50,000
❑$50,000 to less than $75,000
❑$75,000 or more
Closing for all Interviews: (comes after Content Reinterview for Internet and mail respondents and after demographic questions for Nonrespondents.)
Thank you very much for your participation in this important survey.
Your cooperation has made it possible for us to collect better data in the American Community Survey. You’ve been very helpful.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | hoste003 |
| File Modified | 0000-00-00 |
| File Created | 2021-02-01 |