SPI Pilot Study Questionnaire

Survey of Prison Inmates (SPI)
Pilot Study Questionnaire

Page 1

Table of Contents

Interview Set-up Screens

(page 3)

Section 1: Demographics

(pages 4 - 9)

Section 2: Criminal Justice

(pages 10 - 71)

Section 3: Socioeconomic Characteristics

(pages 72 - 93)

Section 4: Mental Health and Treatment

(pages 94 - 103)

Section 5: Physical Health, Treatment, and Disabilities

(pages 104 - 113)

Section 6: Alcohol Use

(pages 114 - 119)

Section 7: Drug Use

(pages 120 - 132)

Section 8: Drug and Alcohol Treatment

(pages 133 - 136)

Section 9: Social Support from Outside the Facility

(pages 137 - 141)

Section 10: Programs, Services, and Work Assignments

(pages 142 - 150)

Section 11: Rule Violations

(pages 152 - 156)

Interview Closeout Screens

(pages 157 - 158)

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Interview Set-up (IS)
IS1

As I mentioned before, the Survey of Prison Inmates is a research study being done by the
Bureau of Justice Statistics and RTI International, a not-for-profit research organization in North
Carolina.
This interview will take about 80 minutes. Your name will never be connected with the
information you provide in this interview. We will treat everything you say as private and
confidential. We will not share any information you provide with anyone outside or at the facility
or anyone who is not working on the project.

INTERVIEWER: IF RESPONDENT ASKS ANY QUESTIONS ABOUT OMB
APPROVAL FOR THIS STUDY, YOU MAY READ THE INFORMATION BELOW.
OTHERWISE ENTER 1 TO CONTINUE TO THE NEXT SCREEN.
Notice: Public reporting for this collection of information is estimated to average 80
minutes per response, including the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing and reviewing
the collection of information. Send comments regarding this burden estimate or any
other aspect of this collection of information, including suggestions for reducing this
burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW,
Washington, DC 20531. An agency may not conduct or sponsor, and a person is not
required to respond to a collection of information unless it displays a currently valid
OMB control number. The OMB control number for this project is XXXX-xxxx.
IS2

FACILITY ID
____________________

IS3

ENTER YOUR INTERVIEWER ID NUMBER:
__________ [ALLOW 6 DIGITS]

IS4

IS AN INCENTIVE BEING OFFERED TO INMATES AT THIS FACILITY?
1
2

YES
NO

Interview Set-up Screens

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Comment [CS1]: Omitted section of text

Survey of Prison Inmates (SPI) Pilot Study Questionnaire

Section 1 — Demographics (DEMO)
NOTE TO PROGRAMMER: We will use the facility ID to create a variable called
GENDER OF FACILITY (Options are Male or Female) that may be used for routing logic.
DEMO1.

What is your date of birth? [TESTED IN COGNITIVE INTERVIEWING]
Month:___ [RANGE: 1 – 12]
Day: ___ RANGE: 1 – 31]
Year: ___ [Range: CURRENT YEAR – 95 TO CURRENT YEAR – 12]

DEMO1a.

[COMPUTER TO CALCULATE AGE] That means you are currently [AGE]
years old. Is that correct?
1
YES
2
NO
DK/REF

DEMO1b.

[IF DEMO1a = 2 OR DK OR REF] How old are you?
AGE IN YEARS: ____ [RANGE: 12 – 95]

DEMO2.

Are you of Spanish, [Latino/Latina], or Hispanic origin? [TESTED IN
COGNITIVE INTERVIEWING]
1 YES
2 NO
DK/REF

DEMO3.

[IF DEMO2=1] Which of these categories describes your origin or descent?
[TESTED IN COGNITIVE INTERVIEWING]
Yes
No
DEMO3a. Mexican-American?
1
2
DEMO3b. Chicano?
1
2
DEMO3c. Mexican?
1
2
DEMO3d. Cuban?
1
2
DEMO3e. Puerto Rican or other Caribbean?
1
2
DEMO3f. Central or South American
1
2
Spanish?
DEMO3g. Some other Spanish group?
1
2

Section 1 - Demographics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

DEMO4.

Which of these categories describes your race? You may answer yes to one or
more of these categories. [TESTED IN COGNITIVE INTERVIEWING]

DEMO4a. White?
DEMO4b. Black or African-American?
DEMO4c. American Indian or Alaska
Native?
DEMO4d. Asian?
DEMO4e. Native Hawaiian or other Pacific
Islander?

DEMO5.

Yes
1
1
1

No
2
2
2

1
1

2
2

At the time of the arrest or charge that led to your incarceration in this prison,
were you… [TESTED IN COGNITIVE INTERVIEWING]
1
Married,
2
Widowed,
3
Divorced,
4
Separated, for reasons other than incarceration, or
5
Never married?
DK/REF

DEMO6.

[IF DEMO5 = 1 OR 2 OR 3 OR 4] Are you now… [TESTED IN COGNITIVE
INTERVIEWING]
Married,
Widowed,
Divorced, or
Separated, for reasons other than incarceration?
DK/REF

(1)
(2)
(3)
(4)

DEMO7.

[IF DEMO5 = 5 OR DK/REF] Are you now…[TESTED IN COGNITIVE
INTERVIEWING]
1
Married,
2
Widowed,
3
Divorced,
4
Separated, for reasons other than incarceration, or
5
Single and never married?
DK/REF

Section 1 - Demographics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DEMO7s.

Do you think of yourself as…
1 Lesbian or gay,
2 Straight, that is not gay,
3 Bisexual, or
4 Something else?
DK/REF

DEMO8.

I have a general question about your health. Would you say your health is…
1 Excellent,
2 Very good,
3 Good,
4 Fair, or
5 Poor?
DK/REF

DEMO9.

Have you ever served in the United States Armed Forces?
1 YES
2 NO
DK/REF

DEMO9a.

Which branches have you served in? MARK ALL THAT APPLY
(1) Army, including the Army National Guard or Reserve
(2) Navy, including the Reserve
(3) Marine Corps, including the Reserve
(4) Air Force, including the Air National Guard or Reserve
(5) Coast Guard, including the Reserve

_______________________________________________________
A – Military Service Block
Block Level Universe: (DEMO9a = 1 OR 2 OR 3 OR 4 OR 5)
DEMOA1.

[IF DEMO9a = 1 OR 2 OR 3 OR 4 OR 5] Are you currently serving in the
United States Armed Forces?
1 YES
2 NO
DK/REF

Section 1 - Demographics

Comment [CS2]: Question removed

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

DEMOA2.

[IF DEMO9a = 1 OR 2 OR 3 OR 4 OR 5] In what year did you first enter the
United States Armed Forces?
YEAR:
___ [RANGE: 1920 – CURRENT YEAR]
DK/REF

DEMOA3.

[IF DEMO9a = 1 OR 2 OR 3 OR 4 OR 5]In what year were you last discharged
from the United States Armed Forces?
(ENTER ‘999’ IF INMATE HAS NOT BEEN DISCHARGED/IS CURRENTLY
SERVING)
YEAR:
___ [RANGE: 1920 – CURRENT YEAR]
DK/REF
999

DEFINE DEMOA1:
IF DEMOA3 = 999 THEN set DEMOA1 = 1
IF DEMOA3 = 1920 – CURRENT DATE THEN set DEMOA1 = 2
ELSE, DEMOA1 = EMPTY

DEMOA4.

[IF DEMOA1 = 1] Altogether, how much time have you served in the United
States Armed Forces?
[IF DEMOA1 = 2] Altogether, how much time did you serve in the United States
Armed Forces?
1 Less than 1 year
2 At least one year but less than 3 years
3 At least 3 years but less than 5 years
4 At least 5 years but less than 10 years
5 At least 10 years but less than 15 years
6 At least 15 years but less than 20 years
7 20 years or more
DK/REF

DEMOA5.

[IF (DEMO9a = 1 OR 2 OR 3 OR 4 OR 5) AND DEMOA1 = 2] While serving
in the United States Armed Forces did you ever serve in a war zone?
[IF (DEMO9a = 1 OR 2 OR 3 OR 4 OR 5) AND DEMOA1 = 1] While serving
in the United States Armed Forces have you ever served in a war zone?
1

YES

Section 1 - Demographics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2 NO
DK/REF

DEMOA6.

[IF DEMOA1= 1] While serving in the United States Armed Forces, have you
seen combat in a line or combat unit?
[IF DEMOA1 = 2] While serving in the United States Armed Forces, did you see
combat in a line or combat unit?
1 YES
2 NO
DK/REF

DEMOA7.

[IF DEMOA6 = 1] Did you see combat in a line or combat unit in…

DEMOA7a. [IF CALCAGE > 80] World War II?
DEMOA7b. [IF CALCAGE > 74] the Korean Conflict?
DEMOA7c. [IF CALCAGE > 52] the Vietnam War?
DEMOA7d. [IF CALCAGE > 38] the Persian Gulf War?
DEMOA7e. [IF CALCAGE > 16] Afghanistan?
DEMOA7f. [IF CALCAGE > 16] Iraq?
DEMOA7g. Some other military operation, which may include
peacekeeping operations

DEMOA8.

Yes
1
1
1
1
1
1
1

No
2
2
2
2
2
2
2

[IF DEMO9a = 1 OR 2 OR 3 OR 4 OR 5] While serving in the United States
Armed Forces, did you suffer any injury as a result of training or combat?
1 YES
2 NO
DK/REF

DEMOA9.

1
2
3
4
5
6

[IF DEMOA1 = 2] What type of discharge did you receive from the United States
Armed Forces?
Honorable
General under honorable conditions
Other than honorable
Bad conduct
Dishonorable
Some other type of discharge

Section 1 - Demographics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DK/REF

DEMOA10

[IF DEMOA9 = 6] What type of discharge did you receive?

1 MEDICAL
2 PSYCHOLOGICAL
3 OTHER
DK/REF

DEMOA11

1
2
3

DEMOA12

[IF DEMOA10 = 1] Was your medical discharge honorable, dishonorable, or
something else?
Honorable
Dishonorable
Something else
DK/REF

[IF DEMOA10 = 2] Was your psychological discharge honorable, dishonorable,
or something else?

1
2
3

Honorable
Dishonorable
Something else
DK/REF
______________________________END Military Service Block (A)

Section 1 - Demographics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Section 2 – Criminal Justice (CJ)

CJ1.

This next section of the survey will ask you questions about your experiences with
parole, probation, incarceration, and crimes you may have committed.
[TESTED IN COGNITIVE INTERVIEWING]
When were you admitted to prison for this incarceration?
CJ1a. 2-DIGIT MONTH: _________ [RANGE: 1 – 12]
DK/REF
CJ1b. 2-DIGIT DAY: ____________ [RANGE: 1 – 31]
DK/REF
CJ1c. 4-DIGIT YEAR: ___________ [RANGE: 1915 – current year]
DK/REF

DEFINE DATE_ADMIT:
IF CJ1a ≠ EMPTY AND CJ1b ≠ EMPTY AND CJ1c ≠ EMPTY THEN DATE_ADMIT = “on
MONTH/DAY/YEAR”
IF CJ1a ≠ EMPTY AND CJ1b = EMPTY AND CJ1c ≠ EMPTY THEN DATE_ADMIT = “in
MONTH, YEAR”
ELSE DATE_ADMIT = EMPTY
CJ2.

[IF CJ1a = DK/REF AND CJ1c ≠ DK OR REF] What time of year was it? Was it
winter, spring, summer, or fall when you were admitted to prison for this incarceration?
1
WINTER
2
SPRING
3
SUMMER
4
FALL
DK/REF

DEFINE CALCTIME:
CALCTIME = CALCULATED BY “SUBTRACTING” DATE OF INCARCERATION
FROM DATE OF INTERVIEW AND THEN ROUNDING. IF ONLY MONTH
AND YEAR ARE PROVIDED USE ‘15’ AS THE DAY. IF CJ2 = 1 – 4 THEN
USE JANUARY 1 FOR WINTER, APRIL 1 FOR SPRING, JULY 1 FOR
SUMMER AND OCTOBER 1 FOR FALL WHEN CREATING THE DATE.
ONCE THE ADMIT DATE IS SUBTRACTED FROM THE DATE OF
INTERVIEW, ROUND THE VALUE AS:
CALCTIME LESS THAN 2 MONTHS: REPORT AS DAYS
CALCTIME IS 2 – 11 MONTHS: REPORT AS MONTHS
CALCTIME IS 12 MONTHS OR MORE: ROUND TO NEAREST YEAR

DEFINE 12MONSTATUS:
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
IF admission date is less than 12 months ago THEN set 12MONSTATUS = 1
IF admission date is at least 12 months ago THEN set 12MONSTATUS = 2
DEFINE 12MON_FILL1:
IF facility admission date is less than 12 months ago THEN 12MON_FILL1 = Since you were
admitted to prison for this incarceration
IF facility admission date is at least 12 months ago THEN 12MON_FILL1 = During the past 12
months
DEFINE 12MON_FILL2:
IF facility admission date is less than 12 months ago THEN 12MON_FILL2 = since you were
admitted to prison for this incarceration
IF facility admission date is at least 12 months ago THEN 12MON_FILL2 = during the past 12
months
CJ3

[IF CALCTIME NE MISSING] That means you have been in prison for this
incarceration for about [CALCTIME]. Is that correct?
1
2

CJ4

YES
NO

[IF (CJ1c=DK OR REF) OR CJ3 = 2] How long have you been in prison for this
incarceration?
INTERVIEWER: PROBE THOROUGHLY TO AVOID A DK OR REFUSE
RESPONSE IF AT ALL POSSIBLE.
1
LESS THAN 1 WEEK
2
AT LEAST 1 WEEK BUT LESS THAN 6 MONTHS
3
AT LEAST 6 MONTHS BUT LESS THAN 1 YEAR
4
AT LEAST 1 YEAR BUT LESS THAN 3 YEARS
5
AT LEAST 3 YEARS BUT LESS THAN 5 YEARS
6
AT LEAST 5 YEARS BUT LESS THAN 10 YEARS
7
10 YEARS OR MORE
DK/REF

UPDATE 12MONSTATUS:
IF CJ4 = 1 – 3 THEN set 12MONSTATUS = 1
IF CJ4 = 4 – 7 OR DK OR REF, THEN set 12MONSTATUS = 2
UPDATE 12MON_FILL1:
IF CJ4 = 1 – 3 THEN 12MON_FILL1 = Since you were admitted to prison for
this incarceration
IF CJ4 = 4 – 7 OR DK OR REF, THEN 12MON_FILL1 = During the past 12
months
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
UPDATE 12MON_FILL2:
IF CJ4 = 1 – 3 THEN 12MON_FILL2 = since you were admitted to prison for
this incarceration
IF CJ4= 4 – 7 OR DK OR REF, THEN 12MON_FILL2 = during the past 12
months

CJ5

Prior to this incarceration in prison, had you ever been sentenced to serve time in prison
or jail?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

CJ6

YES
NO

Go to CJ6
Go to CJ9

[IF A7 = 1] When were you last released from prison or jail after serving a sentence in
prison or jail?
[TESTED IN COGNITIVE INTERVIEWING]
CJ6a. 2-DIGIT MONTH: _________ [RANGE: 1 – 12]
DK/REF
CJ6b. 2-DIGIT DAY: ____________ [RANGE: 1 – 31]
DK/REF
CJ6c. 4-DIGIT YEAR: ___________ [RANGE: 1915 – current year]
DK/REF

CJ7

[IF CJ6a = DK/REF AND CJ6c ≠ DK OR REF] What time of year was it? Was it winter,
spring, summer, or fall when you were last released from prison or jail after serving a
sentence?
1
WINTER
2
SPRING
3
SUMMER
4
FALL
DK/REF

CJ8

[ACJ5 = 1] Before you were released, how much time had you served in prison or jail on
that sentence?
CJ8a. MONTHS: _________ [RANGE: 1 – 12]
CJ8b. DAYS: ____________ [RANGE: 1 – 31]
CJ8c. YEARS: ___________ [RANGE: 1 – 99]

CJ9

DK/REF
DK/REF
DK/REF

Are you currently incarcerated in this facility because you have been sentenced to serve
time in prison or because you are waiting to be sentenced or some other reason?
[TESTED IN COGNITIVE INTERVIEWING]

Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

1
2
3

Sentenced
Go to CJ10
Waiting to be sentenced
Go to CJ10
Some other reason
Go to CJ9a

CJ9a [IF CJ9=3] Are you currently incarcerated in this facility because you are waiting to go to
trial?
1 YES
2 NO
CJ10 The next few questions are about your experiences with parole or post-release
supervision.
People are sometimes incarcerated in prison for violating their parole or post-release
supervision. When we ask you about parole or post-release supervision, we are talking
about times you may have been supervised in the community after serving a sentence in
prison or jail. Are you incarcerated in this facility because of a parole or post-release
supervision violation?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJA1
Go to CJ11
FI NOTE:

A parole or post-release supervision
violation can result from being
arrested, charged, or sentenced for a
new crime or as a result of violating
the parole conditions.

DEFINE PAROLE_FILL:
IF CJ10 = 1 THEN PAROLE_FILL = “parole”
ELSE PAROLE_FILL = EMPTY

_______________________________________________________
A – Parole Violators Block
Block Level Universe: (CJ10 = 1)
CJA1. [IF CJ10 = 1] In what month and year were you arrested for or charged with the
parole or post-release supervision violation that led to you being incarcerated in this
prison?
[TESTED IN COGNITIVE INTERVIEWING]
(IF MORE THAN ONE DATE GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
NOTIFIED OF CHARGES.)
CJA1a 2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJA1b 4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF
DEFINE DATE_ARREST:
IF CJA1a ≠ EMPTY AND CJA1b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
DEFINE DATE_ARREST2:
IF CJA1a ≠ EMPTY AND CJA1b ≠ EMPTY THEN DATE_ARREST2 = “MONTH, YEAR”
ELSE DATE_ARREST2 = EMPTY

CJA2. [IF CJ10 = 1] For what offenses were you sentenced to serve time in prison and then put
on parole or post-release supervision?
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
[TESTED IN COGNITIVE INTERVIEWING]
(CJA2a)
1 ________________________________
(CJA2b)
2 ________________________________
(CJA2c)
3 ________________________________
(CJA2d)
4 ________________________________
(CJA2e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)

CJA3 [IF CJ10 = 1] When you were released from prison and then put on parole before this
incarceration, were you released by a parole board?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

If CJ9 = 1 Go to CJA4
Go to CJA3a

If CJA9 = 2 Go to CJA7

CJA3a [IF CJA3 = 2] How were you released from prison?
[TESTED IN COGNITIVE INTERVIEWING]
Specify _______________________________________
If CJ9 = 1 Go to CJA4
If CJ9 = 2 Go to CJA7
Sentenced parole violators; new offenses
CJA4 [IF CJ9 = 1 AND CJ10 = 1] Did your parole violation involve being sentenced to serve
time in prison for any new offenses?
[TESTED IN COGNITIVE INTERVIEWING]
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
1
2

YES
NO

Go to CJA5
Go to CJA10

CJA5 [IF CJA4 = 1] In what month and year were you arrested for or charged with those
new offenses?
[TESTED IN COGNITIVE INTERVIEWING]
(IF MORE THAN ONE DATE IS GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJA5a.2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJA5b 4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF
UPDATE DATE_ARREST:
IF CJA5a ≠ EMPTY AND CJA5b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY

CJA6 [IF CJ9 = 1 AND CJA4 = 1] What were the new offenses?
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
[TESTED IN COGNITIVE INTERVIEWING]
(CJA6a)
1 ________________________________
(CJA6b)
2 ________________________________
(CJA6c)
3 ________________________________
(CJA6d)
4 ________________________________
(CJA6e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)
A
Parole Violation
B
Probation Violation
Go to CJA10
Unsentenced parole violators; new offenses
CJA7 [IF ((CJ9 = 2 OR 3) AND Q3 = 1) OR Q6 = 2] Did your parole violation involve being
arrested for or charged with any new offenses?
1
2

YES
NO

Go to CJA8
Go to CJA10

CJA8 [IF Q6 = 1] In what month and year were you arrested for or charged with those
new offenses?
(IF MORE THAN ONE DATE IS GIVEN, TAKE THE EARLIEST DATE.)
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJA8a 2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJA8b 4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF
UPDATE DATE_ARREST:
IF CJA8a ≠ EMPTY AND CJA8b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
CJA9 [IF Q6c = 1] What were the new offenses?
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
(CJA9a)
1 ________________________________
(CJA9b)
2 ________________________________
(CJA9c)
3 ________________________________
(CJA9d)
4 ________________________________
(CJA9e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)
A
Parole Violation
B
Probation Violation
Go to CJA10
Parole violators; violations and revocation
CJA10 [IF CJ10 = 1] Did your parole violation that led to this incarceration involve a violation
of the terms of your parole conditions?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

YES
NO

CJA11 [IF CJ10= 1] Has your parole been taken away or revoked?
1
2

YES
NO

Go to CJA12
Go to CJA13

CJA12 [IF CJA11 = 1] What were the specific reasons that your parole was taken away or
revoked? Any others? (CHECK ALL THAT APPLY)
1
2
3
4

ARREST/CONVICTION FOR NEW OFFENSE
POSITIVE TEST FOR DRUG USE
P OS S ES S ION OF DR UG(S )
FAILURE TO REPORT FOR DRUG TESTING

Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
5
6
7
8
9
10
11
12
13
14

FAILURE TO REPORT FOR ALCOHOL OR DRUG TREATMENT
FAILURE TO REPORT FOR MENTAL HEALTH TREATMENT
FAILURE TO REPORT FOR OTHER COUNSELING
FAILURE TO REPORT TO PAROLE OFFICER/ABSCONDED
LEFT JURISDICTION WITHOUT PERMISSION
FAILURE TO SECURE OR MAINTAIN EMPLOYMENT
FAILURE TO PAY FINES, RESTITUTION, OR OTHER FINANCIAL
OBLIGATIONS (E.G., CHILD SUPPORT)
MAINTAINED CONTACT WITH OTHER KNOWN OFFENDERS
P OS S ES S I O N O F GU N ( S )
OTHER – (CJA12_OTH) Specify: ______________________
Go to CJ41

CJA13 [IF CJA11 = 2] Are you awaiting a parole revocation hearing?
1
YES
2
NO
Go to CJ41
______________________________END Parole Violators Block (A)

CJ11 [IF CJ10 = 2] The next few questions are about your experience with probation.
Are you incarcerated in this facility because of a probation violation?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

YES
NO

Go to CJB1
Go to CJ15
FI NOTE:

A probation violation can result from
being arrested, charged, or sentenced
for a new crime or as a result of
violating the conditions of probation

UPDATE PAROLE_FILL:
IF CJ10 = 1 THEN PAROLE_FILL = “parole”
IF CK10 ≠ 1 AND CJ11 = 1 THEN PAROLE_FILL = “probation”
ELSE PAROLE_FILL = EMPTY
_______________________________________________________
B – Probation Violators Block
Block Level Universe: (CJ11 = 1 )
CJB1. [IF CJ11 = 1] In what month and year were you arrested for or charged with the
probation violation that led to you being incarcerated in this prison?
[TESTED IN COGNITIVE INTERVIEWING]
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
(IF MORE THAN ONE DATE IS GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJB1a
2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJB1b
4-DIGIT YEAR: ________ [RANGE: 1915 – current year]
DK/REF
UPDATE DATE_ARREST:
IF CJB1a ≠ EMPTY AND CJB1b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
UPDATE DATE_ARREST2:
IF CJB1a ≠ EMPTY AND CJB1b ≠ EMPTY THEN DATE_ARREST2 = “ MONTH, YEAR”
ELSE DATE_ARREST2 = EMPTY
CJB2 [IF CJ11 = 1] Now we are interested in how you received your probation sentence. Was
your probation sentence a stand-alone sentence given by the court with no prison or jail
time? [TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJB3
Go to CJB2a

CJB2a [IF CJB2 = 2] Was your probation sentence part of a split sentence connected to serving
time in a prison or jail? [TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

CJB3 [IF CJ11 = 1] For what offenses were you put on probation?
[TESTED IN COGNITIVE INTERVIEWING]
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
(CJB3a)
1 ________________________________
(CJB3b)
2 ________________________________
(CJB3c)
3 ________________________________
(CJB3d)
4 ________________________________
(CJB3e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)
If CJB2b = 1 Go to CJB4
If CJB2b = 2 Go to CJB5
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

CJB4 [IF CJB2b = 1] When you were released from prison or jail and then put on probation
before this incarceration, were you released by a board?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

YES
NO

CJB4a [IF CJB4 = 2] How were you released from prison or jail?
[TESTED IN COGNITIVE INTERVIEWING]
Specify _______________________________________
If CJ9 = 1 Go to CJB5
If CJ9 = 2 Go to CJB8

Sentenced probation violators; new offenses
CJB5 [IF CJ9 = 1 AND CJ11 = 1] Did your probation violation involve being sentenced to
serve time in prison for any new offenses?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

YES
NO

Go to CJB6
Go to CJB8

CJB6 [IF CJB5 = 1] In what month and year were you arrested for or charged with those
new offenses??
[TESTED IN COGNITIVE INTERVIEWING]
(IF MORE THAN ONE DATE IS GIVEN, TAKE THE EARLIEST DATE.
IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJB6a. 2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJB6b.4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF
UPDATE DATE_ARREST:
IF CJB6a ≠ EMPTY AND CJB6b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
Go to CJB6
CJB7 [IF CJB5 = 1] What were the new offenses?
[TESTED IN COGNITIVE INTERVIEWING]
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
(CJB7a)
(CJB7b)
Section 2 – Criminal Justice

1 ________________________________
2 ________________________________
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
(CJB7c)
3 ________________________________
(CJB7d)
4 ________________________________
(CJB7e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)
A
Parole Violation
B
Probation Violation
Go to CJB11
Unsentenced probation violators; new offenses)
CJB8 [IF (CJ9 = 2 AND CJ11 = 1) OR CJB5 = 2] Did your probation violation involve being
arrested or charged with any new offenses?
1
2

YES
NO

Go to CJB9
Go to CJB11

CJB9 [IF Q15c = 1] In what month and year were you arrested for or charged with those
new offenses?
(IF MORE THAN ONE DATE GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJB9a. 2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJB9b.4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF
UPDATE DATE_ARREST:
IF CJB9a ≠ EMPTY AND CJB9b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
CJB10 [IF CJB8 = 1] What were the new offenses?
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
(CJB10a)
1 ________________________________
(CJB10b)
2 ________________________________
(CJB10c)
3 ________________________________
(CJB10d)
4 ________________________________
(CJB10e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)
A
Parole Violation
B
Probation Violation
Go to CJB11
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

Probation violators; violations and revocation
CJB11 [IF CJ11 = 1] Did your probation violation that led to this incarceration involve a
violation of the terms of your probation conditions?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

YES
NO

CJB12 [IF CJ11 = 1] Has your probation been taken away or revoked?
1
2

YES
NO

Go to CJB13
Go to CJB14

CJB13 [IF CJB12 = 1] What were the specific reasons that your probation was taken away or
revoked? Any others? (CHECK ALL THAT APPLY)
1
2
3
4
5
6
7
8
9
10
11
12
13
14

ARREST/CONVICTION FOR NEW OFFENSE
POSITIVE TEST FOR DRUG USE
P OS S ES S ION OF DR UG(S )
FAILURE TO REPORT FOR DRUG TESTING
FAILURE TO REPORT FOR ALCOHOL OR DRUG TREATMENT
FAILURE TO REPORT FOR MENTAL HEALTH TREATMENT
FAILURE TO REPORT FOR OTHER COUNSELING
FAILURE TO REPORT TO PAROLE OFFICER/ABSCONDED
LEFT JURISDICTION WITHOUT PERMISSION
FAILURE TO SECURE OR MAINTAIN EMPLOYMENT
FAILURE TO PAY FINES, RESTITUTION, OR OTHER FINANCIAL
OBLIGATIONS (E.G., CHILD SUPPORT)
MAINTAINED CONTACT WITH OTHER KNOWN OFFENDERS
P OS S ES S I O N O F GU N ( S )
OTHER – (CJB13_OTH) SPECIFY: __________________________
Go to CJ41

CJB14 [IF CJB12 = 2] Are you awaiting a probation revocation hearing?
1
YES
2
NO
Go to CJ41
______________________________END Probation Violators Block (B)
Parole or probation violators; no new offenses
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJ12 [(CJ10 = 1 AND CJA4 = 2) OR (CJ11 = 1 AND CJB5 = 2)] In what month and year
were you taken into custody for your [PAROLE_FILL] violation?
(IF MORE THAN ONE DATE GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJ12a.
2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJ12b.
4-DIGIT YEAR: ________ [RANGE: 1915 – current year]
DK/REF
Go to CJ13
DEFINE DATE_CUSTODY:
IF CJ12a ≠ EMPTY AND CJ12b ≠ EMPTY THEN DATE_CUSTODY = “in MONTH, YEAR”
ELSE DATE_CUSTODY = EMPTY

CJ13 [(CJ10 = 1 AND CJA4 = 2) OR (CJ11 = 1 AND CJB5 = 2)] Now I would like you to
think back to the time when you originally served a sentence for [insert offenses from
CJA2 or CJB3] before being released on [PAROLE_FILL].
In what month and year were you arrested for or charged with [insert offenses from
CJA2 or CJB3]?
(IF MORE THAN ONE DATE IS GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJ13a
2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJ13b
4-DIGIT YEAR: ________ [RANGE: 1915 – current year]
DK/REF
Go to CJ14
DEFINE DATE_ARREST3:
IF CJ13a ≠ EMPTY AND CJ13b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
CJ14. [(CJ10 = 1 AND CJA4 = 2) OR (CJ11 = 1 AND CJB5 = 2)] When were you admitted to
prison for that incarceration?
CJ14a.

2-DIGIT MONTH: _________ [RANGE: 1 – 12]
DK/REF
CJ14b.
4-DIGIT YEAR: ________[RANGE: 1915 – current year]
DK/REF
Go to CJ41
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DEFINE DATE_ADMIT2:
IF CJ14a ≠ EMPTY AND CJ14b = EMPTY AND THEN DATE_ADMIT2 = “in MONTH,
YEAR”
ELSE DATE_ADMIT2 = EMPTY

Prisoners not incarcerated for a P or P violation; P and P status at admission
CJ15 [IF CJ10 = 2 AND CJ11 = 2] At the time that you were admitted to prison
[DATE_ADMIT] for this incarceration, were you on parole or post-release supervision?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJ16
Go to CJ21

CJ16 [IF CJ15 = 1] For what offenses were you sentenced to serve time in prison and then put
on parole?
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
(CJ16a)
1 ________________________________
(CJ16b)
2 ________________________________
(CJ16c)
3 ________________________________
(CJ16d)
4 ________________________________
(CJ16e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)
Go to CJ17
CJ17 [IF CJ15 = 1] When you were released from prison and then put on parole before this
incarceration, were you released by a parole board?
1
2

Yes
No

Go to CJ18
Go to CJ17a

CJ17a [IF Q37 = 2] How were you released from prison?
Specify _______________________________________

CJ18 [IF CJ15 = 1] Has your parole been taken away or revoked?
1
2

YES
NO

Section 2 – Criminal Justice

Go to CJ19
Go to CJ20
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJ19 [IF CJ18 = 1] What were the specific reasons that your parole was taken away or
revoked? Any others? (CHECK ALL THAT APPLY)
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Arrest/conviction for new offense
Positive test for drug use
P o s s es s io n o f d ru g(s )
Failure to report for drug testing
Failure to report for alcohol or drug treatment
Failure to report for mental health treatment
Failure to report for other counseling
Failure to report to probation officer/absconded
Left jurisdiction without permission
Failure to secure or maintain employment
Failure to pay fines, restitution, or other financial obligations (e.g.,
child support)
Maintained contacts with other known offenders
P o s s es s i o n o f gu n (s )

OTHER – (CJ20_OTH) Specify: ___________________
If CJ9 = 1 Go to CJ28
If CJ9 = 2 Go to CJ30
If CJ9a =1 Go to CJ32
If CJ9a = 2 Go to CJ34

CJ20 [IF CJ18 = 2] Are you awaiting a parole revocation hearing?
1
YES
2
NO
If CJ9 = 1 Go to CJ28
If CJ9 = 2 Go to CJ30
If CJ9a =1 Go to CJ32
If CJ9a = 2 Go to CJ34

CJ21 [IF CJ10 = 2 AND CJ11 = 2 AND CJ15 = 2] At the time that you were admitted to prison
[DATE_ADMIT] for this incarceration, were you on probation?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

YES
NO

Go to CJ22
Go to CJ28

CJ22 [IF CJ21 = 1] Now we are interested in how you received your probation sentence. Was
your probation sentence a stand-alone sentence given by the court with no prison or jail
time? [TESTED IN COGNITIVE INTERVIEWING]
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
1
2

Yes
No

Go to CJ23
Go to CJ22a

CJ22a [IF CJ22 = 2] Was your probation sentence part of a split sentence connected to serving
time in a prison or jail? [TESTED IN COGNITIVE INTERVIEWING]

1
2

Yes
No

CJ23 [IF CJ21 =1] For what offenses were you put on probation?
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
[TESTED IN COGNITIVE INTERVIEWING]
(CJ23a)
1 ________________________________
(CJ23b)
2 ________________________________
(CJ23c)
3 ________________________________
(CJ23d)
4 ________________________________
(CJ23e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT)

CJ24 [IF CJ22a = 1] When you were released from prison or jail and then put on probation
before this incarceration, were you released by a board?
1
2

YES
NO

Go to CJ25
Go to CJ24a

CJ24a [IF CJ24 = 2] How were you released from prison or jail?
Specify _______________________________________
CJ25 Has your probation been taken away or revoked?
1
2

YES
NO

Go to CJ26
Go to CJ27

CJ26 [IF CJ25 = 1] What were the specific reasons that your probation was taken away or
revoked? Any others? (CHECK ALL THAT APPLY)
1
2
3
4

ARREST/CONVICTION FOR NEW OFFENSE
POSITIVE TEST FOR DRUG USE
P OS S ES S ION OF DR UG(S )
FAILURE TO REPORT FOR DRUG TESTING

Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
5
FAILURE TO REPORT FOR ALCOHOL OR DRUG
TREATMENT
6
FAILURE TO REPORT FOR MENTAL HEALTH
TREATMENT
7
FAILURE TO REPORT FOR OTHER COUNSELING
8
FAILURE TO REPORT TO PROBATION
OFFICER/ABSCONDED
9
LEFT JURISDICTION WITHOUT PERMISSION
10
FAILURE TO SECURE OR MAINTAIN EMPLOYMENT
11
FAILURE TO PAY FINES, RESTITUTION, OR OTHER
FINANCIAL OBLIGATIONS (E.G., CHILD SUPPORT)
12
MAINTAINED CONTACTS WITH OTHER KNOWN
OFFENDERS
13
P OS S ES S I O N O F GU N ( S )
14

OTHER – (CJ26_OTH) SPECIFY: ___________________
If CJ9 = 1 Go to CJ28
If CJ9 = 2 Go to CJ30
If CJ9a =1 Go to CJ32
If CJ9a = 2 Go to CJ34

CJ27 [IF CJ25 = 2] Are you awaiting a probation revocation hearing?
1
2

YES
NO
If CJ9 = 1 Go to CJ28
If CJ9 = 2 Go to CJ30
If CJ9a =1 Go to CJ32
If CJ9a = 2 Go to CJ34

Sentenced prisoners not incarcerated for a P or P violation
CJ28 [IF CJ9 = 1 AND CJ10 = 2 AND CJ11 = 2] For what offenses were you sentenced to
serve time in prison for this incarceration?
[TESTED IN COGNITIVE INTERVIEWING]
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
(CJ28a)
(CJ28b)
(CJ28c)
(CJ28d)
Section 2 – Criminal Justice

1 ________________________________
2 ________________________________
3 ________________________________
4 ________________________________
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
(CJ28e)
5 ________________________________
(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)
A
B

Parole Violation
Probation Violation

Go to CJ29
CJ29 In what month and year were you arrested for or charged with those offenses?
(IF MORE THAN ONE DATE GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJ29a 2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJ29b 4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF
UPDATE DATE_ARREST:
IF CJ29a ≠ EMPTY AND CJ29b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
Go to CJ41
Unsentenced prisoners waiting to be sentenced, not incarcerated for a P or P violation
CJ30 [IF CJ9 = 2 AND CJ10 = 2 AND CJ11 = 2] For what offenses are you now waiting to be
sentenced?
(USE THE LOOKUP TABLE TO ENTER OFFENSES. USE ‘OTHER’ IF OFFENSE
IS NOT FOUND IN THE TABLE. ENTER ‘999’ AFTER THE LAST OFFENSE IS
RECORDED.)
(CJ30a)
(CJ30b)
(CJ30c)
(CJ30d)
(CJ30e)

1 ________________________________
2 ________________________________
3 ________________________________
4 ________________________________
5 ________________________________

(VERIFY THE RECORDED OFFENSE WITH THE RESPONDENT.)
Go to CJ31
CJ31 [IF CJ9 = 2 AND CJ10 = 2 AND CJ11 = 2] In what month and year were you arrested
for or charged with those offenses?
(IF MORE THAN ONE DATE GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJ31a
2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJ31b 4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF
UPDATE DATE_ARREST:
IF CJ31a ≠ EMPTY AND CJ31b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
Go to CJ41
Unsentenced prisoners awaiting trial, not incarcerated for a P or P violation
CJ32 [IF CJ9a = 1 AND CJ10 = 2 AND CJ11 = 2] For what offenses are you now awaiting
trial?
(CJ32a)
(CJ32b)
(CJ32c)
(CJ32d)
(CJ32e)

1 ________________________________
2 ________________________________
3 ________________________________
4 ________________________________
5 ________________________________

(VERIFY THE RECORDED OFFENSES WITH THE RESPONDENT.)
CJ33 [IF CJ9a = 1 AND CJ10 = 2 AND CJ11 = 2] In what month and year were you
arrested for or charged with those offenses?
(IF MORE THAN ONE DATE GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJ33a
CJ33b

2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF

UPDATE DATE_ARREST:
IF CJ33a ≠ EMPTY AND CJ33b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
Go to CJ41
Unsentenced prisoners not awaiting trial, not incarcerated for a P or P violation
CJ34 [IF CJ9a = 2 AND AND CJ10 = 2 AND CJ11 = 2] Are you in this facility because you
are being held….
Yes
No
CJ34a for other authorities?
1 Go to CJ35
2 Go to CJ34b
[IF CJ34a = 2]
1 Go to CJ37
2 Go to CJ34c
CJ34b for safe keeping?
[IF CJ34b = 2]
1 Go to CJ38
2 Go to CJ34d
CJ34c for a civil commitment?
[IF CJ34c = 2]
1 Go to CJ39
2 Go to CJ41
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJ34d any other reason?
(CJ34_OTH) SPECIFY ________

CJ35 [IF CJ34a = 1] For what other authorities are you being held? (ALLOW ONLY 1
ENTRY)
1
State authorities
2
Local authorities
3
Federal Bureau of prisons
4
U.S. Immigration and Customs Enforcement
5
U.S. Marshals Service
6
Other – (CJ35_OTH) Specify: __________________
Go to CJ36
CJ36 [IF CJ34a = 1] For what offenses are you being held for [INSERT RESPONSE FROM
CJ35]?
(CJ36a)
1 ________________________________
(CJ36b)
2 ________________________________
(CJ36c)
3 ________________________________
(CJ36d)
4 ________________________________
(CJ36e)
5 ________________________________
(VERIFY THE RECORDED OFFENSES WITH THE RESPONDENT.)
Go to CJ40
CJ37 [IF CJ34b=1] For what offenses are you in safekeeping?
(CJ37a)
(CJ37b)
(CJ37c)
(CJ37d)
(CJ37e)

1 ________________________________
2 ________________________________
3 ________________________________
4 ________________________________
5 ________________________________

(VERIFY THE RECORDED OFFENSES WITH THE RESPONDENT.)
Go to CJ40

CJ38 [IF CJ34c=1] For what offenses are you being held on a civil commitment?
(CJ38a)
(CJ38b)
(CJ38c)
(CJ38d)
Section 2 – Criminal Justice

1 ________________________________
2 ________________________________
3 ________________________________
4 ________________________________
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
(CJ38e)

5 ________________________________

(VERIFY THE RECORDED OFFENSES WITH THE RESPONDENT.)
Go to CJ40
CJ39 [IF CJ34d=1] For what offenses are you being held?
(CJ39a)
1 ________________________________
(CJ39b)
2 ________________________________
(CJ39c)
3 ________________________________
(CJ39d)
4 ________________________________
(CJ39e)
5 ________________________________
(VERIFY THE RECORDED OFFENSES WITH THE RESPONDENT.)
Go to CJ40
CJ40 [IF Q44a = 1 OR Q44b = 1 OR Q44c = 1 OR Q44d = 1] In what month and year were you
arrested for or charged with those offenses?
(IF MORE THAN ONE DATE GIVEN, TAKE THE EARLIEST DATE.)
(IF NO PHYSICAL ARREST TOOK PLACE, ASK FOR THE DATE WHEN
NOTIFIED OF CHARGES.)
CJ40a.
2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJ40b
4-DIGIT YEAR: ________ [RANGE: 1915 – current year]
DK/REF
UPDATE DATE_ARREST:
IF CJ40a ≠ EMPTY AND CJ40b ≠ EMPTY THEN DATE_ARREST = “in MONTH, YEAR”
ELSE DATE_ARREST = EMPTY
Go to CJ41

CJ41 [IF CJ9 = 1 OR 2] Altogether, how long did you spend in jail after you were arrested
or charged [DATE_ARREST] [DATE_ARREST3] and before being admitted to
prison [DATE_ADMIT][DATE_ADMIT2]?
[TESTED IN COGNITIVE INTERVIEWING]
0

NO TIME IN JAIL
DK/REF

If 1 offense go to CJC2
If 2+ offenses go to CJC4
If 1 offense go to CJC2
If 2+ offenses go to CJC4

CJ41a. YEARS:___________
Section 2 – Criminal Justice

[RANGE: 0 – 5, blank]
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJ41b. MONTHS:______________
[RANGE: 0 – 30, blank]
CJ41c. WEEKS: ______________
[RANGE: 0 – 30, blank]
CJ41d. DAYS: ___________
[RANGE: 0 – 200, blank]
If 1 offense go to CJC2
If 2+ offenses go to CJC4

_______________________________________________________
C – Sentencing Block
Block Level Universe: (CJ9 = 1)
CJC1 [IF CJ9 = 1 AND (CJ41 = 1 DAY OR LONGER)] How much jail time was applied
to your prison sentence?
[TESTED IN COGNITIVE INTERVIEWING]
0
NONE OF IT
1
ALL OF IT
If 1 offense go to CJC2
If 2+ offenses go to CJC4

CJ41a. YEARS:__________
CJ41b. MONTHS:__________
CJ41c. WEEKS: __________
CJ41d. DAYS: ___________
If 1 offense go to CJC2
If 2+ offenses go to CJC4

[RANGE:
[RANGE:
[RANGE:
[RANGE:

0 – 5, blank]
0 – 30, blank]
0 – 30, blank]
0 – 200, blank]

Sentenced prisoners with one offense
DEFINE OFFENSE_SINGLE:
IF CJA6 = 1 offense THEN OFFENSE_SINGLE = offense listed in CJA6
IF CJA6 = EMPTY AND CJA2 = 1 offense THEN OFFENSE_SINGLE = offense listed in
CJA2
IF CJB7 = 1 offense THEN OFFENSE_SINGLE = offense listed in CJB7
IF CJB7 = EMPTY AND CJB3 = 1 offense THEN OFFENSE_SINGLE = offense listed in CJB3
IF CJ28 = 1 offense THEN OFFENSE_SINGLE = offense listed in CJ28

CJC2
[IF CJ9 = 1 AND
(CJA4 = 2 AND CJA2 = 1 offense) OR
(CJA4 = 1 AND CJA6 = 1 offense) OR
(CJB5 = 2 AND CJB3 = 1 offense) OR
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
(CJB5 = 1 AND CJB7 = 1 offense) OR
(CJ10 = 2 AND CJ11 = 2 AND CJ28 = 1 offense)]
How long is your sentence to prison for [OFFENSE_SINGLE]? Include any suspended
time. (DID THE INMATE GIVE A SINGLE/FLAT SENTENCE OR A RANGE OF
TIME?) [TESTED IN COGNITIVE INTERVIEWING]
1

SINGLE OR FLAT SENTENCE (GO TO CJC3a)

2

RANGE OF TIME OR INDETERMINATE SENTENCE (GO TO CJC3b)

CJC3a (RECORD SINGLE/FLAT SENTENCE)
1
2
3
4
5

Life
Life plus additional years
Li f e wi t h o u t p aro l e
Death
Intermittent (weekends/nights)
OR

CJC3a1.
CJC3a2
CJC3a3

YEARS:
MONTHS:
DAYS:

[RANGE: 1 – 99, blank]
[RANGE: 1 – 99, blank]
[RANGE: 1 – 90, blank]

CJC3b (RECORD RANGE OF TIME OR INDETERMINATE SENTENCE)

CJC3b1YEARS:
CJC3b2 MONTHS:
CJC3b3 DAYS:

Minimum
Maximum
____(Range 1-50, blank)____(Range 1-99, blank)
____(Range 1-36, blank)____(Range 1-99, blank)
____(Range 1-90, blank)____(Range 1-90, blank)

Sentenced prisoners with multiple offenses
DEFINE OFFENSES_MULTI:
IF CJA6 = 2+ offenses THEN OFFENSES_MULTI = offenses listed in CJA6
IF CJA6 = EMPTY AND CJA2 = 2+ offenses THEN OFFENSES_MULTI = offenses listed in
CJA2
IF CJB7 = 2+ offenses THEN OFFENSES_MULTI = offenses listed in CJB7
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
IF CJB7 = EMPTY AND CJB3 = 2+ offenses THEN OFFENSES_MULTI = offenses listed in
CJB3
IF CJ28 = 2+ offenses THEN OFFENSES_MULTI = offenses listed in CJ28

CJC4
[IF CJ9 = 1 AND
(CJA4 = 2 AND CJA2 = 2+ offenses) OR
(CJA4 = 1 AND CJA6 = 2+ offenses) OR
(CJB5 = 2 AND CJB3 = 2+ offenses) OR
(CJB5 = 1 AND CJB7 = 2+ offenses) OR
(CJ10 = 2 AND CJ11 = 2 AND CJ28 = 2+ offenses)]
What is the total maximum sentence length to prison for ALL the
consecutive sentences you are serving? [OFFENSES_MULTI]? Include any
suspended time.
[TESTED IN COGNITIVE INTERVIEWING]
(DID THE INMATE GIVE A SINGLE/FLAT SENTENCE OR A RANGE OF
TIME?)
1

SINGLE OR FLAT SENTENCE (GO TO CJC5a)

2

RANGE OF TIME OR INDETERMINATE SENTENCE (GO TO CJC5b)

CJC5a (RECORD SINGLE/FLAT SENTENCE)
1
2
3
4
5

Life
Life plus additional years
Li f e wi t hou t p aro l e
Death
Intermittent (weekends/nights)
OR

CJC5a1.
CJC5a2
CJC5a3

YEARS:
MONTHS:
DAYS:

[RANGE: 1 – 99, blank]
[RANGE: 1 – 99, blank]
[RANGE: 1 – 90, blank]

CJC5b (RECORD RANGE OF TIME OR INDETERMINATE SENTENCE)
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Minimum
Maximum
(Range 1-50, blank)____(Range 1-99, blank)
____(Range 1-36, blank)____(Range 1-99, blank)
(Range 1-90, blank)____(Range 1-90, blank)

CJC5b1YEARS:____
CJC5b2 MONTHS:
CJC5b3 DAYS:____

CJC6 [IF CJ9 = 1] Has any part of your total sentence been suspended?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF
CJC7 [IF CJC6 = 1] By how much was your sentence suspended?
[TESTED IN COGNITIVE INTERVIEWING]
1

ALL OF IT
OR

CJC7a
CJC7b
CJC7c

YEARS:
MONTHS:
DAYS:

[RANGE: 1 – 60, blank]
[RANGE: 1 – 30, blank]
[RANGE: 1 – 200, blank]

CJC8 [IF CJ9 = 1] Did you receive an increase in your sentence because of —

CJC8a a firearms violation?
CJC8b habitual offender, or second or third strike?
CJC8c the type of drug offense?

Yes
1
1
1

No
2
2
2

CJC9 [IF CJ9 = 1 AND (CJA2 OR CJA6 OR CJB3 OR CJB7 OR CJ28) = 2+] Of the
[OFFENSES_MULTI], for which offense did you receive the longest sentence?
[Display offenses from OFFENSES_MULTI as a pre-chart numbered 1-5 above
question]
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3
4
5

(FIRST OFFENSE LISTED)
(SECOND OFFENSE LISTED)
(THIRD OFFENSE LISTED)
(FOURTH OFFENSE LISTED)
(FIFTH OFFENSE LISTED)

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
8
9

INMATE ONLY RECEIVED ONCE SENTENCE
ALL SENTENCES ARE THE SAME LENGTH

IF FI ENDORSES “9” IN CJC9, THEN USE A HIERARCHY RULE SUCH THAT THE
CONTROLLING OFFENSE ABOUT WHICH WE WILL COLLECT DETAILS IS 1) A
VIOLENT OFFENSE (IF THEY REPORT A VIOLENT OFFENSE), 2) A PROPERTY
OFFENSE (IF THEY REPORT A PROPERTY OFFENSE), OR A DRUG OFFENSE (IF
THEY REPORT A DRUG OFFENSE)
CJC10 [IF CJC9 = 9] How long was the sentence for
[OFFENSES_MULTI]?
Include any suspended time.
(DID THE INMATE GIVE A SINGLE/FLAT SENTENCE OR A RANGE OF
TIME?)
1

SINGLE OR FLAT SENTENCE (GO TO CJC10a)

2

RANGE OF TIME OR INDETERMINATE SENTENCE (GO TO CJC10b)

CJC10a (RECORD SINGLE/FLAT SENTENCE)
1
2
3
4
5

Life
Life plus additional years
Li f e wi t h o u t p aro l e
Death
Intermittent (weekends/nights)
OR

CJC10a1.
CJC10a2
CJC10a3

YEARS:
MONTHS:
DAYS:

[RANGE: 1 – 99, blank]
[RANGE: 1 – 99, blank]
[RANGE: 1 – 90, blank]

CJC10b (RECORD RANGE OF TIME OR INDETERMINATE SENTENCE)

CJC10b1YEARS:____
CJC10b2 MONTHS:
CJC10b3 DAYS:____

Minimum
Maximum
(Range 1-50, blank)____(Range 1-99, blank)
____(Range 1-36, blank)____(Range 1-99, blank)
(Range 1-90, blank)____(Range 1-90, blank)

CJC11 [IF CJ9 = 1] Does your sentence for this incarceration include –
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
[TESTED IN COGNITIVE INTERVIEWING]
Yes
1
1
1
1

No
2
2
2
2

CJC12 [IF CJ9 = 1] Does your sentence for this incarceration include –
Yes
CJC12a. Community Service?
1
CJC12b Mandatory drug testing?
1
CJC12c Drug or alcohol treatment program?
1
CJC12d Sex offenders treatment program?
1
CJC12e Psychiatric or psychological counseling?
1
CJC12f Any other special conditions or restrictions?
1
(CJC12_OTH) SPECIFY ____________________

No
2
2
2
2
2
2

CJC11a Court costs or felony assessment fees?
CJC11b Any fines?
CJC11c Restitution to the victim if there was one?
CJC11d Some other type of fee or payment?
(CJC11_OTH) SPECIFY ____________________

______________________________END Sentencing Block (C)

CJ42 Do you have a definite date on which you expect to be released from prison?
1
2

YES
NO

Go to CJ43
Go to CJ44

CJ43 Keep previous question on screen [IF CJ42 = 1] In what month and year do you
expect to be released?
CJ43a
2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
CJ43b
4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF
Go to CJ46
CJ44 [IF CJ42 = 2] Do you expect to ever be released from prison?
1
2

YES
NO

Go to CJ45
Go to CJ48

CJ45 Keep previous question on screen [IF CJ44 = 1] In what month and year is your
earliest possible release date?
CJ45a
CJ45b

2-DIGIT MONTH: _________[RANGE: 1 – 12]
DK/REF
4-DIGIT YEAR: ________ [RANGE: 1915 – current year] DK/REF

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Go to CJ46
CJ46 [IF CJ42 = 1 OR CJ44 = 1] When you are released, do you expect to be supervised in the
community on either parole or probation?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJ48
ESTABLISH CONTROLLING OFFENSE FOR ALL INMATES
• Sentenced inmates:
o With one offense then that offense is the controlling offense
o With multiple offenses and sentences, the controlling offense is the
offense with the longest sentence
o With multiple offenses and one sentence, the controlling offense is the
“most serious” offense which is determined using the look-up tables and a
hierarchy, where violent is most serious, then property, then drug
• Unsentenced prisoners:
o With one offense then that offense is the controlling offense (For those
awaiting sentencing the offenses they were convicted od/awaiting
sentencing for are used; for all other inmates including those awaiting trial
the arrest offenses are used)
o With multiple offenses, the “most serious” offense is the controlling
offense and is determined using the look-up tables (For those awaiting
sentencing the offenses they were convicted of/awaiting sentencing for are
used; for all other inmates including those awaiting trial the arrest offenses
are used)
FI WILL RECORD EACH CRIME/OFFENSE LITERAL HOWEVER IT IS TOLD TO THEM
BY THE INMATE. IN A SECOND STEP, THE FI WILL USE A LOOKUP TABLE TO LINK
EACH LITERAL WITH AN OFFENSE IN OUR DATABASE, WHICH MAPS TO NCRP
OFFENSE CODES AND WILL DETERMINE WHETHER EACH OFFENSE IS IN THE
VIOLENT, PROPERTY, DRUG, OR OTHER CATEGORY.
IF THE LOOKUP TABLE DOES NOT ENABLE THE FI TO LINK TO AN OFFENSE IN
OUR DATABASE, THE FI WILL ASK CJ47 FOR EACH OFFENSE. ONCE IT IS
DETERMINED WHICH OFFENSE HAS THE LONGEST SENTENCE AND IT IS KNOWN
WHICH CATEGORY EACH OFFENSE FALLS INTO (VIOLENT, PROPERTY, DRUG, OR
OTHER), THEN WE KNOW WHICH INCIDENT CHARACTERISTICS SECTION OF THIS
MODULE (VIOLENT, PROPERTY OR DRUG) THE INMATE SHOULD RECEIVE.
CJ47 [IF LITERAL CANNOT BE LINKED TO AN OFFENSE THE LOOKUP TABLE Is
the [CONTROLLING_OFFENSE] generally considered a –
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
[TESTED IN COGNITIVE INTERVIEWING]
1
2

3

4
5

Violent offense? Store 1 in CONTROLLING_TYPE
Property offense? Did you take, damage or handle someone's
property, defraud them of something of theirs, embezzle
something of value, burglarize a building, or obtain money or
other
financial
gain
by
deceit?
Store
2
in
CONTROLLING_TYPE
Violation of laws which could or did give you some financial
gain, but not a violent or drug offense? Store 2 in
CONTROLLING_TYPE
Drug offense? Store 3 in CONTROLLING_TYPE
Public order offense? Store 4 in CONTROLLING_TYPE
Go to CJ48
DK/REF Go to CJ48

DEFINE CONTROLLING_TYPE
IF CONTROLLING_OFFENSE is a Violent Offense THEN CONTROLLING_TYPE = 1
IF CONTROLLING_OFFENSE is a Property Offense THEN CONTROLLING_TYPE = 2
IF CONTROLLING_OFFENSE is a Drug Offense THEN CONTROLLING_TYPE = 3
IF CONTROLLING_OFFENSE is a Public Order Offense THEN CONTROLLING_TYPE = 4
D – Attorney Questions Block
Block Level Universe: (CJ9 = 1 OR 2)
CJD1 [IF CJ9 = 1 OR 2]
I am now going to ask you some questions related to your
experiences with being represented by private attorneys or lawyers, or public attorneys or
lawyers, including public defenders.
At any time between when you were arrested or charged ([DATE_ARREST])
[DATE_ARREST3] and when you were admitted to prison on [DATE_ADMIT]
[DATE_ADMIT2], were you represented by any kind of attorney or lawyer?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJD2
Go to CJD1

CJD1a [If CJD1 = 2] Did you represent yourself?
1
Yes Go to Violent Crime, Property Crime, or Drug Crime Section,
depending on Controlling Offense
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2

No Go to CJD2

CJD2 [IF CJD1 = 1] Were you represented by a public defender or a lawyer who was appointed
by the court to represent you?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJD3
Go to CJD4

CJD3 [IF CJD2 = 1] Did you have to pay the public defender or lawyer who was representing
you?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No
Go to CJD4

CJD4 [IF CJD1 = 1] Were you represented by a lawyer who you or someone else hired and had
to pay to represent you?
1
2

Yes
No
Go to Violent Crime, Property Crime, or Drug Crime Section, depending
on Controlling Offense

______________________________END Attorney Questions Block (D)

E – Violent Crime and Victims Block
Block Level Universe: (CJ9 = 1 AND CONTROLLING_TYPE = 1)

CJE1 [IF CJ9 = 1 AND CONTROLLING_TYPE = 1] The next few questions are about
the victims of the [CONTROLLING_OFFENSE] for which you are now
serving time in prison.
Was there one victim of the [CONTROLLING_OFFENSE] or more than one?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3

ONE VICTIM
Go t o CJEA1
More than one victim - Go to CJEB1
NO VICTIM OR VICTIM WAS NOT A PERSON Go to CJ48

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DK Go to CJ48
REF Go to CJ48
EA –Victims Block – Single Victim
Block Level Universe: (CJ9 = 1 AND CONTROLLING_TYPE = 1 AND CJE1 = 1)
CJEA1 [IF CJE1 = 1] Was the person of Spanish, Latino, or Hispanic origin?
1
YES
2
NO
DK
REF
CJEA2 [CJE1 = 1] What race was the person? You may answer yes to one or more of these
categories.
1
2
3
5
6
DK
REF

White?
Black or African American?
American Indian or Alaska Native?
Asian?
Native Hawaiian or Other Pacific Islander?

CJEA3 [IF CJE1 = 1] Was the person male or female?
[TESTED IN COGNITIVE INTERVIEWING]
1
Male
2
Female
DK
REF
CJEA4 [IF CJE1 = 1] How old would you say the person was?
1
Under 12 years
2
12 to 17
3
18 to 24
4
25 to 34
5
35 to 54
6
55 or older
DK/REF
CJEA5 [IF CJE1 = 1] Was the person someone you knew or a stranger you had never seen
before?
[TESTED IN COGNITIVE INTERVIEWING]
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Comment [CS3]: Question wording enhanced

Survey of Prison Inmates (SPI) Pilot Study Questionnaire
1
KNEW Go to CJEA6
2
STRANGER
DK/REF
CJEA6 [IF CJEA5 = 1] How well did you know the person - by sight only, casual
acquaintance, or well known?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3

SIGHT ONLY
CASUAL ACQUAINTANCE
WELL KNOWN

CJEA7 [IF CJEA6 = 2 OR 3] What was the person's relationship to you at the time of the
crime? For example, a friend, relative, etc.
1
2
3
4
5
6
7
8
9
10
11

SPOUSE
EX- SPOUSE
PARENT/STEP-PARENT
OWN CHILD
ST E PC HI LD
BROTHER/SISTER/STEPBROTHER/STEPSISTER
OTHER RELATIVE – (CJEA7_RELSPECIFY_______
BOYFRIEND/GIRLFRIEND
EX-BOYFRIEND/EX-GIRLFRIEND
FRIEND/EX-FRIEND
OTHER (CJEA7_OTH) SPECIFY:________________

DEFINE VIOLENT_TYPE
IF CONTROLLING_TYPE = 1 AND there is a match of literals with "rape" from Lookup
Table THEN VIOLENT_TYPE = 1 (RAPE)
IF CONTROLLING_TYPE = 1 AND there is a match of literals with "murder",
"manslaughter", or "homicide" from Lookup Table THEN VIOLENT_TYPE = 2
(MURDER/MANSLAUGHTER/HOMOCIDE)
IF CONTROLLING_TYPE = 1 AND there is NO match of literals with "rape", "murder",
"manslaughter", or "homicide" from Lookup Table THEN VIOLENT_TYPE = EMPTY

CJEA8 [IF CJE1 = 1 AND VIOLENT_TYPE = EMPTY] (INTERVIEWER: CLASSIFY
THIS OFFENSE, [CONTROLLING_OFFENSE], INTO ONE OF THE
CATEGORIES BELOW)
1

RAPE - Go to CJEA11

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2
3

MURDER/MANSLAUGHTER/HOMICIDE - Go to CJEA12
OTHER VIOLENT OFFENSE - Go to CJEA9

UPDATE VIOLENT_TYPE
IF CONTROLLING_TYPE = 1 AND there was NO match of literals with "rape" from
Lookup Table and CJEA8 = 1 THEN VIOLENT_TYPE = 1 (RAPE)
IF CONTROLLING_TYPE = 1 AND there was NO match of literals with "murder",
"manslaughter", or "homicide" from Lookup Table and CJEA8 = 2 THEN
VIOLENT_TYPE = 2 (MURDER/MANSLAUGHTER/HOMOCIDE)
IF CONTROLLING_TYPE = 1 AND there was NO match of literals with "rape", "murder",
"manslaughter", or "homicide" from Lookup Table and CJEA8 = 3 THEN
VIOLENT_TYPE = 3
CJEA9 [IF CJE1 = 1 AND VIOLENT_TYPE = 3] Was this person hurt or injured during the
[CONTROLLING_OFFENSE]?
1
Yes Go to CJEA10
2
No Go to CJEA12
DK Go to CJEA12
REF Go to CJEA12
CJEA10[IF CJEA9 = 1] What were the injuries? Any other injuries? (CHECK ALL THAT
APPLY)
1
2
3
4
5
6
7
8
8
9
DK
REF

VICTIM DIED
VICTIM RAPED OR SEXUALLY ASSAULTED
KNIFE OR STAB WOUND
GUN S HOT, BULLET WOUNDS
B R OK EN B O N ES
TEETH KNOCKED OUT OR CHIPPED
I N T ER N A L I N J U R IES
KNOCKED UNCONSCIOUS
BRUISES, BLACK EYE, CUTS, SCRATCHES, SWELLING
OTHER (S5Q4B_OTH) SPECIFY:___________________

All Skip to CJEA12
CJEA11 [CJE1 = 1 AND (VIOLENT_TYPE = 3 OR CJEA9 = 2]
During the rape, how was the victim hurt or injured? Any
other injuries? (CHECK ALL THAT APPLY)
1

KNIFE OR STAB WOUND

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2
GUN SHOT, BULLET WOUNDS
3
BROKEN BONES, TEETH KNOCKED OUT, OR CHIPPED TEETH
4
INTERNAL INJURIES
5
KNOCKED UNCONSCIOUS
6
BRUISES, BLACK EYE, CUTS, SCRATCHES, SWELLING
7
OTHER(CJEA11_OTH) SPECIFY:___________________
8
NOT PHYSICALLY INJURED
DK/REF
(DO NOT ALLOW 1-7 WITH AN 8 ENTRY)
CJEA12 [IF CJE1 = 1] In your opinion, was the victim drinking alcohol or on drugs at the
time of the offense?
1
YES Go to CJEA13
2
NO
Go to CJE2
DK/REF
CJEA13. Keep previous question on screen Which was it?
1
Alcohol
2
Drugs
3
Both
4
Alcohol or on drugs -could not tell
which
DK/REF
All Skip to CJE2
______________________________END Victims Block – Single Victim (EA)
EB –Victims Block – Multiple Victims
Block Level Universe: (CJ9 = 1 AND CONTROLLING_TYPE = 1 AND CJE1 = 2)

CJEB1[IF CJE1 = 2] How many persons were
victims?
[TESTED IN COGNITIVE INTERVIEWING]
___ Persons (Range 2-20) DK/REF
CJEB2 [IF CJE1 = 2] Were these persons victims of a single incident or more than one
incident of the crime?
[TESTED IN COGNITIVE INTERVIEWING]
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
(1)
(2)

ONE INCIDENT
MULTIPLE INCIDENTS

CJEB3.[IF CJEI = 2] Were any of the persons of Spanish, Latino, or Hispanic origin?
Yes
No - Go t o C JEB5
(DK/REF - Go to CJEB5
(1)

(2)

CJEB4 [IF CJEB3 = 1] Were all the persons Hispanic, were most of them Hispanic, were equal
numbers of them Hispanic and non-Hispanic, or were most of them non-Hispanic?
All were Hispanic
Most were Hispanic
( 3 ) They were evenly divided
( 4 ) Most were non-Hispanic
DK/REF
(1)
(2)

Comment [CS4]: Question wording enhanced.

CJEB5 [IF CJE1 = 2] What race or races were the persons? You may answer yes to one or more
of these categories.
(1) White?
(2) Black or African American?
(3) American Indian or Alaska Native?
(4) Asian?
(5) Native Hawaiian or Other Pacific Islander?
DK/REF
I f i n m a t e r e p o r t s o n l y o n e r a c e g o to CJEB7, otherwise go to CJEB6
CJEB6 [IF CJEB5 = MORE THAN 1 RESPONSE] What race were most of the persons?
(1) Mostly White
(2) Mostly Black or African American
(3) Mostly American Indian or Alaska Native
(4) Mostly Asian
(5) Mostly Native Hawaiian or Other Pacific Islander
DK/REF
CJEB7 [IF CJE1 = 2] Were the persons male or female?
All male - Go to CJEB9
All female - Go to CJEB9
( 3 ) Both male and female - Go to CJEB8
DK/REF - Skip to CJEB9
(1)
(2)

CJEB8 [IF CJEB7 = 3] Were most of the persons male or female?
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Mostly male
Mostly female
(3) They were evenly divided
DK/REF
(1)
(2)

CJEB9[IF CJE1 = 2] Approximately, how old would you say the youngest person was?
1
Under 12 years
2
12 to 17
3
18 to 24
4
25 to 34
5
35 to 54
6
55 or older
DK/RE
F
CJEB10 [IF CJE1 = 2] Approximately, how old would you say the oldest person was?
1
Under 12 years
2
12 to 17
3
18 to 24
4
25 to 34
5
35 to 54
6
55 or older
DK/RE
F
CJEB11 [IF CJE1 = 2] Were any of the persons known to you or were they all strangers
you had never seen before?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3

All known
Some known
All strangers DK/REF

CJEB12 [IF CJEB11 = 1 OR 2] How well did you know the persons? Did you know any
of them…
[TESTED IN COGNITIVE INTERVIEWING]

CJEB12a. By sight only?
CJEB12b As casual acquaintances?
CJEB12c Well known?

Section 2 – Criminal Justice

Yes
1
1
1

No
2
2
2

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJEB13
[IF CJEB12b = 1 OR CJEB12c = 11 At the time of the crime, what was the
relationship to you of the well-known persons and/or the casual acquaintances?
For example, friends, relatives, etc.
(CHECKALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3
4
5
6
7
8
9
10
11

SPOUSE
EX- SPOUSE
PARENT/STEP-PARENT
OWN CHILD
ST E PC HI LD
BROTHER/SISTER/STEPBROTHER/STEPSISTER
OTHER RELATIVE – (S5Q9C7_OTH)SPECIFY_______
BOYFRIEND/GIRLFRIEND
EX-BOYFRIEND/EX-GIRLFRIEND
FRIEND/EX-FRIEND
OTHER (CJEB13_OTH) SPECIFY:________________

DEFINE VIOLENT_TYPE
IF CONTROLLING_TYPE = 1 AND there is a match of literals with "rape" from Lookup
Table THEN VIOLENT_TYPE = 1 (RAPE)
IF CONTROLLING_TYPE = 1 AND there is a match of literals with "murder",
"manslaughter", or "homicide" from Lookup Table THEN VIOLENT_TYPE = 2
(MURDER/MANSLAUGHTER/HOMOCIDE)
IF CONTROLLING_TYPE = 1 AND there is NO match of literals with "rape", "murder",
"manslaughter", or "homicide" from Lookup Table THEN VIOLENT_TYPE = EMPTY

CJEB14 [IF CJE1 = 2 AND VIOLENT_TYPE = EMPTY] (INTERVIEWER: CLASSIFY
THIS OFFENSE, [CONTROLLING_OFFENSE], INTO ONE OF THE
CATEGORIES BELOW)
1
2
3

RAPE - Go to CJEB17
MURDER/MANSLAUGHTER/HOMICIDE - Go to CJEB18
OTHER VIOLENT OFFENSE - Go to CJEB15

UPDATE VIOLENT_TYPE
IF CONTROLLING_TYPE = 1 AND there was NO match of literals with "rape" from
Lookup Table and CJEB14 = 1 THEN VIOLENT_TYPE = 1 (RAPE)
IF CONTROLLING_TYPE = 1 AND there was NO match of literals with "murder",
"manslaughter", or "homicide" from Lookup Table and CJEB14 = 2 THEN
VIOLENT_TYPE = 2 (MURDER/MANSLAUGHTER/HOMOCIDE)
IF CONTROLLING_TYPE = 1 AND there was NO match of literals with "rape", "murder",
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
"manslaughter", or "homicide" from Lookup Table and CJEB14 = 3 THEN
VIOLENT_TYPE = 3
CJEB15 [IF CJE1 = 2 AND VIOLENT_TYPE = 3] Were any of the victims hurt or injured
during the [CONTROLLING_OFFENSE]
1
Yes
2
No Go to CJEB18
DK/REF - Go to CJEB18
CJEB16[IF CJEB15 = 1] What were the injuries? Any other injuries?
(CHECK ALL THAT APPLY)
1
VICTIM DIED
2
VICTIM RAPED OR SEXUALLY ASSAULTED
3
KNIFE OR STAB WOUND
4
GUN SHOT, BULLET WOUNDS
5
BROKEN BONES, TEETH KNOCKED OUT, OR CHIPPED TEETH
6
INTERNAL INJURIES
7
KNOCKED UNCONSCIOUS
8
BRUISES, BLACK EYE, CUTS, SCRATCHES, SWELLING
9
OTHER (CJEB16_OTH) SPECIFY:________________
DK/REF
CJEB17 [IF CJEB14= 1 OR CJEB16 = 2]
During the rape, how were the victims hurt or injured? Any other injuries?
MARK ALL THAT APPLY
1
KNIFE OR STAB WOUND
2
GUN SHOT, BULLET WOUNDS
3
BROKEN BONES, TEETH KNOCKED OUT, OR CHIPPED TEETH
4
INTERNAL INJURIES
5
KNOCKED UNCONSCIOUS
6
BRUISES, BLACK EYE, CUTS, SCRATCHES, SWELLING
7
OTHER(CJEB17_OTH) SPECIFY:___________________
8
NOT PHYSICALLY INJURED
DK/REF
(DO NOT ALLOW 1-7 WITH AN 8 ENTRY)

CJEB18 [CJE1 = 2] In your opinion, were any of the victims under the influence of
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
alcohol or drugs at the time of the offense?
1
YES Go to CJEB19
2
NO
Go to CJE2
DK/REF Go to CJE2

CJEB19 [CJEB18= 1] Keep previous question on screen Which was it?
1
Alcohol
2
Drugs
3
Both
4
Alcohol or drugs - could not tell which
DK/REF
All Skip to CJE2
______________________________END Victims Block – Multiple Victims (EB)

CJE2 [CJE1 = 1 OR 2] Other than the victim(s), was there anyone else with you when the
crime occurred?
(1)
(2)
(3)

YES
NO - Skip to CJ48
RESPONDENT NOT AT SITE OF CRIME - Skip to CJ48

CJE3 [CJE2 = 1] How many others were with you?
____Persons (Range 1-20)

CJE4 [CJE3 = 1-20] Were any of them also charged with the crime?
1
2

YES
NO

All skip to CJ48

______________________________END Violent Crime and Victims Block (E)
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F – Property Crime Block
Block Level Universe: (CJ9 = 1 AND CONTROLLING_TYPE = 2)

CJF1[CJ9 = 1 AND CONTROLLING_TYPE = 2] Did you acquire or receive any money,
checks, or bank deposits, as a result of the [CONTROLLING_OFFENSE] for which
you are now serving time in prison?
1
YES
2
NO Go to S5Q12c
DK/REF
Go to S5Q12c
CJF2 [CJF1 = 1] How much did you obtain?
$____ (1-100,000)
DK/REF
CJF3 [CJ9 = 1 AND CONTROLLING_TYPE = 2] Did you acquire or receive any goods
or property other than money as a result of the [CONTROLLING_OFFENSE]?
1
YES Go to CJF4
2
NO Go to CJF5
DK/REF
Go to CJF5

CJF4[CJF3 = 1] What did you obtain? (CHECK ALL THAT APPLY)
1
PURSE OR WALLET
2
CREDIT CARDS
3
MOTOR VEHICLE
4
MOTOR VEHICLE PARTS
5
HOUSEHOLD OR PERSONAL PROPERTY
6
COMMERCIAL GOODS
7
FI R E A R M S
8
DRUGS
9
OTHER PROPERTY (CJF4_OTH) Specify:_________
DK/REF

(1)

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H_CJF4 (HELP Screen for CJF4)
PROPERTY OBTAINED
Motor vehicle - An entire car, truck, van, boat, snow mobile, or other vehicle. A vehicle
is stolen, even if later recovered.
Motor vehicle parts - A part of the vehicle (see above). If a vehicle is stolen and then
recovered with a part missing, e.g., the stereo, both “motor vehicle” and “motor vehicle
part” should be checked.
Household or personal property - Includes any property owned by the victim(s)
personally (except for money, purses, wallets, motor vehicles, and credit cards which
are included in a separate question or other categories) or by the household, e.g.,
computer, TVs, camera.
Commercial goods - Property owned by a store or other business or governmental
enterprise.
Firearms - Guns. Toy guns would be included under household or personal property.
CJF5 [CJ9 = 1 AND CONTROLLING_TYPE = 2] Did you damage anything that
belonged to someone else?
1
YES Go to CJF6
2
NO Go to CJF7
DK/REF
Go to CJF7

CJF6 [CJF5 = 1]. What did you damage? (CHECKALL THAT APPLY)
1
2
3
4
5

HOME OR APARTMENT BUILDING/GARAGE
MOTOR VEHICLE
PERSONAL EFFECTS OF VICTIM
GOVERNMENT/BUSINESS/PUBLIC/COMMERCIAL
BUILDING OR PROPERTY
OTHER (CJF6_OTH) Specify:____________

H_CJF5
PROPERTY DAMAGED
Home or apartment building/garage - Includes dwelling units or adjacent buildings
Motor vehicle - An entire car, truck, van, boat, snow mobile, or other vehicle
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Personal effects of victim - Any personal property owned or possessed by the victim
other than the building in which the victim lives or an adjacent building.
Government/business/public/commercial building or property - Any property,
including buildings, goods, inventories, or other things owned or possessed by a
governmental unit, business or other commercial enterprise, or the public.

CJF7 Before your conviction for [CONTROLLING_OFFENSE], did you have a job
where you were responsible for or had access to money, property, or
opportunities which could be turned into money?
1

YES Go to CJF8

2

NO

DK/REF

Go to CJ48
Go to CJ48

CJF8 [CJF7 = 1] Were you able to commit the [CONTROLLING_OFFENSE]
because of that money, property or opportunities given by your job?
1

YES

2

NO

DK/REF
Go to CJ48

______________________________END Property Crime Block (F)
G – Drug Crime Block
Block Level Universe: (CJ9 = 1 AND CONTROLLING_TYPE = 3)

CJG1 [CJ9 = 1 AND CONTROLLING_TYPE = 3] (INTERVIEWER: ARE ANY OF THE
OFFENSES BELOW “POSESSION” OF A DRUG?)
[CONTROLLING_OFFENSE]
1
2
NO Go to CJG3
NO DK/REF ENTRIES ALLOWED
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YES Go to CJG2

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CJG2[CJG1 = 1] You said that you were convicted for drug possession. Was that
possession with intent to distribute drugs?
[TESTED IN COGNITIVE INTERVIEWING]
1

YES

2

NO

DK/REF

CJG3 [CJG1 = 1 OR CJG2 = 1]
You said that you were convicted for [CONTROLLING_OFFENSE] What drugs
were involved? Any others?
(CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3
4
5
6
7
8
9
10

MARIJUANA OR HASHISH
COCAINE
CRACK
HEROIN
PCP (ANGEL DUST” OR PHENCYCLIDINE)
ECSTACY (MDMA)
OTHER HALLUCINOGENS (LSD, PEYOTE, MESCALINE, OR
PSILOCYBIN, FOUND IN MUSHROOMS)
METHAMPHETAMINE (METH, CRYSTAL, OR CRANK)
PRESCRIPTION MEDICATIONS
OTHER (CJG3_OTH) Specify:__________________

CJG3a [CJG3 = 1] Approximately what amount of marijuana or hashish was involved?
____Joints (Range 1-100, blank)
____Grams (Range 1-1000, blank)
____Kilograms (Range 1-1000, blank)
____Ounces (Range 1-16, blank)
____Pounds (Range 1-500000, blank)
____Tons (Range 1-1000, blank)
____
Other (CJG3a_OTH) Specify:______________

DK/REF

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CJG3b [CJG3 = 2] Approximately what amount of cocaine was involved?
____Milligrams (Range 0.00-200, blank)
____Grams (Range 0.00-1000, blank)
____Kilograms (Range 0.00-500, blank)
____Ounces (Range 0.00-32, blank)
____Pounds (Range 0.00-5, blank)
____Rocks (Range 0.00-200, blank)
____
Other (CJG3b_OTH) Specify:______________
DK/REF

CJG3c [CJG3 = 3] Approximately what amount of crack cocaine was involved?
____Milligrams (Range 0.00-200, blank)
____Grams (Range 0.00-1000, blank)
____Kilograms (Range 0.00-500, blank)
____Ounces (Range 0.00-32, blank)
____Pounds (Range 0.00-5, blank)
____Rocks (Range 0.00-200, blank)
____
Other (CJG3c_OTH) Specify:______________
DK/REF
CJG3d [CJG3 = 4] Approximately what amount of heroin was involved?
[TESTED IN COGNITIVE INTERVIEWING]
____Milligrams (Range 0.00-500, blank)
____Grams (Range 0.00-900, blank)
____Kilograms (Range 0.00-100, blank)
____Ounces (Range 0.00-32, blank)
____Pounds (Range 0.00-20, blank)
____Tons (Range 0.00-2, blank)
____ Other (CJG3d_OTH) Specify:______________
DK/REF

CJG3e [CJG3 = 5] Approximately what amount of PCP was involved?
____Pills/capsules (Range 1-1000, blank)
____Grams (Range 1-1000, blank)
____Kilograms (Range 1-10, blank)
____Ounces (Range 1-16, blank)
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____Pounds (Range 1-5, blank)
____Liters (Range 1-3)
____Gallons (Range 1-5)
____
Other (CJG3E_OTH) Specify:______________
DK/REF
CJG3f [CJG3 = 6] Approximately what amount of ecstasy was involved?
____Pills (Range 0.00-1000, blank)
____Grams (Range 0.00-1000, blank)
____Kilograms (Range 0.00-10 blank)
____Ounces (Range 0.00-16, blank)
____Pounds (Range 0.00-5, blank)
____Liters (Range 0.00-10, blank)
____Gallons (Range 0.00-5, blank)
____
Other (CJG3f_OTH) Specify:______________
DK/REF
CJG3g [CJG3 = 7] Approximately what amount of other hallucinogens (LSD, PEYOTE,
MESCALINE, OR PSILOCYBIN, FOUND IN MUSHROOMS) was involved?
____Pills (Range 1-3500)
____Papers, squares, windowpanes, cubes (Range 1-3000)
____Grams (Range 0.00-1000, blank)
____Kilograms (Range 0.00-10 blank)
____Ounces (Range 0.00-16, blank)
____Pounds (Range 0.00-5, blank)
____Liters (Range 1-3)
____Gallons (Range 1-5)
____
Other (CJG3g_OTH) Specify:______________
DK/REF
CJG3h [CJG3 = 8] Approximately what amount of methamphetamine or amphetamine
was involved?
____Milligrams (Range 0.00-200, blank)
____Grams (Range 0.00-1000, blank)
____Kilograms (Range 0.00-500, blank)
____Ounces (Range 0.00-32, blank)
____Pounds (Range 0.00-5, blank)
____Rocks (Range 0.00-200, blank)
____
Other (CJG3h_OTH) Specify:______________
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DK/REF
CJG3i [CJG3 = 9] Approximately what amount of prescription medications was
involved?
____Pills (Range 0.00-1000, blank)
____Grams (Range 0.00-1000, blank)
____Kilograms (Range 0.00-10 blank)
____Ounces (Range 0.00-16, blank)
____Pounds (Range 0.00-5, blank)
____Liters (Range 0.00-10, blank)
____Gallons (Range 0.00-5, blank)
____
Other (CJG3i_OTH) Specify:______________
DK/REF
CJG3j [CJG3 = 10] Approximately what amount of [CJG3_OTH]
was involved?
____Pills (Range 0.00-1000, blank)
____Grams (Range 0.00-1000, blank)
____Kilograms (Range 0.00-10 blank)
____Ounces (Range 0.00-16, blank)
____Pounds (Range 0.00-5, blank)
____Liters (Range 0.00-10, blank)
____Gallons (Range 0.00-5, blank)
____
Other (CJG3j_OTH) Specify:______________
DK/REF

CJG4 [CJ9 = 1 AND CONTROLLING_TYPE = 3] The next few questions are
about-drug related activities you may have been involved with. At the
time of your arrest for [CONTROLLING_OFFENSE] were you –
Yes
No
CJG4a Importing or helping others import illegal
1
2
drugs into the United States?
CJG4b Illegally manufacturing, growing or helping
1
2
others manufacture or grow drugs?
CJG4c Laundering drug money?
1
2
CJG4d Distributing or helping to distribute drugs to
1
2
dealers?
CJG4e Selling or helping to sell drugs to others for
1
2
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
their use?
CJG4g Using or possessing illegal drugs?

1

2

Yes
1
1

No
2
2

1

2

1
1
1

2
2
2

CJG5 [IF CJG4d or CJG4e = 1] Were you ...
[TESTED IN COGNITIVE INTERVIEWING]
[AND CJG4a ≠ 1] CJG5a A street-level dealer?
[AND CJG4a ≠ 1] CJG5b A dealer above the streetlevel dealer?
[AND CJG4a ≠ 1] CJG5c A bodyguard, strongman or
debt collector?
[AND CJG4a ≠ 1] CJG5d A go-between or broker?
[AND CJG4a ≠ 1] CJG5e A money runner?
[AND CJG4a = 1] CJG5f A courier, mule or loader?

DEFINE DRUGDEAL_FILL:
IF CJG5a = 1 THEN DRUGDEAL_FILL = “a street level dealer,”
IF CJG5b = 1 THEN DRUGDEAL_FILL = “a dealer above the street level,”
IF CJG5c = 1 THEN DRUGDEAL_FILL = “a bodyguard, strong man or debt collector,”
IF CJG5d = 1 THEN DRUGDEAL_FILL = “a go-between or broker,”
IF CJG5e = 1 THEN DRUGDEAL_FILL = “a money runner,”
IF CJG5f = 1 THEN DRUGDEAL_FILL = “a courier, mule or loader,”
Fill with all selected

IF all = “No,” skip to CJG7
CJG6 [When you were [DRUGDEAL_FILL] what drugs were involved? Any
others? (CHECK ALL THAT APPLY)
1
2
3
4
5
6
7
8
9
10

MARIJUANA OR HASHISH
COCAINE
CRACK
HEROIN
PCP (“ANGEL DUST” OR PHENCYCLIDINE)
ECSTACY (MDMA)
OTHER HALLUCINOGENS (LSD, PEYOTE, MESCALINE, OR
PSILOCYBIN, FOUND IN MUSHROOMS)
METHAMPHETAMINE (METH, CRYSTAL, OR CRANK)
PRESCRIPTION MEDICATIONS
OTHER (CJG6_OTH) Specify:__________________

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CJG7 In the 12 months prior to the arrest or charge that led to your current
incarceration[DATE_ARREST] were you a part of any group or organization
that engaged in drug manufacturing, importing, distribution or selling?
1
2

YES Go to CJG8
NO- Skip to CJ48

CJG8 [IF CJG7 = 1] Altogether, about how many people would you say regularly
participated in that group or organization?
____ Number of people
(Range 1-50)
CJG9 [IF CJG7 = 1] Which of these best describes your role in that group or
organization–
1
A leader or organizer?
2 A middle man?
3 An underling, such as a carrier, runner, etc?
4 A s el l er ?
5 Ot h er ( CJ G 9 _ OTH ) SPECI FY: _ _ _ _ _ _ _ _ _ _ _ _
CJG10 [IF CJG7 = 1] With what drugs was the group or
organization involved? Any others? (CHECK
ALL THAT APPLY)
1
2
3
4
5
6
7
8
9
10

MARIJUANA OR HASHISH
COCAINE
CRACK
HEROIN
PCP (ANGEL DUST” OR PHENCYCLIDINE)
ECSTACY (MDMA)
OTHER HALLUCINOGENS (LSD, PEYOTE, MESCALINE, OR
PSILOCYBIN, FOUND IN MUSHROOMS)
METHAMPHETAMINE (METH, CRYSTAL, OR CRANK)
PRESCRIPTION MEDICATIONS
OTHER (CJG10_OTH) Specify:__________________

______________________________END Drug Crime Block (G)

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All Inmates
CJ48 At the time of the arrest or charge [DATE_ARREST] that led to your current
incarceration in what country did you live?
1
United States Go to CJ49
2
OTHER (CJ48_OTH) SPECIFY ______________________ Go to CJ52
_
CJ49 [IF CJ48 = 1] At the time of the arrest or charge [DATE_ARREST] that led to your
current incarceration in what state and city or town did you live?
CJ49a. City/Town ______________________
CJ49b State_____ ENTER (h) FOR VALID 2 CHARACTER STATE
CODES
DK/REF Go to CJ52
Store the numeric State FIPS Codes listed below
01 ... AL
17 ...IL
30 ... MT
44 . . RI
02 ... AK
18 ...IN
31 ... NE
45 . . SC
04 ... AZ
19 ...IA
32 ... NV
46 . . SD
05 ... AR
20 ...KS
33 ... NH
47 .. TN
06 ... CA
21 ...KY 34 ... NJ
48 .. TX
08 ... CO
22 ...LA 35 ... NM
49 .. UT
09 ... CT
23 ...ME 36 ... NY
50 .. VT
10 ... DE
24 ...MD 37 ... NC
51 . . VA
11 ... DC
25 ...MA 38 ... ND
53 . . WA
12 ... FL
26 ...MI
39 ... OH
54 . . WV
13 ... GA
27 ...MN 40 ... OK
55 . . WI
15 ... HI
28 ...MS 41 ... OR
56 . . WY
16 ... ID
29 ...MO 42 ... PA
66 . . PR (Puerto
Rico)
CJ49a [IF CJ48 = 1] At the time of the arrest or charge [DATE_ARREST] that led to your
current incarceration what was the zip code where you were living?
Zip Code _______
If CJ9 = 1 AND CJ48 =1 Go to CJ50
Else Go to CJ52
CJ50 [IF CJ9 = 1 AND CJ48 = 1] Did the [CONTROLLING_OFFENSE] occur in [Fill
City from CJ49a] [Fill State from CJ49b]?
(1)
(2)

Yes -Skip to CJ52
No
Go to CJ51

CJ51 [IF CJ50 = 2] In what city and state did the (Insert controlling offense) occur?
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City/Place
State_____ENTER (h) FOR VALID 2 CHARACTER STATE CODES
CJ52 Were you acting alone when you committed the [CONTROLLING_OFFENSE] or was
someone or more than one person helping you?
1
2

ACTING ALONE
Go to CJ57
SOMEONE OR MORE THAN ONE PERSON WAS HELPING Go to CJ53

CJ53 [IF V1 = 2] How many people were helping you commit the
[CONTROLLING_OFFENSE]?
1
ONE Go to CJ54
2
TWO OR MORE
DK/REF
Go to CJ57

Go to CJ54

DEFINE PEOPLE_FILL
IF CJ53 = 1 THEN PEOPLE_FILL = “person who was”
IF CJ53 = 2 THEN PEOPLE_FILL = “people who were”
CJ54 [IF CJ53 = 1 OR 2] Did the [PEOPLE_FILL] helping you commit the
[CONTROLLING_OFFENSE] get charged with a crime?
1
YES
2
NO
DK/REF

AND CJ53 = 1 go to CJ56, AND CJ53 = 2 go to CJ54a
Go to CJ57
Go to CJ57

CJ54a [IF CJ54 = 1 AND CJ53 = 2] How many of the people who were helping you commit the
[CONTROLLING_OFFENSE] got charged with a crime?
1
One Go to CJ56
2
Two or more Go to CJ55
DK/REF
Go to CJ57

CJ55 [IF CJ54a = 2] How many of the people who were helping you commit the (Insert
controlling offense) got sentenced to serve time in prison or jail?
1
One
2
Two or more
Go to V5
CJ56 [IF CJ54 = 1 OR CJ54a = 1] Did the person who was helping you commit the (Insert
controlling offense) get sentenced to serve time in prison or jail?
1

Yes

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2
No
Go to V5

CJ57 Did you carry, possess, or use a weapon when the [CONTROLLING_OFFENSE]
occurred?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

YES
NO

Go to CJH1
Go to CJ58

H – Weapons Block
Block Level Universe: (CJ57 = 1)

CJH1
[IF CJ57 = 1] How many weapons did you carry, possess, or use when
the [CONTROLLING_OFFENSE] occurred?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

ONE
TWO OR MORE

DEFINE WEAPONS_FILL:
IF CJH1 = 1 THEN WEAPONS_FILL = “kind of weapon was it”
IF CJH1 = 2 THEN WEAPONS_FILL = “kinds of weapons were they”

CJH2

1
2
3
4
5
6

[IF CJ57 = 1] What [WEAPONS_FILL]? (CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
FIREARM Go to CJH3
TOY OR BB GUN (INCLUDE FAKE OR NON_FIRING
GUNS)
KNI FE
OTHER SHARP OBJECT (SCISSORS, ICE PICK, AX, ETC)
BLUNT OBJECT (ROCK, CLUB, BLACKJACK, ETC.)
ANOTHER WEAPON (CJH2_OTH) SPECIFY__________________

DEFINE CJH2_FILL:
IF CJH2 = 1 THEN CJH2_FILL = “firearm”
IF CJH2 = 2 THEN CJH2_FILL = “toy or bb gun”
IF CJH2 = 3 THEN CJH2_FILL = “knife”
IF CJH2 = 4 THEN CJH2_FILL = “sharp object”
IF CJH2 = 5 THEN CJH2_FILL = “blunt object”
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IF CJH2 = 6 AND CJH2_OTH ne EMPTY THEN CJH2_FILL = open-ended response from
CJH2_OTH

CJH3G4 [IF CJH1 = 2 and CJH2 = 1] How many firearms did you carry,
possess, or use when the (Insert controlling offense) occurred?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3
4

ONE
TWO TO THREE
FOUR TO FIVE
MORE THAN FIVE

DEFINE FIREARM_FILL1:
IF (CJH1 = 1 AND CJH2 = 1) OR G4 = 1 THEN FIREARM_FILL1 = “type of firearm was it”
IF G4 = 2 OR 3 OR 4 THEN FIREARM_FILL1 = “types of firearms were they”
DEFINE FIREARM_FILL2:
IF (CJH1 = 1 AND CJH2 = 1) OR G4 = 1 THEN FIREARM_FILL2 = “the firearm”
IF G4 = 2 OR 3 OR 4 THEN FIREARM_FILL2 = “any of the firearms”

CJH4G5

1
2
3
4

[IF CJH2 = 1] What [FIREARM_FILL1]? (CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
A HANDGUN?
A RIFLE?
A SHOTGUN?
SOME OTHER TYPE OF FIREARM?
(CJH4_OTH)Specify___________

DEFINE HANDGUN_FILL:
IF CJH4 = 1 AND G4 = 1 THEN HANDGUN_FILL = “Was the handgun”
IF CJH4 = 1 AND G4 = 2 OR 3 OR 4 THEN HANDGUN_FILL = “Were any of the handguns”
DEFINE RIFLE_FILL:
IF CJH4 = 2 AND G4 = 1 THEN RIFLE_FILL = “Was the rifle”
IF CJH4 = 2 AND G4 = 2 OR 3 OR 4 THEN RIFLE_FILL = “Were any of the rifles”
DEFINE SHOTGUN_FILL:
IF CJH4 = 3 ANS G4 = 1 THEN SHOTGUN_FILL = “Was the shotgun”
IF CJH4 = 3 AND G4 = 2 OR 3 OR 4 THEN SHOTGUN_FILL = “Were any of the shotguns”
DEFINE GUNTYPE_FILL:
IF CJH4 = 1 THEN GUNTYPE_FILL = “handgun”
IF CJH4 = 2 THEN GUNTYPE_FILL = “rifle”
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IF CJH4 = 3 THEN GUNTYPE_FILL = “shotgun”
IF CJH4_OTH ≠ Empty THEN GUNTYPE_FILL = verbatim from CJH4_OTH
Include all, separated by commas for example: “handgun, rifle, shotgun”

CJH5 [IF CJH4 = 1] [HANDGUN_FILL] ...
CJH5a a revolver or pistol?
CJH5b a conventional semiautomatic pistol?
CJH5c a submachine gun-style semiautomatic pistol?
CJH5d a fully automatic pistol?
CJH5e another type of pistol?
(CJH5_OTH) SPECIFY ______________________

Yes
1
1
1
1
1

No
2
2
2
2
2

Yes
1

No
2

1

2

1
1
1

2
2
2

Yes
1

No
2

1
1

2
2

1

2

CJH6 [IF CJH4 = 2] [RIFLE-FILL] ...
CJH6a a bolt-action, pump-action, lever-action or
single-shot rifle?
CJH6b a modern military-style semiautomatic rifle
(e.g., AK-47, SKS, AR-15)?
CJH6c another semiautomatic rifle?
CJH6d a fully-automatic rifle?
CJH6e another type of rifle?
(CJH6_OTH) SPECIFY ______________________

CJH7 [IF CJH4 = 2] [SHOTGUN_FILL] ...
CJH7a a bolt-action, pump-action, lever-action,
double-barreled, or single-shot shotgun?
CJH7b a semiautomatic shotgun?
CJH7c a revolving cylinder shotgun, such as a Street
Sweeper or Striker 12?
CJH7d another type of shotgun?
(CJH7_OTH) SPECIFY ______________________

CJH8 [IF CJH2 = 1] Did you show or point [FIREARM_FILL2] at anyone during the (Insert
controlling offense)?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

YES
NO

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CJH9

[IF CJH2 = 1] Did you fire [FIREARM_FILL2] during the
[CONTROLLING_OFENSE]
[TESTED IN COGNITIVE INTERVIEWING]
1
2

CJH10

YES
NO

Go to CJH10
Go to CJH12

[IF CJH9 = 1] Did you shoot anyone?
1
2

CJH11

YES
NO

Go to CJH11
Go to CJH12

[IF CJH10 = 1] Did anyone you shot die?
1
YES
2
NO
Go to CJH12

CJH12

[IF CJH2 = 1] How did you obtain the [GUNTYPE_FILL] that you carried,
possessed, or used during the (Insert controlling offense)? (CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3
4
5
6
7
8
9
10

STOLE IT
RENTED IT
BORROWED FROM OR WAS HOLDING FOR SOMEBODY
TRADED SOMETHING FOR IT
BOUGHT IT Go to G14
SOMEONE BOUGHT IT FOR ME Go to G16
SOMEONE GAVE IT TO ME AS A GIFT
FOUND IT/WAS AT LOCATION WHERE OFFENSE OCCURRED
WAS BROUGHT BY SOMEONE ELSE
Other – (G12_OTH) Specify:_______________________

[IF CJH2 = 1AND (CJH12 ≠ 6 OR 7 OR 8 OR 9 OR 10)] Where did you
obtain the [GUNTYPE_FILL]? (CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]

CJH13

1
2
3

GUN SHOP OR GUN STORE
PAWN SHOP
FLEA MARKET

Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
4
5
6
7
8
9
10

CJH14

GUN SHOW
FROM THE VICTIM(S)
FROM A FRIEND OR FAMILY MEMBER
FROM A FENCE/BLACK MARKET SOURCE
OFF THE STREET/FROM A DRUG DEALER
IN A BURGLARY
OTHER – (G13_OTH) Specify:____________________________

[IF CJH12 = 6] Where did that person buy the [GUNTYPE_FILL]?
1
2
3
4
5
6
7
8
9

CJH15

GUN SHOP OR GUN STORE
PAWN SHOP
FLEA MARKET
GUN SHOW
FROM THE VICTIM(S)
FROM A FRIEND OR FAMILY MEMBER
FROM A FENCE/BLACK MARKET SOURCE
OFF THE STREET/FROM A DRUG DEALER
OTHER – (G14_OTH) Specify:___________________________

1
2
3
4
5

[IF CJH12= 6] Why did someone buy the [GUNTYPE_FILL] for you? (CHECK
ALL THAT APPLY)

CJH16

COULD NOT TRAVEL TO WHERE THE SELLER WAS
NOT ALLOWED BECAUSE TOO YOUNG
NOT ALLOWED BECAUSE OF CRIMINAL RECORD
THEY COULD GET IT MORE QUICKLY OR EASILY
OTHER – (G15_OTH) Specify: __________________________

[IF CJH2 = 1] Did you get the [GUNTYPE_FILL] because you were planning to
carry, possess, or use it during the (Insert controlling offense)?
1
2

YES
NO

CJH17 [CJH2 – 1-6] Did you use the [CJH2_FILL]...

CJH17a To scare the victim?
CJH17b To kill the victim?
CJH17c To get away?
Section 2 – Criminal Justice

Yes
1
1
1

No
2
2
2
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJH17d To protect yourself?
CJH17e In any other way?
(CJH17e_OTH) SPECIFY ____________________

1
1

2
2

______________________________END Weapons Block (H)
CJ58 At the time of the arrest or charge that led to this incarceration, were you a member of a
gang?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
Go to CJ59

CJ59. These next questions are about your experience with crime and the juvenile and adult
criminal justice systems over your lifetime. When answering these questions, please
think about your entire life and include things that you may have already told me about.
Comment [leg5]: In SPI 2004 was use “…for a
crime?”

How old were you the first time you were arrested for any offense?
[TESTED IN COGNITIVE INTERVIEWING]
AGE: ________________ [RANGE: 6 – CALCAGE]
Go to CJ60

CJ60 [IF CONTROLLING_TYPE NE 1] Have you ever been arrested for a violent offense?
Violent offenses include crimes like physical or sexual assault, rape, robbery,
manslaughter, murder, attempted murder, or kidnapping.
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJ60a
Go to CJ61

CJ60a [IF B4 = 1] Have you ever been convicted of a violent offense?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Section 2 – Criminal Justice

Go to CJ60b
Go to CJ61

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

CJ60b. [IF CJ60a = 1 OR CONTROLLING_TYPE NE 1Altogether, how many times in your
life have you been convicted of a violent offense? Please remember to include any
violent offenses you may have already told me about.
______ times
Go to CJ60c
CJ60c [IF CJ60a = 1 OR CONTROLLING_TYPE NE 1] Have you ever been convicted of a
felony violent offense?
1
2
CJ60d

Yes
No

Go to CJ60d
Go to CJ61

[IF CJ60c = 1] Altogether, how many times in your life have you been convicted of a
felony violent offense?
______ times
Go to CJ61

CJ61 [IF CONTROLLING_TYPE NE 2] Have you ever been arrested for a property offense?
Property offenses include crimes like burglary, larceny, theft, auto theft, bad checks,
fraud, forgery, arson, or possession of stolen goods.
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJ61a
Go to CJ62

CJ61a [IF CJ61 = 1] Have you ever been convicted of a property offense?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
CJ61b

Yes
No

Go to CJ61b
Go to CJ62

[IF CJ61a = 1 OR CONTROLLING OFFENSE IS PROPERTY] Altogether, how
many times in your life have you been convicted of a property offense? Please remember
to include any property offenses you may have already told me about.
______ times
Go to CJ61c

CJ61c [IF CJ61a = 1 OR CONTROLLING_TYPE = 2] Have you ever been convicted of a
felony property offense?
1
2

Yes
No

Section 2 – Criminal Justice

Go to CJ61d
Go to CJ62
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

CJ61d

[IF CJ61c = 1] Altogether, how many times in your life have you been convicted of a
felony property offense?
______ times
Go to CJ62

CJ62 [IF CONTROLLING_TYPE NE 3] Have you ever been arrested for a drug offense?
Drug offenses include crimes like possessing, selling, trafficking, importing, smuggling,
or manufacturing illegal drugs or drug paraphernalia.
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJ62a
Go to CJ63

CJ62a [IF CJ62 = 1] Have you ever been convicted of a drug offense?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
CJ62b

Yes
No

Go to CJ62b
Go to BCJ63

[IF CJ62a = 1 OR CONTROLLING_TYPE NE 3] Altogether, how many times in
your life have you been convicted of a drug offense? Please remember to include any
drug offenses you may have already told me about.
[TESTED IN COGNITIVE INTERVIEWING]
______ times
Go to CJ62c

CJ62c [IF CJ62a = 1 OR CONTROLLING_TYPE = 3] Have you ever been convicted of a
felony drug offense?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
CJ62d

Yes
No

Go to CJ62d
Go to CJ63

[IF CJ62c = 1] Altogether, how many times in your life have you been convicted of a
felony drug offense?
[TESTED IN COGNITIVE INTERVIEWING]
______ times
Go to CJ63

Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJ63 Altogether, how many times in your life have you been arrested for any offenses? Please
include any arrests you have already told me about and times when you may have been
arrested but not convicted.
[TESTED IN COGNITIVE INTERVIEWING]
______ times
Go to CJ64
CJ64 [IF CJ63 = 1+] Altogether, how many times in your life have you been convicted of a
felony offense?
[TESTED IN COGNITIVE INTERVIEWING]
______ times

CJ65 Altogether, how many times in your life have you been released from prison and been put
on parole or post-release supervision?
[TESTED IN COGNITIVE INTERVIEWING]
______ times
CJ66 [IF CJ65 = 1+] Altogether, how many times in your life have you had your parole or
post-release supervision revoked?
[TESTED IN COGNITIVE INTERVIEWING]
______ times

CJ67 Altogether, how many times in your life have you been sentenced to probation?
(INCLUDE SHOCK PROBATION)
[TESTED IN COGNITIVE INTERVIEWING]
______ times
CJ68 [IF CJ67 = 1+] Altogether, how many times in your life have you had your probation
sentence revoked?
[TESTED IN COGNITIVE INTERVIEWING]
______ times
CJ69 Have you ever been sentenced to serve time in a juvenile correctional facility?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Section 2 – Criminal Justice

Go to CJ70
Go to CJ73
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
CJ70 [IF CJ69 = 1] Altogether, how many different times in your life have you been sentenced
to serve time in a juvenile correctional facility?
[TESTED IN COGNITIVE INTERVIEWING]
______ times
Go to CJ71
CJ71 [IF CJ69 = 1] When was the first time you were admitted to a juvenile facility to serve a
sentence?
[TESTED IN COGNITIVE INTERVIEWING]
CJ71a. 2-DIGIT MONTH: _________ [RANGE: 1 – 12]
CJ71b. 2-DIGIT DAY: ____________ [RANGE: 1 – 31]
CJ71c. 4-DIGIT YEAR: ___________ [RANGE: 1915 – current year]
CJ71d [IF CJ69 = 1 AND CJ71c = DK/REF] How old were you the first time you were admitted
to a juvenile correctional facility to serve a sentence?
[TESTED IN COGNITIVE INTERVIEWING]
___________________ years-old
CJ72 [IF CJ69 = 1 AND CJ71a = DK/REF] What time of year was it? Was it winter, spring,
summer, or fall the first time you were admitted to a juvenile correctional facility to serve
a sentence?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3
4

WINTER
SPRING
SUMMER
FALL

CJ73 Have you ever been sentenced to serve time in a local or county jail?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJ74
Go to CJ78
FI NOTE:

This does not include times you may
have been in jail awaiting a prison
sentence.

CJ74 [IF CJ73 = 1] Altogether, how many different times in your life have you been sentenced
to serve time in a local or county jail?
[TESTED IN COGNITIVE INTERVIEWING]
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

______ times
Go to BCJ75
CJ75 [IF CJ73 = 1] When was the first time you were admitted to a local or county jail to serve
a sentence?
[TESTED IN COGNITIVE INTERVIEWING]
CJ75a. 2-DIGIT MONTH: _________ [RANGE: 1 – 12]
CJ75b. 2-DIGIT DAY: ____________ [RANGE: 1 – 31]
CJ75c. 4-DIGIT YEAR: ___________ [RANGE: 1915 – current year]
CJ76 [IF CJ73 = 1 AND IF CJ75c = DK/REF] How old were you the first time you were
admitted to a local or county jail to serve a sentence?
[TESTED IN COGNITIVE INTERVIEWING]
___________________ years-old
DK/REF
CJ77 [IF CJ73 = 1 AND IF CJ75a = DK/REF] What time of year was it? Was it winter, spring,
summer, or fall the first time you were admitted to a local or county jail to serve a
sentence?
[TESTED IN COGNITIVE INTERVIEWING]
1
WINTER
2
SPRING
3
SUMMER
4
FALL
DK/REF
CJ78 [IF CJ9 = 2 OR 3] Have you ever been sentenced to serve time in a state or federal
prison?
[TESTED IN COGNITIVE INTERVIEWING]
1
2

Yes
No

Go to CJ79
Go to NEXT MODULE

CJ79 [IF CJ78 = 1 OR Q1 = 1] Altogether, how many different times in your life have you
been sentenced to serve time in a state or federal prison?
[TESTED IN COGNITIVE INTERVIEWING]
______ times
Go to CJ80
CJ80 [IF CJ78 = 1 (OR CJ9 = 1 and CJ79 ≠ 1)] When was the first time you were admitted to a
state or federal prison to serve a sentence?
Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
[TESTED IN COGNITIVE INTERVIEWING]
CJ80a. 2-DIGIT MONTH: _________ [RANGE: 1 – 12]
CJ80b. 4-DIGIT YEAR: ___________ [RANGE: 1915 – current year]
CJ81 [IF CJ80b = DK/REF] How old were you the first time you were admitted to a state or
federal prison to serve a sentence?
[TESTED IN COGNITIVE INTERVIEWING]
___________________ years-old

CJ82 [IF BCJ80a = DK/REF] What time of year was it? Was it winter, spring, summer, or fall
the first time you were admitted to a state or federal prison to serve a sentence?
[TESTED IN COGNITIVE INTERVIEWING]
1
WINTER
2
SPRING
3
SUMMER
4
FALL
DK/REF

Section 2 – Criminal Justice

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Section 3 - Socioeconomic Characteristics (SES)

SES1

Earlier I asked you if you were of Spanish, [Latino/Latina], or Hispanic origin and
which category best described your race. Now I would like you to think about
how other people would describe you. Do you think other people would
describe you as Hispanic or [Latino/Latina]?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF

SES2

Now I would like you to think about how other people would describe your race.
Do you think they would describe you as…
[TESTED IN COGNITIVE INTERVIEWING]
1 White
2 Black or African American
3 American Indian or Alaska Native
4 Asian
5 Native Hawaiian or other Pacific Islander or
6 Something else
DK/REF

SES2a

[IF SES2 = 6] How do you think other people would describe your race?
___________________________________ [ALLOW 40 CHARACTERS]
DK/REF

SES3

These next questions are about your education, employment, and income.
Before your admission to prison for this incarceration
[DATE_ADMIT], what was the highest grade of school that you had
attended?
ELEMENTARY
(1 First
(2 Second
(3 Third
(4 Fourth
(5 Fifth
(6 Sixth
)(7 Seventh
(8 Eighth

HIGH SCHOOL
(9) Ninth
(10 Tenth
(11 Eleventh
(12 Twelfth

COLLEGE
(13 Freshman
(14 Sophomore
(15 Junior
(16 Senior
GRADUATE SCHOOL
(17 One year
(18) Two or more years

(ATTENDED SCHOOL IN ANOTHER COUNTRY/SYSTEM THAT IS NOT
Section 3 – Socioeconomic Characteristics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
COMPARABLE CODE AS 30)
DK/REF
_______________________________________________________
A – Education Block
Block Level Universe: (SES3 = 1-18)
SESA1

[IF SES3 = 1 – 18) Did you complete that year of school?
1
YES
2
NO
DK/REF

SESA2

[IF (SES3 = 1 – 11 AND SESA1 = 1) OR (SES3 = 12 AND SESA1 = 2)
Do you have a GED, that is, a high school equivalency certificate?
1
YES
2
NO
DK/REF

SESA3.

[IF (SES3 = 12 AND SESA1 = 1) OR SES3 = 13 – 18] Did you receive a
GED or a high school diploma for finishing high school?
1
GED
2
HIGH SCHOOL DIPLOMA
DK/REF

SESA4.

[IF SESA3 = 1] Did you earn your GED while you were incarcerated in a
prison or jail?
1
YES
2
NO
DK/REF

SESA5

[IF SES3 = 1 – 11 OR (SES3 = 12 AND SESA1 = 2)] People leave school
before completing their high school diploma for many different reasons. Why
did you leave school before completing your high school diploma? (CHECK
ALL THAT APPLY)
1
2
3
4
5
6

GOT A JOB
DIDN’T LIKE SCHOOL
COULDN’T GET ALONG WITH TEACHERS
COULDN’T GET ALONG WITH THE OTHER STUDENTS
[IF GENDER = FEMALE] WAS PREGNANT
BECAME THE MOTHER / FATHER OF A BABY

Section 3 – Socioeconomic Characteristics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
7
8
9
10
11
12
13
14
15
16
17
18

HAD TO SUPPORT HIS/HER FAMILY
SUSPENDED FROM SCHOOL
DID NOT FEEL SAFE AT SCHOOL
HAD TO CARE FOR A FAMILY MEMBER
EXPELLED FROM SCHOOL
FELT YOU DIDN’T BELONG AT SCHOOL
COULDN’T KEEP UP WITH YOUR SCHOOLWORK
GETTING POOR GRADES / FAILING SCHOOL
GOT MARRIED OR PLANNED TO GET MARRIED
CHANGED SCHOOLS AND DIDN’T LIKE YOUR NEW SCHOOL
COULDN’T WORK AND GO TO SCHOOL AT THE SAME TIME
THOUGHT HE/SHE WOULDN’T PASS THE STATE
COMPETENCY TEST
19
THOUGHT HE/SHE WOULDN’T BE ABLE TO COMPLETE THE
HS COURSEWORK REQUIREMENTS
20
THOUGHT IT WOULD BE EASIER TO GET A GED
21
MISSED TOO MANY SCHOOL DAYS
22
EXTENDED ILLNESS
23
SOME OTHER REASON (SESA5_OTH) SPECIFY:______________
DK/REF
______________________________END Education Block (A)
SES4

01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20

When you were growing up, what language or languages were usually spoken
in your home? (CHECK ALL THAT APPLY)
Cambodian
Chinese
Czech
Danish
Dutch
English
Finnish
Flemish
French
Gaelic
German
Greek
Hungarian
Italian
Japanese
Korean
Lao, Laotian
Latin
Lithuanian
Norwegian

21
22
23
24
25
26
27
28
29
30
31
32
33

Section 3 – Socioeconomic Characteristics

Philippine
Polish
Portuguese
Romanian
Serbo-Croatian
Slovak
Spanish
Swedish
Thai
Ukrainian
Vietnamese
Yiddish
Other
(SES4_OTH)
SPECIFY:_____

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DK/REF
SES5

Were you born in the United States or some other country?
1
UNITED STATES Go to SES8a
2
OTHER COUNTRY Go to SES6
DK/REF

SES6

[IF SES5 = 2] What country were you born in?
1
2
3
4
5
6
7
8
9
10
11
12

SES6A

Belize
Canada
Colombia
China
Cuba
Dominican Republic
El Salvador
England (Britain)
Germany
Guatemala
Guyana (Guiana)
Haiti

13
14
15
16
17
18
19
20
21
22
23

Honduras
Italy
Jamaica
Mexico
Nigeria
Panama
Phillipines
Puerto Rico
Tobago, Trinidad
Vietnam
OTHER (SES6_OTH)
SPECIFY:__________________

[IF SES6 NE BLANK OR SES6_OTH NE BLANK] Are you now a citizen of
[SES6 OR SES6_OTH]?
1
YES
2
NO
DK/REF

SES7

[IF SES6A=2] Of what country are you a citizen?
1
2
3
4
5
6
7
8
9
10
11
12

Belize
Canada
Colombia
China
Cuba
Dominican Republic
El Salvador
England (Britain)
Germany
Guatemala
Guyana (Guiana)
Haiti

Section 3 – Socioeconomic Characteristics

13
14
15
16
17
18
19
20
21
22
23
24

Honduras
Italy
Jamaica
Mexico
Nigeria
Panama
Phillipines
Puerto Rico
Tobago, Trinidad
United States
Vietnam
OTHER (SES7_OTH)
SPECIFY:____________
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
SES7a

[IF SES7 = 22] Are you a naturalized citizen of the United States?
1
Yes
2
No
DK/REF

SES7B

[IF SES6A = 1 OR SES7 NE 22] Are you also a citizen of the United States?
1
Yes
2
No
DK/REF

SES8a

[Q3 = 1 OR Q11 = 1] Now I’m going to read you a list of places you may have
lived during the 12 months prior to [DATE_ARREST2] when you were
arrested or charged with a [PAROLE_FILL] violation. At any time during
those 12 months did you live…
[TESTED IN COGNITIVE INTERVIEWING]
Yes
No
SES8a1. In your own house, apartment, or mobile
1
2
home?
SES8a2. In someone else’s house, apartment, or
1
2
mobile home?
SES8a3. In transitional housing for former inmates,
1
2
such as a halfway house?
SES8a4. In a residential treatment facility?
1
2
SES8a5. In a rooming house, hotel, or motel?
1
2
SES8a6. In a car, truck, or other motor vehicle?
1
2
SES8a7. In a homeless shelter, on the street, or in
1
2
some outdoor location?
SES8a8. In a prison, jail, or some other type of
1
2
detention facility?
SES8a9. In some other place?
1
2

SES8b

[Q3 NE 1 AND Q11 NE 1] Now I’m going to read you a list of places you may
have lived during the 12 months prior to the arrest or charge [DATE_ARREST]
that led to this incarceration. At any time during those 12 months did you live…
[TESTED IN COGNITIVE INTERVIEWING]
Yes
No
SES8b1. In your own house, apartment, or mobile
1
2
home?
SES8b2. In someone else’s house, apartment, or
1
2
mobile home?
SES8b3. In transitional housing for former inmates,
1
2
such as a halfway house?
SES8b4. In a residential treatment facility?
1
2

Section 3 – Socioeconomic Characteristics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
SES8b5. In a rooming house, hotel, or motel?
SES8b6. In a car, truck, or other motor vehicle?
SES8b7. In a homeless shelter, on the street, or in
some outdoor location?
SES8b8. In a prison, jail, or some other type of
detention facility?
SES8b9. In some other place?
SES8c

1
1

2
2

1

2

1

2

1

2

[IF (SES8a8 = 1 OR SES8b8 = 1) AND ALL OTHER SES8a AND SES8b
ITEMS = 2 OR DK OR REF] Were you incarcerated in a prison, jail, or other
detention facility for the entire 12 months before the arrest or charge that led to
this incarceration?
YES
1
NO
2
DK/REF

SES9

[IF SES8c = BLANK OR 2 OR DK OR REF] Where were you living just
before the arrest or charge that led to this incarceration?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3

INMATE’S OWN HOUSE, APARTMENT, OR MOBILE HOME
SOMEONE ELSE’S HOUSE, APARTMENT OR MOBILE HOME
TRANSITIONAL HOUSING FOR FORMER INMATES, SUCH AS
HALFWAY HOUSES
4
RESIDENTIAL TREATMENT FACILITY
5
ROOMING HOUSE, HOTEL, OR MOTEL
6
CAR, TRUCK, OR OTHER MOTOR VEHICLE
HOMELESS SHELTER, ON THE STREET, OR IN SOME
7
OUTDOOR LOCATION
8
PRISON, JAIL, OR SOME OTHER TYPE OF DETENTION
FACILITY
9
SOME OTHER PLACE
DK/REF

SES9a

[IF SES9 = 8] Were you incarcerated in a prison, jail, or other detention facility
for the entire 30 days before the arrest or charge that led to this incarceration?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF

SES10

[IF SES9 = 1 OR 2 OR 5 OR 6 OR 7 OR 9 ] At the time of the arrest or charge
that led to this incarceration, were you living alone or with other people?
[TESTED IN COGNITIVE INTERVIEWING]

Section 3 – Socioeconomic Characteristics

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

1
LIVED ALONE
2
LIVED WITH OTHER PEOPLE
DK/REF
SES11

[IF SES10 = 2] How many people were you living with at the
time of the arrest or charge that led to this incarceration?
[TESTED IN COGNITIVE INTERVIEWING]
NUMBER OF PEOPLE: _______[RANGE: 0 – 15]
DK/REF

DEFINE PERSON_FILL:
IF SES11 = 1 THEN PERSON_FILL = “was this person”
IF SES11 = 2 – 15 THEN PERSON_FILL = “were these people”
SES12

[IF SES11 = 1 - 15] How [PERSON_FILL] related to you?
(CHECK ALL THAT APPLY)
1
PARTNER, INCLUDING SPOUSE OR GIRL/BOYFRIEND
2
BIOLOGICAL / ADOPTED CHILDREN UNDER 18
3
STEPCHILDREN / PARTNER’S CHILDREN UNDER 18
4
BIOLOGICAL / ADOPTED CHILDREN OVER 18
5
STEPCHILDREN / PARTNER’S CHILDREN OVER 18
6
MOTHER / STEPMOTHER
7
FATHER / STEPFATHER
8
SIBLING / BROTHER OR SISTER
9
GRANDMOTHER
10
GRANDFATHER
11
OTHER CHILDREN UNDER 18 NOT RELATED TO YOU
12
OTHER FAMILY MEMBERS
FOSTER FAMILY
13
14
FRIENDS
OTHER NON-RELATIVE / NOT A FRIEND
15
DK/REF

SES13

[IF SES11 NE 0 OR DK/REF] At the time of the arrest or charge that led
to this incarceration, how many of the people living with you were 15
years old or older?
[TESTED IN COGNITIVE INTERVIEWING]
NUMBER OF PEOPLE: ___________ [RANGE: 0 – VALUE OF SES11]
DK/REF

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SES14

[IF SES13 = 1 or more] Think about the income you and the [SES13
VALUE] other people 15 or older living with you received from all sources
in the 30 days before the arrest or charge that led to this incarceration.
What was your total household income in those 30 days?
[TESTED IN COGNITIVE INTERVIEWING]
TOTAL HOUSEHOLD INCOME: ____________ [RANGE: 0 – 99,999]
DK/REF

SES15

Do you have any children? Please include any of your own biological
children as well as any step- or adopted children.
1
YES
2
NO
DK/REF

Go to SESB1
Go to SES16

_______________________________________________________
B – Children Block
Block Level Universe: (SES15 = 1)

SESB1

[IF SES15 = 1] How many children do you have?
# OF CHILDREN: _________ [RANGE: 1 – 20]
DK/REF

SESB1a

[IF SESB1 = 1] How old is your child? (FOR CHILDREN UNDER AGE 1
CODE AS 0)
AGE OF CHILD: __________ [RANGE: 0 – 75]
DK/REF

DEFINE CHILDAGE_FILL:
IF SESB1a ≠ EMPTY, DK, REF THEN CHILDAGE_FILL = “SESB1a VALUE year old”
ELSE CHILDAGE_FILL = EMPTY
SESB1b

[IF SESB1 = 2 OR MORE] How old is your [youngest/next youngest] child?
[LOOP THROUGH UNTIL ALL CHILDREN ARE REPORTED ON.]
(FOR CHILDREN UNDER AGE 1 CODE AS 0)
AGE OF CHILD: _________ [RANGE: 0 – 75]
DK/REF

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CALCULATED VARIABLE:
CREATE #UNDER18
IF SESB1a LT 18 OR IF ONLY ONE CHILD AGE IN SESB1b LT 18 THEN
#UNDER18 = 1
IF 2 CHILDREN’S AGES IN SESB1b LT 18 THEN #UNDER18 = 2
IF 3 CHILDREN’S AGES IN SESB1b LT 18 THEN #UNDER18 = 3
....
IF 20 CHILDREN’S AGES IN SESB1b LT 18 THEN #UNDER18 = 20
ELSE #UNDER18 = BLANK
DEFINE #UNDER18_FILL:
IF #UNDER18 = 1 THEN #UNDER18_FILL = EMPTY
IF #UNDER18 = 2 – 20 THEN #UNDER18_FILL = #UNDER18
DEFINE CHILD_FILL1:
IF #UNDER18 = 1 THEN CHILD_FILL1 = “child who is”
IF #UNDER18 = 2 – 20 THEN CHILD_FILL1 = “children who are”
DEFINE CHILD_FILL2:
IF #UNDER18 = 1 THEN CHILD_FILL2 = “your”
IF #UNDER18 = 2 – 20 THEN CHILD_FILL2 = “any of your”
DEFINE CHILD_FILL3:
IF #UNDER18 = 1 THEN CHILD_FILL3 = “child”
IF #UNDER18 = 2 – 20 THEN CHILD_FILL3 = “children”
DEFINE THIS_FILL1:
IF #UNDER18 = 1 THEN THIS_FILL1 = “this”
IF #UNDER18 = 2 – 20 THEN THIS_FILL1 = “any of these”
DEFINE THIS_FILL2:
IF #UNDER18 = 1 THEN THIS_FILL2 = “this”
IF #UNDER18 = 2 – 20 THEN THIS_FILL2 = “these”
SESB2

[IF #UNDER18 = 1 OR MORE] Now I am going to ask you some
questions about your [#UNDER18_FILL] [CHILD_FILL1]
currently under the age of 18. Just before the arrest or charge that
led to this incarceration, were you the primary source of financial
support for [CHILD_FILL2] [#UNDER18_FILL] [CHILD_FILL1]
currently under 18?
1
YES
2
NO
DK/REF

SESB3

[IF #UNDER18 > 1 AND SESB2 = 1] How many of

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
these[#UNDER18_FILL] children were you providing primary financial
support to just before the arrest or charge that led to this incarceration?
NUMBER: ___________ [RANGE: 1 – SESB1 VALUE]
DK/REF
SESB4

[IF #UNDER18 = 1 OR MORE] Were you living with [THIS-FILL1]
[#UNDER18_FILL] [CHILD_FILL3] just before the arrest that led to this
incarceration?
1
YES
2
NO
DK/REF

SESB5

[IF #UNDER18 > 1 AND SESB4 = 1] How many of these
[#UNDER18_FILL] children were you living with just before the arrest or
charge that led to this current incarceration?
NUMBER: ____________ [RANGE 1 – #UNDER]
DK/REF

DEFINE CHILD_FILL4:
IF SESB5 = 1 THEN CHILD_FILL4 = “child”
IF SESB5 = 2 OR MORE THEN CHILD_FILL4 = “children”
CREATE #SESB5:
#SESB5 = SESB1 Value – SESB5 Value
DEFINE CHILD_FILL5:
IF #SESB5 = 1 THEN CHILD_FILL5 = “child”
IF #SESB5 = 2 OR MORE THEN CHILD_FILL5 = “children”
DEFINE IS_FILL:
IF SESB5 = 1 THEN IS_FILL = “is”
IF SESB5 = 2 OR MORE THEN IS_FILL = “are”
SESB6

[IF (#UNDER18 = 1 AND SESB4 = 1) OR SESB5 = 1 OR MORE] How
much of the daily care for SESB1a[THIS_FILL2] [CHILDAGE_FILL]
[CHILD_FILL3] did you usually provide? Would you say…
[TESTED IN COGNITIVE INTERVIEWING]
1
All of it,
2
Some of it, or
3
None of it
DK/REF

SESB7

Who [IS_FILL] your [SESB5 VALUE] [CHILD_FILL4] that you were living

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
with just before the arrest or charge that led to this incarceration living with
now? (CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1

CHILD’S MOTHER / FATHER (INCLUDING STEP
PARENTS)
2
CHILD’S GRANDMOTHER
3
CHILD’S GRANDFATHER
4
OTHER RELATIVES
5
INMATE’S BOYFRIEND / GIRLFRIEND / PARTNER
/SPOUSE
6
INMATE’S FRIENDS
7
FRIENDS OF THE INMATE’S CHILD(REN)
8
FOSTER PARENT(S)/FOSTER HOME
9
INCARCERATED
10
AGENCY OR INSTITUTION (INCLUDING MENTAL
HEALTH FACILITY, GROUP HOME, RESIDENTIAL
TREATMENT FACILITY)
11
CHILD LIVES ON OWN (INCLUDES SCHOOL/COLLEGE,
MILITARY, MONASTARY ETC.)
12
SOMEONE ELSE (SESB7_OTH) SPECIFY:___________
13
DECEASED
DK/REF
SESB8

[IF #UNDER18 = 1 AND SESB4 = 2] Who is your [CHILDAGE_FILL]
child that was living with you just before the arrest or charge that led to
this incarceration living with now?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3
4
5
6
7
8
9
10

11
12

CHILD’S MOTHER / FATHER (INCLUDING STEP
PARENTS)
CHILD’S GRANDMOTHER
CHILD’S GRANDFATHER
OTHER RELATIVES
INMATE’S BOYFRIEND / GIRLFRIEND / PARTNER
/SPOUSE
INMATE’S FRIENDS
FRIENDS OF THE INMATE’S CHILD(REN)
FOSTER PARENT(S)/FOSTER HOME
INCARCERATED
AGENCY OR INSTITUTION (INCLUDING MENTAL
HEALTH FACILITY, GROUP HOME, RESIDENTIAL
TREATMENT FACILITY)
CHILD LIVES ON OWN (INCLUDES SCHOOL/COLLEGE,
MILITARY, MONASTARY ETC.)
SOMEONE ELSE (SESB8_OTH) SPECIFY:___________

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13
DECEASED
DK/REF
SESB9

[IF SESB5 > 1] How many of the [SESB5 VALUE] children that you lived
with just before the arrest or charge that led to this incarceration are currently
living together?
NUMBER: ___________ [RANGE: 2 – SESB5 VALUE]
DK/REF

SESB10

[IF SESB5 LT #UNDER18] Who [IS_FILL] your [#SESB5]
[CHILD_FILL5] that were not living with you at the time of the arrest or
charge that led to this incarceration living with now? (CHECK ALL
THAT APPLY)
1

CHILD’S MOTHER / FATHER (INCLUDING STEP
PARENTS)
2
CHILD’S GRANDMOTHER
3
CHILD’S GRANDFATHER
4
OTHER RELATIVES
5
INMATE’S BOYFRIEND / GIRLFRIEND / PARTNER
/SPOUSE
6
INMATE’S FRIENDS
7
FRIENDS OF THE INMATE’S CHILD(REN)
8
FOSTER PARENT(S)/FOSTER HOME
9
INCARCERATED
10
AGENCY OR INSTITUTION (INCLUDING MENTAL
HEALTH FACILITY, GROUP HOME, RESIDENTIAL
TREATMENT FACILITY)
11
CHILD LIVES ON OWN (INCLUDES SCHOOL/COLLEGE,
MILITARY, MONASTARY ETC.)
12
SOMEONE ELSE (SESB10_OTH) SPECIFY:__________
13
DECEASED
DK/REF
SESB11

[IF #UNDER18 >0] At the time of the arrest or charge that led to this
incarceration, did you have a legal agreement either through a court or
child support agency that specified the amount of child support you should
pay for any of your children who were under the age of 18?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES Go to SESB12
2
NO Go to SES16
DK/REF

SESB12

[IF SESB11 = 1] Do you owe any back child support?

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
[TESTED IN COGNITIVE INTERVIEWING]
1
YES Go to SESB13
2
NO Go to SES16
DK/REF
SESB13

[IF SESB12 = 1] How much back child support do you owe?
1
Less than $1,000
2
$1,000 to $3,999
3
$4,000 to $6,999
4
$7,000 to $9,999
5
$10,000 or more
DK/REF

SESB14

[IF SESB12 = 1] Since you entered prison [DATE_ADMIT], has the state
forgiven or decreased any of the back child support debt that you owe?

1
YES
2
NO
DK/REF
______________________________END Children Block (B)

SES16

[ IF SES15 = 2, DK, REF] Have you had any biological children in your
lifetime?
1
YES
2
NO
DK/REF

SES17

[ IF SES15 =1] Earli er I as ked you how man y children you
currentl y have, in clu d ing an y biological, adopted, or s tep children.
No w I wo u ld like to know ab out only yo ur biological children.
[ ENTER 1 TO CONTINUE]

SES18

[ IF SES16 = 1 OR SES1 5 = 1] How many biological children have
you h ad in yo ur lif etime?
NUMBER: ___________ [RANGE: 0 – 20]
DK/REF

SES19

[ IF SES8 c NE 1 ] Excludin g an y ill egal acti vities , during the 12
month s befo re th e arres t o r charge that led to this incarceration,
did you have a job or a b u s in ess ?

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
1
YES Go to SESC1
2
NO
Go to SES20
DK/REF
_______________________________________________________
C – Employed Block
Block Level Universe: (SES19 = 1)
SESC1

[ IF SES19 = 1] Durin g th os e 12 months how man y w eeks were you
wo rkin g? Th ere are 52 weeks in 12 months .
WEEKS: _________ [ RANGE: 1 – 52]
DK/REF

SESC2

[ IF SESC1 LT 52] Wh y weren’t you working during thos e
[d ifferen ce o f 5 2 minus SESC1] weeks ? (CHECK ALL THAT
APP LY)
1
2
3

NO SUITABLE WORK AVAILABLE
COULDN’T FIND ANY WORK
LACK OF NECESSARY SCHOOLING, TRAINING, SKILLS, OR
EXPERIENCE
4
MEDICAL CONDITION, ILL HEALTH, PHYSICAL OR MENTAL
DISABILITY
5
EMOTIONAL OR MENTAL HEALTH PROBLEM
6
EMPLOYERS THOUGHT YOU WERE TOO YOUNG
7
EMPLOYERS THOUGHT YOU WERE TOO OLD
8
CRIMINAL RECORD WAS A HANDICAP
9
FAMILY RESPONSIBILITIES OR COULDN’T ARRANGE CHILD
CARE
10
STAY AT HOME PARENT
11
ON WELFARE OR OTHER PUBLIC ASSISTANCE
12
IN SCHOOL / SPECIAL TRAINING PROGRAM
13
DIDN’T NEED JOB
14
DIDN’T WANT JOB
15
ILLEGAL ACTIVITIES
16
ON DRUGS / ALCOHOL
17
RETIRED
18
INCARCERATED
19
OT HER (S ES C 2 _ OTH) S P EC IF Y: _____________
20
NO SPECIFIC REASON
DK/REF
SESC3

[IF SES19 = 1] Excluding any illegal activities, during the 30 days before the
arrest or charge that led to this incarceration, how many different jobs or
businesses did you have? Please only think about jobs or businesses you worked at

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
in the 30 days before you entered prison on [DATE_ADMIT].
[TESTED IN COGNITIVE INTERVIEWING]
1
ONE
2
TWO
3
THREE
4
FOUR OR MORE
5
NONE
DK/REF
SESC4

[IF SESC3 = 1] Was this full-time, part-time, or work done occasionally?
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3

SESC5

FULL-TIME
PART-TIME
WORK DONE OCCASIONALLY DK/REF

[IF SESC3 = 1] At that job, were you…
1

An employee of a private, for-profit company or business or of an
individual, for wages, salary, or commissions
2
An employee of a private, not-for-profit, tax exempt, or charitable
organization
3
A local government employee
4
A state government employee
5
A Federal government employee
6
Self-employed in your own not incorporated business, professional
practice, or farm
7
Self-employed in your own incorporated business, professional practice or
farm
8
Working without pay in a family business or farm
DK/REF
SESC6

[IF SESC3 = 2 – 4] Were any of these jobs or businesses …

SESC61. Full-time work?
SESC62. Part-time work?
SESC63. Work done
Occasionally?
SESC7

Yes
1
1
1

No
2
2
2

[IF SESC3 = 2 – 4] Please think about the job that you considered your main job.
At that job were you…
1

An employee of a private, for-profit company or business or of an
individual, for wages, salary, or commissions

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2

An employee of a private, not-for-profit, tax exempt, or charitable
organization
3
A local government employee
4
A state government employee
5
A Federal government employee
6
Self-employed in your own not incorporated business, professional
practice, or farm
7
Self-employed in your own incorporated business, professional practice or
farm?
8
Working without pay in a family business or farm
DK/REF
SESC8

[IF SESC3 = 1 - 4] For whom did you work?
[NAME OF COMPANY, BUSINESS, OR OTHER EMPLOYER]
_____________________________________[ALLOW 80 CHARACTERS]
DK/REF

SESC9

[IF SESC3 = 1 - 4] What kind of business or industry was that?
[DESCRIBE THE ACTIVITY AT THE LOCATION WHERE EMPLOYED.
FOR EXAMPLE, HOSPITAL, NEWSPAPER PUBLISHING, MAIL ORDER
HOUSE, AUTO ENGINE MANUFACTURING, BANK]
____________________________________ [ALLOW 120 CHARACTERS]
DK/REF

SESC9a

[IF SESC9 NE BLANK OR DK/REF] Is this mainly…
1
Manufacturing,
2
Wholesale trade,
3
Retail trade, or
4
Something else?
DK/REF

SESC10

[IF SESC3 = 1 - 4] What kind of work were you doing at that job?
________________________________________ [ALLOW 80 CHARACTERS]
DK/REF

SESC11

[IF SESC3 = 1 - 4] What were your most important activities or duties at that
job?
_______________________________________ [ALLOW 120 CHARACTERS]
DK/REF

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
SESC12

[IF SESC3 = 1 - 4] How often were you paid at that job? Were you paid…
1
At the end of the day,
2
At the end of the week,
3
Every two weeks,
4
Monthly, or
5
Some other way?
DK/REF

SESC12a

[IF SESC12 = 5] How were you paid at that job?
____________________________________ [ALLOW 40 CHARCTERS]
DK/REF

______________________________END Employed Block (C)

SES20

[IF SES19 = 2 SESC3 = 5] In the 30 days before the arrest or charge that led to
this incarceration, were you looking for work?
1
YES
2
NO
DK/REF

SES21

Go to SES22
Go to SES21

[IF SES20 = 2] What were the reasons you were not looking for work? (CHECK
ALL THAT APPLY)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

NO SUITABLE WORK AVAILABLE
COULDN’T FIND ANY WORK
LACK OF NECESSARY SCHOOLING, TRAINING, SKILLS, OR
EXPERIENCE
MEDICAL CONDITION, ILL HEALTH, PHYSICAL OR MENTAL
DISABILITY
EMOTIONAL OR MENTAL HEALTH PROBLEM
EMPLOYERS THOUGHT YOU WERE TOO YOUNG
EMPLOYERS THOUGHT YOU WERE TOO OLD
CRIMINAL RECORD WAS A HANDICAP
FAMILY RESPONSIBILITIES OR COULDN’T ARRANGE CHILD
CARE
STAY AT HOME PARENT
ON WELFARE OR OTHER PUBLIC ASSISTANCE
IN SCHOOL / SPECIAL PROGRAM
DIDN’T NEED JOB
DIDN’T WANT JOB
ILLEGAL ACTIVITIES

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16
17
18
19
SES22

ON DRUGS / ALCOHOL
RETIRED
OT HER (S ES 2 1_ OTH)S P EC IF Y: _ ____________
NO SPECIFIC REASON

[IF SESC3 = 5 OR SES8c = 1] Excluding any illegal activities, in what month and
year did you last work at a job or business? Please only think about jobs or
businesses you worked at before you entered prison [DATE_ADMIT]?
MONTH: ____ [Range: 1-12]
YEAR: ____ [Range: 1930 – CURRENT YEAR]
(IF INMATENEVER WORKED AT A JOB OR BUSINESS CODE AS
999)
DK/REF

SES23

[IF SES22 NE 999 OR DK/REF] Was it full-time, part-time, or occasional work?
1
FULL-TIME
2
PART-TIME
3
OCCASIONAL
DK/REF

SES24

[IF SES22 NE 999 OR DK/REF] What kind of work were you doing at that job?
________________________________________ [ALLOW 80 CHARACTERS]
DK/REF

SES25

[IF SES22 NE 999 OR DK/REF] What were your most important activities or
duties at that job?
_______________________________________ [ALLOW 100 CHARACTERS]
DK/REF

SES26

[IF SES22 NE 999 OR DK/REF] How often were you paid at that job? Were
you paid…
1
At the end of the day,
2
At the end of the week,
3
Every two weeks,
4
Monthly, or
5
Some other way?
DK/REF

SES26a

[IF SES26 = 5] How were you paid at that job?
____________________________________ [ALLOW 40 CHARCTERS]

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DK/REF
SES27

[IF SES8c ne 1] In the 30 days before the arrest or charge that led to this
incarceration, did you receive any income from…

SES27a. Wages, salary, commissions, bonuses,
or tips from a job? Please do not include money
earned from any illegal activities.
SES27b. Self-employment from your own
business or farm?
SES27c. Social Security or Railroad
Retirement?
SES27d. Supplemental Security Income or
SSI?
SES27e. Any public assistance or welfare
payments from the state or local welfare office?
SES27f. Retirement, survivor, or disability
pensions?
SES27g. Veteran’s Administration payments?
SES27h. Unemployment compensation?
SES27i. Child support or alimony?
SES27j. Disability benefits?
SES27k. Illegal activities such as theft or drug
sales?
SES27l. Any other source of income?
SES28

Yes
1

No
2

1

2

1

2

1

2

1

2

1

2

1
1
1
1
1

2
2
2
2
2

1

2

[IF AT LEAST ONE CATEGORY IN SES27 = 1] Think about the income
you received from all sources during the 30 days before the arrest or charge
that led to this incarceration. What was your total income for that 30 day
period?
[TESTED IN COGNITIVE INTERVIEWING]
TOTAL PERSONAL INCOME: _______________ [RANGE: 0 – 99,999]
DK/REF

SES29

[IF SES27k =1] How much of your total income during those 30 days came
from illegal activity? Would you say…
[TESTED IN COGNITIVE INTERVIEWING]
1
All of it
2
Most of it
3
Some of it, or
4
Just a little of it?
DK/REF

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
SES30

In the 30 days before the arrest or charge that led to this incarcearation, were
you covered by any of the following types of health insurance or health
coverage plans?

SES30a. Insurance through a current employer or
union of yours or another family member?
SES30b. Insurance purchased directly from an
insurance company by you or another family
member?
SES30c. Medicare, for people 65 and older, or
people with certain disabilities?
SES30d. Medicaid, Medical Assistance, or any
kind of government-assistance plan for those with
low incomes or a disability?
SES30e. TRICARE or other military health care?
SES30f. VA? Please answer yes if you have ever
used or enrolled in VA healthcare.
SES30g. Indian Health Service?
SES30h. Any other type of health insurance or
health coverage plan?
SES31

Yes

No

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

Comment [CS6]: Question text changed
Comment [CS7]: Question text changed

Comment [CS8]: Question text changed

[IF SES30h = 1] What other type of health insurance or health coverage plan
did you have in the 30 days before the arrest or charge that led to this
incarceration?
NAME OF PLAN: ______________________ [ALLOW 40 CHARACTERS]
DK/REF

DEFINE 18_FILL1:
IF AGE LT 18 = 1 THEN 18_FILL1 = “Have you ever lived”
IF AGE = 18 or older THEN 18FILL_1 = “Before you were 18 did you ever live”
SES32

[18_FILL1] in a homeless shelter, on the street, or in some outdoor
location, even if it was only for a short time?
1
YES
2
NO
DK/REF

SES33

[18_FILL1] in a foster home, agency or institution, even if it was only for
a short time?
1
YES
NO
2
DK/REF

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SES34

[IF SES33 = 1] Was it a foster home, agency or institution, or both?
1
FOSTER HOME
2
AGENCY OR INSTITUTION
BOTH
3
DK/REF

DEFINE 18_FILL2:
IF AGE LT 18 = 1 THEN 18_FILL2 = “While you were growing up”
IF AGE = 18 or older THEN 18FILL_2 = “Before you were 18”
SES35

[18_FILL2] who did you live with for most of the time? (CHECK ALL
THAT APPLY)
1
2
3
4
5
6
7
8
9
10

11

BOTH PARENTS (INCLUDING STEP-PARENTS)
M O T H E R (INCLUDING STEPMOTHER)
F A T H E R (INCLUDING STEPFATHER)
FOSTER PARENT(S)/FOSTER HOME
GRANDMOTHER
GRANDFATHER
OTHER RELATIVE(S)
FRIENDS
INCARCERATED
AGENCY OR INSTITUTION (INCLUDING MENTAL HEALTH
FACILITY, GROUP HOME, RESIDENTIAL TREATMENT
FACILITY
SOMEONE ELSE (S7Q12a_OTH) SPECIFY:____________________

DEFINE 18_FILL3:
IF AGE LT 18 = 1 THEN 18_FILL3 = “Did”
IF AGE = 18 or older THEN 18FILL_3 = “Before you were 18 did”
SES36

[18_FILL3] any of your parents or guardians ever receive welfare or
public assistance, for example, AFDC, TANF, food stamps, Medicaid or
WIC?
1
YES
2
NO
DK/REF

DEFINE 18_FILL4:
IF AGE LT 18 = 1 THEN 18_FILL4 = “Have you ever lived”
IF AGE = 18 or older THEN 18FILL_4 = “Before you were 18, did you ever live”
SES37

[18_FILL4]in public housing or publicly-assisted housing, for e

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
xample, Section 8 housing?
1
YES
2
NO
DK/REF
DEFINE 18_FILL5:
IF AGE LT 18 = 1 THEN 18_FILL5 = “Have”
IF AGE = 18 or older THEN 18FILL_5 = “Before you were 18, did any of”
SES38

[18_FILL5] your parents or guardians abuse alcohol or drugs?
1
YES
NO
2
DK/REF

SES38a

[IF SES38 = 1] Was it alcohol, drugs or both?
1
ALCOHOL
2
DRUGS
BOTH
3
DK/REF

SES39

Now I would like to ask about your relatives who may have been
sentenced to serve time in jail or prison. Please include step-relatives when
answering.
Have any of the following people been sentenced to served time in jail or
prison.

SES39a. Your mother?
SES39b. Your father?
SES39c. Siblings?
SES39d. Spouses or partners?
SES39e. Children?

Section 3 – Socioeconomic Characteristics

Yes
1
1
1
1
1

No
2
2
2
2
2

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Section 4 – Mental Health and Treatment (MH)
DEFINE DATE_30
DATE_30 = INTERVIEW DATE – 30 DAYS BUT SHOULD BE
FILLED AS JUST THE MONTH AND DAY.
DEFINE DATE_12
DATE_12 = DATE OF INTERVIEW – 1 YEAR
MH1 The next questions are about how you have been feeling during the past
30 days, that is since [DATE_30].
About how often during the past 30 days did you feel nervous?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH2 During the past 30 days, about how often did you feel hopeless?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH3 During the past 30 days, about how often did you feel restless or
fidgety?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH4 How often in the past 30 days did you feel so depressed that nothing
could cheer you up?
1
2
3

All of the time
Most of the time
Some of the time

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4
A little of the time
5
None of the time
DK/REF
MH5 About how often in the past 30 days did you feel that everything was an
effort?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH6 About how often in the past 30 days did you feel worthless?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH7 The last questions asked about how you have been feeling during the past 30 days. Now
think about the past 12 months. Was there a month in the past 12 months when you felt
more depressed, anxious, or emotionally stressed than you felt during the past 30 days?
1
YES
2
NO
DK/REF
MH8 [IF MH7 = 1] Think of one month in the past 12 months when you were the most
depressed, anxious, or emotionally stressed.
During that month, how often did you feel nervous?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF

MH9 [IF MH7 = 1] During that same month when you were at your worst emotionally, how
often did you feel hopeless?
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1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH10 [IF MH7 =1] During that same month when you were at your worst emotionally, how
often did you feel restless or fidgety?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH11 [IF MH7 =1] During that same month when you were at your worst emotionally, how
often did you feel so sad or depressed that nothing could cheer you up?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH12 [IF MH7 =1] During that same month when you were at your worst emotionally, how
often did you feel that everything was an effort?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
MH13 [IF MH7 =1] During that same month when you were at your worst emotionally, how
often did you feel down on yourself, no good, or worthless?
1
2
3
4
5

All of the time
Most of the time
Some of the time
A little of the time
None of the time

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DK/REF
MH14During the past 12 months, that is since [DATE_12], have you had a period lasting
several days or longer when most of the day you were very discouraged about how
things were going in your life?
1
YES
2
NO
DK/REF
MH15 During the past 12 months, that is since [DATE_12], has there been a time when you
were feeling depressed or down most of the day?
1
YES
2
NO
DK/REF
MH16 [IF MH15 = 1] You mentioned there was time during the past 12 months when you felt
depressed or down for most of the day. Did you feel this way nearly every day for at
least two weeks?
1
YES
2
NO
DK/REF
MH17 Some people have times lasting several days or longer when they feel much more excited
or manic or more full of energy than usual. Their minds go too fast. They talk a lot.
They are very restless and sometimes do things unusual for them, such as driving too fast
or spending too much money.
Have you ever felt like this for several days or longer?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF
MH18 Have you ever in your life had a time lasting several days or longer when most of the
time you were so irritable or grouchy that you started arguments, shouted at people, or
hit people? [TESTED IN COGNITIVE INTERVIEWING]

1
YES
2
NO
DK/REF
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MH19 During the past 12 months, that is since [DATE_12], did you have times lasting a month
or longer when you were nervous, edgy, anxious, or worried most of the time?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF
MH20 During the past 12 months, that is since [DATE_12], have you had an attack of fear or
panic when all of a sudden you felt very frightened, anxious, or uneasy?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF
MH21 During the past 12 months, that is since [DATE_12], did you have anxiety attacks – when
all of a sudden you felt very frightened or panicky and you had physical sensations like
pounding heart, shortness of breath, dizziness, or feeling you were going to throw up –
that made you feel you were going to lose control or go crazy or die?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF
MH22 This question is about things that make some people feel afraid even though they know
there is no real danger.
During the past 12 months, that is since [DATE_12], was there a time when you had a
strong fear of:
[TESTED IN COGNITIVE INTERVIEWING]

MH22a. Bugs?
MH22b. Snakes?
MH22c. Dogs?
MH22d. Any other animals?
MH22e. Closed spaces like caves, tunnels, closets, or
elevators?

YES
1
1
1
1
1

NO
2
2
2
2
2

MH23 Have you ever in your life had any experience that was so frightening, horrible, or
upsetting that it caused you to be constantly on guard, watchful, or easily startled?
1
YES
2
NO
DK/REF
MH24 [IF MH23 = 1] During the past 12 months have you had these feelings of constantly
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
being on guard, watchful, or easily startled?
1
YES
2
NO
DK/REF
MH25 Have you ever in your life had any experience that was so frightening, horrible, or
upsetting that it caused you to feel numb or detached from others, activities, or your
surroundings?
1
YES
2
NO
DK/REF
MH26 [IF MH25 = 1] During the past 12 months, have you had these feelings of constantly
being numb or detached from others, activities, or your surroundings?
1
YES
2
NO
DK/REF
MH27 During a typical day, do you experience sudden spells of depression, irritability, anxiety,
or anger?
1
YES
2
NO
DK/REF
MH28 Some people find their mood changes frequently – as if they spend every day on an
emotional roller coaster. For example, they might switch from feeling angry to depressed
to anxious many times a day. Does this sound like you?
1
YES
2
NO
DK/REF
MH29 Do you keep changing the way you present yourself to other people because you don’t
know who you really are?
1
YES
2
NO
DK/REF
MH30 Do you often feel like your beliefs change so much that you don’t know what you really
believe any more?
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1
YES
2
NO
DK/REF
MH31 Have you ever been told by a medical doctor or a mental health professional, such as a
psychiatrist or psychologist that you had…[TESTED IN COGNITIVE
INTERVIEWING]
Yes No
MH31a. Manic depression, a bipolar disorder, or mania?
1
2
MH31b. A depressive disorder?
1
2
MH31c. Schizophrenia or another psychotic disorder?
1
2
MH31d. Post-traumatic stress disorder or PTSD?
1
2
MH31e. Another anxiety disorder, such as panic disorder or
1
2
obsessive-compulsive disorder, also known as OCD?
MH31f. A personality disorder, such as antisocial or borderline
1
2
personality
MH31g. A mental or emotional condition other than those listed
1
2
above?
MH32 The next questions are about any times you may have stayed overnight in any type of
hospital or other facility for any problem with your emotions, nerves, or mental health.
Please do not include any overnight hospital stays for alcohol or drug use.
Have you ever stayed overnight or longer in any type of hospital or other facility to
receive treatment or counseling for any problem you were having with your emotions,
nerves, or mental health?
1
YES
2
NO
DK/REF
MH33 [IF MH32 = 1] During the 12 months before the arrest or charge that led to this
incarceration, did you stay overnight or longer in any type of hospital or other facility to
receive treatment or counseling for any problem you were having with your emotions,
nerves, or mental health?
1
YES
2
NO
DK/REF

MH34 Now I’m going to ask you about any visits you have made to a medical doctor, nurse or
other mental health professional such as a psychiatrist, psychologist, or social worker for
any problem with your emotions, nerves or mental health that did not involve an
overnight stay.
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Have you ever visited a medical doctor, nurse, or other mental health professional for any
problem with your emotions, nerves, or mental health?
1 YES
2 NO
DK/REF
MH35 [IF MH34 = 1] During the 12 months before the arrest or charge that led to this
incarceration, did you make any visits to a medical doctor, nurse, or other mental health
professional for any problem with your emotions, nerves, or mental health?
1 YES
2 NO
DK/REF

MH36 The next questions are about services you may have received for any problem with your
emotions, nerves, or mental health. As you answer these questions please do not include
any services you may have received for drug or alcohol use. Some questions ask about
prescription medicine. Prescription medicines are drugs that you take if a doctor
authorizes them for you.
Have you ever taken any prescription medicine for any problem you were having with
your emotions, nerves, or mental health?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF
MH37 [IF STATUS = SENTENCED AND MH36 = 1] At the time of the offense for which you
are currently serving time, were you taking prescription medicine for any problem you
were having with your emotions, nerves, or mental health?
[IF STATUS = NOT SENTENCED AND MH36 = 1] At the time of the offense for
which you are currently being held, were you taking prescription medicine for any
problem you were having with your emotions, nerves, or mental health?
1
YES
2
NO
DK/REF
MH38 [MH36 = 1] Since you were admitted to prison [DATE _ADMIT], have you taken
prescription medicine for any problem you were having with your emotions, nerves, or
mental health? [TESTED IN COGNITIVE INTERVIEWING]
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1
YES
2
NO
DK/REF
MH39 [IF MH38 = 1] Are you currently taking prescription medicine for any problem with
your emotions, nerves, or mental health? [TESTED IN COGNITIVE
INTERVIEWING]
1
YES
2
NO
DK/REF
MH40 [IF MH39 = 2] Why aren’t you currently taking prescription medicine for problems
with your emotions, nerves, or mental health? [TESTED IN COGNITIVE
INTERVIEWING]
YES NO
MH40a. You have not seen a doctor to get the medicine
1
2
MH40b. The doctor at the facility doesn’t think you need medicine
1
2
MH40c. You don’t like taking the medicine
1
2
MH40d. You don’t think you need the medicine
1
2
MH40e. The facility is not willing to give the medicine to you
1
2
MH40f. You would have to be transferred to a different facility to
1
2
receive the medicine
MH40g. You don’t currently have problems with your emotions,
1
2
nerves, or mental health
MH40h. Some other reason
1
2

MH41 Have you ever received counseling, treatment, or therapy from a mental health
professional such as a psychiatrist, psychologist, social worker, or nurse for any problem
you were having with your emotions, nerves, or mental health?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF
MH42 [IF MH41 = 1] Since you were admitted to prison [DATE_ADMIT], have you received
counseling, treatment, or therapy from a mental health professional such as a psychiatrist,
psychologist, social worker, or nurse for any problem you were having with your
emotions, nerves, or mental health?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF
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MH43 [IF MH42 = 1] Are you currently receiving any counseling, treatment, or therapy from a
mental health professional such as a psychiatrist, psychologist, social worker, or nurse for
any problem with your emotions, nerves, or mental health?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Section 5 - Physical Health, Treatment, and Disabilities (PH)

DEFINE DATE_ADMIT
DATE_ADMIT = Date admitted to prison stored within fields in
the Criminal Justice (CJ) Module – Forthcoming. SHOULD BE
DISPLAYED AS MONTH/DAY/YEAR, preceded by the word,
“on”
PH_INTRO The next questions are about your health and any health and dental care you may
have received since you were admitted to this facility [DATE_ADMIT]. Some questions
may ask about prescription medicines. Prescription medicines are drugs that you take if a
doctor authorizes them for you. (ENTER TO CONTINUE)

PH1

When you entered prison [DATE_ADMIT], did a staff person…

PH1a. check to see if you were sick, injured, drunk, or
high?
PH1b. ask you any questions about your health or medical
history?
PH1c. ask if you had ever thought about or tried to
commit suicide?

PH2

Yes
1

No
2

1

2

1

2

[IF GENDER OF FACILITY = FEMALE] At the time you entered prison
[DATE_ADMIT], were you pregnant?
1
YES
2
NO
DK/REF

PH3

Since you entered prison [DATE_ADMIT], have you had any problems with your teeth
or gums?
1
YES
2
NO
DK/REF

PH4

[If PH3 = 1], Did you see a dentist, doctor, nurse, or other health care provider for any of
these problems with your teeth or gums?
1

YES

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2
NO
DK/REF
PH5

Since you entered prison [DATE_ADMIT], have you seen a doctor, nurse, or other health
care provider for any reason other than those already mentioned?
1
YES
2
NO
DK/REF

PH6

[IF PH5 = 1] Since you entered prison [DATE_ADMIT] have you seen a doctor, nurse
or other health care provider outside the prison, for example in a community hospital,
doctor’s office, or clinic?
1
YES
2
NO
DK/REF

PH7

These next questions are about specific medical problems you may have had in the
past or have currently. [TESTED IN COGNITIVE INTERVIEWING]

PH8

Has a doctor, nurse, or other health care provider ever told you that you had…
[TESTED IN COGNITIVE INTERVIEWING]
Yes No
PH8a. Any type of cancer?
1
2
PH8b. High blood pressure or hypertension?
1
2
PH8c. A stroke?
1
2
PH8d. [IF MALE: Diabetes, high blood sugar, or sugar
1
2
diabetes?
IF FEMALE: Diabetes, high blood sugar, or sugar diabetes
that was not due to being pregnant?]
PH8e. Heart disease, including a heart attack, coronary heart
1
2
disease, angina, congestive heart failure or other heart
problems?
PH8f. A problem with your kidneys?
1
2
PH8g. Some form of arthritis, rheumatoid arthritis, gout,
1
2
lupus, or fibromyalgia?
PH8h. Asthma?
1
2
PH8i. Cirrhosis of the liver?
1
2
PH8j. HIV – the virus that causes AIDS?
1
2
PH8k. Tuberculosis, also called TB?
1
2
PH8l. Hepatitis B?
1
2
PH8m. Hepatitis C?
1
2

PH9

Have you ever been paralyzed or unable to move your legs, arms, or other areas of

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Comment [m9]: NEW QUESTION – not even
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
your body? Please do not include times when you may have been held down, tied up, or
medicated.
[TESTED IN COGNITIVE INTERVIEWING]
1 YES
2 NO
DK/REF
PH10 [IF PH8j = 2] Have you ever been tested for HIV – the virus that causes AIDS?
[TESTED IN COGNITIVE INTERVIEWING]
1 YES
2 NO
DK/REF
PH11 [IF PH8a = 1 OR PH8b = 1 OR PH8c = 1 OR PH8d = 1 OR PH8e = 1 OR PH8f = 1 OR
PH8g = 1 OR PH8h = 1 OR PH8i = 1 OR PH8k = 1OR PH8l = 1 OR PH8m = 1] Has a
doctor, nurse, or other health care provider told you that you currently have…
[TESTED IN COGNITIVE INTERVIEWING]
NOTE TO PROGRAMMERS: THIS SCREEN SHOULD FILL WITH ONLY
THOSE DISEASES THE R ENDORSED IN PH8.

PH11a. [IF PH8a = 1] Any type of cancer?
PH11b. [IF PH8b = 1] High blood pressure or hypertension?
PH11c. [IF PH8c = 1] Problems caused by a stroke?
PH11d. [IF PH8d = 1] Diabetes, high blood sugar, or sugar
diabetes?
PH11e. [IF PH8e = 1] Heart disease, including a heart
attack, coronary heart disease, angina, congestive heart
failure or other heart problems?
PH11f. [IF PH8f = 1] A problem with your kidneys?
PH11g. [IF P11g = 1] Arthritis, rheumatoid arthritis, gout,
lupus, or fibromyalgia?
PH11h. [IF PH8h = 1] Asthma?
PH11i. [IF PH8i = 1] Cirrhosis of the liver?
PH11k. [IF PH8l = 1] Hepatitis B?
PH11l. [IF PH8m = 1] Hepatitis C?

Yes No
1
2
1
2
1
2
1
2
1

2

1
1

2
2

1
1
1
1

2
2
2
2

PH12 [IF PH9 = 1] Are you currently paralyzed or unable to move parts of your body?
1 YES
2 NO
DK/REF

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PH13 [IF PH11a = 1] Are you currently taking prescription medicine or receiving other
treatment for your cancer?
1
YES
2
NO
DK/REF

PH14 [IF PH11b = 1] Are you currently taking prescription medicine or receiving other
treatment for your high blood pressure or hypertension?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF

PH15 [IF PH11c = 1] Are you currently taking prescription medicine or receiving other
treatment for problems caused by a stroke?
1
YES
2
NO
DK/REF

PH16 [IF PH11d = 1] Are you currently taking prescription medicine or receiving other
treatment for your diabetes, high blood sugar, or sugar diabetes
1
YES
2
NO
DK/REF

PH17 [IF PH11e = 1] Are you currently taking prescription medicine or receiving other
treatment for your heart disease?
1
YES
2
NO
DK/REF

PH18 [IF PH11f = 1] Are you currently taking prescription medicine or receiving other
treatment for your kidney problem?
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Comment [m10]: PH13-PH26 –modified version
of question in ’04 that asked about seeing a doctor
for the problem, now ask taking prescription
medication or receiving other tx.

Survey of Prison Inmates (SPI) Pilot Study Questionnaire

1
YES
2
NO
DK/REF

PH19 [IF PH11g = 1] Are you currently taking prescription medicine or receiving other
treatment for your arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
1
YES
2
NO
DK/REF

PH20 [IF PH11h = 1] Are you currently taking prescription medicine or receiving other
treatment for your asthma?
1
YES
2
NO
DK/REF

PH21 [IF PH11i = 1] Are you currently taking prescription medicine or receiving other
treatment for your cirrhosis of the liver?
1
YES
2
NO
DK/REF
PH22 [IF PH8j = 1] Are you currently taking prescription medicine or receiving other
treatment for your HIV – the virus that causes AIDS?
1
YES
2
NO
DK/REF
PH23 [IF PH8k = 1] Are you currently taking prescription medicine or receiving other
treatment for your tuberculosis or TB?
1
YES
2
NO
DK/REF
PH24 [IF PH11l = 1] Are you currently taking prescription medicine or receiving other
treatment for your Hepatitis B?
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1
YES
2
NO
DK/REF
PH25 [IF PH11m = 1] Are you currently taking prescription medicine for your Hepatitis C?
1
YES
2
NO
DK/REF

PH26 [IF PH12 = 1] Are you currently taking prescription medicine or receiving other
treatment for your paralysis?
1
YES
2
NO
DK/REF
PH27

These next questions are about smoking cigarettes.
Have you smoked at least 100 cigarettes in your entire life (that is, about 5 packs)?
1 YES
2 NO
DK/REF

PH28

[IF PH27 = 1] How old were you when you first started smoking cigarettes fairly
regularly?
ENTER ZERO IF RESPONDENT NEVER SMOKED CIGARETTES FAIRLY
REGULARLY.
AGE 1st SMOKED FAIRLY REGULARLY: ____ [RANGE: 7 – CURRENT AGE]
DK/REF

PH29

[IF PH27 = 1] Are you allowed to smoke at this facility?
1
YES
2
NO
DK/REF

PH30

[IF PH27 = 1 AND PH29 = 1] Do you now smoke cigarettes every day, some days, or
not all?
1

EVERY DAY

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2
SOME DAYS
3
NOT AT ALL
DK/REF
PH31

[IF PH30 = 1 OR 2] On how many of the past 30 days did you smoke cigarettes?
NUMBER OF DAYS SMOKED: ________ [RANGE: 1 – 30]
DK/REF

PH32

[IF PH30 = 1 OR 2] On average, when you smoked during the past 30 days, about
how many cigarettes did you smoke a day?
IF LESS THAN 1, ENTER “1"
NUMBER OF CIGARETTES A DAY: __________ [RANGE: 1 – 30]
DK/REF

PH33

[IF PH30=3] Why haven’t you smoked any cigarettes during the past 30 days?
1
COULD NOT AFFORD TO BUY CIGARETTES
2
DID NOT WANT TO SMOKE CIGARETTES
3
TRYING TO QUIT
4
SOME OTHER REASON
DK/REF

PH34

[IF PH27 = 1] In the 30 days before the arrest or charge that led to your current
incarceration, did you smoke cigarettes every day, some days, or not at all?
1
EVERY DAY
2
SOME DAYS
3
NOT AT ALL
DK/REF

PH35

How tall are you?
FEET: __________ [RANGE: 3 – 7]
INCHES: ________ [RANGE: 0 – 11]
DK/REF

PH36

How much do you currently weigh?
POUNDS: __________ [RANGE: 75 - 500]
DK/REF

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Comment [m11]: Changed reference period
from last 24 hours to last 30 days.

PH37 In the last 30 days, did you spend any time doing physical exercise, for
example sports, weightlifting, or running?
1
YES
2
NO
DK/REF

PH38 [IF PH37 = 1] On how many of those 30 days did you spend time doing any
physical exercise?

Comment [m12]: Changed reference period
from last 24 hours to last 30 days.

NUMBER OF DAYS: ________ [RANGE: 1 - 30]
DK/REF

PH39 The next questions are about difficulties that you might have due to a physical, mental, or
emotional problem.

PH40 Are you deaf or do you have serious difficulty hearing?
1 YES
2 NO
DK/REF
PH41 Are you blind or do you have serious difficulty seeing even when wearing glasses?
1 YES
2 NO
DK/REF
PH42 Because of a physical, mental, or emotional problem, do you have serious difficulty
concentrating, remembering, or making decisions?
1 YES
2 NO
DK/REF
PH43 Do you have serious difficulty walking or climbing stairs?
1 YES
2 NO
DK/REF
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Comment [m13]: PH39-PH44 Similar to ’04 but
modified to match ACS.

Survey of Prison Inmates (SPI) Pilot Study Questionnaire
PH44 Do you have difficulty dressing or bathing?
1 YES
2 NO
DK/REF

PH45 Because of a physical, mental, or emotional problem, do you have difficulty doing
activities on your own such as going to meal time, going outside, working in or outside of
this facility, going to classes, or attending programs?
1 YES
2 NO
DK/REF
PH46

[IF PH45 = 1] Is the difficulty you experience doing activities on your own caused
by…
PH46a. A physical problem?
PH46b. A mental or emotional problem?

Yes
1
1

No
2
2

PH47 [IF PH46 = 1] As a result of a physical problem, how much difficulty do you have
doing activities on your own?
1
Only a little difficulty
2
Some difficulty
3
A lot of difficulty
DK/REF
PH48 [IF PH46b = 1] As a result of a mental or emotional problem, how much difficulty do
you have doing activities on your own?
1
Only a little difficulty
2
Some difficulty
3
A lot of difficulty
DK/REF
PH49 Has a doctor, psychologist, or teacher ever told you that you have an attention
deficit disorder, sometimes called ADD or ADHD?
1
YES
2
NO
DK/REF

PH50 Has a doctor, psychologist, or teacher ever told you that you have a learning
Section 5 – Physical Health, Treatment, and Disabilities

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Comment [m14]: Modified from”Do you have
…”

Survey of Prison Inmates (SPI) Pilot Study Questionnaire

1
2

disability, such as dyslexia or dyscalculia?
YES
NO
DK/REF

PH51 Have you ever been enrolled in special education classes, sometimes called
SPED?
1
YES
2
NO
DK/REF

Section 5 – Physical Health, Treatment, and Disabilities

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Section 6 ― Alcohol Use (AU)
AU1

The next questions are about alcoholic beverages, such as beer, wine, brandy, and mixed
drinks. These questions are about drinks of alcoholic beverages. Throughout these
questions, by a “drink,” we mean a can or bottle of beer, a glass of wine or a wine cooler,
a shot of liquor, or a mixed drink with liquor in it. We are not asking about times when
you only had a sip or two from a drink.
Have you ever, even once, had a drink of any type of alcoholic beverage? Please do not
include times when you only had a sip or two from a drink.
1
YES
2
NO
DK/REF

AU2

[IF AU1=1] About how old were you when you first started drinking alcohol, other than
small tastes or sips?
AGE: _____________________ [RANGE: 1 – 99]
DK/REF

AU3

[IF AU1=1] Have you ever drunk alcoholic beverages, more than once a week for more
than a month?
1
YES
2
NO
DK/REF

AU4 [IF AU1=1] During the 12 month before the arrest or charge that led to this incarceration,
how often did you usually drink alcohol?
1
Daily or almost daily
2
At least once a week
3
Less than once a week
4
About once a month
5
Less than once a month
6
Not at all
DK/REF
AU5

[IF AU1=1] Had you been drinking any alcohol at the time of [the offense / any of the
offenses] for which you are now incarcerated?
1
YES
2
NO
DK/REF

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

AU6

[IF AU4=1 - 5] During the 12 months before the arrest or charge that led to this
incarceration, did you drive a car, motorcycle, truck, boat, or any other vehicle after
having too much to drink?
1
YES
2
NO
DK/REF

AU7

[IF AU6=1] During that same 12 month period did you have an accident as a result of
driving a vehicle after you had been drinking?
1
YES
2
NO
DK/REF

_______________________________________________________

D – Alcohol Dependency and Abuse Items
Block Level Universe: (AU4 = 1 – 5)

AUD1

[IF AU4 = 1 - 5] Think about your use of alcohol during the 12 months before the arrest
or charge that led to this incarceration.
During that 12 month period, was there a month or more when you spent a lot of your
time getting or drinking alcohol?
1
YES
2
NO
DK/REF

AUD2

[IF AUD1 = 2 OR DK/REF] During the 12 months before the arrest or charge that led to
this incarceration, was there a month or more when you spent a lot of time getting over
the effects of the alcohol you drank?
1
YES
2
NO
DK/REF

AUD3

[IF AU4 = 1 - 5] During the 12 months before the arrest or charge that led to this
incarceration, did you try to set limits on how often or how much alcohol you would
drink?
1

YES

Section 6 – Alcohol Use

Page 115

Comment [leg15]: While we measured
dependency and abuse in prior iterations of SPI, the
section has been redesigned so that the items are
“new” in the sense that they comport with how the
symptoms are measured in the National Survey of
Drug Use and Health (NSDUH) to facilitate
comparisons with the general population

Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2
NO
DK/REF
AUD4

[IF AUD3 = 1] Were you able to keep to the limits you set, or did you often drink more
than you intended to?
1
USUALLY KEPT TO LIMITS SET
2
OFTEN DRANK MORE THAN INTENDED
DK/REF

AUD5

[IF AU4 = 1 - 5] During that 12 month period, did you need to drink more alcohol than
you used to in order to get the effect you wanted?
1
YES
2
NO
DK/REF

AUD6

[IF AUD5=2 OR DK/REF] During that 12 month period, did you notice that drinking the
same amount of alcohol had less effect on you than it used to?
1
YES
2
NO
DK/REF

AUD7

[IF AU4 = 1 - 5] During that 12 month period, did you want to or try to cut down or
stop drinking alcohol?
1
YES
2
NO
DK/REF

AUD8

[IF AUD7 = 1] During that 12 month period, were you able to cut down or stop drinking
alcohol every time you wanted to or tried to?
1
YES
2
NO
DK/REF

AUD9

[IF (AUD7 = 2 OR DK/REF) OR (AUD8 = 2 OR DK/REF)] During that 12 month
period, did you cut down or stop drinking at least one time?
1
YES
2
NO
DK/REF

AUD10

[IF AUD8 = 1 OR AUD9 = 1] During that 12 month period, did you have 2 or more of
these symptoms after you cut back or stopped drinking alcohol?
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble

Section 6 – Alcohol Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
•
•
•
•
•
•

Having trouble sleeping
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
YES
2
NO
DK/REF
AUD11

[IF AUD10 = 1] During that 12 month period, did you have 2 or more of these
symptoms at the same time that lasted for longer than a day after you cut back or
stopped drinking alcohol?
•
•
•
•
•
•
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
YES
2
NO
DK/REF
AUD12

[IF AU4 = 1 - 5] During that 12 month period, did you have any problems with your
emotions, nerves, or mental health that were probably caused or made worse by drinking
alcohol?
1
YES
2
NO
DK/REF

AUD13

[IF AUD12 = 1] Did you continue to drink alcohol even though you thought drinking
was causing you to have problems with your emotions, nerves, or mental health?
1
YES
2
NO
DK/REF

AUD14

[IF (AUD12 = 2 OR DK/REF) OR (AUD13 = 2 OR DK/REF)] During that 12 month
period, did you have any physical health problems that were probably caused or made
worse by drinking alcohol?
1
YES
2
NO
DK/REF

Section 6 – Alcohol Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

AUD15

[IF AUD14 = 1] Did you continue to drink alcohol even though you thought drinking
was causing you to have physical problems?
1
YES
2
NO
DK/REF

AUD16

[IF AU4 = 1 - 5] This question is about important activities such as working, going to
school, taking care of children, doing fun things such as hobbies and sports, and spending
time with friends and family.
During the 12 months before the arrest or charge that led to this incarceration, did
drinking alcohol cause you to give up or spend less time doing these types of important
activities?
1
YES
2
NO
DK/REF

AUD17

[IF AU4 = 1 - 5] Sometimes people who drink alcohol have serious problems at home,
work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the 12 months before the arrest or charge that led to this incarceration, did
drinking alcohol cause you to have serious problems like this either at home, work, or
school?
1
YES
2
NO
DK/REF
AUD18

[IF AU4 = 1 - 5] During that 12 month period, did you regularly drink alcohol and then
do something where being drunk might have put you in physical danger?
1
YES
2
NO
DK/REF

AUD19

[IF AU4 = 1 - 5] During that12 month period, did drinking alcohol cause you to do
things that repeatedly got you in trouble with the law?
1
YES
2
NO
DK/REF

Section 6 – Alcohol Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
AUD20

[IF AU4 = 1 - 5] During that 12 month period, did you have any problems with family or
friends that were probably caused by your drinking?
1
YES
2
NO
DK/REF

AUD21

[IF AUD20 = 1] Did you continue to drink alcohol even though you thought your
drinking caused problems with family or friends?
1
YES
2
NO
DK/REF

______________________________END Alcohol Dependency and Abuse Items Block (D)

Section 6 – Alcohol Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Section 7 ― Drug Use (DU)
DEFINE PRDRUG_TYPES
PRDRUG_TYPES = Types of prescription drugs from DU1k ,
DU1l, DU1m, and DU1n
IF DU1k = 1 display “pain relievers”
IF DU1l = 1 display “tranquilizers”
IF DU1m = 1 display “stimulants”
IF DU1n =1 display “sedatives”
[pain relievers/tranquilizers/stimulants/sedatives]

DU1. These next questions are about using drugs other than alcohol.
Have you ever used...
[TESTED IN COGNITIVE INTERVIEWING]
YES
1

NO
2

DU1b. Any form of cocaine, including powder, “crack”, free
base, and coca paste?

1

2

DU1c.

[IF J1b = 1] Have you ever used “crack”?

1

2

DU1d.

Heroin?

DU1a. Marijuana or hashish?

1

2

DU1e. PCP? PCP is also called “angel dust” or phencyclidine.

1

2

DU1f.

1

2

Have you ever used any other type of hallucinogen,
including LSD, peyote, mescaline, or psilocybin, found in
mushrooms?

1

2

Inhalants - that is substances that people sniff or inhale
for kicks or to get high? These include: amyl nitrite,
locker room odorizers, cleaning fluid, gasoline, glue,
nitrous oxide, or spray paints.

1

2

Have you ever used Methamphetamine, also known as
meth, crystal, or crank?

1

2

1

2

1

2

DU1g

DU1h.

DU1i.

Ecstasy, also known as MDMA?

DU1j. Have you ever used other illegal drugs other than those
I’ve just asked you about?
(DU1j_OTH) SPECIFY: __________________________
DU1k.

Have you ever used a prescription pain reliever such as
Darvon, Percocet, Vicodan, Methadone, or OxyContin that
was not prescribed for you or that you took only for the
experience or feeling it caused?

Section 7 – Drug Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

DU2

DU1l. Have you ever use a prescription tranquilizer such as
Xanax, Ativan, Valium, Klonopin, or Clonazepam that was
not prescribed for you or that you took only for the
experience or feeling it caused?

1

2

DU1m. Have you ever used a prescription stimulant such as
Methedrine, Amphetamines, Ritalin, or Dexedrine that was
not prescribed for you or that you took only for the
experience or feeling it caused?

1

2

DU1n. Have you ever used a prescription sedative such as
barbiturates, Methaqualone, Nembutal, Seconal, or Restoril
that was not prescribed for you or that you took only for
the experience or feeling it caused?

1

2

Have you ever used prescription pain relievers, tranquilizers, stimulants, or sedatives
when you did not have your own prescription from a doctor?
1
YES
2
NO
DK/REF

DU3

Have you ever used prescription pain relievers, tranquilizers, stimulants, or sedatives that
you had your own prescription for, but that you took more often or in larger amounts than
your doctor told you to?
1
YES
2
NO
DK/REF

DU4

Have you ever used prescription pain relievers, tranquilizers, stimulants, or sedatives just
to get high?
1
YES
2
NO
DK/REF

DU5

[IF DU1b=1 OR DU1d=1 OR DU1j=1 OR DU1m = 1] Have you ever, even once, used a
needle to inject any drug that was not prescribed for you or that you took only for the
experience or feeling it caused?
1
YES
2
NO
DK/REF

Section 7 – Drug Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DU6

[IF DU5 = 1] Have you ever used a needle that you knew or suspected had been used by
someone else for injecting drugs or shared a needle that you had used with someone else?
1
YES
2
NO
DK/REF

DU7

[IF DU1a = 1] Have you ever used marijuana or hashish once a week or more for at least
a month?
1
YES
2
NO
DK/REF

DU8

[IF DU1b = 1] Have you ever used any form of cocaine, including “crack”, free base,
and coca paste once a week or more for at least a month?
1
YES
2
NO
DK/REF

DU9

[IF DU1c = 1] Have you ever used “crack” once a week or more for at least a month?
1
YES
2
NO
DK/REF

DU10 [IF DU1d = 1] Have you ever used heroin once a week or more for at least a month?
1
YES
2
NO
DK/REF

DU11 [IF DU1e = 1] Have you ever used PCP once a week or more for at least a month?
1

YES

Section 7 – Drug Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2
NO
DK/REF

DU12 [IF DU1f = 1] Have you ever used Ecstasy or MDMA once a week or more for at least a
month?
1
YES
2
NO
DK/REF

DU13 [IF DU1g = 1] Have you ever used any other type of hallucinogen, including LSD,
peyote, mescaline, or psilocybin, found in mushrooms once a week or more for at least a
month?
1
YES
2
NO
DK/REF

DU14 [IF DU1h = 1] Have you ever used any inhalant for kicks or to get high once a week or
more for at least a month?
1
YES
2
NO
DK/REF

DU15 [IF DU1i = 1] Have you ever used Methamphetamine once a week or more for at least a
month?
1
YES
2
NO
DK/REF

DU16 [IF DU1k = 1 OR DU1l = 1 OR DU1m = 1 OR DU1n =1] Have you ever used
prescription [PRDRUG_TYPES] that were not prescribed for you or that you took only
for the experience or feeling it caused once a week or more for at least a month?
1

YES

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2
NO
DK/REF

DU17 [IF DU1a = 1 OR DU1b = 1 OR DU1c = 1 OR DU1d = 1 OR DU1e = 1 OR DU1f = 1
OR DU1g= 1 OR DU1h = 1 OR DU1i = 1 OR DU1j = 1 OR DU1k = 1OR DU1l = 1 OR
DU1m = 1 OR DU1n = 1] Now I would like for you to think about the 30 days before
the arrest or charge that led to this incarceration. During those 30 days did you use…
[TESTED IN COGNITIVE INTERVIEWING]
NOTE TO PROGRAMMERS: THIS SCREEN SHOULD FILL WITH ONLY
THOSE DRUGS THE R ENDORSED IN DU1.
YES

NO

DU17a. [IF DU1a = 1] Marijuana or hashish?

1

2

DU17b. [IF DU1b = 1] Any form of cocaine, including powder,
“crack”, free base, and coca paste?

1

2

DU17c.

1

2

DU17d. [IF DU1d = 1 Heroin?

1

2

DU17e. [IF DU1e = 1] PCP? PCP is also called “angel dust” or
phencyclidine.

1

2

DU17f. [IF DU1f = 1] Ecstasy, also known as MDMA?

[IF DU1c = 1] “Crack”?

1

2

[IF DU1g = 1] Any other type of hallucinogen,
including LSD, peyote, mescaline, or psilocybin, found in
mushrooms?

1

2

DU17h. [IF DU1h = 1] Inhalants - that is substances that people
sniff or inhale for kicks or to get high? These include:
amyl nitrite, locker room odorizers, cleaning fluid,
gasoline, glue, nitrous oxide, or spray paints.

1

2

1

2

DU17j. [IF DU1j = 1] Other illegal drugs like [FILL SPECIFY
FIELD FROM DU1j_OTH]

1

2

DU17k. [IF DU1k = 1] A prescription pain reliever such as
Darvon, Percocet, Vicodan, Methadone, or OxyContin that
was not prescribed for you or that you took only for the
experience or feeling it caused?

1

2

DU17l. [IF DU1l = 1] A prescription tranquilizer such as
Xanax, Ativan, Valium, Klonopin, or Clonazepam that was
not prescribed for you or that you took only for the
experience or feeling it caused?

1

2

DU17g

DU17i.

[IF DU1i = 1] Methamphetamine, also known as meth,
crystal, or crank?

Section 7 – Drug Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DU17m. [IF DU1m = 1] A prescription stimulant such as
Methedrine, Amphetamines, Ritalin, or Dexedrine that was
not prescribed for you or that you took only for the
experience or feeling it caused?
DU17n. [IF DU1n = 1] A prescription sedative such as
barbiturates, Methaqualone, Nembutal, Seconal, or Restoril
that was not prescribed for you or that you took only for
the experience or feeling it caused?

1

2

DU18 [IF DU1a = 1 OR DU17b = 1 OR DU17c = 1 OR DU17d = 1 OR DU17e = 1 OR DU17f
= 1 OR DU17g= 1 OR DU17h = 1 OR DU17i = 1 OR DU17j = 1 OR DU17k = 1 OR
DU17l = 1 OR DU17m = 1 OR DU17n = 1] In the 30 days before the arrest or charge
that led to this incarceration, how did you get the drugs you were using?
YES NO

DU19.

DU18a. Bought them from a stranger?

1

2

DU18b.

Bought them from a dealer you know?

1

2

DU18c.

Bought them from a friend?

1

2

DU18d. Stole them?

1

2

DU18e. Given to you by friends or acquaintances?

1

2

DU18f.

1

2

DU18g. Traded sex for the drugs?

Used a fake or forged prescription?

1

2

DU18h

1

2

Got the drugs some other way?

[IF MORE THAN 1 of (DU18a, DU18b, DU18c, DU18d, DU18e, DU18f,
DU18g, or DU18h) = 1] What was the main way you got the drugs you were
using in the 30 days before the arrest or charge that led to this incarceration?
NOTE TO PROGRAMMERS: THIS ANSWER PANE SHOULD FILL
WITH ONLY THOSE ANSWER CATEGORIES THAT THE
RESPONDENT GAVE “YES” RESPONSES TO IN DU18.
[IF DU18a=1] 1
BOUGHT THEM FROM A STRANGER
[IF DU18b=1] 2
BOUGHT THEM FROM A DEALER YOU KNOW
[IF DU18c=1] 3
BOUGHT THEM FROM A FRIEND
[IF DU18d=1] 4
STOLE THEM
[IF DU18e=1] 5
GIVEN TO YOU BY FRIENDS OR ACQUAINTANCES
[IF DU18f=1] 6
USED A FAKE OR FORGED PRESCRIPTION
[IF DU18g=1] 7
TRADED SEX FOR THE DRUGS
[IF DU18h=1] 8
GOT THE DRUGS SOME OTHER WAY
DK/REF

Section 7 – Drug Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DU20 [IF DU1a = 1 OR DU1b = 1 OR DU1c = 1 OR DU1d = 1 OR DU1e = 1 OR DU1f = 1
OR DU1g= 1 OR DU1h = 1 OR DU1i = 1 OR DU1j = 1] Now I would like for you to
think about the 12 months before the arrest or charge that led to this incarceration. During
those 12 months did you use any illegal drugs?
1
YES
2
NO
DK/REF
DU21 [DU1k = 1OR DU1l = 1 OR DU1m = 1 OR DU1n = 1] During the 12 months before the
arrest or charge that led to this incarceration, did you use any prescription medicine that
you took only for the experience or feeling it caused?
1
YES
2
NO
DK/REF

DU22 [IF DU20 = 1 OR DU21= 1] ] These next questions are about experiences many people
have in connection with their use of drugs.
During the 12 months before the arrest or charge that led to this incarceration, did you
drive a car, motorcycle, truck, boat, or any other motor vehicle while under the influence
of an illegal drug or a drug that you used only for non-medical reasons?
1
YES
2
NO
DK/REF
DU23 [IF DU22 = 1] During that same 12 month period did you have an accident as a result of
driving a vehicle while you were under the influence of an illegal drug or a drug that was
not prescribed for you or that you used only for the experience or feeling it caused?
1
YES
2
NO
DK/REF
DU24 [IF DU20 = 1] During that 12 month period did you use any illegal drugs regularly, that
is at least once a week?
1 YES
2 NO
DK/REF
DU25 [IF DU21 = 1] During that 12 month period did you use any prescription medicine that
you took only for the experience or feeling it caused regularly, that is at least once a
Section 7 – Drug Use

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
week?
1 YES
2 NO
DK/REF
_______________________________________________________
D – Substance Dependency and Abuse Items Block
Block Level Universe: (DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1
OR DU1f=1 OR DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR
DU1l=1 OR DU1m=1 OR DU1n=1)
DUD1 [DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] During the 12 months before the arrest or charge that led to this
incarceration, was there a month or more when you spent a lot of your time getting or
using drugs?
1
YES
2
NO
DK/REF
DUD2 [IF DUD1=2] During the 12 months before the arrest or charge that led to this
incarceration, was there a month or more when you spent a lot of your time getting over
the effects of the drugs you used?
1
YES
2
NO
DK/REF
DUD3 [DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] During the 12 months before the arrest or charge that led to this
incarceration, did you try to set limits on how often or how much drugs you would use?
1
YES
2
NO
DK/REF
DUD4 [IF DUD3=1] Were you able to keep to the limits you set, or did you often use drugs
more than you intended to?
1
YES
2
NO
DK/REF
Section 7 – Drug Use

Page 127

Comment [leg16]: While we measured
dependency and abuse in prior iterations of SPI, the
section has been redesigned so that the items are
“new” in the sense that they comport with how the
symptoms are measured in the National Survey of
Drug Use and Health (NSDUH) to facilitate
comparisons with the general population

Survey of Prison Inmates (SPI) Pilot Study Questionnaire

DUD5 [DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] During the 12 months before the arrest or charge that led to this
incarceration, did you need to use more drugs than you used to in order to get the effect
you wanted?
1
YES
2
NO
DK/REF
DUD6 [IF DUD5=2] During that 12 month period, did you notice that using the same amount of
drugs had less effect on you than it used to?
1
YES
2
NO
DK/REF
DUD7 [DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] During that 12 month period, did you want to or try to cut down or stop
using drugs?
1
YES
2
NO
DK/REF
DUD8 [IF DUD7=1] During that 12 month period, were you able to cut down or stop using
drugs every time you wanted to or tried to?
1
YES
2
NO
DK/REF
DUD9 [IF (DUD7=2 OR DK/REF) OR (DUD8=2 OR DK/REF)] During that 12 month period,
did you cut down or stop using drugs at least one time?
1
YES
2
NO
DK/REF
DUD10 [IF DUD8=1 OR DUD9=1] During that 12 month period, did you feel kind of blue or
down when you cut down or stopped using drugs?
1
2

YES
NO

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DK/REF
DUD11 [IF DUD10=1] During that 12 month period, did you have two or more of these
symptoms after you cut back or stopped using drugs?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
YES
2
NO
DK/REF
DUD12 [IF DUD11 = 1] During that 12 month period, did you have two or more of these
symptoms at the same time that lasted for longer than a day after you cut back or
stopped using drugs?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1 YES
2 NO
DK/REF
DUD13 [IF DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] During that 12 month period, did you have any problems with your
emotions, nerves, or mental health that were probably caused or made worse by your use
of drugs?
1
YES
2
NO
DK/REF
DUD14 [IF DUD13 = 1] Did you continue to use drugs even though you thought it was causing
you to have problems with your emotions, nerves, or mental health?
1
YES
2
NO
DK/REF
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DUD15 [IF (DUD13=2 OR DK/REF) OR (UDR14=2 OR DK/ REF] During the 12 months
before the arrest or charge that led to this incarceration, did you have any physical health
problems that were probably caused or made worse by your use of drugs?
1
YES
2
NO
DK/REF
DUD16 [IF DUD15=1] Did you continue to use drugs even though you thought it was causing
you to have physical problems?
1
YES
2
NO
DK/REF
DUD17 [IF DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] This question is about important activities such as working, going to
school, taking care of children, doing fun things such as hobbies and sports, and spending
time with friends and family.
During the 12 months before the arrest or charge that led to this incarceration, did using
drugs cause you to give up or spend less time doing these types of important activities?
1 YES
2 NO
DK/REF
DUD18 [IF DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] Sometimes people who use drugs have serious problems at home, work or
school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the 12 months before the arrest or charge that led to this incarceration, did using
drugs cause you to have serious problems like this either at home, work, or school?
1 YES
2 NO
DK/REF
DUD19 [IF DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] During that 12 month period, did you regularly use drugs and then do
something where using drugs might have put you in physical danger?
1
YES
2
NO
DK/REF
DUD20 [IF DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] During that 12 month period, did using drugs cause you to do things that
repeatedly got you in trouble with the law?
1
YES
2
NO
DK/REF
DUD21 [IF DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] During that 12 month period, did you have any problems with family or
friends that were probably caused by your use of drugs?
1
YES
2
NO
DK/REF
DUD22 [IF DUD21 = 1] Did you continue to use drugs even though you thought it caused
problems with family or friends?
1
YES
2
NO
DK/REF
______________________________END Substance Dependency and Abuse Items Block (D)

DU26. [IF DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1] Were you under the influence of any drugs at the time of the arrest or
charge that led to this incarceration?
1
YES
2
NO
DK/REF
DU27 [IF DU26 = 1] What drugs were you under the influence of at the time of the arrest or
charge that led to this incarceration?
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NOTE TO PROGRAMMERS: THIS SCREEN SHOULD FILL WITH ONLY
THOSE DRUGS THE R ENDORSED IN DU1.
YES

NO

DU27a. [IF DU1a = 1]Marijuana or hashish?

1

2

DU27b. [IF DU1b = 1] Any form of cocaine, including powder,
“crack”, free base, and coca paste?

1

2

DU27c.

1

2

[IF DU1c = 1] “crack”?

DU27d. [IF DU1d = 1] Heroin?

1

2

DU27e.

1

2

1

2

1

2

DU27h. [IF DU1h = 1] Inhalants, such as amyl nitrite, locker
room odorizers, cleaning fluid, gasoline, glue, nitrous
oxide, or spray paints?

1

2

DU27i. [IF DU1i = 1] Methamphetamine?

1

2

DU27j. [IF DU1j = 1] An illegal drug other than those I’ve just
asked about?

1

2

DU27k. [IF DU1k = 1 OR DU1l = 1 OR DU1m = 1 OR DU1n
=1] Prescription [PRDRUG_TYPES] that were not
prescribed for you or that you took only for the experience
or feeling they caused?

1

2

[IF DU1e = 1] PCP?

DU27f. [IF DU1f = 1] Ecstasy, also known as MDMA?
DU27g

[IF DU1g = 1] Any other type of hallucinogen,
including LSD, peyote, mescaline, or psilocybin, found in
mushrooms?

Section 7 – Drug Use

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Section 8 — Drug and Alcohol Treatment (DAT)
DAT1. [IF DU1a =1 OR DU1b=1 OR DU1c=1 OR DU1d=1 OR DU1e=1 OR DU1f=1 OR
DU1g=1 OR DU1h=1 OR DU1i=1 OR DU1j=1 OR DU1k=1 OR DU1l=1 OR DU1m=1
OR DU1n=1 OR AU1=1] These next questions deal with treatment for alcohol and drug
problems, not including cigarettes. Please report treatment or counseling designed to
help you reduce or stop your alcohol or drug use. Please include detoxification and any
other treatment for medical problems associated with your alcohol or drug use.
Have you ever received treatment or counseling for your use of alcohol or any drug, not
counting cigarettes?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF

DAT2 [IF DAT1 = 1] Was the treatment or counseling you received for alcohol use only, drug
use only, or both alcohol and drug use?
1
ALCOHOL USE ONLY
2
DRUG USE ONLY
3
BOTH ALCOHOL AND DRUG USE
DK/REF

DAT3 [IF DAT1 = 1] Have you received any kind of treatment or counseling for your use of
alcohol or any drug while you were incarcerated in a prison, jail, or some other type of
correctional facility?
1
YES
2
NO
DK/REF
DAT4 [IF DAT3 = 1 AND DAT2 = 3] Was the treatment or counseling you received while you
were incarcerated for alcohol use only, drug use only, or both alcohol and drug use?
1
ALCOHOL USE ONLY
2
DRUG USE ONLY
3
BOTH ALCOHOL AND DRUG USE
DK/REF
DAT5 [IF DAT3 = 1] Was any of the treatment or counseling you received while you were
incarcerated mandatory – that is, were you required to attend it?
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1
YES
2
NO
DK/REF
DAT6 [IF DAT1 = 1 AND PROBATION OR PAROLE REPORTED IN SECTION 2] Have
you ever received any kind of treatment or counseling for your use of alcohol or any
drug while you were on probation or parole?
1
YES
2
NO
DK/REF
FI NOTE:
The respondent should include treatment
or counseling received from any source –
whether it was a part of his/her postincarceration supervision or not.
DAT7 [IF DAT6 = 1 AND DAT2 = 3] Was the treatment or counseling you received while you
were on probation or parole for alcohol use only, drug use only, or both alcohol and drug
use?
1
ALCOHOL USE ONLY
2
DRUG USE ONLY
3
BOTH ALCOHOL AND DRUG USE
DK/REF
DAT8 [IF DAT6 = 1] Was any of the treatment or counseling you received while on probation
or parole mandatory – that is, were you required to attend it?
1
YES
2
NO
DK/REF
DAT9

[IF DAT1 = 1] In the 12 months before the arrest or charge that led to this
incarceration, did you receive treatment or counseling for your use of alcohol or any
drug?
1
YES
2
NO
DK/REF

DAT10 [IF DAT9 = 1] In the 12 months before the arrest or charge that led to this incarceration,
did you receive treatment or counseling for your use of alcohol or any drug…
[TESTED IN COGNITIVE INTERVIEWING]
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YES
1

NO
2

1

2

1

2

1

2

DAT10e. In a mental health center or facility where you did not
stay overnight

1

2

DAT10f. In an emergency room?

1

2

DAT10g. In a private doctor’s office?
DAT10h. In a prison or jail?
DAT10i. In a self-help group such as Alcoholics Anonymous or
Narcotics Anonymous?
DAT10j. In some other place other than these I’ve just asked
about? (DAT10_OTH) SPECIFY:
______________________

1
1

2
2

1

2

1

2

DAT10a. In an alcohol or drug detoxification unit?
DAT10b. In a hospital overnight as an inpatient?
DAT10c. In a residential drug or alcohol rehabilitation facility or
unit where you stayed overnight?
DAT10d. In a drug or alcohol rehabilitation facility where you
did not stay overnight

DAT11 [IF (DAT10a OR DAT10b OR DAT10c OR DAT10d OR DAT10e OR DAT10f OR
DAT10g OR DAT10h OR DAT10i OR DAT10j) = 1 AND DAT2 = 3] Did you receive
the treatment or counseling for problems with alcohol, drugs, or both?
1
ALCOHOL ONLY
2
DRUGS ONLY
3
BOTH ALCOHOL AND DRUGS
DK/REF

DAT12 [IF DAT1 = 1] Since you entered prison [DATE_ADMIT], have you received any
kind of treatment or counseling for your use of alcohol or any drug?
1
YES
2
NO
DK/REF
DAT13 [IF DAT12 = 1 AND DAT2 = 3] [Since you entered prison [DATE_ADMIT]...Did you
receive treatment or counseling for problems with alcohol, drugs, or both?
1

ALCOHOL ONLY

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2
DRUGS ONLY
3
BOTH DRUGS AND ALCOHOL
DK/REF
DAT14 [DAT12 = 1] Since you entered prison [DATE_ADMIT], have you been required to
receive treatment for your use of alcohol or any drug?
1
YES
2
NO
DK/REF
DAT15 [DAT12 = 2] Since you entered prison [DATE_ADMIT], have you felt that you needed
treatment or counseling for alcohol or drug use?
1
YES
2
NO
DK/REF
DAT16 [IF DAT15 = 1] Are you currently receiving any kind of treatment or counseling for
alcohol or drug use?
1
YES
2
NO
DK/REF
DAT17 [IF DAT16 = 2] Why aren’t you currently receiving treatment for alcohol or drug use?

DAT17a. You are not currently eligible to receive alcohol or
drug treatment
DAT17b. Treatment for alcohol or drug use is not available at
this facility
DAT17c. Staff at this facility don’t think you need treatment for
alcohol or drug use
DAT17d. You don’t like the alcohol or drug treatment
programs available at this facility
DAT17e. Some other reason,
(DAT17_OTH) SPECIFY: _______________________

Section 8 – Drug and Alcohol Treatment

YES

NO

1

2

1

2

1

2

1

2

1

2

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Comment [leg17]: Note that prior iterations of
SPI only focused on contact with minor children, the
type of contact (i.e., mail, visits), and the frequency.
So essentially this is a new section that covers
contact with different types of people and their
relationship to the inmate, the type of contact, and
frequency of contact (by specific type for children)

Section 9 - Social Support from Outside the Facility (SS)

DEFINE 12MONSTATUS:
IF admission date is less than 12 months ago THEN set 12MONSTATUS = 1
IF admission date is at least 12 months ago THEN set 12MONSTATUS = 2
DEFINE 12MON_FILL1:
IF facility admission date is less than 12 months ago THEN 12MON_FILL1 = “Since you
arrived at this facility”
IF facility admission date is at least 12 months ago THEN 12MON_FILL1 = “During the past 12
months”
DEFINE 12MON_FILL2:
IF facility admission date is less than 12 months ago THEN 12MON_FILL2 = “since you arrived
at this facility”
IF facility admission date is at least 12 months ago THEN 12MON_FILL2 = “during the past 12
months”
DEFINE DATE_ADMIT2:
IF [12MONSTATUS=1 AND (MONTH ne EMPTY and DAY ne EMPTY and YEAR ne
EMPTY) THEN DATE_ADMIT2 = “on MONTH/DAY/YEAR”
ELSE DATE_ADMIT2 = EMPTY
This fill is used in fields SS3, SS4, SS5, SS6, SS7, and SS8 and will only fill when asking
the question(s) of inmates who reported a month, day, and year they were admitted and have
been incarcerated for less than 12 months.

SS_INTRO This next set of questions is about contact you have had with people outside this
facility. By contact we mean phone calls, video visits, mail, or in-person visits, and we
are interested in contact you have had with your family members, friends, partners, loved
ones, or other people you know. We do not want to know their names, but we will want
you to tell us who they are or your relationship with the person, such as your husband or
wife.
SS1

[IF 12MONSTATUS = 2] In the past 12 months, who from outside the facility have you
had contact with? (CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1.
2.
3.
4.
5.
6.
7.

CURRENT PARTNER (SPOUSE OR GIRL/BOYFRIEND)
EX-PARTNER (EX-SPOUSE OR EX-GIRL/BOYFRIEND)
CHILDREN UNDER 18 (BIOLOGICAL/ADOPTED/STEP/PARTNER’S)
CHILDREN OVER 18 (BIOLOGICAL/ADOPTED/STEP/PARTNER’S)
PARENTS
SIBLINGS
GRANDPARENTS

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
8. OTHER CHILDREN UNDER 18 NOT RELATED TO YOU
9. OTHER FAMILY MEMBERS
10. FOSTER FAMILY
11. FRIENDS
12. OTHER NON-RELATIVE(S)/NOT FRIEND(S)
13. NOBODY (NEXT MODULE)
SS2

[IF 12MONSTATUS = 1] Since you were admitted to prison for this incarceration
[DATE_ADMIT2], who from outside the facility have you had contact with? (CHECK
ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1. CURRENT PARTNER (SPOUSE OR GIRL/BOYFRIEND)
2. EX-PARTNER (EX-SPOUSE OR EX-GIRL/BOYFRIEND)
3. CHILDREN UNDER 18 (BIOLOGICAL/ADOPTED/STEP/PARTNER’S)
4. CHILDREN OVER 18 (BIOLOGICAL/ADOPTED/STEP/PARTNER’S)
5. PARENTS
6. SIBLINGS
7. GRANDPARENTS
8. OTHER CHILDREN UNDER 18 NOT RELATED TO YOU
9. OTHER FAMILY MEMBERS
10. FOSTER FAMILY
11. FRIENDS
12. OTHER NON-RELATIVE(S)/NOT FRIEND(S)
13. NOBODY (NEXT MODULE)

SS3

Now I would like for you to tell me about the contact you have had with these people
[12MON_FILL2] [DATE_ADMIT2].
YES NO

SS3a. Have you had in-person visits with any of these people?
[TESTED IN COGNITIVE INTERVIEWING]

1

2

SS3b. Have you exchanged letters with any of these people?

1

2

SS3c. Have you talked on the phone with any of these people?

1

2

SS3d. Have you exchanged text messages with any of these people?

1

2

SS3e. Have you exchanged email messages with any of these people?
SS3f. Some Other Way? (such as dvds, cds, or tapes)
(SS3_OTH) SPECIFY ______________________________

1

2

1

2

SS4

[IF SS3a = 2] Why do you think you have not received an in-person visit from any of
these people [12MON_FILL2] [DATE_ADMIT2]? (CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1. LIVES TOO FAR AWAY

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
2. CAN’T HAVE VISITORS
3. INMATE DOESN’T WANT PERSON TO SEE HIM/HER
INCARCERATED
4. CAN’T AFFORD TO TRAVEL TO FACILITY
5. VISITING FACILITY WILL BE UNSAFE
6. PERSON DOESN’T WANT TO SEE INMATE WHILE INCARCERATED
7. OTHER

SS5

[12MON_FILL1] [DATE_ADMIT2], about how often have you…

Daily or almost daily = 1
At least once a week = 2
At least once a month = 3
Less than once a month = 4
Never = 5
1

2

3 4

5

SS5a. [IF SS3a = 1] had in-person visits with any of these people?
SS5b. [IF SS3b = 1] exchanged letters with any of these people?
SS5c. [IF SS3c = 1] had phone calls with any of these people?
SS5d. [IF SS3d = 1] exchanged text messages with any of these people?
SS5e. [IF SS3e = 1] exchanged email messages with any of these people?
SS6

[IF #UNDER18 = 1or more] Now I would like for you to tell me about the contact you
have had with any of your [#UNDER18] children who are under 18 years old.
[12MON_FILL1] [DATE_ADMIT2], what type of contact have you had with any of
those children under 18 years old?
[TESTED IN COGNITIVE INTERVIEWING]
YES NO

SS6a. Have you had in-person visits?

1

2

SS6b. Have you exchanged letters?

1

2

SS6c. Have you had phone calls?

1

2

SS6d. Have you exchanged text messages?

1

2

SS6e. Have you exchanged email messages?
SS6f. Some Other Way? (such as dvds, cds, or tapes)
(SS6_OTH) SPECIFY ______________________________

1

2

1

2

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
SS7

[12MON_FILL1] [DATE_ADMIT2], about how often have you…

Daily or almost daily = 1
At least once a week = 2
At least once a month = 3
Less than once a month = 4
Never = 5
1

2

3 4

5

SS7a. [IF SS6a = 1] had in-person visits with any of those children under
18?
SS7b. [IF SS6b = 1] exchanged letters with any of those children under 18?
SS7c. [IF SS6c = 1] had phone calls with any of those children under 18?
SS7d. [IF SS6d = 1] exchanged text messages with any of those children
under 18?
SS7e. [IF SS6e = 1] exchanged email messages with any of those children
under 18?
SS8

[IF SS6a = 2] Why do you think you have not received an in-person visit from any of
those children under 18 [12MON_FILL2] [DATE_ADMIT2]? (CHECK ALL THAT
APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1.
2.
3.
4.
5.
6.
7.

LIVES TOO FAR AWAY
CAN’T HAVE VISITORS
INMATE DOESN’T WANT CHILD TO SEE THEM INCARCERATED
CAN’T AFFORD TO TRAVEL TO FACILITY
VISITING FACILITY WILL BE UNSAFE
CHILD DOESN’T WANT TO SEE INMATE WHILE INCARCERATED
CHILD’S OTHER PARENT/GUARDIAN DOESN’T WANT CHILD TO
VISIT
8. OTHER

SS9

Where do you plan to live when you are released into the community? (CHECK ALL
THAT APPLY)
1. IN YOUR OWN HOUSE, APARTMENT, OR MOBILE HOME
2. IN SOMEONE ELSE’S HOUSE, APARTMENT, OR MOBILE HOME
3. IN TRANSITIONAL HOUSING FOR FORMER INMATES, SUCH AS A

Section 9 – Social Support from Outside the Facility

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
HALFWAY HOUSE
IN A RESIDENTIAL TREATMENT FACILITY
IN A ROOMING HOUSE, HOTEL, OR MOTEL
IN A CAR, TRUCK, OR OTHER MOTOR VEHICLE
IN A HOMELESS SHELTER, ON THE STREET, OR IN SOME OUTDOOR
LOCATION
8. IN SOME OTHER PLACE
4.
5.
6.
7.

SS10 Who do you plan to live with when you are released into the community? (CHECK ALL
THAT APPLY)
1. CURRENT PARTNER (SPOUSE OR GIRL/BOYFRIEND)
2. EX-PARTNER (EX-SPOUSE OR EX-GIRL/BOYFRIEND)
3. BIOLOGICAL/STEP CHILDREN UNDER18
4. ADOPTED/PARTNER’S CHILDREN UNDER18
5. CHILDREN OVER 18 (BIOLOGICAL/STEP/ADOPTED/PARTNER’S)
6. PARENTS
7. SIBLINGS
8. GRANDPARENTS
9. OTHER CHILDREN UNDER 18 NOT RELATED TO YOU
10. OTHER FAMILY MEMBERS
11. FOSTER FAMILY
12. FRIENDS
13. OTHER NON-RELATIVE(S) / NOT FRIEND(S)
14. NOBODY

Section 9 – Social Support from Outside the Facility

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Section 10 – Programs, Services, and Work Assignments (P)
P_INTRO

Inmates may receive a wide variety of services and programs while they are
incarcerated. This next set of questions is about any services you may have
received or programs you may have participated in while you were incarcerated.
(ENTER TO CONTINUE)
[TESTED IN COGNITIVE INTERVIEWING]

P1

Since you were admitted to prison for this incarceration [DATE_ADMIT], have
you participated in any education programs, such as high school, GED, adult
basic education, or college courses?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF

P2

[IF 12MONSTATUS=2 AND P1 = 1] In the past 12 months, that is since
(DATE_12], have you participated in any education programs?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF

P3

[IF P1 = 1 AND (12MONSTATUS=1 OR P2 = 1)] Are you currently
participating in any education programs?
[TESTED IN COGNITIVE INTERVIEWING]
1
YES
2
NO
DK/REF

P3a

[IF P1 = 1 AND P3 = 2] Why are you no longer participating in any education
programs? (CHECK ALL THAT APPLY)
[TESTED IN COGNITIVE INTERVIEWING]
1
2
3
4

COMPLETED OR GRADUATED FROM PROGRAM
QUIT OR DROPPED OUT OF PROGRAM
NO LONGER ALLOWED TO PARTICIPATE IN PROGRAM
SENT TO ANOTHER FACILITY BEFORE COMPLETING THE
PROGRAM
5
SOME OTHER REASON
DK/REF
P4

[IF P1 = 2] What is the main reason you have not participated in any education

Section 10 – Programs, Services, and Work Assignments

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
programs since you were admitted to prison for this incarceration
[DATE_ADMIT]?
[TESTED IN COGNITIVE INTERVIEWING]
1
DOESN’T KNOW ANYTHING ABOUT PROGRAM
2
DOESN’T NEED PROGRAM
3
HASN’T BEEN OFFERED THE CHANCE TO ATTEND PROGRAM
4
HAS HEARD BAD THINGS ABOUT PROGRAM
5
STAFF DIDN’T WANT HIM/HER TO ATTEND PROGRAM
6
TOO BUSY TO ATTEND PROGRAM
7
NOT QUALIFIED/ALLOWED TO ATTEND PROGRAM
8
SOME OTHER REASON
DK/REF
P5

[IF P1 = 1] I am going to read a list of reasons why people may participate in
education programs. For each reason, please tell me whether you feel it is very
important, somewhat important, or not important at all.
[TESTED IN COGNITIVE INTERVIEWING]

P5a. To break up boredom or see
what it was like?
P5b. To spend time with friends or
make friends?
P5c. To try to get out of prison early?
P5d. To help or improve yourself by
getting an education?
P6

Very
Important

Sort of
Important

Not Important
at All

1

2

3

1

2

3

1

2

3

1

2

3

[IF P1 = 1] How much did staff influence your decision to participate in education
programs?
[TESTED IN COGNITIVE INTERVIEWING]
1
Staff made you participate in this program
2
Staff suggested you participate in this program
3
Staff had no influence on your decision
DK/REF

P7

[IF P1 = 1] We’d like to know how much you think participating in education
programs may help you. Response options will be: A lot, Some, and Not at all.
[TESTED IN COGNITIVE INTERVIEWING]
How much do you think participating in education programs will help you…
A Lot

Section 10 – Programs, Services, and Work Assignments

Some

Not at All
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Survey of Prison Inmates (SPI) Pilot Study Questionnaire

P8

P7a. Adjust to living inside prison?

1

2

3

P7b. Get a better education?
P7c. Get and keep a job once you are
released?
P7d. Avoid breaking the law once
you are released?

1

2

3

1

2

3

1

2

3

Since you were admitted to prison for this incarceration [DATE_ADMIT], have
you participated in any job training programs, such as employment readiness or
vocational training?
1
YES
2
NO
DK/REF

P9

[IF 12MONSTATUS=2 AND P8 = 1] In the past 12 months, that is since
(DATE_12], have you participated in any job training programs?
1
YES
2
NO
DK/REF

P10

[IF P8 = 1 AND (12MONSTATUS=1 OR P9 = 1)] Are you currently
participating in any job training programs?
1
YES
2
NO
DK/REF

P10a

[IF P8 = 1 AND P10 = 2] Why are you no longer participating in any job training
programs? (CHECK ALL THAT APPLY)
1
2
3
4

COMPLETED OR GRADUATED FROM PROGRAM
QUIT OR DROPPED OUT OF PROGRAM
NO LONGER ALLOWED TO PARTICIPATE IN PROGRAM
SENT TO ANOTHER FACILITY BEFORE COMPLETING THE
PROGRAM
5
SOME OTHER REASON
DK/REF
P11

[IF P8 = 2] What is the main reason you have not participated in any job training
programs since you were admitted to prison for this incarceration
[DATE_ADMIT]?
1

DOESN’T KNOW ANYTHING ABOUT PROGRAM

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2
DOESN’T NEED PROGRAM
3
HASN’T BEEN OFFERED THE CHANCE TO ATTEND PROGRAM
4
HAS HEARD BAD THINGS ABOUT PROGRAM
5
STAFF DIDN’T WANT HIM/HER TO ATTEND PROGRAM
6.
TOO BUSY TO ATTEND PROGRAM
7
NOT QUALIFIED/ALLOWED TO ATTEND PROGRAM
8
SOME OTHER REASON
DK/REF

P12

[IF P8 = 1] I am going to read a list of reasons why people may participate in job
training programs. For each reason, please tell me whether you feel it is very
important, somewhat important, or not important at all.

P12a. To break up boredom or see
what it was like?
P12b. To spend time with friends or
make friends?
P12c. To try to get out of prison
early?
P12d. To help or improve yourself by
learning new skills?
P13

Very
Important

Sort of
Important

Not Important
at All

1

2

3

1

2

3

1

2

3

1

2

3

[IF P8 = 1] How much did staff influence your decision to participate in job
training programs?
1
Staff made you participate in this program
2
Staff suggested you participate in this program
3
Staff had no influence on your decision
DK/REF

P14

[IF P8 = 1] We’d like to know how much you think participating in job training
programs will help you. Response options will be: A lot, Some, and Not at all.
How much do you think participating in job training programs will help you…
A Lot
1

Some
2

Not at All
3

P14b. Get a better education?
P14c. Get and keep a job once you
are released?

1

2

3

1

2

3

P14d. Avoid breaking the law once

1

2

3

P14a. Adjust to living inside prison?

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you are released?
P15

Since you were admitted to prison for this incarceration [DATE_ADMIT], have
you participated in any parenting or child rearing classes?
1
YES
2
NO
DK/REF

P16

Go to P16
Go to P17

[IF P15 = 1] How much did staff influence your decision to participate in
parenting or child rearing classes?
1
Staff made me participate in this program
2
Staff suggested I participate in this program
3
Staff had no influence on my decision
DK/REF

P17

Since you were admitted to prison for this incarceration [DATE_ADMIT], have
you participated in any English as a Second Language, or ESL, courses?
1
YES
2
NO
DK/REF

P18

Go to P18
Go to P19

[IF P17 = 1] How much did staff influence your decision to participate in English
as a Second Language, or ESL, courses?
1
Staff made me participate in this program
2
Staff suggested I participate in this program
3
Staff had no influence on my decision
DK/REF

P19

Since you were admitted to prison for this incarceration [DATE_ADMIT], have
you participated in any anger management or conflict resolution classes?
1
YES
2
NO
DK/REF

P20

Go to P20
Go to P21

[IF P19 = 1] How much did staff influence your decision to participate in anger
management or conflict resolution classes?
1
Staff made me participate in this program
2
Staff suggested I participate in this program
3
Staff had no influence on my decision
DK/REF

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P21

Since you were admitted to prison for this incarceration [DATE_ADMIT], have
you participated in any money management or financial planning classes?
1
YES
2
NO
DK/REF

P22

Go to P22
Go to P23

[IF P21 = 1] How much did staff influence your decision to participate in money
management or financial planning classes?
1
Staff made me participate in this program
2
Staff suggested I participate in this program
3
Staff had no influence on my decision
DK/REF

P23

Since you were admitted to prison for this incarceration [DATE_ADMIT], have
you participated in any sex offender treatment programs?
1
YES
2
NO
DK/REF

P24

Go to P24
Go to 25

[IF P23 = 1] How much did staff influence your decision to participate in sex
offender treatment programs?
1
Staff made me participate in this program
2
Staff suggested I participate in this program
3
Staff had no influence on my decision
DK/REF

P25

Since you were admitted to prison for this incarceration [DATE_ADMIT], have
you participated in any pre-release or reentry planning programs?
1
YES
2
NO
DK/REF

P26

[IF 12MONSTATUS=2 AND IF P25 = 1] In the past 12 months, that is since
[DATE_12], have you participated in any pre-release or reentry planning
programs?
1
YES
2
NO
DK/REF

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P27

[IF P25 = 1 AND (12MONSTATUS=1 OR P26 = 1)] Are you currently
participating in any pre-release or reentry planning programs?
1
YES
2
NO
DK/REF

P27a

[IF P25 = 1 AND P27 = 2] Why are you no longer participating in any pre-release
or reentry planning programs? (CHECK ALL THAT APPLY)
1
2
3
4

COMPLETED OR GRADUATED FROM PROGRAM
QUIT OR DROPPED OUT OF PROGRAM
NO LONGER ALLOWED TO PARTICIPATE IN PROGRAM
SENT TO ANOTHER FACILITY BEFORE COMPLETING THE
PROGRAM
5
SOME OTHER REASON
DK/REF
P28

[IF P25 = 2] What is the main reason you have not participated in any pre-release
or reentry planning programs since you were admitted to prison for this
incarceration [DATE_ADMIT]?
1
DOESN’T KNOW ANYTHING ABOUT PROGRAM
2
DOESN’T NEED PROGRAM
3
HASN’T BEEN OFFERED THE CHANCE TO ATTEND PROGRAM
4
HAS HEARD BAD THINGS ABOUT PROGRAM
5
STAFF DIDN’T WANT HIM/HER TO ATTEND PROGRAM
6
TOO BUSY TO ATTEND PROGRAM
7
NOT QUALIFIED/ALLOWED TO ATTEND PROGRAM
8
SOME OTHER REASON
DK/REF

P29

[IF P25 = 1] I am going to read a list of reasons why people may participate in
pre-release or reentry planning programs. For each reason, please tell me whether
you feel it is very important, somewhat important, or not important at all.

P29a. To break up boredom or see
what it was like?
P29b. To spend time with friends or
make friends?
P29c. To try to get out of prison
early?
P29d. To help or improve yourself?

Very
Important

Sort of
Important

Not Important
at All

1

2

3

1

2

3

1

2

3

1

2

3

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P30

[IF P25 = 1] How much did staff influence your decision to participate in prerelease or reentry planning programs?
1
Staff made me participate in this program
2
Staff suggested I participate in this program
3
Staff had no influence on my decision
DK/REF

P31

[IF P25 = 1] We’d like to know how much you think participating in pre-release
or reentry planning programs will help you. Response options will be: A lot,
Some, and Not at all.
How much do you think participating in pre-release or reentry planning will help
you…

P31a. Adjust to living inside prison?
P31b. Get a better education?
P31c. Get and keep a job once you
are released?
P31d. Avoid breaking the law once
you are released?
P32

Some
2

Not at All
3

1

2

3

1

2

3

1

2

3

Do you currently have a work assignment either inside the facility, on
facility grounds, or outside the prison facility for which you leave the
prison grounds?
1
YES
2
NO
DK/REF

P33

A Lot
1

Go to P33
Go to P34

What sorts of work assignments do you have currently? (CHECK ALL THAT
APPLY)
1
2
3
4
5
6
7

GENERAL JANITORIAL DUTIES
(CLEANING/ORDERLY/SWEEPING)
GROUNDS OR ROAD MAINTENANCE
FOOD PREPARATION OR RELATED DUTIES (KITCHEN,
BAKERY, BUTCHERY, ETC.)
LAUNDRY
HOSPITAL, INFIRMARY, OR OTHER MEDICAL
SERVICES
FARMING/FORESTRY/RANCHING
GOODS PRODUCTION/INDUSTRIES/CONTRACT

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8

9
10

P34

SERVICES (TELEMARKETING, TAG SHOP, PRINT SHOP,
ETC.)
OTHER SERVICES SUCH AS LIBRARY, STOCKROOM,
STORE, OFFICE HELP, RECREATION, SEW SHOP, BARBER
OR BEAUTY SHOP, ETC.
MAINTENANCE OR REPAIR/CONSTRUCTION
OTHER – (P33_OTH) SPECIFY________________

[IF P32 = 1] I am going to read a list of reasons why people may choose to have a
work assignment while they are in prison. For each reason, please tell me
whether you feel it is very important, somewhat important, or not important at all.

P34a. To break up boredom or see
what it was like?
P34b. To spend time with friends or
make friends?
P34c. To try to get out of prison early?
P34d. To help or improve yourself?
P34e. To learn some new job skills?
P34f. To make money?

P35

Sort of
Important

Not Important
at All

1

2

3

1
1
1
1
1

2
2
2
2
2

3
3
3
3
3

[IF P34 = 1] How much did staff influence your decision to have a work
assignment while you are in prison? Would you say?
1
2
3

P36

Very
Important

Staff made you have a work assignment
Staff suggested you have a work assignment
Staff had no influence on your decision to have a work assignment

[IF (DEMOA9a = 1 – 5) AND CJ42 NE 2 AND CJ44 NE 2 AND (CJC5a NE 1 –
4)] After you are released from prison, do you expect to be eligible for any health
care benefits from the VA such as treatment for physical or mental health
problems or treatment for drug or alcohol use?
1
YES
2
NO
DK/REF

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Section 11 ― Rule Violations and Complaints (RV)
RV1

There are lots of rules that inmates are expected to follow. For example, prisons often
have rules against having or using alcohol or drugs, possessing weapons or stolen
property, verbally or physically assaulting other inmates or staff, trying to escape, not
following facility schedules or guidelines, disrupting the facility environment, and
other types of rules not mentioned here. This next set of questions is about any prison
rules that you may have broken.
Since you were admitted to prison for this incarceration [DATE_ADMIT], how many
times have you been written up for or found guilty of breaking any prison rules?
TIMES: ________________ [RANGE: 0 – 500]
DK/REF

RV2

[IF RV1 ≥ 1 AND 12MONSTATUS = 2] In the past 12 months, how many times
have you been written up for or found guilty of breaking any prison rules?
TIMES: ________________ [RANGE: 1 – 250]
DK/REF

RV3

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of a drug or alcohol violation, such as possession, use, or selling?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of a
drug or alcohol violation, such as possession, use, or selling?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF

RV4

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of possession of a weapon?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of
possession of a weapon?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF

RV5

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of possession of stolen property?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of

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possession of stolen property?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF
RV6

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of possession of any other unauthorized substance or item?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of
possession of any other unauthorized substance or item?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF

RV7

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of verbal assault on a correctional officer or other staff member?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of
verbal assault on a correctional officer or other staff member?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF

RV8

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of physical assault on a correctional officer or other staff member?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of
physical assault on a correctional officer or other staff member?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF

RV9

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of verbal assault on another inmate?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of
verbal assault on another inmate?

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TIMES: ________________ [RANGE: 0 – 250]
DK/REF
RV10

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of a physical assault on another inmate?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of
physical assault on another inmate?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF

RV11

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of escape or attempted escape?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of
escape or attempted escape?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF

RV12

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of any other major violations, such as work slowdowns, food
strikes, setting fires, rioting, etc.?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you been written up for or found guilty of
any other major violations, such as work slowdowns, food strikes, setting fires, rioting,
etc.?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF

RV13

[IF RV2 ≥ 1] During the past 12 months, how many times have you been written up
for or found guilty of any other minor violations relating to facility orderliness and
operation, such as being out of place, disobeying orders, uses of abusive language,
horseplay, failing to follow sanitary regulations?
[IF RV1 ≥ 1 AND 12MONSTATUS = 1] Since you were admitted to prison

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[DATE_ADMIT], how many times have you been written up for or found guilty of
any other minor violations relating to facility orderliness and operation, such as being
out of place, disobeying orders, uses of abusive language, horseplay, failing to follow
sanitary regulations?
TIMES: ________________ [RANGE: 0 – 250]
DK/REF
RV14 [IF RV3 OR RV4 OR RV5 OR RV6 OR RV7 OR RV8 OR RV9 OR RV10 OR RV11
OR RV12 OR RV13 ≥ 1] So you have told me that you were written up for or
found guilty of:
•
•
•
•
•
•
•
•
•
•
•

[IF RV3 = 1] A drug or alcohol violation
[IF RV4 = 1] Possession of a weapon
[IF RV5 = 1] Possession of stolen property
[IF RV6 = 1] Possession of any unauthorized substance or item
[IF RV7 = 1] A verbal assault on staff
[IF RV8 = 1] A physical assault on staff
[IF RV9 = 1] A verbal assault on an inmate
[IF RV10 = 1] A physical assault on an inmate
[IF RV11 = 1] An escape or attempted escape
[IF RV12 = 1] Some other major violation
[IF RV13 = 1] Some other minor violation

Which of these rule violations occurred most recently?
1
A DRUG OR ALCOHOL VIOLATION
2
POSSESSION OF A WEAPON
POSSESSION OF STOLEN PROPERTY
3
4
POSSESSION OF ANY UNAUTHORIZED SUBSTANCE OR ITEM
A VERBAL ASSAULT ON STAFF
5
6
A PHYSICAL ASSAULT ON STAFF
7
A VERBAL ASSAULT ON AN INMATE
8
A PHYSICAL ASSAULT ON AN INMATE
9
AN ESCAPE OR ATTEMPTED ESCAPE
SOME OTHER MAJOR VIOLATION
10
11
SOME OTHER MINOR VIOLATION
DK/REF
DEFINE RV14_FILL
IF RV14 = 1 THEN RV14_FILL = drug or alcohol violation
IF RV14 = 2 THEN RV14_FILL = possession of a weapon

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IF RV14 = 3 THEN RV14_FILL = possession of stolen property
IF RV14 = 4 THEN RV14_FILL = possession of any unauthorized substance
or item
IF RV14 = 5 THEN RV14_FILL = verbal assault on staff
IF RV14 = 6 THEN RV14_FILL = physical assault on staff
IF RV14 = 7 THEN RV14_FILL = verbal assault on an inmate
IF RV14 = 8 THEN RV14_FILL = physical assault on an inmate
IF RV14 = 9 THEN RV14_FILL = escape or attempted escape
IF RV14 = 10 THEN RV14_FILL = other major violation
IF RV14 = 11 THEN RV14_FILL = other minor violation
ELSE RV14_FILL = violation
RV15

[IF RV14 NE BLANK] Did any disciplinary action take place for that
[RV14_FILL]?
1
2

YES
NO

DK/REF
RV16 [IF RV15 = 1] What disciplinary action took place for that [RV14_FILL]? Any
others? MARK ALL THAT APPLY

1
2
3
4
5
6
7
8
9
10
11
12
13

SOLITARY CONFINEMENT OR SEGREGATION
CONFINEMENT TO OWN CELL OR QUARTERS
HIGHER CUSTODY LEVEL WITHIN FACILITY
TRANSFERRED TO ANOTHER FACILITY
LOSS OF “GOOD/GAIN” TIME / “BAD” TIME
RECEIVED A NEW SENTENCE
GIVEN EXTRA WORK
LOSS OR CHANGE OF WORK ASSIGNMENT
LOSS OF PRIVILEGES (INCLUDING COMMISSARY AND
VISITING PRIVELEGES)
PUT IN RESTRAINTS
RECEIVED FORMAL REPRIMAND ONLY
RECEIVED NO PUNISHMENT / PUNISHMENT SUSPENDED
OTHER

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DK/REF
RV17 [IF R16 = 13] What other disciplinary action took place?
SPECIFY: _________________________ [ALLOW 75 CHARACTERS]
DK/REF
RV18 Now we have a few questions about any complaints or grievances that you may have
made to the facility.
[IF 12MONSTAT = 2] During the past 12 months, have you filed a complaint or a
grievance for any reason?
[IF 12MONSTAT = 1] Since you were admitted to prison [DATE_ADMIT], have you
filed a complaint or a grievance for any reason?
1
YES
2
NO
DK/REF
RV19 [IF RV18 = 1 AND 12MONSTAT = 2] During the past 12 months, how many times
have you filed a complaint or a grievance for any reason?
[IF RV18 = 1 AND 12MONSTAT = 1] Since you were admitted to prison
[DATE_ADMIT], how many times have you filed a complaint or a grievance for any
reason?
1
1 TIME
2
2 TIMES
3
3 – 5 TIMES
4
6 – 10 TIMES
5
11 TIMES OR MORE
DK/REF

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Survey of Prison Inmates (SPI) Pilot Study Questionnaire
Interview Closeout Screens (IC)
A - Respondent Items

ICA1 This is the end of the interview. However, I would like to ask you to participate in one
additional aspect of our research. We would like to obtain information on your use of
any programs or benefits provided by the Social Security Administration. These include
programs like Medicare, Supplemental Security Income, also known as SSI, and
disability and survivor benefits. The information we are requesting is protected by
Federal law and cannot be released to us without your consent.
In order to access your Social Security Administration record containing your private
information we will need your Social Security Number. We will only use your Social
Security Number to access your Social Security Administration records and will not
release your data to any agency or individual who is not directly involved with our
research. The Bureau of Justice Statistics will combine your records with other
information from this study for research purposes only. Both the Bureau of Justice
Statistics and RTI International are committed to maintaining the privacy and
confidentiality of the data you provide. As with the other information you have provided
today, your Social Security Number will be protected by a Privacy Certificate.
Providing your Social Security Number is voluntary. There will be no effect on your
benefits if you do not provide it. Whether you provide it or not will not affect your legal
status or any decisions regarding your release from this facility in any way.
If you are willing, please tell me your Social Security Number.
1 ENTER SOCIAL SECURITY NUMBER
2 INMATE DOES NOT HAVE SOCIAL SECURITY NUMBER
DK
REF

ICA2 [IF ICA1 = 1] ENTER SOCIAL SECURITY NUMBER:
|

|

|

| |

|

|

|

|

|

| _|

ICA3 Thank you. I just have a couple of questions I would like to ask you about your
experience with the interview. First, would you say this interview was:
1
Too short,
2
Just about right the right length, or
3
Too long?
DK/REF
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ICA4 Did you feel like you had enough privacy while you were answering the questions I
asked you during the interview?
1
YES
2
NO
DK/REF

ICA5 Those are all the questions I have for you. Thank you for your time and cooperation.
INTERVIEWER: NOTIFY OFFICER THAT THE INMATE IS FINISHED AND
CAN LEAVE THE INTERVIEW ROOM. AFTER THE INMATE LEAVES THE
ROOM, ENTER 1 TO CONTINUE ON TO YOUR INTERVIEWER DEBRIEFING
QUESTIONS.

Interview Closeout Screens

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