NHTSA Form 1148 OMB No. 2127-XXXX
Expiration Date:
NHTSA National Survey of Pedestrian and Bicyclist Attitudes and Behavior Questionnaire
QLAN WHICH LANGUAGE INTERVIEW CONDUCTED IN
1 English
2 Spanish
4548C: CELL SAMPLE
SC1. Hello, I am _____ calling on behalf of the U.S. Department of Transportation. We are conducting a national study on pedestrian and bicyclist behavior.
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 –
SC2. I know I’m calling you on your cell phone, but we are conducting a brief survey on pedestrian and bicyclist behavior and we would like to send you $10 if you are eligible and willing to answer some questions. The survey is completely voluntary and will only take about 20 minutes. Any answers you give are kept strictly private.
[IF NECESSARY READ: Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current valid OMB Control Number. The OMB Control Number for this information collection is XXXX-XXXX.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.]
Are you 16 years old or older?
1 Yes
2 Yes, no time SCHEDULE CALLBACK
3 No SCREEN OUT
9 Refused THANK AND END -
Qualified Level 1
SC3. Not counting this cell phone, 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
9 Don’t know/Refused THANK AND END,
SC4a. 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 (SCRN OUT: NOT CELL MOSTLY) SKIP TO SCR1
3 Very few or none on cell phones (SCRN OUT: NOT CELL MOSTLY) SKIP TO SCR1
8 (VOL) Don’t know (SCRN OUT: NOT CELL MOSTLY) SKIP TO SCR1
9 (VOL) Refused (SCRN OUT: NOT CELL MOSTLY) SKIP TO SCR1
SC4b. 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
SKIP TO SA3
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 pedestrian and bicyclist behavior. This collection of information is VOLUNTARY and will be used for statistical purposes only. The interview will take approximately 20 minutes. Your participation is anonymous, and we will not collect any personal information that would allow anyone to identify you.
[IF NECESSARY READ: Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current valid OMB Control Number. The OMB Control Number for this information collection is XXXX-XXXX.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.]
How many persons, age 16 and older, live in this household?
[ENTER NUMBER 1-10]
98 NONE SCREEN OUT
99 Don’t know/Refused THANK AND END
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
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
SL1d. Hello, I am _____ calling on behalf of the U.S. Department of Transportation. We are conducting a national study on pedestrian and bicyclist behavior. This collection of information is VOLUNTARY and will be used for statistical purposes only. The interview will take approximately 20 minutes. Your participation is anonymous, and we will not collect any personal information that would allow anyone to identify you.
[IF NECESSARY READ: Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current valid OMB Control Number. The OMB Control Number for this information collection is XXXX-XXXX.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.]
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
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 pedestrian and bicyclist behavior. This collection of information is VOLUNTARY and will be used for statistical purposes only. The interview will take approximately 20 minutes. Your participation is anonymous, and we will not collect any personal information that would allow anyone to identify you.
[IF NEEDED: Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current valid OMB Control Number. The OMB Control Number for this information collection is XXXX-XXXX.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.]
How many persons, age 16 to 39, live in this household?
[ENTER NUMBER 1-10]
98 NONE SCREEN OUT
99 Don’t know/Refused THANK AND END
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
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 39, 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
SO1d. Hello, I am _____ calling on behalf of the U.S. Department of Transportation. We are conducting a national study on pedestrian and bicyclist behavior. This collection of information is VOLUNTARY and will be used for statistical purposes only. The interview will take approximately 20 minutes. Your participation is anonymous, and we will not collect any personal information that would allow anyone to identify you.
[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.
Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current valid OMB Control Number. The OMB Control Number for this information collection is XXXX-XXXX.]
Could I please confirm that you are a household member age 16 to 39?
1 Yes
2 No SCHEDULE CALLBACK
9 Refused THANK AND END
SA3. Record gender from observation. (Ask only if Necessary)
1 Male
2 Female
Qualified Level 2
1 When was the last time you rode a bicycle? Do not include stationary bikes. (Open ended and code time frame)
Within the past week
Within the past month, but not the past week
Within the past year, but not past month
1-2 years ago
3-5 years ago
More than 5 years ago (Skip to #34)
Never (Skip to #34)
2 Do you have a bicycle available for your use? Again, do not include stationary bikes.
Yes
No (Skip to instruction before #4)
(DK) (Skip to instruction before #4)
(Refused) (Skip to instruction before #4)
If #1 = 1 or 2, skip to #4
3 Why haven’t you ridden your bicycle recently? (Multiple Record) (Open ended and code)
Bad weather
Too busy, no opportunity
Bike is broken
No safe place to ride
Disability/other health impairment
Other transportation is faster
Don’t know how to ride a bike
Other (specify)
(DK)
(Refused)
Continue if #1 = 1 or 2. Otherwise skip to #24.
4. Thinking about the past 30 days, about how many of those days did you ride a bicycle? (Open ended and code actual number)
00 None (Skip to #24)
01-
31
98 (DK)
99 (Refused)
5 The last day you rode a bicycle, was it on a weekday or the weekend?
Weekday (Monday – Friday)
Weekend (Saturday or Sunday)
(DK)
(Refused)
REVIEWER NOTE: READ SLOWLY:)
I would now like to know about EACH of the individual trips that you made on the last day you rode a bicycle. A TRIP is defined as going from a starting point to a destination for a specific purpose without any stops along the way. If you left your house to go on a bike ride with no real destination and returned to your house that would be considered ONE trip. If you rode from your house to a friend's house for a visit, then rode back home, that would be TWO trips. If you rode from your home to a friend’s house, then to a store, and then back home again, that would count as THREE trips. I am going to ask about these individual trips one at a time.
6. Thinking of this last day that you rode your bike, what was your starting point for your first trip of the day? (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
08 Work
09 School/Campus
10 Park/field
11 Grocery store/Drug store/Convenience store
12 Mall/Strip mall/Shopping center
13 Restaurant
14 Train/subway/bus station or stop
7. What was the main purpose of this trip? (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 Commuting to work
07 Commuting to school
08 Recreation
09 Exercise/for my health
10 Personal errands (to the store, post office, and so on)
11 Required for my job
12 Drop off/Pick up someone
13 Visit a friend or relative
8. Where did this trip end? (Open ended and code)
01 Other (list)
02 (DK)/A location you cannot remember
03 (Refused)/A location you prefer not to share
04 HOLD
05 HOLD
08 Work
09 School/Campus
10 Park/field
11 Grocery store/Drug store/Convenience store
12 Mall/Strip mall/Shopping center
13 Restaurant
14 Train/subway/bus station or stop
9. Did you take any more bike trips on this day?
1 Yes (Continue)
2 No (Skip to #15)
3 (DK) (Skip to #15)
4 (Refused) (Skip to #15)
10. How many more bike trips did you take on this day? (Open ended and code actual number)
01-
30
31 31 or more
32 (DK)
33 (Refused)
(SURVENT NOTE: Ask #11-#14 for each trip before going to the next trip, if applicable)
11. Now, I'll ask you about your (read A-E, as appropriate) trip. You just mentioned you ended your last trip at (a) (response in #8 or #13 A-D, as appropriate). Is this where you started your (read A-E) trip of the day?
1 Yes
2 No
3 (No more trips) - (Skip to #15)
4 (DK)
5 (Refused)
A. (If code 01-31 in #10, ask:) Second _____(1360)
B. (If code 02-31 in #10, ask:) Third _____(1361)
C. (If code 03-31 in #10, ask:) Fourth _____(1362)
D. (If code 04-31 in #10, ask:) Fifth _____(1363)
E. (If code 05-31 in #10, ask:) Sixth _____(1364)
(For each code 1 in #11 A-E,
Autocode response from #8 or #14 A-D, as appropriate
into #12 A-E, as appropriate AND Skip to #13;
Otherwise, Continue)
12. What was your starting point for this trip? (Display A-E, as appropriate) (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
08 Work
09 School/Campus
10 Park/field
11 Grocery store/Drug store/Convenience store
12 Mall/Strip mall/Shopping center
13 Restaurant
14 Train/subway/bus station or stop
A. (If code 01-31 in #10, ask:) Second
(1366)
B. (If code 02-31 in #10, ask:) Third
(1368)
C. (If code 03-31 in #10, ask:) Fourth
D. (If code 04-31 in #10, ask:) Fifth
E. (If code 05-31 in #10, ask:) Sixth
(1374)
13. What was the main purpose of this trip? (Display A-E, as appropriate) (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 Commuting to work
07 Commuting to school
08 Recreation
09 Exercise/for my health
10 Personal errands (to the store, post office, and so on)
11 Required for my job
12 Drop off/Pick up someone
13 Visit a friend or relative
A. (If code 01-31 in #10, ask:) Second
B. (If code 02-31 in #10, ask:) Third
C. (If code 03-31 in #10, ask:) Fourth
D. (If code 04-31 in #10, ask:) Fifth
E. (If code 05-31 in #10, ask:) Sixth
14. Where did this trip end? (Display A-E, as appropriate) (Open ended and code)
01 Other (list)
02 (DK)/A location you cannot remember
03 (Refused)/A location you prefer not to share
04 HOLD
05 HOLD
08 Work
09 School/Campus
10 Park/field
11 Grocery store/Drug store/Convenience store
12 Mall/Strip mall/Shopping center
13 Restaurant
14 Train/subway/bus station or stop
A. (If code 01-31 in #10, ask:) Second
B. (If code 02-31 in #10, ask:) Third
C. (If code 03-31 in #10, ask:) Fourth
D. (If code 04-31 in #10, ask:) Fifth
E. (If code 05-31 in #10, ask:) Sixth
15. When you began riding your bicycle that day, did you begin riding during the:
1 Morning
2 Afternoon
3 Evening, or
4 Nighttime when it was dark
5 Don’t Know
6 Refused
16. When you finished riding your bicycle that day, did your (last) trip end during the:
1 Morning
2 Afternoon
3 Evening, or
4 Nighttime when it was dark
5 Don’t Know
6 Refused
17. When you rode your bicycle that day, did you ride mostly on (read 06-11, then 01)?
01 Or some other surface (list)
02 (DK)
03 (Refused)
04 Hold
05 Hold
06 Paved roads, not on shoulder (Skip to #19)
07 Shoulders of paved roads (Skip to #19)
08 Bike lanes on roads (Skip to #19)
09 Sidewalks
10 Bike paths, walking paths or trails
11 Unpaved roads (e.g., dirt, gravel, sand) (Skip to #19)
18. Was any of this ride on streets or roads where cars could travel?
Yes
No (Skip to #20)
(Don’t Know) (Skip to #20)
Refused) (Skip to #20)
19. When riding your bike in the street, did you mostly ride(read 1-2)?
1 Facing traffic, that is, riding against the direction of the cars
2 With traffic, that is riding in the same direction as the cars
3 (Varies/Depends)
4 (Not applicable/Never ride in the street)
5 (DK)
6 (Refused)
20. Was anyone else with you when you were riding your bicycle that day, or was all your riding done alone?
01 Rode with others
02 Rode alone
03 (DK)
04 (Refused)
21. Did you feel threatened for your personal safety at any time when you rode your bike that day?
1 Yes (Continue)
2 No (Skip to #24)
3 (DK) (Skip to #24)
4 (Refused) (Skip to #24)
22. Did you feel threatened for your personal safety because of any of the following? How about (read and rotate A-E, then F)?
1 Yes
2 No
3 (DK)
4 (Refused)
A. Motorists
B. The potential for crime
C. Uneven walkways or roadway surfaces
D. Dogs or other animals
E. Something else? (If "Yes", ask:) What else? (Open ended)
01 Other (list)
02 (DK)
03 (Refused)
04 No/Nothing else
05 Too much bicycle or pedestrian traffic
06 Lack of room to ride
07 Obstacles blocking path
08 Not maintained
If code 1 in #22A, Continue; Otherwise, Skip to #24)
23. What did motorists do to make you feel threatened? (Open ended and code) (Multiple Record)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
07 Entered intersection without looking
08 Drove very close to me
09 Honked at me
10 Almost hit me/near miss
11 Just the presence of the motorist was threatening
12 Too fast
24. Now I’d like to find out how people learn about bicycling safety. In the past five years, have you received any training in bicycling safety?
Yes
No (Skip to #26)
(DK) (Skip to #26)
(Refused) (Skip to #26)
25. Who provided the training to you? (Open ended and code)
Bicycle store
Police
Friends
Teachers/schools
Bicycle club
State/Local bike programs
Family
Other (specify)
26. If you wanted to learn (if #24 = 1, insert the word “more”) about bicycling safety, where would you go or look for information? (Open ended and code)(Multiple Record)
Bicycle store
Department of Motor vehicles
Police
Automobile Association
Teachers/Schools
Bicycle Club
State/Local Bike programs
Book/Magazine/Video Store
Internet
Family
NHTSA
(DK)
(Refused)
Continue if #1 = 1, 2, or 3. Otherwise skip to #34.
27. During the past year, how much of your biking was done when it was dark or nearly dark outside? (Read 5-0)
5 Nearly all
4 More than half
3 About half
2 Some
1 Almost none
0 None
6 (DK)
7 (Refused)
(If code 2-5 in #27, Continue;
Otherwise, Skip to #30)
28. When you ride your bike after dark, do you do anything to make yourself more visible to motorists?
1 Yes (Continue)
2 No (Skip to #30)
3 (DK) (Skip to #30)
4 (Refused) (Skip to #30)
29. What do you do to make yourself or your bike more visible after dark? (Open ended and code) (Multiple Record)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
07 Use bike taillight
08 Wear fluorescent or reflective clothing/shoes
09 Wear other lights on self or belongings
10 Ensure bicycle has reflectors
11 Ride only in well-lit areas
30. During the past year, how often did you use an electronic device like a cell phone or mp3 player WHILE YOU WERE RIDING YOUR BIKE? Did you use an electronic device during: [Read responses 5 through 0]
5 Nearly all your bike trips
4 More than half your bike trips
3 About half your bike trips
2 Some of your bike trips
1 Almost none of your bike trips, or
0 None of your bike trips
6 (DK)
7 (Refused)
GENERAL BICYCLE HABITS
(READ:) Now I would like to know about your biking habits.
31. On average during the summer months, how often do you use a bicycle? (Read 1-4) (If necessary, read:) Summer months are May through September.
2 At least once a month, but not weekly
3 Less than once a month, but at least once during the summer
4 Never
5 (DK)
6 (Refused)
32. On a typical day that you ride a bicycle, about how long do you ride? Don’t count any stops – just the average amount of time you travel on your bike. (Open ended and code time)
Hours: ____ and Minutes: ____
97 [Volunteered: It differs too much to say]
98 (Don’t Know)
99 (Refused)
33. Compared to about a year ago, would you say you are now riding a bike more often, less often or about the same amount?
3 More often
2 Same amount
1 Less often
4 (DK)
5 (Refused)
34. Are bike PATHS, that is, paths away from the road on which bikes can travel, available in the area where you live?
1 Yes
2 No (Skip to #37)
3 (DK) (Skip to #37)
4 (Refused) (Skip to #37)
If #34 = 1 and #1 = 1, 2, or 3, continue. Otherwise skip to #37.
35. Do you ride on bike paths (read 5-1)?
5 Every time you ride a bike (Skip to #37)
4 Most of the time (Skip to #37)
3 Some of the time (Skip to #37)
2 Hardly ever, OR (Continue)
1 Never (Continue)
6 (DK) (Skip to #37)
7 (Refused) (Skip to #37)
36. What is the main reason that you choose not to use the bike paths? (Open ended and code) (INTERVIEWER NOTE: If respondent says, Don't like them; Probe for why)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 Not in good repair
07 Don't go where I need to go
08 Too crowded with bicycles or pedestrians
09 HOLD
10 Don't feel safe
37. Are bike LANES, that is, marked lanes on a public road reserved for bikes to travel, available in the area where you live?
1 Yes
2 No (Go to instruction before #40)
3 (DK) (Go to instruction before #40)
4 (Refused) (Go to instruction before #40)
If #37 = 1 and #1 = 1, 2, or 3, continue.
If #37 = 1 and #1 = 4, skip to #41.
If #37 = 1 and #1 > 4, skip to #46.
38. Do you ride in bike LANES (read 5-1)?
5 Every time you ride a bike (Skip to #40)
4 Most of the time (Skip to #40)
3 Some of the time (Skip to #40)
2 Hardly ever, OR (Continue)
1 Never (Continue)
6 (DK) (Skip to #40)
7 (Refused) (Skip to #40)
39. What is the main reason that you choose not to use the bike lanes? (Open ended and code) (INTERVIEWER NOTE: If respondent says, Don't like them; Probe for why)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 Not in good repair
07 Don't go where I need to go
08 Too crowded with bicycles or pedestrians
09 HOLD
10 Don't feel safe
If #1 = 1, 2, or 3, continue.
If #1 = 4, skip to #41.
If #1 > 4, skip to #46.
40. When you are bicycling, how often do you have to change your route because of obstacles, such as construction, heavy traffic, and roads in poor condition? Does this happen nearly all of the time, most, some, or almost none of the time?
Nearly all the time
Most of the time
Some of the time
Almost none of the time
(Don’t Know)
(Refused)
41. In the past two years, were you ever injured while you were riding a bike? Only count injuries that required attention by a medical professional.
1 Yes (Continue)
2 No (Skip to instruction before #44)
3 (DK/Not sure) (Skip to instruction before #44)
4 (Refused) (Skip to instruction before #44)
42. Was this injury a result of being hit by a motor vehicle?
1 Yes (Skip to instruction before #44)
2 No (Continue)
3 (DK) (Skip to instruction before #44)
4 (Refused) (Skip to instruction before #44)
43. How did you injure yourself while riding your bike? (Open ended and code)
Specify .
98 (Don’t Know)
99 (Refused)
If #1 > 3, skip to #46. Otherwise continue.
44. When riding a bike, do you wear a helmet for (read 6-1)?
6 All of your rides
5 Nearly all of your rides
4 Most of your rides
3 Some of your rides
2 Not very many of your rides
1 Never or you don’t have access to a helmet
7 (DK)
8 (Refused)
(If code 6 in #44, Skip to #46;
Otherwise, Continue)
45. What are the reasons you don't always wear a bike helmet? Is it because (read and rotate A-I, then read J)?
1 Yes
2 No
3 (DK)
B. You don’t think helmets provide much protection in case of accident
C. You don’t like the way you look when you wear a helmet _____(2220)
D. Helmets obstruct your vision
E. Helmets are uncomfortable
F. You don’t wear a helmet for short trips
G. It’s too hot wearing a helmet
H. Helmets cost too much
I. You don’t have a helmet
J. Some other reasons? (If "Yes", ask:) What other reason? (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 No/No other reason
05 HOLD
06 Don’t need to wear one
46. In your opinion, how much protection against head injuries do bike helmets provide children? Would you say bike helmets provide children very little protection, some protection, or a lot of protection against head injuries?
1 Very little protection
2 Some protection
3 A lot of protection
4 (DK)
5 (Refused
47. What about for adults? Do bike helmets provide adults very little protection, some protection, or a lot of protection against head injuries?
1 Very little protection
2 Some protection
3 A lot of protection
4 (DK)
5 (Refused
48. How satisfied are you with how your local community is designed for making bike riding safe? Are you (read 5-1)?
5 Very satisfied
4 Somewhat satisfied
3 Neither satisfied nor dissatisfied
2 Somewhat dissatisfied
1 Very dissatisfied
6 (DK)
7 (Refused)
49. Are there any changes you would like made in your community for bicyclists?
1 Yes (Continue)
2 No (Skip to #51)
3 (DK) (Skip to #51)
4 (Refused) (Skip to #51)
50. What changes would you like to see made in your community? (Open ended and code) (Multiple Record)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 More bike trails
07 More bike paths
08 More bike lanes
09 Allow bikes on sidewalks
10 Don't allow bikes on sidewalks
51. Is there a law or ordinance in your State, city, or county that requires adults and/or children to wear a helmet when riding a bike?
1 Yes
2 No (Skip to #54)
3 (DK) (Skip to #54)
4 (Refused) (Skip to #54)
52. Is it a State, city, or county law?
State law
City law
County law
Other (specify)
(DK)
(Refused)
53. Does this law require all bicyclists, or only children, to wear helmets?
All bicyclists
Only children
(DK)
(Refused)
54. Do you favor or oppose laws that require (read and rotate A-B)?
1 Favor
2 Oppose
3 (DK/no opinion)
4 (Refused)
A. Children to wear helmets whenever they are riding a bike _____(1710)
B. Adults to wear helmets whenever they are riding a bike _____(1711)
PEDESTRIANS:
(READ:) This next section is about walking rather than biking. By walking we mean any outdoor walking, jogging, or running that lasts at least 5 minutes or more. (INTERVIEWER NOTE: If respondent asks, they should NOT include roller-blading, roller-skating, skateboarding and scooter use)
55. When was the last time you walked outside for 5 minutes or more? (Open ended and code time frame)
Within the past week (Continue)
Within the past month, but not the past week (Continue)
Within the past year, but not past month (Skip to #76)
1-2 years ago (Skip to Read before #82)
3-5 years ago (Skip to Read before #82)
More than 5 years ago (Skip to Read before #82)
Never (Skip to Read before #82)
56. Thinking about the past 30 days, about how many of those days did you walk? (Open ended and code actual number)
00 None (Skip to #76)
31 (Continue)
98 (DK) (Continue)
99 (Refused) (Continue)
57. The last day you walked outside for 5 minutes or more, was it on a weekday or the weekend?
Weekday (Monday – Friday)
Weekend (Saturday or Sunday)
(DK)
(Refused)
(INTERVIEWER NOTE: READ SLOWLY:)
I would now like to know about EACH of the individual trips that you made on the last day you walked. A TRIP is defined as going from a starting point to a destination for a specific purpose without any stops along the way. If you left your house on a walk with no real destination and returned to your house that would be considered ONE trip. If you walked from your house to a friend's house for a visit, then walked back home, that would be TWO trips. If you walked from your home to a friend’s house, then to a store, and then back home again, that would count as THREE trips. I am going to ask about these individual trips one at a time.
58. What was your starting point for your first trip of the day? (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
08 Work
09 School/Campus
10 Park/field
11 Grocery store/Drug store/Convenience store
12 Mall/Strip mall/Shopping center
13 Restaurant
14 Train/subway/bus station or stop
59. What was the main purpose of this trip? (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 Commuting to work
07 Commuting to school
08 Recreation
09 Exercise/for my health
10 Personal errands (to the store, post office, and so on)
11 Required for my job
12 Drop off/Pick up someone
13 Visit a friend or relative
14 Walk the dog
15 Escort child to school
60. Where did this trip end? (Open ended and code)
01 Other (list)
02 (DK)/A location you cannot remember
03 (Refused)/A location you prefer not to share
04 HOLD
05 HOLD
08 Work
09 School/Campus
10 Park/field
11 Grocery store/Drug store/Convenience store
12 Mall/Strip mall/Shopping center
13 Restaurant
14 Train/subway/bus station or stop
61. Did you take any more walking trips on this day?
1 Yes (Continue)
2 No (Skip to #67)
3 (DK) (Skip to #67)
4 (Refused) (Skip to #67)
62. How many more walking trips did you take on this day? (Open ended and code actual number)
01-
30
31 31 or more
32 (DK)
33 (Refused)
(SURVENT NOTE: Ask #63-#66 for each trip before going to the next trip, if applicable)
63. Now, I'll ask you about your (read A-E, as appropriate) trip. You just mentioned you ended your last trip at (a) (response in #60 or #66 A-D, as appropriate). Is this where you started your (read A-E) trip of the day?
1 Yes
2 No
3 (No more trips) - (Skip to #67)
4 (DK)
5 (Refused)
A. (If code 01-31 in #62, ask:) Second _____(1775)
B. (If code 02-31 in #62, ask:) Third _____(1776)
C. (If code 03-31 in #62, ask:) Fourth _____(1777)
D. (If code 04-31 in #62, ask:) Fifth _____(1778)
E. (If code 05-31 in #62, ask:) Sixth _____(1779)
(For each code 1 in #63 A-E,
Autocode response from #60 or #66 A-D, as appropriate
into #64 A-E, as appropriate AND Skip to #65;
Otherwise, Continue)
64. What was your starting point for this trip? (Display A-E, as appropriate) (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
08 Work
09 School/Campus
10 Park/field
11 Grocery store/Drug store/Convenience store
12 Mall/Strip mall/Shopping center
13 Restaurant
14 Train/subway/bus station or stop
A. (If code 01-31 in #62, ask:) Second
(1802)
B. (If code 02-31 in #62, ask:) Third
C. (If code 03-31 in #62, ask:) Fourth
(1806)
D. (If code 04-31 in #62, ask:) Fifth
(1808)
E. (If code 05-31 in #62, ask:) Sixth
65. What was the main purpose of this trip? (Display A-E, as appropriate) (Open ended and code)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 Commuting to work
07 Commuting to school
08 Recreation
09 Exercise/for my health
10 Personal errands (to the store, post office, and so on)
11 Required for my job
12 Drop off/Pick up someone
13 Visit a friend or relative
14 Walk the dog
15 Escort child to school
A. (If code 01-31 in #62, ask:) Second
B. (If code 02-31 in #62, ask:) Third
C. (If code 03-31 in #62, ask:) Fourth
D. (If code 04-31 in #62, ask:) Fifth
E. (If code 05-31 in #62, ask:) Sixth
66. Where did this trip end? (Display A-E, as appropriate) (Open ended and code)
01 Other (list)
02 (DK)/A location you cannot remember
03 (Refused)/A location you prefer not to share
04 HOLD
05 HOLD
08 Work
09 School/Campus
10 Park/field
11 Grocery store/Drug store/Convenience store
12 Mall/Strip mall/Shopping center
13 Restaurant
14 Train/subway/bus station or stop
A. (If code 01-31 in #62, ask:) Second
B. (If code 02-31 in #62, ask:) Third
C. (If code 03-31 in #62, ask:) Fourth
D. (If code 04-31 in #62, ask:) Fifth
E. (If code 05-31 in #62, ask:) Sixth
67. When you began walking that day, did you begin walking during the:
1 Morning
2 Afternoon
3 Evening, or
4 Nighttime when it was dark
5 Don’t Know
6 Refused
68. When you finished walking that day, did your (last) trip end during the:
1 Morning
2 Afternoon
3 Evening, or
4 Nighttime when it was dark
5 Don’t Know
6 Refused
69. When you were walking that day, did you walk mostly on (read 06-11, then 01)?
01 Or some other surface (list)
02 (DK)
03 (Refused)
04 Hold
05 Hold
06 Paved roads, not on shoulder (Skip to #71)
07 Shoulders of paved roads (Skip to #71)
08 Grass or fields
09 Sidewalks
10 Bike paths, walking paths or trails
11 Unpaved roads (for example dirt, gravel, sand)(Skip to #71)
70. Not including crossing streets, did you walk in the street or road, or on the shoulder of the road? [If yes, probe for which one]
Yes, road
Yes, shoulder
Yes, both
No (Skip to #72)
(Don’t Know) (Skip to #72)
Refused) (Skip to #72)
71. When you were walking (in the street/on the shoulder), were you usually walking (read 1-2)?
1 Facing traffic, that is, walking against traffic, or
2 With traffic, that is walking in the same direction as the cars
3 (Varies/Depends)
4 (Not applicable/Never walk in the street)
5 (DK)
6 (Refused)
72. Was anyone else with you when you were walking, or was all your walking done alone?
01 Walked with others
02 Walked alone
03 (DK)
04 (Refused)
73. Did you feel threatened for your personal safety at any time while walking that day?
1 Yes (Continue)
2 No (Skip to #76)
3 (DK) (Skip to #76)
4 (Refused) (Skip to #76)
74. Did you feel threatened for your personal safety because of any of the following? How about (read and rotate A-E, then F)?
1 Yes
2 No
3 (DK)
4 (Refused)
A. Motorists
B. The potential for crime
C. Uneven walkways or roadway surfaces
D. Dogs or other animals
E. Something else? (If "Yes", ask:) What else? (Open ended)
01 Other (list)
02 (DK)
03 (Refused)
04 No/Nothing else
05 Too much bicycle or pedestrian traffic
06 Lack of room to ride
07 Obstacles blocking path
08 Not maintained
(If code 1 in #74-A, Continue;
Otherwise, Skip to #76)
75. What did motorists do to make you feel threatened? (Open ended and code) (Multiple Record)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
07 Entered intersection without looking
08 Drove very close to me
09 Honked at me
10 Almost hit me/near miss
11 Just the presence of the motorist was threatening
12 Too fast
76. During the past year, how much of your walking was done when it was dark or nearly dark outside? (Read 5-0)
5 Nearly all
4 More than half
3 About half
2 Some
1 Almost none
0 None
6 (DK)
7 (Refused)
(If code 2-5 in #76, Continue;
Otherwise, Skip to #79)
77. When you walk after dark, do you do anything to make yourself more visible to motorists?
1 Yes - (Continue)
2 No (Skip to #79)
3 (DK) (Skip to #79)
4 (Refused) (Skip to #79)
78. What do you do to make yourself more visible when walking after dark? (Open ended and code)(Multiple Record)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
07 Wear fluorescent or reflective clothing/Shoes
08 Wear or carry a flashlight
09 Walk only in well-lit areas
79. During the past year, how often did you use an electronic device like a cell phone or mp3 player WHILE YOU WERE walking outside? Did you use an electronic device during: [Read responses 5 through 0]
5 Nearly all your outdoor walking trips
4 More than half your walking trips
3 About half your walking trips
2 Some of your walking trips
1 Almost none of your walking trips, or
0 None of your walking trips
6 (DK)
7 (Refused)
GENERAL WALKING HABITS
(READ:) Now I would like to know about your walking habits.
80. On average during the summer months, how often do you walk? (Read 1-4) (If necessary, read:) Summer months are May through September.
2 At least once a month, but not weekly
3 Less than once a month, but at least once during the summer
4 Never
5 (DK)
6 (Refused)
81. Compared to about a year ago, would you say you are now walking more often, less often or about the same amount?
3 More often
2 Same amount
1 Less often
4 (DK)
5 (Refused)
Now I’d like you to think of the neighborhood where you live.
82. Are there sidewalks in your neighborhood(Read 1-4):
Along almost all streets
Along most streets
Along some streets, or
Along almost no streets (Skip To Q86)
83. In what condition are these sidewalks? Are they in excellent, good, fair, or poor condition?
Excellent
Good
Fair
Poor
(Don’t Know)
(Refused)
If #55 = 4, skip to #86
If #55 > 4, skip to #89
84. Do you use sidewalks (read 5-1)?
5 Every time you walk (Skip to #86)
4 Most of the time (Skip to #86)
3 Some of the time (Skip to #86)
2 Hardly ever, OR (Continue)
1 Never (Continue)
6 (DK) (Skip to #86)
7 (Refused) (Skip to #86)
85. What is the main reason that you hardly ever or never use sidewalks? (Open ended and code) (INTERVIEWER NOTE: If respondent says, Don't like them; Probe for why)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 Not in good repair
07 Don't go where I need to go
08 Too crowded
09 Prefer softer surface
10 Don't feel safe
86. In the past two years, were you ever injured while you were walking? Only count injuries that required attention by a medical professional.
1 Yes (Continue)
2 No (Skip to #89)
3 (DK/Not sure) (Skip to #89)
4 (Refused) (Skip to #89)
87. Was this injury a result of being hit by a motor vehicle?
1 Yes (Skip to #89)
2 No (Continue)
3 (DK) (Skip to #89)
4 (Refused) (Skip to #89)
88. How did you injure yourself while you were walking? (Open ended and code)
Specify .
98 (Don’t Know)
99 (Refused)
89. How satisfied are you with how your local community is designed for making walking safe? Are you (read 5-1)?
5 Very satisfied
4 Somewhat satisfied
3 Neither satisfied nor dissatisfied
2 Somewhat dissatisfied
1 Very dissatisfied
6 (DK)
7 (Refused)
90. Are there any changes you would like made in your community for pedestrians?
1 Yes (Continue)
2 No (Skip to Read before #92)
3 (DK) (Skip to Read before #92)
4 (Refused) (Skip to Read before #92)
91. What changes would you like to see made in your community? (Open ended and code) (Multiple Record)
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 More crosswalks
07 More sidewalks
08 More lights on streets
09 More lights on paths/trails
For the next couple of questions, please tell me what in your opinion is correct. First,
92. Are bicyclists supposed to stop at traffic lights and stop signs, like motor vehicles, or are they supposed to use their own judgment on whether they need to stop at red lights and stop signs?
Must stop, like motor vehicles
Can use own judgment
(Don’t Know)
(Refused)
93. What do flashing red lights on a school bus mean for an approaching driver? Do they mean (Read 1-3)
Stop until lights stop flashing, or
Slow and then proceed with caution, or
Be prepared to stop, if necessary?
(Don’t Know)
(Refused)
94. If a pedestrian is walking in the street after dark and not wearing reflective clothing, how close would you say an approaching car has to be to see the pedestrian directly ahead? [Distance Can Be Reported In Either Feet, Yards, or Car Lengths]
Feet
Yards
Car Lengths
998 (Don’t Know)
999 (Refused)
95. Now I’m going to read you a few statements. Please tell me whether you strongly agree, somewhat agree, somewhat disagree, strongly disagree, or neither agree nor disagree.(read and rotate A-E)?
5 Strongly agree
4 Somewhat agree
3 Neither agree nor disagree
2 Somewhat disagree
1 Strongly disagree
6 (DK)
7 (Refused)
A. I would like to walk more than I am currently walking
B. I would like to bicycle more than I am currently bicycling
C. Drivers in my community usually yield to pedestrians in crosswalks
D. Bicyclists are just as entitled to ride on the road as are motorists
E. Driver manuals that are used to study for a driver’s license should include information about how to avoid accidents with Pedestrians and Bicyclists
F. A driver who doesn’t yield to pedestrians walking legally at a crosswalk should be ticketed
96 (If 95-A is Strongly or Somewhat Agree) What would you say is the most important reason why you do not walk as much as you would like? (Open ended and code)
Too busy
Poor health
No one to walk with
No sidewalks/sidewalks in poor condition
No shops or other interesting places to go
Fear street crime
Too many cars
Fast traffic
Have things to carry
Weather isn’t good for walking
Don’t think about it
Other (specify)
(Don’t Know)
(Refused)
97. (If 95-B is Strongly or Somewhat Agree) What would you say is the most important reason why you do not bicycle as much as you would like? (Open ended and code)
Too busy
Poor health
No one to bike with
No sidewalks/sidewalks in poor condition
No shops or other interesting places to go
Fear street crime
Too many cars
Fast traffic
Have things to carry
Weather isn’t good for bicycling
Don’t think about it
Other (specify)
(Don’t Know)
(Refused)
98. Is it safe or dangerous to walk in your neighborhood?
Safe (Skip to #100)
Dangerous
(Don’t Know) (Skip to #100)
(Refused) (Skip to #100)
99. Why do you feel this way?(Open ended and code) (Multiple Record)
(Specify) .
100. Is it safe or dangerous to ride a bicycle in your neighborhood?
Safe (Skip to #102)
Dangerous
(Don’t Know) (Skip to #102)
(Refused) (Skip to #102)
101 Why do you feel this way? (Open ended and code) (Multiple Record)
(Specify) .
CHILDREN WALKING/BIKING
102. In your opinion, what should be the youngest age that a child is allowed to cross a neighborhood street alone? A neighborhood street is defined as having low traffic volume and low traffic speeds.
Age
98 (Don’t Know)
99 (Refused)
103. How many children, less than 16 years of age, currently reside in your household? Please do not count students living away from home or boarders. (Open ended and code)
0 None (Skip to #107)
1 One
2 Two
3 Three
4 Four
5 Five
6 Six
7 Seven or more
8 (DK) (Skip to #107)
9 (Refused) (Skip to #107)
104 How old is [the/the oldest] child?
Age
98 (Don’t Know)
99 (Refused)
If #104 < 5, Skip to #107
105. How many days does this child ride a bicycle during a typical week in the Summer?
(0-7)
98 (Don’t Know)
99 (Refused)
If #105 = 0, Skip to #107
106 When riding a bicycle, does this child wear a helmet for (read 6-1)
6 All rides
5 Nearly all rides
4 Most rides
3 Some rides
2 Not very many rides, or
1 Never
7 (DK)
8 (Refused)
(READ:) Now, I have a few questions about the area where you live.
107. Do you currently live in a (read 06-09, then 01)?
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 House
07 Townhouse or row house
08 Apartment or condo
09 Mobile home, OR
108. These next questions ask about the area that is within two blocks around where you live. Two blocks is about 1/4 mile. [(If necessary, read:) Or the length of about four football or soccer fields.] Are there (read A-J, as appropriate) within ¼ mile of where you live?
1 Yes
2 No
3 (DK)
4 (Refused)
A. Single-family houses
B. Townhouses, apartments or condos
D. Mobile homes
E. Parks or recreational area
F. Farms or ranches
G. Commercial businesses (If necessary, read:) such as stores or restaurants
H. Public buildings (If necessary, read:) such as schools, hospital or government offices
I. Industrial buildings or factories
J. Heavy street traffic
DEMOGRAPHICS BEGIN HERE:
(READ:) Now, I have just a few last questions for classification purposes only.
109. AGE: What is your age? (Open ended and code actual age)
99 99+
DK (DK)
RF (Refused)
(If DK or RF in #109 Continue;
Otherwise, Skip to #111)
110. AGE: Please stop me when I reach the category that includes your age? (Read 01-08)
01 16 or 17
02 18 to 24
03 25 to 34
04 35 to 44
05 45 to 54
06 55 to 64
07 65 to 74, or
08 75 or older
98 (DK)
99 (Refused)
111. EMPLOYMENT STATUS: Are you currently employed full-time, part-time, un-employed and looking for work, retired, going to school, a homemaker, or do you do something else? [MULTIPLE RECORD]
01 Something else (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 Employed full-time
07 Employed part-time
08 Unemployed and looking for work
09 Retired
10 Going to school
11 Homemaker
12 (Disabled)
112. EDUCATION: What is the highest grade or year of school you have completed? (Open ended and code)
01 No formal education
02 First through 7th grade
03 8th grade
04 Some high school
05 High school graduate or GED
06 Some college
07 Four-year college graduate
08 Some graduate school
09 Graduate degree
10 (DK)
11 (Refused)
113. ETHNICITY: Are you of Hispanic or Latino origin or descent?
1 Yes
2 No
3 (DK)
4 (Refused)
114. RACE: 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) .
99 (VOL) Refused
(If code 6 in #114, Continue;
Otherwise, Skip to #116)
115. Do you consider yourself to be white-Hispanic or black-Hispanic?
01 Other (list)
02 (DK)
03 (Refused)
04 HOLD
05 HOLD
06 White-Hispanic
07 Black-Hispanic
08 (Hispanic/Respondent refused to discriminate)
116. INCOME: Which of the following categories best describes your total household income before taxes in 2011? Your best estimate is fine. Would it be (read 1-7)?
1 Less than $5,000
2 $5,000 to less than $15,000
3 $15,000 to less than $30,000
4 $30,000 to less than $50,000
5 $50,000 to less than $75,000
6 $75,000 to less than $100,000, OR
7 $100,000 or more
8 (DK)
9 (Refused)
117. GENDER: (Ask if necessary) Are you male or female?
1 Male
2 Female
118 How often do you drive a motor vehicle? Almost every day, a few days a week, a few days a month, a few days a year, or do you never drive?
Almost every day/every day
Few days a week
Few days a month
Few days a year
Never
More than a year ago since drove
Other
(Don’t’ Know)
(Refused)
119. How many licensed motor vehicles are owned, leased, or available for regular use by members of your household? (Open ended and code)
0 None
1 One
2 Two
3 Three
4 Four
5 Five
6 6 or more
7 (DK)
8 (Refused)
120. Do you currently have any disability, health impairment or condition that limits the amount of walking you can do?
1 Yes
2 (Volunteered: Yes, I use a wheelchair) (Skip to Q122)
3 (Volunteered: Yes, I use a motorized chair) (Skip to Q122)
4 No (Skip to Q122)
5 (DK) (Skip to Q122)
6 (Refused) (Skip to Q122)
121 Do you use special equipment to help you walk, or do you use a wheelchair, or do you use a motorized chair?
Yes, special equipment
Yes, a wheelchair
Yes, a motorized chair
No
(DK)
(Refused)
122. In general, how easy or difficult is it for you to travel to the places in your community where you want to go? Would you say it is (Read 1-4):
Very easy; (Skip To Read Before Q125)
Somewhat easy; (Skip To Read Before Q125)
Somewhat difficult; or (Skip To Q124)
Very Difficult. (Skip To Q124)
(Volunteered) It depends on where I am traveling from. (Continue To Q123)
123. From which places do you find it more difficult to travel to the places you want to go? (Open ended and code) (Multiple Record)
1 Home
2 Work
3 Doctor’s Office
4 HOLD
5 HOLD
6 HOLD
7 (DK)
8 (Refused)
124. What are the reasons it is difficult for you to travel to the places in your community where you want to go? (Open ended and code) (Multiple Record)
1 Don’t have access to vehicle
2 Vehicles can’t accommodate mobility equipment
3 Sidewalks are inadequate/poor condition
4 HOLD
5 HOLD
6 HOLD
7 (DK)
8 (Refused)
125. May I please have your zip code?
ENTER 5 DIGIT ZIP CODE:
99998 (VOL) Don't Know
99999 (VOL) Refused
ASK ONLY FOR LANDLINE SAMPLE, OR IF SC3=2, ELSE SKIP TO Q128
126. For analysis purposes only, does your household have a single phone NUMBER, or does it have more than ONE phone NUMBER coming into it? (NOTE TO INTERVIEWER: We need the number of different phone lines, NOT the number of TELEPHONES in the household)
1 Single phone number
2 More than one phone number
3 (DK)
4 (Refused)
(If code 1, 3 or 4 in #126,
Autocode 1 in #127, and Skip to Q128, Otherwise continue
127. And, NOT including lines dedicated to a fax machine, modem or used strictly for business purposes, how many different phone NUMBERS do you have coming into your household? (Open ended and code)
1 One
2 Two
3 Three
4 Four
5 Five or more
6 (DK)
7 (Refused)
128. During the past 12 months, has your household been without telephone service for 1 week or more? Do not include interruptions of telephone service because of weather or natural disasters.
1 Yes
2 No
7 Don’t know / Not sure
9 Refused
ASK ONLY FOR LANDLINE SAMPLE
129. 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)
CELL SAMPLE ONLY:
130. How many persons, age 16 and older, live in your household?
[ENTER NUMBER 1-10]
98 NONE
99 Don’t know/Refused
ASK ONLY IF LANDLINE SAMPLE AND (Q129=2)
131. 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 LANDLINE SAMPLE AND (Q129=2)
132. 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
Q133 Did you visit the National Highway Traffic Safety Administration website to find out more information about the survey? (at www.nhtsa.dot.gov )
Yes
No
(DK)
(Refused)
FOR LANDLINE AND LANDLINE OVERSAMPLE ONLY
Those are all the questions I have for you. Thank you for your participation.
FOR CELL SAMPLE ONLY
C1. May I please have your name, street address, city, and state and zipcode so I can send you your $10 incentive check?
ENTER NAME:
ENTER ADDRESS:
ENTER CITY:
ENTER STATE:
ENTER ZIP:
Those are all the questions I have for you. Thank you for your participation.
SCR1. I am sorry but you are not eligible to participate in the survey today. Thank you for your cooperation and I hope you have a pleasant evening.
(THANK RESPONDENT)
| File Type | application/msword |
| File Title | Appendix B-1 |
| Author | Dawn Balmforth |
| Last Modified By | alan.block |
| File Modified | 2012-02-15 |
| File Created | 2012-02-14 |