| General Questions | |
| G01. How many individuals are providing information for this interview? Indicate actual number _ _ |
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| G02. What is (are) your current position(s) in this school/district? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .................................................................................. ) f) police official _ g) other _ (specify .................................................................................. ) |
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| G03. What was (were) your position(s) during the period in which this event took place? Do NOT read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .................................................................................. ) f) police official _ g) other _ (specify .................................................................................. ) |
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| QUESTIONS about the school | |
| Case ID. To be assigned by study coordinator, record 5-digit number _ _ _ _ _ | |
| S01. Is the school associated with this death a public, private or charter school? _ Do NOT read options 1=public 2=private 3=charter 8=unknown 9=refused to answer |
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| S02. Is the school associated with this death an alternative school? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| S05. Has there ever been another violent death associated with this school? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| S06. What grade levels are served by this school? Write K thru 12...to be coded later ________ | |
| S15. What is the school's average daily attendance rate? ____________________ | |
| S18. How many students, if any, withdrew from school in the month following the death? To be coded later _____________________ |
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| S19. Does the school currently use any of the following security measures? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors _ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify..............................................................................................) |
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| S20. Does the school currently have a violence prevention curriculum and is it required? _ Read options 1= yes, there is a REQUIRED curriculum 2= yes, there is an ELECTIVE curriculum 3= no such instruction* 7= not applicable* 8=unknown* 9=refused to answer* |
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| *Go to Question #S25, page S4 ...Otherwise, proceed with Question #S21a. | |
| S21a. Is the curriculum used commercially available? _ Do NOT read options 1=yes (specify product name.............................................................................) 2=no 7=not applicable 8=unknown 9=refused to answer |
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| S21. Is the violence prevention curriculum taught separately or as part of another course? _ Do NOT read options 1=a separate course 2=part of another course (specify course............................................................. ) 7=not applicable 8=unknown 9=refused to answer |
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| Do NOT read options | |
| 1=a separate course | |
| 2=part of another course (specify course............................................................. ) | |
| 7=not applicable | |
| 8=unknown | |
| 9=refused to answer | |
| S22a. How long has the violence prevention curriculum been in place? _ Do NOT read options 1=less than one year 2=one to five years 3=greater than five years 7=not applicable 8=unknown 9=refused to answer |
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| S22. How many students are exposed to the violence prevention curriculum each academic year? To be coded later _____________________ |
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| S23. For those student who participate, what is the total number of violence prevention course hours or class periods provided in one school year? To be coded later _____________________ | |
| S24. Which of the following components does the violence prevention curriculum include? a) how to avoid conflicts _ b) how to manage anger _ c) how to settle conflicts without physical fighting _ d) how to handle stress in healthy ways _ e) risks associated with physical fighting _ f) risks associated with carrying and using weapons _ g) risks associated with gang activities _ h) what to do if someone is thinking about suicide _ i) statistics on adolescent deaths from violence and suicide _ j) social norms on violence-related risk behaviors _ (PROBE: norms=socially accepted attitudes) k) other components _ (specify.............................................................................................) |
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| S25. Were any of the following security measures operating at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors ___ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify..............................................................................................) |
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| S26a. Did the school have a violence prevention curriculum in place at the time of this event? _ Do NOT read options 1=yes (specify.............................................................................) 2=no 7=not applicable 8=unknown 9=refused to answer |
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| S27. What actions did the school take in response to the death. (PROBE FOR: immediate, long-term, policy, environmental, social, curricular) to be coded later, please note sources ...................................................................................................................................................................................................................................................................................................................................... |
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| Sw01. How many incidents of student weapon carrying were identified by school staff during the year in which the incident took place? (Excluding this event) _ _ 00-##=actual number 77=not applicable 88=unknown 99=refused to answer |
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| Sw02. How many weapons were confiscated from students during the school year in which the incident took place? (Please indicate the number of each type of weapon confiscated) (Excluding this event) a) Handguns ___ b) Long guns ___ c) Knives, razors, box cutters, or other blades ___ d) Mace, pepper spray ___ e) Other (specify ____________) |
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| Sw03. At the time the incident took place, did the school have an official policy regarding student weapon carrying? _ Do not read options 1=yes* 2=no** 7=not applicable 8=unknown 9=refused to answer |
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| *If yes, proceed with Question Sw04; then skip to Question S28, page S6 | |
| **If no, skip to Question Sw05, then proceed to Question S28, page S6. | |
| Sw04. Please describe what actions the policy stipulated should be taken by the school when a student was identified with a weapon while under the supervision of the school? ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... | |
| Sw05. If no, please describe what actions were typically taken by the school when a student was identified with a weapon while under the supervision of the school? ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... | |
| S28. How well do you know this school and its history? _ Read options 1= extensive knowledge of school 2= some knowledge of school 3= little knowledge of school 4= no knowledge of school |
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| QUESTIONS about the event: SCHOOL INTERVIEW | |
| E01. Where did the injury event occur? Read options - can list more than one response; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown, 9=refused to answer 1= on school property __ 2= on the way to or from the campus* __ 3= at an off-campus school-sponsored event* __ 4= on the way to or from a school sponsored event* __ 6= other* (specify..............................................................................................) |
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| *If the event occurred off campus, skip to Question #E03, below .... otherwise, proceed with Question #E02 | |
| E02. Where on the campus did the injury event occur? Read options - can list more than one response; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown, 9=refused to answer 01= in a classroom __ 02= in a hallway __ 03= in a cafeteria __ 04= in a gymnasium __ 05= in a locker room __ 06= in an office __ 07= on campus lawn or gardens __ 08= on sporting fields or playground __ 09= in a parking lot __ 10= in a driveway __ 66= other indoor __ (specify..............................................................................................) 67= other outdoor __ (specify............................................................................................) |
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| After completing E02, if any victim was killed off-campus ask E03, if not skip to Question #E04, page E2. | |
| E03. Where did the off-campus injury event occur? _ _ Read options; code written responses later; code leading zeros 01= on the street, sidewalk, footpath 02= on a bus or public transport vehicle 03= waiting for or alighting from bus or public transport vehicle 04= in a privately-owned vehicle 05= on private property 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
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| E04. Which of the following best describes the context in which the injury event occurred? _ _ Read options; code written responses later; code leading zeros 01= on a day when no classes or school events were held 02= on a school day before classes began 03= while classes were being held 04= on a school day during lunch, recess or other break, including class changes 05= immediately after school 06= on a school day during after-school practice or detention 07= on a school day after official activities 08= at a school sporting activity 09= at another official school-sponsored activity 10= on the way to or from a school-sponsored activity 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
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| E05. At the time of fatal injury were any the victims in some place they ought not to have been? _ Do NOT read options (PROBE: an area of restricted access) 1=yes (specify........................................................................................................... ) 2=no 7=not applicable 9=unknown/refused to answer |
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| E06. At the time of fatal injury were any of the offenders in some place they ought not to have been? _ Do NOT read options (PROBE: an area of restricted access) 1=yes (specify........................................................................................................... ) 2=no 7=not applicable 9=unknown/refused to answer |
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| E07. What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) single suicide _ b) suicide pact _ c) drug related _ d) gang related _ e) robbery, attempted robbery _ f) rape, attempted sex crime _ g) dispute over money or property _ h) dispute over romantic relationship _ i) dispute related to sporting event _ j) dispute, other or unspecified _ k) racially or hate crime motivated _ l) victim killed by police or security personnel _ m) victim killed by civilian during commission of a crime _ n) random victim _ o) unintentional injury _ p) other _ (specify..............................................................................................) |
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| E08. Briefly describe the circumstances of the fatal injury and events leading up to it, including history of prior conflicts between the principles, etc. Code later ...................................................................................................................................................................................................................................................................................................................................... |
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| E09. What was the method of fatal injury? _ _ Read options; code leading zeros 01= firearm (specify..............................................................) 02= knife, razor, box cutter or other blade 03= beaten with club, bat, other object 04= beaten, no weapon used 05= motor vehicle 06= hanging/strangulation 07= poisoning, solid or liquid 08= asphyxiation by gas 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
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| E10. After a tragedy such as this people look for things, such as comments, notes, threats, or actions that took place prior to the incident that could have signaled a potential risk for this type of behavior. Which of the following did any of the offenders, or victims in the case of suicide, leave as signs that they were considering this action? Please include as many signs as you can think of even if they were things that nobody could have recognized as a sign at the time they happened. Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {E10a} notes ____ {E10b} journal entry ___ {E10c} threats___ {E10d} other actions (specify.................................................................) |
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| E12. Based on the information you have regarding the timing of precipitating factors and the amount of preparation required, how much time do you think that this offender (victim if suicide) spent planning this incident? Do not read options; complete information for minutes, hours and days; code later a) minutes ___ b) hours ___ c) days ___ |
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| Esc01. Did any of the following events occur during the 2 weeks before or after this incident? Please note all that apply: Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown {Esc01a} Prom/dance/social event _ {Esc01b} Graduation _ {Esc01c} Homecoming _ {Esc01d} Rivalry game between schools _ {Esc01e} Holiday break _ {Esc01f} Report card distribution _ {Esc01g} Other _ (specify __________________________) |
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| Esc03. Was the victim cited or disciplined for disruptive behavior during the 2 weeks before the event? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| If suicide, skip to E13, page E5. | |
| Esc04. Was the offender cited for disruptive behavior during the 2 weeks before the event? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| E13. How well do you know the details of this event? _ Read options 1= extensive knowledge of event 2= some knowledge of event 3= little knowledge of event 4= no knowledge of event |
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| QUESTIONS about the Victim: SCHOOL INTERVIEW | |
| CaseID. Case ID Number To be assigned by study coordinator, record 5-digit number _ _ _ _ _ | |
| V01. How many victims were fatally injured in this event? Write in actual number _ _ | |
| V01a. Victim Number Number for this victim, is assigned by the primary data collector. _ | |
| V02. What was the date of the fatal injury? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | |
| V03. What was the time of the fatal injury? Record in military time _ _ _ _ | |
| V04. What was the date of death? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | |
| V05. What was the time of death? Record in military time _ _ _ _ | |
| V06. What was this victim's date of birth? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | |
| V07. What was this victim's age in years at the time of death? _ _ 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
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| V08. What was this victim's gender? _ _ Do NOT read options 1=male 2=female 7=not applicable 8=unknown 9=refused to answer |
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| V09. What was the victim's race? _ Do NOT read Options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
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| V10. Was this victim of Latino or Hispanic origin? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
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| V11. Which of the following best describes the victim's family structure/living arrangements at the time of death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
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| V13. Had the victim ever been charged with a crime before the fatal injury? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
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| Vp01. Youth often affiliate with distinct peer groups. With which one of the following groups would you say this victim was most closely affiliated? _ _ Read options 01= street gang 02= tagging crew (spray paint graffiti of groups logo or “tag” around the neighborhood) 03= Wannabes (dress and act like gang members without actually belonging to a street gang) 04= Druggies or Stoners 05= Hip-Hop 06= Gothic 07= Punkers 08= Skaters/Surfers 09= Rockers 10= Cowboys/girls 11= Brains 12= Jocks, Athletes 13= Preppies 14= Geeks 15= Band 16= Hackers 17= Bible study 18= Granolas 19= Loner 20= Not a loner but no particular group 66= other (specify...........................................) 77= not applicable 88=unknown 99=refused to answer |
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| Vp02. In the year prior to this event, was there a change in this victim’s peer group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| V15. Did the victim use alcohol or other drugs at least once a week? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| V16. Was there evidence that the victim was intoxicated with alcohol or other drugs at the time of death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Vw01. During the year prior to this incident, had the victim ever been found carrying a weapon on school grounds or on the way to or from school? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| Vw02. During the year prior to this incident, how many times had the victim been found carrying a weapon on school grounds or on the way to or from school? _ _ 01-##=actual number of times the victim carried a weapon 77=not applicable 88=unknown 99=refused to answer |
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| Vw03. For the most recent event prior to the date of fatal injury, which of the following types of weapons was the victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify.....................................................................) e) other _ (specify........................................................................) |
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| Vw04. What, if any, actions did the school take in response to the victim’s most recent incident of weapon carrying? ...................................................................................................................................................................................................................................................................................................................................................... | |
| V18. Was the victim carrying a weapon at the time of the fatal injury? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| *If no, Go to Question #V21, page V6. | |
| V19. At the time of the fatal injury, which of the following types of weapon was this victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
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| V20. Where did this victim obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) from home _ (specify weapon................................) b) from friend or relative outside household _ (specify weapon................................) c) purchased for himself/herself _ (specify weapon................................) d) stolen _ (specify weapon................................) e) from the victim (specify weapon................................)_ f) other _ (specify weapon................................) |
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| V21. What was the highest grade or year of school this victim completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
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| V22. What was the victim's affiliation with the school associated with this death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified victim* 66=other* (specify.............................................................................................................) 77=not applicable* 88=unknown* 99=refused to answer* |
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| *If the victim is NOT a student, Go to Question #V30, page V10. | |
| V23. How many years had the victim attended his or her school? _ _ Do NOT read options; code leading zeros 00=less than one school year 01-12=number of years 13=more than 12 years 77=not applicable 88=unknown 99=refused to answer |
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| V25. How many times in the last year was the victim suspended or expelled from his or her school? _ Do NOT read options 0=none, never suspended 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
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| V27. What extracurricular activities was the victim involved in? To be coded later ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... |
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| Vr01. To the best of your knowledge, in the 12 months prior to this event was the victim reported to the principal’s office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr01a} disobeying authority figure__ {Vr01b} namecalling or teasing peers __ {Vr01c} physical fighting with peers _ {Vr01d} damaging another's personal property_ _ {Vr01e} stealing another's personal property __ |
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| Vr01a. To the best of your knowledge, in the 12 months prior to this event was this individual victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr01a} called names by peers__ {Vr01b} bullied by peers __ {Vr01c} had personal property damaged or stolen _ {Vr01d} physically threatened by peers __ _ {Vr01e} physically assaulted by peers __ |
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| Vr02. To the best of your knowledge, did the victim experience any of the following events in the last 12 months? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr02a} family moved to an new home or apartment _ {Vr02b} parents divorced_ {Vr02c} family had a new baby _ {Vr02d} anyone moved out of the house _ ( specify..............................................................)_ {Vr02e} family member died ( specify...........................................................................) {Vr02f} a close relative or friend died ( specify.....................................................................)_ {Vr02g} family member became seriously ill, badly injured or was admitted to the hospital ( specify....................................................................) {Vr02h} a close relative or friend beaten or attacked _ ( specify............................................) {Vr02i} saw someone beaten, attacked or shot _ ( specify ......................................................) {Vr02j} changed where they went to school _ {Vr02k} romantic breakup _ |
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| Vr03a. At the time of the event, was this victim demonstrating symptoms, such as impulsivity, short attention span, and distractibility, consistent with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Vr03. At the time of the event, was the victim medically diagnosed with an Attention Deficit or a Hyperactivity Disorder? Do not read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
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| *If no, skip to Question Vr05, below. | |
| Vr04. Was the victim being treated in any of the following ways for this problem? _ Read options 1= medication alone 2= behavioral/environmental modification alone 3= both medication and behavioral/environmental modification 4= no treatment 6= other (specify..............................................................................................) 7= not applicable 8= unknown 9= refused to answer |
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| Vr05. At the time of the event, did this victim have a diagnosed Learning Disability? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Vm01. In the year prior to this event, did this victim receive school-sponsored psychological counseling services? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Vm02. In the year prior to this event, was this victim ever treated for depression? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Vm03a. Did this victim have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vm03a} alcoholism _ {Vm03b} drug abuse _ {Vm03c} child abuse/neglect __ {Vm03d} intimate partner violence_ |
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| *If yes to all of the above, then skip to Vm04, below. | |
| Vm03. To the best of your knowledge, did this victim have a suspected family history of ..... Read only those options not above, Coding instructions: 1=yes, 2=no, 8=unknown. {Vm03a} alcoholism _ {Vm03b} drug abuse _ {Vm03c} child abuse/neglect __ {Vm03d} intimate partner violence_ |
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| Vm04. To the best of your knowledge, did this victim have a suspected family history of ..... _ _ 00= did not excel in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
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| Vm05. In what subject areas, if any, did this victim seem to have particular difficulty? _ _ 00= did not have difficulty in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
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| V30. Which of the following situations best describes this victim's death? _ _ Read options; code leading zero 01= single victim suicide 02= multiple victim suicide 03= single victim homicide; unknown number of offenders 04= single victim homicide; single offender 05= single victim homicide; multiple offenders 06= multiple victim homicide; unknown number of offenders 07= multiple victim homicide; single offender 08= multiple victim homicide; multiple offenders 09= combination murder/suicide 10= intention undetermined 66= other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
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| Vs01. Do you have any knowledge that this victim had, in the year prior to this event exhibited any of the following signs and symptoms of suicide? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vs01a} Thoughts/threats of suicide_ {Vs01b} Plans of suicide_ {Vs01c} Previous suicide attempts_ |
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| *If no to all, skip to Vm08, page V11. | |
| Vs02. To whom was this suicidal behavior reported? _ _ Do not read options 01=no one 02=parents 03=other family 04=peers 05=school staff 06=other medical/mental health professional 66=other (specify...........................................) 77=not applicable 88=unknown 99=refused to answer |
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| Vs03. What, if any, actions were taken by the school in response to this suicidal behavior? .................................................................................................................................................................................................................................................................................................................................................................................. |
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| Vm08. What was the perceived sexual orientation of this victim? _ Do not read options 1=homosexual 2=heterosexual 3=bisexual 7=not applicable 8=unknown 9=refused to answer |
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| V32. How well do you know the background of this victim? _ Read options 1= extensive knowledge of this victim 2= some knowledge of this victim 3= little knowledge of this victim 4= no knowledge of this victim |
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| V33. How many alleged offenders were responsible for the victim's death? _ Do NOT read options (PROBE: alleged offender = legally charged as offender) 0=none, death was self-inflicted 1-5=actual number of offenders* 6=more than 5* 7=not applicable 8=unknown 9=refused to answer |
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| *If there is more than one victim, complete a"Victim" section for each victim, starting with Question V01...Otherwise go to Question #Vi01. | |
| Vi01. Were there any victims that suffered nonfatal injuries at the time of this event? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| *If no, skip to Question V32, page V12. | |
| Vi02. How many nonfatal injuries occurred at the time of this event? _ _ 01-##=actual number of nonfatal injuries 77=not applicable 88=unknown 99=refused to answer |
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| Vi03. How many victims that suffered nonfatal injuries required hospital admission? _ _ 00-##=actual number of nonfatal injuries that required hospital admission 77=not applicable 88=unknown 99=refused to answer |
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| *If there are no data available on any alleged offender, conclude the interview...Otherwise, complete "Offender" section, starting with question "X01" | |
| QUESTIONS about Alleged Offender: SCHOOL INTERVIEW | |
| CaseID. Case ID Number Case number is assigned by study coordinator. _ _ _ _ _ | |
| X01. How many offenders were officially charged for this incident? Write in actual number. _ _ | |
| X01a. Offender Number Number for this offender is assigned by the primary data collector. _ | |
| X06. What was this offender's date of birth? Record month/date/year, code leading zeros, code four-digit years _ _/_ _/_ _ _ _ |
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| X07. What was this offender's age in years at time of victim's death? _ _ Do NOT read options, code leading zero 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
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| X08. What was this offender's gender? _ _ Do NOT read options, code leading zero 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
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| X09.What was this offender's race? _ Do NOT read options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
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| X10. Was this offender of Latino or Hispanic origin? _ Do NOT read options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
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| X11. Which of the following best describes this offender's family structure or living arrangements at the time of the victim's death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
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| X13. Had this offender ever been charged with a crime before the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Xp01. Youth often affiliate with distinct peer groups. With which one of the following groups would you say the offender was most closely affiliated? _ _ Read options 01= Member of an identified street gang 02= Member of a tagging crew (spray paint graffiti of groups logo or “tag” around the neighborhood) 03= Wannabes (dress and act like gang members without actually belonging to a street gang) 04= Druggies or Stoners 05= Hip-Hop 06= Gothic 07= Punkers 08= Skaters/Surfers 09= Rockers 10= Cowboys/girls 11= Brains 12= Jocks, Athletes 13= Preppies 14= Geeks 15= Band 16= Hackers 17= Bible study 18= Granolas 19= Loner 20= Not a loner but no particular group 66= other (specify...........................................) 77= not applicable 88=unknown 99=refused to answer |
|
| Xp02. In the year prior to this event, was there a change in this offender’s peer group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| X15. Did this offender use alcohol or other drugs at least once a week at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| X16. Was there evidence that this offender was intoxicated with alcohol or other drugs at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| X17. What was the relationship of this to the victim? _ _ Read options; code written responses later 01= relatives (specify..................) 02= romantic partner 03= close friend 04= casual acquaintances 05= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
|
| Xw01. During the year prior to this incident, had the offender ever been found carrying a weapon on school grounds or on the way to or from school? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|
| If no, Go to Question #X18, pageO4. | |
| Xw02. During the year prior to this incident, how many times had this offender been found carrying a weapon on school grounds or on the way to or from school? _ _ Do NOT read options, code leading zeros 01-##=actual number of times the victim carried a weapon 77=not applicable 88=unknown 99=refused to answer |
|
| Xw03. For the most recent event prior to the date of fatal injury, was this offender carrying any of the following types of weapon? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
|
| Xw04. What, if any, actions did the school take in response to this offender’s most recent incident of weapon carrying? ...................................................................................................................................................................................................................................................................................................................................... | |
| X18. Was this offender carrying a weapon at the time of the fatal injury? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|
| *Skip to Question #X21, page O5. | |
| X19. At the time of the fatal injury, which of the following types of weapon was this offender carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
|
| X20. Where did this offender obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) from home _ (specify weapon................................) b) from friend or relative outside household _ (specify weapon................................) c) purchased for himself/herself _ (specify weapon................................) d) stolen _ (specify weapon................................) e) from the victim (specify weapon................................)_ f) other _ (specify weapon................................) |
|
| X21. What was the highest grade or year of school this offender completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify..................) 77=not applicable 88=unknown 99=refused to answer |
|
| X22. What was this offender's affiliation with the school associated with the victim's death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified offender* 66=other* (specify..................) 77=not applicable 88=unknown 99=refused to answer |
|
| *If this offender is NOT a student, Go to Question Xs01, page O9 . | |
| X23. For how many years has this offender attended his or her school? _ _ Do NOT read options; code leading zeros 00=less than one school year 01-12=number of years 13=more than 12 years 77=not applicable 88=unknown 99=refused to answer |
|
| X25. How many times was this offender suspended or expelled from his or her school? _ Do NOT read options 0=none, never suspended or expelled 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
|
| X27. What extracurricular activities was this offender involved in at the time of the victim's death? to be coded later; please note the sources. ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... |
|
| Xr01. To the best of your knowledge, in the 12 months prior to this event was this offender reported to the office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr01a} disobeying authority figure__ {Xr01b} name calling or teasing peers _ {Xr01c} physical fighting with peers _ {Xr01d} damaging another's personal property_ _ {Xr01e} stealing another's personal property __ |
|
| Xr01a. To the best of your knowledge, in the 12 months prior to this event was this offender victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr01a} called names by peers__ {Xr01b} bullied by peers __ {Xr01c} had personal property damaged or stolen _ {Xr01d} physically threatened by peers __ _ {Xr01e} physically assaulted by peers __ |
|
| Xr02. To the best of your knowledge, did this offender experience any of the following events in the last 12 months? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr02a} family moved to a new home or apartment _ {Xr02b} parents divorced_ {Xr02c} family had a new baby _ {Xr02d} anyone moved out of the house ( specify..............................................................)_ {Xr02e} family member died (specify....................................................)_ {Xr02f} a close relative or friend died ( specify....................................................................)_ {Xr02g} family member became seriously ill, badly injured or was admitted to the hospital (specify ...........)_ {Xr02h} a close relative or friend beaten or attacked ( specify ............................................)_ {Xr02i} saw someone beaten, attacked or shot (specify .......................................................)_ {Xr02j} changed where they went to school _ {Xr02k} romantic breakup _ |
|
| Xr03a. At the time of the event, was this offender demonstrating symptoms, such as impulsivity, short attention span, and distractibility, consistent with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|
| Xr03. At the time of the event, was this offender medically diagnosed with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|
| *If no, skip to Question Xr05, below. | |
| Xr04. Were they being treated in any of the following ways for this problem? _ Read options 1= medication alone 2= behavioral/environmental modification alone 3= both medication and behavioral/environmental modification 4= no treatment 7=not applicable 8=unknown 9=refused to answer |
|
| Xr05. At the time of the event, did this offender have a diagnosed Learning Disability? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Xm01. In the year prior to this event, did this offender receive school-sponsored psychological counseling services? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Xm02. In the year prior to this event, was this offender ever treated for depression? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Xm03a. Did this offender have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xm03a} alcoholism _ {Xm03b} drug abuse _ {Xm03c} child abuse/neglect __ {Xm03d} intimate partner violence_ |
|
| *If yes to all of the above, then skip to Xm04, below | |
| Xm03. To the best of your knowledge, did this offender have a suspected family history of ..... Read only those options not confirmed above, Coding instructions: 1=yes, 2=no, 8=unknown. {Xm03a} alcoholism _ {Xm03b} drug abuse _ {Xm03c} child abuse/neglect __ {Xm03d} intimate partner violence_ |
|
| Xm04. In what subject area, if any, did this offender seem to excel? _ _ 00= did not excel in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
|
| Xm05. In what subject areas, if any, did this offender seem to have particular difficulty? _ _ 00= did not have difficulty in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
|
| Xs01. Do you have any knowledge that this offender had, in the year prior to this event exhibited any of the following signs and symptoms of suicide? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xs01a} Thoughts/threats of suicide*_ {Xs01b} Plans of suicide*_ {Xs01c} Previous suicide attempts*_ |
|
| *If no to all, skip to Xm08, page O12 | |
| Xs02. To whom was this suicidal behavior reported? _ _ Do not read options 01=no one 02=parents 03=other family 04=peers 05=school staff 06=other medical/mental health professional 66=other (specify...........................................) 77=not applicable 88=unknown 99=refused to answer |
|
| Xs03. What, if any, actions were taken by the school in response to this suicidal behavior? To be coded later .................................................................................................................................................................................................................................................................................................................................................................. |
|
| Xm08. What was the perceived sexual orientation of this offender? _ Do not read options 1=homosexual 2=heterosexual 3=bisexual 7=not applicable 8=unknown 9=refused to answer |
|
| Xm09. Was there evidence that this offender was targeting a specific person or group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| X32. How well do you know the background of this offender? _ Read options 1= extensive knowledge of this offender 2= some knowledge of this offender 3= little knowledge of this offender 4= no knowledge of this offender |
|
| X31. Was there another offender, in addition to the one we just discussed, involved in this event? _ Read options 1= extensive knowledge of this offender 2= some knowledge of this offender 3= little knowledge of this offender 4= no knowledge of this offender |
|
| *If there is a second alleged offender identified as Offender Y, complete a second "Offender" section, starting with Question X01.......otherwise, conclude the interview. |
| General Questions | |||||
| G01. What is (are) your current position(s) in this school/district? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Up to five respondents can be captured using the items below. Coding should reflect actual participant number up to five. G01a. Respondent 1 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) |
G01b. Respondent 2 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify ...) f) law enforcement official _ g) other _ (specify ..................) |
G01c. Respondent 3 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify ....) f) law enforcement official _ g) other _ (specify .................) |
G01d. Respondent 4 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......) f) law enforcement official _ g) other _ (specify ........) |
G01e. Respondent 5 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify ...........) f) law enforcement official _ g) other _ (specify ....................) |
|
| G02. What was (were) your position(s) during the period in which this event took place? Do NOT read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Up to five respondents can be captured using the items below. Coding should reflect actual participant number up to five. G02a. Respondent 1 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) |
G02b. Respondent 2 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify ...) f) law enforcement official _ g) other _ (specify ..................) |
G02c. Respondent 3 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify ....) f) law enforcement official _ g) other _ (specify .................) |
G02d. Respondent 4 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......) f) law enforcement official _ g) other _ (specify ........) |
G02e. Respondent 5 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify ...........) f) law enforcement official _ g) other _ (specify ....................) |
|
| G03. Where did the injury event occur? Read options 1= on school property 2= on the way to or from the campus* 3= at an off-campus school-sponsored event* 4= on the way to or from a school sponsored event* 6= other* (specify..............................................................) 8= unknown* 9= refused to answer |
|||||
| *If option 1 is selected proceed to Question #S01 | |||||
| *If option 3 is selected, skip to Question # SOC01 | |||||
| *If option 2, 4, or 6 are selected, skip to Question #E02 | |||||
| QUESTIONS about the school (for events occurring on school property) | |||||
| S01. Is the school associated with this death an alternative school? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| S02. Our study defines a school associated violent death as a suicide, homicide or legal intervention related death that occurred on school property, on the way to or from school, or at or on the way to or from a school sponsored event. Has this school ever experienced another violent death that meets this definition? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| S03. Did this school recently experience an increase in the size of the student population due to a merger with another school / with other schools? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| S04. During the time when the event of interest occurred, did the school regularly use paid law enforcement or security services--- Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown |
|||||
| Code | |||||
| S04.a) At any time during school hours | |||||
| S04.b) While students were arriving and/or leaving | |||||
| S04.c) At selected school activities (e.g., athletic and social events, open houses, science fairs) | |||||
| S04.d) When school/school activities not occurring | |||||
| S04.e) Other (please specify) | |||||
| S05. At the time when the event occurred did the school use full-time security personnel? _ 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
|||||
| *If school did not use full-time security personnel, skip to Question #S06 otherwise, proceed with Question #S05a | |||||
| S05a. Number of School Resource Officers/Sworn Law Enforcement Officers __ | |||||
| S05b Number of Private Security Officers __ | |||||
| S06. Were any of the following security measures in use at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown |
|||||
| Measure | Location or Type of Measure | Code | |||
| S06a) Walk Through Metal Detectors | |||||
| S06a1 | If yes, how often? | ||||
| 1 Daily | |||||
| 2 2 to 3 times per week | |||||
| 3 Weekly | |||||
| 4 Biweekly | |||||
| 5 As warranted | |||||
| 6 Never | |||||
| S06a2) | Where were the walk through metal detectors used? | ||||
| S06a2.a) Main entry | |||||
| S06a.2b) Secondary entries | |||||
| S06a2.c) Other | |||||
| Specify | |||||
| S06b) Hand Held Metal Detectors | |||||
| S06b1 | If yes, how often? | ||||
| 1 Daily | |||||
| 2 2 to 3 times per week | |||||
| 3 Weekly | |||||
| 4 Biweekly | |||||
| 5 As warranted | |||||
| 6 Never | |||||
| S06b2) | Where were the walk through metal detectors used? | ||||
| S06b2.a) Main entry | |||||
| S06b2.b) Secondary entries | |||||
| S06b2.c) Other | |||||
| Specify | |||||
| S06c) Surveillance Cameras | |||||
| S06c1) | If yes, When were they used? (Check all that apply) | ||||
| 1 on school days before classes or official school activities began | |||||
| 2 While classes were being held | |||||
| 3 During lunch, recess, or other breaks, | |||||
| 4 During class changes | |||||
| 5 immediately after school | |||||
| 6 During after school practice or detention | |||||
| 7 After official activities | |||||
| 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) | |||||
| 9 Cameras only used as visual detterent | |||||
| S06c2) | Where were the surveillance cameras used? | ||||
| S06c2.a) Entry/exit areas – exterior | |||||
| S06c2.b) Athletic areas | |||||
| S06c2.c) Entry/exit areas – interior | |||||
| S06c2.d) Corridors | |||||
| S06c2.e) Other | |||||
| Specify | |||||
| S06d) Communication Devices | |||||
| S06d.1) 2-way radios | |||||
| S06d.2) 2-way intercom in most classrooms | |||||
| S06d.3) Other | |||||
| Specify | |||||
| S06e) Access Restrictions | |||||
| S06e.1) Proximity or card swipe access for staff | |||||
| S06e.2) Intrusion Alarm Systems | |||||
| S06e3.a) Main building(s) / areas | |||||
| S06e3.b) Parking lot(s) | |||||
| S06e3.c) Other | |||||
| Specify | |||||
| S06e4 | If yes, When were they used? (Check all that apply) | ||||
| 1 on school days before classes or official school activities began | |||||
| 2 While classes were being held | |||||
| 3 During lunch, recess, or other breaks, | |||||
| 4 During class changes | |||||
| 5 immediately after school | |||||
| 6 During after school practice or detention | |||||
| 7 After official activities | |||||
| 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) | |||||
| S07. At the time of the event, was it a policy of the school to do any of the following? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown | |||||
| School Policies | Code | ||||
| S07.a) Require visitors to sign or check in | |||||
| S06.b) Require visitors to sign or check out | |||||
| S07.c) Control access to school buildings during school hours (e.g., locked or monitored doors) | |||||
| S07.d) Control access to school grounds during school hours (e.g., locked or monitored gates) | |||||
| S07.e) Require students to pass through metal detectors each day | |||||
| S07.f) Require visitors to pass through metal detectors | |||||
| S07.g) Perform one or more random metal detector checks on students | |||||
| S07.h) Require most students to stay on campus at lunchtime | |||||
| S07.i) Perform one or more random sweeps for contraband (e.g., drugs or weapons) | |||||
| S07.j) Require drug testing for any students | |||||
| S07.k) Require students to wear uniforms | |||||
| S07.l) Enforce a dress code | |||||
| S07.m) Provide a printed code of student conduct to students | |||||
| S07.n) Provide a printed code of student conduct to parents | |||||
| S07.o) Provide school lockers to students | |||||
| S07.p) Require clear book bags on school grounds | |||||
| S07.q) Ban book bags on school grounds | |||||
| S07.r) Require students to wear badges or picture IDs | |||||
| S07.s) Require faculty and staff to wear badges or picture IDs | |||||
| S07.t) Provide telephones in most classrooms | |||||
| S07.u) Prohibit all tobacco use on school grounds. | |||||
| S07.v) Does the school have a written policy about bullying? (if NO skip to Q6.2) | |||||
| S07.w) Is the written bullying policy included in a student handbook that goes home for student and parental review? | |||||
| S08. What actions did the school take in response to the death? (PROBE FOR: immediate, long-term, policy, environmental, social, curricular) to be coded later, please note sources ....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... |
|||||
| S09. How many incidents of student weapon carrying were identified by school staff during the year in which the incident took place? (Excluding this event) _ _ 00-##=actual number 77=not applicable 88=unknown 99=refused to answer |
|||||
| S10. Please describe what actions the school policy stipulated should be taken by the school when a student was identified with a weapon while under the supervision of the school?.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... | |||||
| skip to Question #E01. | |||||
| QUESTIONS about the off-campus school sponsored event | |||||
| SOC01. Our study defines a school associated violent death as a suicide, homicide or legal intervention related death that occurred on school property, on the way to or from school, or at or on the way to or from a school sponsored event. Has this school ever experienced another violent death that meets this definition? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown |
|||||
| SOC02. During the time when the event of interest occurred, did the school regularly use paid law enforcement or security services at selected school activities (e.g., athletic and social events, open houses, science fairs)? _ Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
|||||
| *If school did not use paid law enforcement or security services, skip to Question #SOC05 otherwise, proceed with Question #SOC03 | |||||
| SOC03. Please indicate the Number of Sworn Law Enforcement Officers used. _ _ _ Do NOT read options, code leading zero 00-∞=actual number 777=not applicable 888=unknown 999=refused to answer |
|||||
| SOC04. Please indicate the Number of Private Security Officers used _ _ _ Do NOT read options, code leading zero 00-∞=actual number 777=not applicable 888=unknown 999=refused to answer |
|||||
| SOC05. Were any of the following security measures in use at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown | |||||
| Measure | Location or Type of Measure | Code | |||
| SOC05a) Walk Through Metal Detectors | |||||
| SOC05a1) | If yes, how often? | ||||
| 1 Daily | |||||
| 2 2 to 3 times per week | |||||
| 3 Weekly | |||||
| 4 Biweekly | |||||
| 5 As warranted | |||||
| 6 Never | |||||
| SOC05a2) | Where were the walk through metal detectors used? | ||||
| SOC05a2.a) Main entry | |||||
| SOC05a2.b) Secondary entries | |||||
| SOC05a2.c) Other | |||||
| Specify | |||||
| SOC05b) Hand Held Metal Detectors | |||||
| SOC05b1) | If yes, how often? | ||||
| 1 Daily | |||||
| 2 2 to 3 times per week | |||||
| 3 Weekly | |||||
| 4 Biweekly | |||||
| 5 As warranted | |||||
| 6 Never | |||||
| SOC05b2) | Where were the walk through metal detectors used? | ||||
| SOC05b2.a) Main entry | |||||
| SOC05b2.b) Secondary entries | |||||
| SOC05b2.c) Other | |||||
| Specify | |||||
| SOC05c) Surveillance Cameras | |||||
| SOC05c1) | If yes, When were they used? (Check all that apply) | ||||
| 1 on school days before classes or official school activities began | |||||
| 2 While classes were being held | |||||
| 3 During lunch, recess, or other breaks, | |||||
| 4 During class changes | |||||
| 5 immediately after school | |||||
| 6 During after school practice or detention | |||||
| 7 After official activities | |||||
| 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) | |||||
| 9 Cameras only used as visual detterent | |||||
| SOC05c2) | Where were the surveillance cameras used? | ||||
| SOC05c2.a) Entry/exit areas – exterior | |||||
| SOC05c2.b) Athletic areas | |||||
| SOC05c2.c) Entry/exit areas – interior | |||||
| SOC05c2.d) Corridors | |||||
| SOC05c2.e) Other | |||||
| Specify | |||||
| SOC05d) Communication Devices | |||||
| SOC05d.1) 2-way radios | |||||
| SOC05d.2) 2-way intercom in most classrooms | |||||
| SOC05d.3) Other | |||||
| Specify | |||||
| SOC05e) Access Restrictions | |||||
| SOC05e.1) Proximity or card swipe access for staff | |||||
| SOC05e.2) Intrusion Alarm Systems | |||||
| SOC05e3) | If yes, where? | ||||
| SOC05e3.a) Main building(s) / areas | |||||
| SOC05e3.b Parking lot(s) | |||||
| SOC05e3.c) Other | |||||
| Specify | |||||
| SOC05e4) | If yes, When were they used? (Check all that apply) | ||||
| 1 on school days before classes or official school activities began | |||||
| 2 While classes were being held | |||||
| 3 During lunch, recess, or other breaks, | |||||
| 4 During class changes | |||||
| 5 immediately after school | |||||
| 6 During after school practice or detention | |||||
| 7 After official activities | |||||
| 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) | |||||
| Skip to Question #E02. | |||||
| QUESTIONS about the event: | SCHOOL INTERVIEW | ||||
| E01. Where on the campus did the injury event occur? Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable locations | |||||
| Location | Code | ||||
| 01= in a classroom | |||||
| 02= in a hallway | |||||
| 03= in a cafeteria | |||||
| 04= in a gymnasium | |||||
| 05= in a locker room | |||||
| 06= in an office | |||||
| 07= in a stairwell | |||||
| 08= in a restroom | |||||
| 09= in a break room or lounge | |||||
| 10= in an auditorium | |||||
| 11= on campus lawn or gardens | |||||
| 12= on sporting fields or playground | |||||
| 13= in a parking lot | |||||
| 14= in a driveway | |||||
| 15= at a bus pickup or drop off point | |||||
| 66= other indoor location | |||||
| Specify | |||||
| 67= other outdoor location | |||||
| Specify | |||||
| 77= not applicable | |||||
| 88= unknown | |||||
| 99= refused to answer | |||||
| Skip to Question #E03. | |||||
| E02. Where did the off-campus injury event occur? Read options; code written responses later; code leading zeros 01= on the street, sidewalk, footpath 02= on a bus or public transport vehicle 03= waiting for or getting on or off a bus or public transport vehicle 04= in a privately-owned vehicle / car 05= on private property (specify________________________) 06= at a sporting complex (pool, stadium, off campus gym, rec center etc…) 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
|||||
| E03. Which of the following best describes the context in which the injury event occurred? _ _ Read options; code written responses later; code leading zeros 01= on a day when no classes or school events were held (e.g., a weekend, holiday, or an official school break) 02= on a school day before classes began 03= while classes were being held 04= during a school assembly 04= on a school day during lunch, recess or other break, including class changes 05= immediately after school 06= on a school day during after-school practice or detention 07= on a school day after official activities 08= at a school sporting activity 09= at another official school-sponsored activity 10= on the way to or from a school-sponsored activity 66= other (specify.......................................................) 77= not applicable 88= unknown 99= refused to answer |
|||||
| E04. What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable motives. |
|||||
| Motive | Code | ||||
| a) single suicide | |||||
| b) suicide pact | |||||
| c) drug related | |||||
| d) gang related | |||||
| e) robbery, attempted robbery | |||||
| f) rape, attempted sex crime | |||||
| g) dispute over money or property | |||||
| h) dispute over romantic relationship | |||||
| i) dispute related to sporting event | |||||
| j) dispute, other or unspecified | |||||
| k) racially or hate crime motivated | |||||
| l) victim killed by law enforcement or security personnel | |||||
| m) victim killed by civilian during commission of a crime | |||||
| n) act of terrorism | |||||
| o) random victim | |||||
| p) victim was a bystander | |||||
| q) victim was intervener assisting a crime victim | |||||
| r) other | |||||
| Specify | |||||
| E05. Briefly describe the circumstances of the fatal injury and events leading up to it, including history of prior conflicts between the principles, etc. Code later __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ | |||||
| E06. What was the method of fatal injury? Read options; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable methods utilized. |
|||||
| Method | Code | ||||
| 01= firearm | |||||
| Specify | |||||
| 02= knife, razor, box cutter or other blade | |||||
| 03= beaten with club, bat, pipe, chain, or other object | |||||
| 04= beaten, no weapon used | |||||
| 05= motor vehicle | |||||
| 06= hanging/strangulation/asphyxiation by hanging | |||||
| 07= poisoning, solid or liquid | |||||
| 08= asphyxiation by gas | |||||
| 09= other asphyxiation | |||||
| 66= other | |||||
| Specify | |||||
| 77= not applicable | |||||
| 88= unknown | |||||
| 99= refused to answer | |||||
| E07. After a tragedy such as this people look for things, such as comments, notes, threats, or actions that took place prior to the incident that could have signaled a potential risk for this type of behavior. Which of the following did any of the offenders, or victims in the case of suicide, leave as signs that they were considering this action? Please include as many signs as you can think of even if they were things that noone could have recognized as a sign at the time they happened. Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code all applicable signs. |
|||||
| Sign | Code | ||||
| {E07a} notes | |||||
| {E07b} journal entry | |||||
| {E07c} social media (e.g. blogs, Twitter, wall postings on social networking sites) | |||||
| {E07d} verbal threats___ | |||||
| {E07e} electronic media (e.g., email messages, IM, or texts via cellphone, voice mail, video ect..) | |||||
| {E07f} other actions (e.g., playful suggestion that person might commit act, voiced suicidal thoughts) | |||||
| Specify | |||||
| E08. Did anyone know about the possibility of this event before it happened? _ Do NOT read options 1=yes (specify........................................................................................................... ) 2=no* 7=not applicable 9=unknown/refused to answer |
|||||
| *If option 2 is selected, skip to Question #V01. | |||||
| E09. What information was known by the bystander(s) in advance of the attack? Instructions: Capture information for up to five bystanders. | |||||
| E09a. Code later _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
E09b. Code later _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
E09c. Code later _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
E09d. Code later _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
E09e. Code later _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|
| E10. What relationship did the bystander have to the perpetrator(s)? Read options; code written responses later | |||||
| E10a. Bystander #1 | E10b. Bystander #2 | E10c. Bystander #3 | E10d. Bystander #4 | E10e. Bystander #5 | |
| 01= relatives (specify..................) | 01= relatives (specify..................) | 01= relatives (specify..................) | 01= relatives (specify..................) | 01= relatives (specify..................) | |
| 02= romantic partner | 02= romantic partner | 02= romantic partner | 02= romantic partner | 02= romantic partner | |
| 03= close friend | 03= close friend | 03= close friend | 03= close friend | 03= close friend | |
| 04= classmate | 04= classmate | 04= classmate | 04= classmate | 04= classmate | |
| 05= faculty/staff | 05= faculty/staff | 05= faculty/staff | 05= faculty/staff | 05= faculty/staff | |
| 06= fellow student at school, but not classmate | 06= fellow student at school, but not classmate | 06= fellow student at school, but not classmate | 06= fellow student at school, but not classmate | 06= fellow student at school, but not classmate | |
| 07= community / neighborhood acquaintance | 07= community / neighborhood acquaintance | 07= community / neighborhood acquaintance | 07= community / neighborhood acquaintance | 07= community / neighborhood acquaintance | |
| 08= strangers | 08= strangers | 08= strangers | 08= strangers | 08= strangers | |
| 66= other (specify......................) | 66= other (specify......................) | 66= other (specify......................) | 66= other (specify......................) | 66= other (specify......................) | |
| 77=not applicable | 77=not applicable | 77=not applicable | 77=not applicable | 77=not applicable | |
| 88=unknown | 88=unknown | 88=unknown | 88=unknown | 88=unknown | |
| 99=refused to answer | 99=refused to answer | 99=refused to answer | 99=refused to answer | 99=refused to answer | |
| E11. Did the bystander share the information he or she learned of the planned violence with others? Do NOT read options 1=yes (specify........................................................................................................... ) 2=no 7=not applicable 9=unknown/refused to answer |
|||||
| E12. With whom was this information shared? Do not read options; Coding instructions: 1=yes, 2=no, 8=unknown. Select all applicable options. | |||||
| Code | |||||
| 01=no one | |||||
| 02=parents | |||||
| 03=other family | |||||
| 04=peers | |||||
| 05=school staff | |||||
| 06=other medical/mental health professional | |||||
| 66=other | |||||
| Specify | |||||
| 77=not applicable | |||||
| 88=unknown | |||||
| 99=refused to answer | |||||
| QUESTIONS about the Victim: SCHOOL INTERVIEW | |||||
| CaseID. Case ID Number To be assigned by study coordinator, record 5-digit number _ _ _ _ _ |
|||||
| V01. How many victims were fatally injured in this event? Write in actual number _ _ |
|||||
| V01a. Victim Number Number for this victim, is assigned by the primary data collector _ |
|||||
| V02. What was the date of the fatal injury? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ |
|||||
| V03. What was the date of the fatal injury? Record in military time _ _ _ _ | |||||
| V04. What was the date of death? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ |
|||||
| V05. What was this victim's date of birth? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ |
|||||
| V06. What was this victim's age in years at the time of death? _ _ _ Do NOT read options, code leading zero 01-∞=actual age in years 777=not applicable 888=unknown 999=refused to answer |
|||||
| V07. What was this victim's gender? _ Do NOT read options 1=male 2=female 3=transgender 7=not applicable 8=unknown 9=refused to answer |
|||||
| V08. What was the victim's race? _ Do NOT read Options 1 White 2 Black or African American 3 American Indian or Alaska Native 4 Asian Indian 5 Chinese 6 Filipino 7 Japanese 8 Korean 9 Vietnamese 10 Other Asian 11 Native Hawaiian 12 Guamanian or Chamorro 13 Samoan 14 Other Pacific Islander 15 Other (Specify) ______________ 88 Unknown—a person’s race is unknown 99 Refused to Answer |
|||||
| V09. | |||||
| Was this victim of Hispanic, Latino/a ,or Spanish Origin? (One or more categories may be selected) origin? Do NOT read options 1 Not Hispanic or Latino/a or Spanish origin 2 Yes, Mexican, Mexican American, Chicano/a 3 Yes, Puerto Rican 4 Yes, Cuban 5 Yes, another Hispanic, Latino, or Spanish origin 8 Unknown if victim is of Hispanic or Latino origin 9 Refused to Answer |
|||||
| V10. Which of the following best describes the victim's family structure/living arrangements at the time of death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives with legal guardian 05= lives independently 06= foster care 07= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
|||||
| V11. What was the highest grade or year of school this victim completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency(GED) 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
|||||
| V12. Individuals often affiliate with distinct peer groups. To your knowledge, was the victim associated with any distinct peer group? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused* |
|||||
| *If answer is 2 -9, skip to Question # V15. Otherwise, proceed with Question # V12a. | |||||
| V12a. What group (s) were they affiliated with? Code later ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V13. In the year prior to this event, did the victim leave an existing peer group? _ Do not read options 1=yes Specify____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| V14. In the year prior to this event, did the victim join a new peer group? _ Do not read options 1=yes Specify____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| V15. Did the victim use alcohol or other drugs? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| *If answer is 2-9, skip to Question # V16. . otherwise, proceed with Question #V15a. | |||||
| V15a. What types of substances did the victim use? Code later ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V16. Was there evidence that the victim was intoxicated with alcohol or drugs at the time of death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| V17. At the time of death, was the victim perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| V18. Was the victim carrying a weapon at the time of the fatal injury? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| *If no, Go to Question #V21. | |||||
| V19. At the time of the fatal injury, which of the following types of weapon was this victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown | |||||
| Weapon | Code | ||||
| a) firearm | |||||
| specify weapon | |||||
| b) knife, razor, box cutter or other blade | |||||
| c) bat, pipe, chain, or other object | |||||
| d) rope or wire | |||||
| e) other | |||||
| specify weapon | |||||
| V20. Where did this victim obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown |
|||||
| Weapons source | Code | ||||
| a) from home | |||||
| specify weapon | |||||
| b) from friend or relative outside household | |||||
| specify weapon | |||||
| c) purchased for himself/herself | |||||
| specify weapon | |||||
| d) stolen | |||||
| specify weapon | |||||
| e) home-made weapon | |||||
| f) weapon of opportunity (used weapon already present in environment / used object in environment as weapon) | |||||
| g) from the victim | |||||
| specify weapon | |||||
| h) other _ | |||||
| specify weapon | |||||
| V21. What was the victim's affiliation with the school associated with this death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified victim* 66=other* (specify.............................................................................................................) 77=not applicable* 88=unknown* 99=refused to answer* |
|||||
| *If the victim is NOT a student, Go to Question # V31. | |||||
| V22. During the year prior to this incident, how many times had the victim been found carrying a weapon on school grounds or on the way to or from school? _ _ 00-##=actual number of times the victim carried a weapon 77=not applicable 88=unknown 99=refused to answer |
|||||
| *If answer is zero (0), Go to Question #V25. | |||||
| V23. For the most recent event prior to the date of fatal injury, which of the following types of weapons was the victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown |
|||||
| Weapon | Code | ||||
| a) firearm | |||||
| specify weapon | |||||
| b) knife, razor, box cutter or other blade | |||||
| c) bat, pipe, chain, or other object | |||||
| d) rope or wire | |||||
| e) other | |||||
| specify weapon | |||||
| V24. What, if any, actions did the school take in response to the victim’s most recent incident of weapon carrying? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V25. How many years had the victim attended his or her school? _ _ Do NOT read options; code leading zeros 00=less than one school year 01-12=number of years 13=more than 12 years 77=not applicable 88=unknown 99=refused to answer |
|||||
| V26. How many times in the last year was the victim suspended from his or her school? (including in-school suspensions) _ Do NOT read options 0=none, never suspended 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
|||||
| V27. In the last year was the victim expelled from his or her school? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| V28. What extracurricular activities was the victim involved in? | |||||
| To be coded later ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V29. Did the victim experience any school-related crises or traumatic events during the 2 weeks before or after this incident? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| *If no, not applicable, unknown, or refuse, Go to Question #V30. | |||||
| If yes, please complete V29a : | |||||
| V29a. Please briefly describe the specific school-related crises or traumatic events experienced. Code later ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V30. Was a school-related crisis or traumatic event imminent within two weeks of this incident? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| *If no, not applicable, unknown, or refuse, Go to Question #V31. | |||||
| If yes, please complete V30a : | |||||
| V30a. Please briefly describe the specific school-related crises or traumatic events that may have been imminent. Code later ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V31. Did any the victim experience any community-related crises or traumatic events during the 2 weeks before or after this incident? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| *If no, not applicable, unknown, or refuse, Go to Question #V32. | |||||
| If yes, please complete V31a : | |||||
| V31a. Please briefly describe the specific community-related crises or traumatic events experienced. Code later ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V32. Was a community-related crisis or traumatic event imminent within two weeks of the this incident? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| *If no, not applicable, unknown, or refuse, Go to Question #V33. | |||||
| If yes, please complete V32a : | |||||
| V32a. Please briefly describe the specific community-related crises or traumatic events that may have been imminent. Code later ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V33. Did any the victim experience any family-related crises or traumatic events during the 2 weeks before or after this incident? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| *If no, not applicable, unknown, or refuse, Go to Question #V34. | |||||
| If yes, please complete V33a : | |||||
| V33a. Please briefly describe the specific family-related crises or traumatic events experienced. Code later ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V34. Was a family-related crisis or traumatic event imminent within two weeks of the this incident? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| *If no, not applicable, unknown, or refuse and victim is a student Go to Question #V35. *If no, not applicable, unknown, or refuse and victim is not a student Go to Question #V43. |
|||||
| If yes, please complete V34a : | |||||
| V34a. Please briefly describe the specific family-related crises or traumatic events that may have been imminent. Code later ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| *If victim is not a student Go to Question #V43. Otherwise proceed to Question # V35. | |||||
| V35. In the 12 months prior to this event was the victim reported to the principal’s office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
|||||
| Behavior | Code | ||||
| {V35a} disobeying authority figure | |||||
| {V35b} namecalling, taunting, or teasing peers | |||||
| V35b.1 Face to face? | |||||
| V35b.2 Using Electronic means? | |||||
| {V35c} verbal threats | |||||
| {V35d} sent written threats | |||||
| {V35e} sent electronic threats | |||||
| {V35f} Bullied peers | |||||
| {V35g} physically threatened peers | |||||
| {V35h} physical fought with peers | |||||
| {V35i} damaged another's personal property | |||||
| {V35j} damaged school property (tagging, vandalism etc…) | |||||
| {V35k}stole another's personal property | |||||
| {V35l} truancy (skipped school) | |||||
| {V35m} possessed / used illegal substances | |||||
| {V35n}possessed a weapon | |||||
| V36. To the best of your knowledge, in the 12 months prior to this event was this individual victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
|||||
| Type | Code | ||||
| {V36a.1} called names by peers | |||||
| {V36a.2} bullied by peers | |||||
| {V36a.3} had personal property damaged or stolen | |||||
| {V36a.4}verbally threatened by peers | |||||
| {V36a.5}received written threats | |||||
| {V36a.6} electronic threats | |||||
| {V36a.7}physically threatened by peers | |||||
| {V36a.8}physically assaulted by peers | |||||
| V37. At the time of the event, did this victim have a diagnosed Learning Disability? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| V38. In the year prior to this event, did this victim receive any of the following services? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. | |||||
| Services | Code | ||||
| V38.a guidance counseling / advising | |||||
| V38.b psychological counseling | |||||
| V38.c Psychiatric or mental health services | |||||
| V38.d social services | |||||
| V38.e supplemental educational services (including efforts to address learning disabilities) | |||||
| V38.f other services | |||||
| Specify | |||||
| V39. In the year prior to this event, was this victim ever treated for depression? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| V40. Had the victim ever received professional treatment for any other mental health problem? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| V41. If yes, What specific kinds of emotional or mental health problems were treated? To be coded later ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V42. Did this victim have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
|||||
| Code | |||||
| {V42a.1} alcoholism | |||||
| {V42a.2} drug abuse | |||||
| {V42a.3} intimate partner violence | |||||
| {V42a.4.} sexual violence | |||||
| {V42a.5}attempted / completed suicide | |||||
| {V42a.6} arrests / convictions for violent offenses (e.g., assault, homicide etc…) | |||||
| V42b. Did this victim suffer Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
|||||
| Code | |||||
| {V42b.1} physical child abuse | |||||
| {V42b.2} sexual child abuse | |||||
| {V42b.3} emotional / psychological abuse as a child | |||||
| {V42b.4} neglect | |||||
| {V42b.5} victimization in intimate partner violence_/ teen dating violence | |||||
| {V42b.6} victimization in sexual violence | |||||
| V43. Which of the following situations best describes this victim's death? _ _ Read options; code leading zero 01= single victim suicide 02= multiple victim suicide 03= single victim homicide; unknown number of offenders 04= single victim homicide; single offender 05= single victim homicide; multiple offenders 06= multiple victim homicide; unknown number of offenders 07= multiple victim homicide; single offender 08= multiple victim homicide; multiple offenders 09= combination murder/suicide 10= intention undetermined 66= other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
|||||
| V44. Do you have any knowledge that this victim had, in the year prior to this event exhibited any of the following signs and symptoms of suicide? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
|||||
| Signs | Code | ||||
| {V44a} Thoughts/threats of suicide | |||||
| {V44b} Plans of suicide | |||||
| {V44c} Previous suicide attempts | |||||
| *If no to all, skip to V47. | |||||
| V45. To whom was this suicidal behavior reported? Do not read options | |||||
| Code | |||||
| 01=no one | |||||
| 02=parents | |||||
| 03=other family | |||||
| 04=peers | |||||
| 05=school staff | |||||
| 06=other medical/mental health professional | |||||
| 66=other | |||||
| specify weapon | |||||
| 77=not applicable | |||||
| 88=unknown | |||||
| 99=refused to answer | |||||
| V46. What, if any, actions were taken by the school in response to this suicidal behavior? ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
|||||
| V47. Did perceptions about the victim being gay, bisexual, or transgendered contribute to their victimization? _ Do not read options 1=homosexual 2=heterosexual 3=bisexual 4=transgender 5=questioning 7=not applicable 8=unknown 9=refused to answer |
|||||
| V48. Were there any victims that suffered nonfatal injuries at the time of this event? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| *If no, skip to Question #V51. | |||||
| V49. How many persons suffered nonfatal injuries occurred at the time of this event? _ _ 01-##=actual number of nonfatal injuries 77=not applicable 88=unknown 99=refused to answer |
|||||
| V50. How many victims that suffered nonfatal injuries required hospital admission? _ _ 00-##=actual number of nonfatal injuries that required hospital admission 77=not applicable 88=unknown 99=refused to answer |
|||||
| *If there is more than one victim, complete a"Victim" section for each victim, starting with Question V01...Otherwise go to Question #V51. | |||||
| V51. How many alleged offenders were responsible for the victim's death? Do NOT read options (PROBE: alleged offender = legally charged as offender) 0=none, death was self-inflicted 1-5=actual number of offenders* 6=more than 5* 7=not applicable 8=unknown 9=refused to answer |
|||||
| *If there are no data available on any alleged offender, conclude the interview...Otherwise, complete "Offender" section, starting with question #O01. | |||||
| QUESTIONS about Alleged Offender: SCHOOL INTERVIEW | |||||
| 777=not applicable | CaseID. Case ID Number Case number is assigned by study coordinator. _ _ _ _ _ |
||||
| 888=unknown | O01. How many alleged offenders were officially charged for this incident? Write in actual number. _ _ |
||||
| 999=refused to answer | O01a. Offender Number Number for this alleged offender is assigned by the primary data collector. _ |
||||
| O02. What was this alleged offender's date of birth? Record month/date/year, code leading zeros, code four-digit years _ _/_ _/_ _ _ _ |
|||||
| O03. What was this alleged offender's age in years at time of victim's death? _ _ Do NOT read options, code leading zero 01-100=actual age in years 777=not applicable 888=unknown 999=refused to answer |
|||||
| O04. What was this alleged offender's gender? _ Do NOT read options 1=male 2=female 3=transgender 7=not applicable 8=unknown 9=refused to answer |
|||||
| O05. What was this alleged offender's race? _ _ Do NOT read options 1 =White 2 =Black or African American 3 =American Indian or Alaska Native 4 =Asian Indian 5 =Chinese 6=Filipino 7=Japanese 8=Korean 9=Vietnamese 10=Other Asian 11=Native Hawaiian 12=Guamanian or Chamorro 13=Samoan 14=Other Pacific Islander 15=Other (Specify) ______________ 88 =Unknown—a person’s race is unknown 99=Refused to Answer |
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| O06. Was this alleged offender of Hispanic, Latino/a ,or Spanish Origin? _ (One or more categories may be selected) Do NOT read options 1 =Not Hispanic or Latino/a or Spanish origin 2 =Yes, Mexican, Mexican American, Chicano/a 3=Yes, Puerto Rican 4=Yes, Cuban 5=Yes, another Hispanic, Latino, or Spanish origin 9 =Unknown if elder is of Hispanic or Latino origin |
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| O07. Which of the following best describes this alleged offender's family structure or living arrangements at the time of the victim's death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
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| O08. What was the highest grade or year of school this alleged offender completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify..................) 77=not applicable 88=unknown 99=refused to answer |
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| O09. Had this alleged offender ever been arrested before the victim's death? _ Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
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| O10. Had this alleged offender ever been charged with a crime before the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| If yes, please complete O10a & O10b. If no, skip to Question O11. |
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| O10a. What types of charges did the alleged offender face? Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O10b. Which charges resulted in convictions? Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O11. Individuals often affiliate with distinct peer groups. To your knowledge, was the alleged offender associated with any distinct peer group? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
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| *If answer is not yes, skip to Question # O14.... otherwise, proceed with Question # O11a | |||||
| O11a. What groups were they affiliated with? Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O12. In the year prior to this event, did the offender leave an existing peer group? Do NOTread options 1=yes Specify _________________________ 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O13. In the year prior to this event, did the offender join a new peer group? Do NOT read options 1=yes Specify_____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O14. Did this alleged offender use alcohol or other drugs at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| *If answer is 2 -9, skip to Question # O15...otherwise, proceed with Question # O14a. | |||||
| O14a. What types of substances did the alleged offender use? Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O15. Was there evidence that this alleged offender was intoxicated with alcohol or other drugs at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O15a. At the time of death, was the alleged offender perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O16. What was the relationship of this alleged offender to the victim? Read options; code written responses later 01= relatives (specify..................) 02= romantic partner 03= close friend 04= casual acquaintances 05= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
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| O17. Was this alleged offender carrying a weapon at the time of the fatal injury? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| *If answer is not yes, skip to Question #O20. | |||||
| O18. At the time of the fatal injury, which of the following types of weapon was this alleged offender carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown |
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| Weapon | Code | ||||
| a) firearm | |||||
| Specify | |||||
| b) knife, razor, box cutter or other blade | |||||
| c) bat, pipe, chain, or other object | |||||
| d) rope or wire | |||||
| e) other | |||||
| Specify | |||||
| O19. Where did this alleged offender obtain these weapons? | |||||
| Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown | |||||
| Weapons source | Code | ||||
| a) from home | |||||
| specify weapon | |||||
| b) from friend or relative outside household | |||||
| specify weapon | |||||
| c) purchased for himself/herself | |||||
| specify weapon | |||||
| d) stolen | |||||
| specify weapon | |||||
| e) home-made weapon | |||||
| f) weapon of opportunity (used weapon already present in environment / used object in environment as weapon) | |||||
| g) from the victim | |||||
| specify weapon | |||||
| h) other _ | |||||
| specify weapon | |||||
| O20. What was this alleged offender's affiliation with the school associated with the victim's death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=family member of a school staff member 09= resident of surrounding community* 10= not associated with the school or community* 11= unidentified offender* 66=other* (specify..................) 77=not applicable 88=unknown 99=refused to answer |
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| *If this offender is NOT a student, Go to Question O30. | |||||
| O21. During the year prior to this incident, had the alleged offender ever been found carrying a weapon on school grounds or on the way to or from school? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| If no, Go to Question #O25. | |||||
| O22. During the year prior to this incident, how many times had this alleged offender been found carrying a weapon on school grounds or on the way to or from school? _ _ Do NOT read options, code leading zeros 01-##=actual number of times the victim carried a weapon 77=not applicable 88=unknown 99=refused to answer |
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| O23. For the most recent event prior to the date of fatal injury, was this alleged offender carrying any of the following types of weapon? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown |
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| Weapon | Code | ||||
| a) firearm | |||||
| specify weapon | |||||
| b) knife, razor, box cutter or other blade | |||||
| c) bat, pipe, chain, or other object | |||||
| d) rope or wire | |||||
| e) other | |||||
| specify weapon | |||||
| O24. What, if any, actions did the school take in response to this alleged offender’s most recent incident of weapon carrying? ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O25. How many times was this alleged offender suspended from his or her school? (including in school suspensions) _ Do NOT read options 0=none, never suspended or expelled 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
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| O26. Had this alleged offender been expelled from his or her school, in the 12 months preceding the event? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| O27. What extracurricular activities was this alleged offender involved in at the time of the victim's death? to be coded later; please note the sources. ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O28. Did any of the alleged offenders experience any school-related crises or traumatic events during the 2 weeks before or after this incident? If yes, please specify : | |||||
| Do NOT read options | |||||
| 1=yes | |||||
| 2=no* | |||||
| 7=not applicable* | |||||
| 8=unknown* | |||||
| 9=refused to answer* | |||||
| *If no, not applicable, unknown, or refuse Go to Question #O29. | |||||
| O28a. Please briefly describe the specific school-related crises or traumatic events experienced. Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O29. Was a school-related crisis or traumatic event imminent within two weeks of the this incident? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| *If no, not applicable, unknown, or refuse Go to Question #O30. | |||||
| If yes, please complete O29a. | |||||
| O29a. Please briefly describe the specific school-related crises or traumatic events that may have been imminent. Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O30. Did any of the alleged offenders experience any community-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| *If no, not applicable, unknown, or refuse Go to Question #O31. | |||||
| If yes, please complete O30a. | |||||
| O30a. Please briefly describe the specific community-related crises or traumatic events experienced. Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O31. Was a community-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| *If no, not applicable, unknown, or refuse Go to Question #O32. | |||||
| If yes, please complete O31a. | |||||
| O31a. Please briefly describe the specific community-related crises or traumatic events that may have been imminent. Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O32. Did the alleged offender experience any family-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| *If no, not applicable, unknown, or refuse and victim is a student Go to Question #O33. *If no, not applicable, unknown, or refuse and victim is not a student Go to Question #O43. |
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| If yes, please complete O32a | |||||
| O32a. Please briefly describe the specific family-related crises or traumatic events experienced. Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O33. Was a family-related crisis or traumatic event imminent within two weeks of the this incident? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| *If no, not applicable, unknown, or refuse and Offender is a student Go to Question #O34. *If no, not applicable, unknown, or refuse and victim is not a student Go to Question #O43. |
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| If yes, please complete O33a. | |||||
| O33a. Please briefly describe the specific family-related crises or traumatic events that may have been imminent. Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| *If offender is not a student Go to Question #O36. Otherwise proceed to Question # O34. | |||||
| O34. To the best of your knowledge, in the 12 months prior to this event did the alleged offender engage in any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
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| Behavior | Code | ||||
| {O34a} disobeying authority figure | |||||
| {O34b} name-calling, taunting, or teasing peers | |||||
| O34b.1 Face to face? | |||||
| O34b.2 Using Electronic means? | |||||
| {O34c} Verbal threats | |||||
| {O34d} sent written threats | |||||
| {O34e} sent electronic threats | |||||
| {O34f} Bullied peers | |||||
| {O34g} physically threatened peers | |||||
| {O34h} physically fought with peers | |||||
| {O34i} damaged another's personal property | |||||
| {O34j} damaged school property (tagging, vandalism etc…) | |||||
| {O34k}stole another's personal property | |||||
| {O34l} truancy (skipped school) | |||||
| {O34m} possessed / used illegal substances | |||||
| {O34n}possessed a weapon | |||||
| O35a. To the best of your knowledge, in the 12 months prior to this event was this alleged offender victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
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| Type | Code | ||||
| {O35a.1} called names by peers | |||||
| {O35a.2} bullied by peers | |||||
| {O35a.3} had personal property damaged or stolen | |||||
| {O35a.4}verbally threatened by peers | |||||
| {O35a.5}received written threats | |||||
| {O35a.6} electronic threats | |||||
| {O35a.7}physically threatened by peers | |||||
| {O35a.8}physically assaulted by peers | |||||
| O36. At the time of the event, did this alleged offender have a diagnosed Learning Disability? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O37. In the year prior to this event, did this alleged offender receive any of the following services? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
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| Services | Code | ||||
| O37.a guidance counseling / advising | |||||
| O37.b psychological counseling | |||||
| O37.c Psychiatric or mental health services | |||||
| O37.d social services | |||||
| O37.e supplemental educational services (including efforts to address learning disabilities) | |||||
| O37.f other services | |||||
| Specify | |||||
| O38. In the year prior to this event, was this alleged offender ever treated for depression? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O39. Had the alleged offender ever received professional treatment for any other emotional or mental health problem? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| If yes, please complete O39a…otherwise, skip to O40. | |||||
| O39a. If yes, what specific kinds of emotional or mental health problems were treated? To be coded later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O40. Did this alleged offender have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
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| Code | |||||
| {O40.1} alcoholism | |||||
| {O40.2} drug abuse | |||||
| {O40.3} intimate partner violence | |||||
| {O40.4.} sexual violence | |||||
| {O40.5}attempted / completed suicide | |||||
| {O40.6} arrests / convictions for violent offenses (e.g., assault, homicide etc…) | |||||
| O41 Did this alleged offender suffer Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
|||||
| Code | |||||
| {O41.1} physical child abuse | |||||
| {O41.2} sexual child abuse | |||||
| {O41.3} emotional / psychological abuse as a child | |||||
| {O41.4} neglect | |||||
| {O41.5} victimization in intimate partner violence_/ teen dating violence | |||||
| {O41.6} victimization in sexual violence | |||||
| O42. Do you have any knowledge that this alleged offender had, in the year prior to this event exhibited any of the following signs and symptoms of suicide? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. |
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| Signs | Code | ||||
| {O42a} Thoughts/threats of suicide | |||||
| {O42b} Plans of suicide | |||||
| {O42c} Previous suicide attempts | |||||
| *If no to all, skip to O45. | |||||
| O43. To whom was this suicidal behavior reported? Do not read options | |||||
| Code | |||||
| 01=no one | |||||
| 02=parents | |||||
| 03=other family | |||||
| 04=peers | |||||
| 05=school staff | |||||
| 06=other medical/mental health professional | |||||
| 66=other | |||||
| specify | |||||
| 77=not applicable | |||||
| 88=unknown | |||||
| 99=refused to answer | |||||
| *If no, not applicable, unknown, or refuse and Offender is a student Go to Question #O45. *If no, not applicable, unknown, or refuse and Offender is not a student Go to Question #O45. |
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| O44. What, if any, actions were taken by the school in response to this suicidal behavior? To be coded later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O45. Was this alleged offender fatally injured during the event? _ Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
|||||
| *If no then skip to O52…otherwise proceed to question O46. | |||||
| O46. What was the date of the injury event? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ |
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| O47. What was the time of the injury event? Record in military time_ _ _ _ | |||||
| O48. What was the date of death? Record month/date/year, code leading zeros (code four-digit years)_ _/_ _/_ _ _ _ |
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| O49 What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable motives. |
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| Motive | Code | ||||
| a) single suicide | |||||
| b) suicide pact | |||||
| c) victim killed by law enforcement or security personnel | |||||
| d) victim killed by civilian during commission of a crime | |||||
| e) other | |||||
| specif y | |||||
| O50. Briefly describe the circumstances of the fatal injury and events leading up to it, including history of prior conflicts between the principals, etc. Code later ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
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| O51. What was the method of fatal injury? | |||||
| Weapon | Code | ||||
| a) firearm | |||||
| Specify | |||||
| b) knife, razor, box cutter or other blade | |||||
| c) bat, pipe, chain, or other object | |||||
| d) rope or wire | |||||
| e) other | |||||
| Specify | |||||
| O52. Did perceptions about the offender being gay, bisexual, or transgendered contribute to their perpetration? _ Do NOT read options 1=homosexual 2=heterosexual 3=bisexual 4=transgender 5=questioning 7=not applicable 8=unknown 9=refused to answer |
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| O53. Was there evidence that this alleged offender was targeting a specific person or group? _ Do NOT read options 1=yes* 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O54. Was there another alleged offender, in addition to the one we just discussed, involved in this event? _ Do NOT read options 1=yes* 2=no 7=not applicable 8=unknown 9=refused to answer |
|||||
| *If there is a second alleged offender identified as Offender Y, complete a second "Offender" section, starting with Question O01.......otherwise, conclude the interview. | |||||
| Eliminated Items - Reason for removal | Items | Old question format | |
| Used only for administrative purposes. | G01. | How many individuals are providing information for this interview? Indicate actual number _ _ | |
| QUESTIONS about the School: SCHOOL INTERVIEW | |||
| Info can be obtained from DOE database. Removal will reduce respondent burden | S01. | Is the school associated with this death a public, private or charter _ school? Do NOT read options 1=public 2=private 3=charter 8=unknown 9=refused to answer |
|
| Info can be obtained from DOE database. Removal will reduce respondent burden | S06. | What grade levels are served by this school? Write K thru 12...to be coded later ___ | |
| Info can be obtained from DOE database. Removal will reduce respondent burden | S15. | What is the school's average daily attendance rate? _____________ | |
| There is no accurate means for determining which particular students were withdrawn from school due to the SAVD or for other purposes (i.e., family relocating) | S18. | How many students, if any, withdrew from school in the month following the death? to be coded later _______________________ | |
| A majority of schools have some form of curriculum or course/training for students that is aimed at violence prevention. Removal of this item will reduce respondent burden. | S20. | Does the school currently have a violence prevention curriculum and is it required? _ Read options 1= yes, there is a REQUIRED curriculum 2= yes, there is an ELECTIVE curriculum 3= no such instruction* 7= not applicable* 8=unknown* 9=refused to answer* |
|
| A majority of schools have some form of curriculum or course/training for students that is aimed at violence prevention. Removal of this item will reduce respondent burden. | S21a. | Is the curriculum used commercially available? _ Do NOT read options 1=yes (specify product name.............................................................................) 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| A majority of schools have some form of curriculum or course/training for students that is aimed at violence prevention. Removal of this item will reduce respondent burden. | S21. | Is the violence prevention curriculum taught separately or as part of another course? _ Do NOT read options 1=a separate course 2=part of another course (specify course............................................................. ) 7=not applicable 8=unknown 9=refused to answer |
|
| A majority of schools have some form of curriculum or course/training for students that is aimed at violence prevention. Removal of this item will reduce respondent burden. | S22a. | How long has the violence prevention curriculum been in place? _ Do NOT read options 1=less than one year 2=one to five years 3=greater than five years 7=not applicable 8=unknown 9=refused to answer |
|
| A majority of schools have some form of curriculum or course/training for students that is aimed at violence prevention. Removal of this item will reduce respondent burden. | S22. | How many students are exposed to the violence prevention curriculum each academic year? To be coded later _____________________ | |
| A majority of schools have some form of curriculum or course/training for students that is aimed at violence prevention. Removal of this item will reduce respondent burden. | S23. | For those student who participate, what is the total number of violence prevention course hours or class periods provided in one school year? To be coded later ___________ | |
| A majority of schools have some form of curriculum or course/training for students that is aimed at violence prevention. Removal of this item will reduce respondent burden. | S24. | Which of the following components does the violence prevention curriculum include? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) how to avoid conflicts _ b) how to manage anger _ c) how to settle conflicts without physical fighting _ d) how to handle stress in healthy ways _ e) risks associated with physical fighting _ f) risks associated with carrying and using weapons _ g) risks associated with gang activities _ h) what to do if someone is thinking about suicide _ i) statistics on adolescent deaths from violence and suicide _ j) social norms on violence-related risk behaviors _ (PROBE: norms=socially accepted attitudes) k) other components _ (specify.............................................................................................) |
|
| Questions can be answered using combinations of other existing items. Can be removed to reduce respondent burden. | S25 | Were any of the following security measures operating at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors ___ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify...................................................................) |
Added |
| A majority of schools have some form of curriculum or course/training for students that is aimed at violence prevention. Removal of this item will reduce respondent burden. | S26a. | Did the school have a violence prevention curriculum in place at the time of this event? _ Do NOT read options 1=yes (specify.............................................................................) 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| State law forbids weapons to be brought onto school campuses. Removal will reduce respondent burden | Sw02. | How many weapons were confiscated from students during the school year in which the incident took place? (Please indicate the number of each type of weapon confiscated) (Excluding this event) a) Handguns ___ b) Long guns ___ c) Knives, razors, box cutters, or other blades ___ d) Mace, pepper spray ___ e) Other (specify ____________) |
Added |
| State law forbids weapons to be brought onto school campuses. Removal will reduce respondent burden | Sw03. | At the time the incident took place, did the school have an official policy regarding student weapon carrying? _ Do not read options 1=yes* 2=no** 7=not applicable 8=unknown 9=refused to answer |
|
| State law forbids weapons to be brought onto school campuses. Removal will reduce respondent burden. | Sw05. | If no, please describe what actions were typically taken by the school when a student was identified with a weapon while under the supervision of the school? | |
| Removed to reduce respondent burden. | S28. | How well do you know this school and its history? _ Read options 1= extensive knowledge of school 2= some knowledge of school 3= little knowledge of school 4= no knowledge of school |
|
| QUESTIONS about the Event: SCHOOL INTERVIEW | |||
| Questions can be answered using combinations of other existing items. Can be removed to reduce respondent burden. | E01. | Where did the injury event occur? Read options - can list more than one response; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown, 9=refused to answer 1= on school property __ 2= on the way to or from the campus* __ 3= at an off-campus school-sponsored event* __ 4= on the way to or from a school sponsored event* __ 6= other* (specify..............................................................................................) |
Added |
| Questions can be answered using combinations of other existing items. Can be removed to reduce respondent burden. | E05. | At the time of fatal injury were any the victims in some place they ought not to have been? _ Do NOT read options (PROBE: an area of restricted access) 1=yes (specify........................................................................................................... ) 2=no 7=not applicable 9=unknown/refused to answer |
|
| Questions can be answered using combinations of other existing items. Can be removed to reduce respondent burden. | E06. | At the time of fatal injury were any of the offenders in some place they ought not to have been?_ Do NOT read options (PROBE: an area of restricted access) 1=yes (specify........................................................................................................... ) 2=no 7=not applicable 9=unknown/refused to answer |
|
| There is no accurate means for determining amount of time spent planning. | E12. | Based on the information you have regarding the timing of precipitating factors and the amount of preparation required, how much time do you think that this offender (victim if suicide) spent planning this incident? Do not read options; complete information for minutes, hours and days; code later a) minutes ___ b) hours ___ c) days ___ |
|
| Replaced with items that may more accurately capture events or occurences such as crises or traumas that might be associated with behavior observed. | Esc01. | Did any of the following events occur during the 2 weeks before or after this incident? Please note all that apply: Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown {Esc01a} Prom/dance/social event _ {Esc01b} Graduation _ {Esc01c} Homecoming _ {Esc01d} Rivalry game between schools _ {Esc01e} Holiday break _ {Esc01f} Report card distribution _ {Esc01g} Other _ (specify __________________________) |
|
| Replaced with items that may more accurately capture events or occurences such as crises or traumas that might be associated with behavior observed. | Esc03. | Was the victim cited or disciplined for disruptive behavior during the 2 weeks before the event? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Replaced with items that may more accurately capture events or occurences such as crises or traumas that might be associated with behavior observed. | Esc04. | Was the offender cited for disruptive behavior during the 2 weeks before the event? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Removed to reduce respondent burden. | E13. | How well do you know the details of this event? Read options 1= extensive knowledge of event 2= some knowledge of event 3= little knowledge of event 4= no knowledge of event |
|
| QUESTIONS about the Victim: SCHOOL INTERVIEW | |||
| Removed to reduce respondent burden. | V05. | What was the time of death? Record in military time _ _ _ _ | |
| Specific charges not captured in original interview. Charge related information might be available in LE records. | V13. | Had the victim ever been charged with a crime before the fatal injury? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
|
| Replaced with another item. | Vw01. | During the year prior to this incident, had the victim ever been found carrying a weapon on school grounds or on the way to or from school? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|
| Replaced with items that may more accurately capture events or occurences such as crises or traumas that might be associated with behavior observed. | Vr02. | To the best of your knowledge, did the victim experience any of the following events in the last 12 months? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr02a} family moved to an new home or apartment _ {Vr02b} parents divorced_ {Vr02c} family had a new baby _ {Vr02d} anyone moved out of the house _ ( specify.........................................)_ {Vr02e} family member died ( specify...................................................) {Vr02f} a close relative or friend died ( specify..................................................)_ {Vr02g} family member became seriously ill, badly injured or was admitted to the hospital ( specify......) {Vr02h} a close relative or friend beaten or attacked _ ( specify...................) {Vr02i} saw someone beaten, attacked or shot _ ( specify .....................................) {Vr02j} changed where they went to school _ {Vr02k} romantic breakup _ |
|
| Is only one of numerous conditions that might be related to violence. Also subject to missing values. Replaced with item that captures full range of possible emotional and mental health conditions that might contribute to behaviors. | Vr03a. | At the time of the event, was this victim demonstrating symptoms, such as impulsivity, short attention span, and distractibility, consistent with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Is only one of numerous conditions that might be related to violence. Also subject to missing values. Replaced with item that captures full range of possible emotional and mental health conditions that might contribute to behaviors. | Vr03. | At the time of the event, was the victim medically diagnosed with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
|
| Is only one of numerous conditions that might be related to violence. Also subject to missing values. Replaced with item that captures full range of possible emotional and mental health conditions that might contribute to behaviors. | Vr04. | Was the victim being treated in any of the following ways for this problem?_ Read options 1= medication alone 2= behavioral/environmental modification alone 3= both medication and behavioral/environmental modification 4= no treatment 6= other (specify..............................................................................................) 7= not applicable 8= unknown 9= refused to answer |
|
| Item is subject to missing values. Also relies heavily on subjective judgements | Vm03. | To the best of your knowledge, did this victim have a suspected family history of ..... Read only those options not above, Coding instructions: 1=yes, 2=no, 8=unknown. {Vm03a} alcoholism _ {Vm03b} drug abuse _ {Vm03c} child abuse/neglect __ {Vm03d} intimate partner violence_ |
|
| Item does not serve a preventive purpose. | Vm04. | In what subject area, if any, did this victim seem to excel? _ 00= did not excel in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
|
| Item does not serve a preventive purpose. | Vm05. | In what subject areas, if any, did this victim seem to have particular difficulty?_ _ 00= did not have difficulty in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
|
| Replaced with an item that asks wheteher perceptions about the victim's orientation contributed to their victimization. | Vm08. | What was the perceived sexual orientation of this victim? _ Do not read options 1=homosexual 2=heterosexual 3=bisexual 7=not applicable 8=unknown 9=refused to answer |
|
| Removed to reduce respondent burden. | V32. | How well do you know the background of this victim? _ Read options 1= extensive knowledge of this victim 2= some knowledge of this victim 3= little knowledge of this victim 4= no knowledge of this victim |
|
| QUESTIONS about Alleged Offender: SCHOOL INTERVIEW | |||
| Replaced with items that may more accurately capture events or occurences such as crises or traumas that might be associated with behavior observed. | Xr02. | To the best of your knowledge, did this offender experience any of the following events in the last 12 months? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr02a} family moved to a new home or apartment _ {Vr02b} parents divorced_ {Vr02c} family had a new baby _ {Vr02d} anyone moved out of the house ( specify..............................................................)_ {Vr02e} family member died (specify....................................................)_ {Vr02f} a close relative or friend died ( specify....................................................................)_ {Vr02g} family member became seriously ill, badly injured or was admitted to the hospital ( specify ......................)_ {Vr02h} a close relative or friend beaten or attacked ( specify ............................................)_ {Vr02i} saw someone beaten, attacked or shot (specify .......................................................)_ {Vr02j} changed where they went to school _ {Vr02k} romantic breakup _ |
|
| Is only one of numerous conditions that might be related to violence. Also subject to missing values. Replaced with item that captures full range of possible emotional and mental health conditions that might contribute to behaviors. | Xr03a. | At the time of the event, was this offender demonstrating symptoms, such as impulsivity, short attention span, and distractibility, consistent with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Is only one of numerous conditions that might be related to violence. Also subject to missing values. Replaced with item that captures full range of possible emotional and mental health conditions that might contribute to behaviors. | Xr03. | At the time of the event, was this offender medically diagnosed with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|
| Is only one of numerous conditions that might be related to violence. Also subject to missing values. Replaced with item that captures full range of possible emotional and mental health conditions that might contribute to behaviors. | Xr04. | Were they being treated in any of the following ways for this problem?_ Read options 1= medication alone 2= behavioral/environmental modification alone 3= both medication and behavioral/environmental modification 4= no treatment 7=not applicable 8=unknown 9=refused to answer |
|
| Item is subject to missing values. Also relies heavily on subjective judgements | Xm03. | To the best of your knowledge, did this offender have a suspected family history of ..... Read only those options not confirmed above, Coding instructions: 1=yes, 2=no, 8=unknown. {Xm03a} alcoholism _ {Xm03b} drug abuse _ {Xm03c} child abuse/neglect __ {Xm03d} intimate partner violence_ |
|
| Item does not serve a preventive purpose. | Xm04. | In what subject area, if any, did this offender seem to excel? _ _ 00= did not excel in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
|
| Item does not serve a preventive purpose. | Xm05. | In what subject areas, if any, did this offender seem to have particular difficulty?_ _ 00= did not have difficulty in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
|
| Replaced with an item that asks whether the perceptions about the offender contributed to their perpetration. | Xm08. | What was the perceived sexual orientation of this offender?_ Do not read options 1=homosexual 2=heterosexual 3=bisexual 7=not applicable 8=unknown 9=refused to answer |
|
| Item does not serve a preventive purpose. | X23. | For how many years has this offender attended his or her school? _ _ Do NOT read options; code leading zeros 00=less than one school year 01-12=number of years 13=more than 12 years 77=not applicable 88=unknown 99=refused to answer |
Added |
| Removed to reduce respondent burden. | X32. | How well do you know the background of this offender? _ Read options 1= extensive knowledge of this offender 2= some knowledge of this offender 3= little knowledge of this offender 4= no knowledge of this offender |
| ITEMS | SCHOOL INTERVIEW | |||||
| G03. | Where did the injury event occur? Read options 1= on school property 2= on the way to or from the campus* 3= at an off-campus school-sponsored event* 4= on the way to or from a school sponsored event* 6= other* (specify..............................................................) 8= unknown* 9= refused to answer |
Added | ||||
| S02. | Our study defines a school associated violent death as a suicide, homicide or legal intervention related death that occurred on school property, on the way to or from school, or at or on the way to or from a school sponsored event. Has this school ever experienced another violent death that meets this definition? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
Added | ||||
| S03. | Did this school recently experience an increase in the size of the student population due to a merger with another school / with other schools? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| S04. | During the time when the event of interest occurred, did the school regularly use paid law enforcement or security services--- Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown S04.a) At any time during school hours _ S04.b) While students were arriving and/or leaving _ S04.c) At selected school activities _ (e.g., athletic and social events, open houses, science fairs) S04.d) When school/school activities not occurring _ S04.e) Other _ (please specify ________________) |
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| S05. | At the time when the event occurred did the school use full-time security personnel? _ 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
Added | ||||
| S05a. | Number of School Resource Officers/Sworn Law Enforcement Officers __ | Added | ||||
| S05b. | Number of Private Security Officers __ | Added | ||||
| S06. | At the time of the event, was it a policy of the school to do any of the following? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Measure Location or Type of Measure Code S06a) Walk Through Metal Detectors S06a1) If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never S06a2) Where were the walk through metal detectors used? S06a2.a) Main entry S06a2.b) Secondary entries S06a2.c) Other - Specify S06b) Hand Held Metal Detectors S06b1) If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never S06b2) Where were the walk through metal detectors used? S06b2.a) Main entry S06b2.b) Secondary entries S06b2.c) Other - Specify |
S06c) Surveillance Cameras S06c1) If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 5 After official activities 6 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) 7 Cameras only used as visual detterent S06c2) Where were the surveillance cameras used? S06c2.a) Entry/exit areas – exterior S06c2.b) Athletic areas S06c2.c) Entry/exit areas – interior S06c2.d) Corridors S06c2.e) Other Specify |
S06d) Communication Devices S06d.1) 2-way radios S06d.2) 2-way intercom in most classrooms S06d.3) Other - Specify S06e) Access Restrictions S06e.1) Proximity or card swipe access for staff S06e.2) Intrusion Alarm Systems S06e3) If yes, where? S06e3.a) Main building(s) / areas S06e3.b) Parking lot(s) S06e3.c) Other - Specify S06e4) If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) |
Added | ||
| S07. | At the time of the event, was it a policy of the school to do any of the following? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown School Policies S07.a) Require visitors to sign or check in S07.b) Require visitors to sign or check out S07.c) Control access to school buildings during school hours (e.g., locked or monitored doors) S07.d) Control access to school grounds during school hours (e.g., locked or monitored gates) S07.e) Require students to pass through metal detectors each day S07.f) Require visitors to pass through metal detectors S07.g) Perform one or more random metal detector checks on students S07.h) Require most students to stay on campus at lunchtime S07.i) Perform one or more random sweeps for contraband (e.g., drugs or weapons) S07.j) Require drug testing for any students S07.k) Require students to wear uniforms S07.l) Enforce a dress code S07.m) Provide a printed code of student conduct to students S07.n) Provide a printed code of student conduct to parents S07.o) Provide school lockers to students S07.p) Require clear book bags on school grounds S07.q) Ban book bags on school grounds S07.r) Require students to wear badges or picture IDs S07.s) Require faculty and staff to wear badges or picture IDs S07.t) Provide telephones in most classrooms S07.u) Prohibit all tobacco use on school grounds. S07.v) Does the school have a written policy about bullying? (if NO skip to Q6.2) S07.w) Is the written bullying policy included in a student handbook that goes home for student and parental review? |
Added | ||||
| QUESTIONS about the off-campus school sponsored event: | SCHOOL INTERVIEW | |||||
| SOC01. | Our study defines a school associated violent death as a suicide, homicide or legal intervention related death that occurred on school property, on the way to or from school, or at or on the way to or from a school sponsored event. Has this school ever experienced another violent death that meets this definition? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
Added | ||||
| SOC02. | During the time when the event of interest occurred, did the school regularly use paid law enforcement or security services at selected school activities (e.g., athletic and social events, open houses, science fairs)? _ Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
Added | ||||
| SOC03. | Please indicate the Number of Sworn Law Enforcement Officers used. _ _ _ Do NOT read options, code leading zero 00-∞=actual number 777=not applicable 888=unknown 999=refused to answer |
Added | ||||
| SOC04. | Please indicate the Number of Private Security Officers used _ _ _ Do NOT read options, code leading zero 00-∞=actual number 777=not applicable 888=unknown 999=refused to answer |
Added | ||||
| SOC05. | Were any of the following security measures in use at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Measure Location or Type of Measure Code SOC05a) Walk Through Metal Detectors SOC05a1 If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never SOC05a2 Where were the walk through metal detectors used? SOC05a2.a) Main entry SOC05a2.b) Secondary entries SOC05a2.c) Other Specify SOC05b) Hand Held Metal Detectors SOC05b1 If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never SOC05b2 Where were the walk through metal detectors used? SOC05b2.a) Main entry SOC05b2.b) Secondary entries SOC05b2.c) Other Specify SOC05c) Surveillance Cameras SOC05c1 If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) 9 Cameras only used as visual detterent SOC05c2 Where were the surveillance cameras used? SOC05c2.a) Entry/exit areas – exterior SOC05c2.b) Athletic areas SOC05c2.c) Entry/exit areas – interior SOC05c2.d) Corridors SOC05c2.e) Other Specify SOC05d) Communication Devices SOC05d.1) 2-way radios SOC05d.2) 2-way intercom in most classrooms SOC05d.3) Other Specify SOC05e) Access Restrictions SOC05e.1) Proximity or card swipe access for staff SOC05e.2) Intrusion Alarm Systems SOC05e3 If yes, where? SOC05e3.a) Main building(s) / areas SOC05e3.b) Parking lot(s) SOC05e3.c) Other Specify SOC05e4 If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) |
Added | ||||
| QUESTIONS about Event: | SCHOOL INTERVIEW | |||||
| E08. | Did anyone know about the possibility of this event before it happened? _ Do NOT read options 1=yes (specify................................................... ) 2=no* 7=not applicable 9=unknown/refused to answer |
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| E09. | What information was known by the bystander(s) in advance of the attack? Instructions: Capture information for up to five bystanders |
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| E09a. Code later ________________________________________________________________________________________________________________________________________________________________________________ |
E09b. Code later ________________________________________________________________________________________________________________________________________________________________________________ |
E09c. Code later ________________________________________________________________________________________________________________________________________________________________________________ |
E09d. Code later ________________________________________________________________________________________________________________________________________________________________________________ |
E09e. Code later ________________________________________________________________________________________________________________________________________________________________________________ |
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| E10. | What relationship did the bystander have to the perpetrator(s)? _ _ Read options; code written responses later |
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| E10a. Bystander #1 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
E10b. Bystander #2 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
E10c. Bystander #3 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
E10d. Bystander #4 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
E10e. Bystander #5 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
||
| E11. | Did the bystander share the information he or she learned of the planned violence with others? Do NOT read options 1=yes (specify.................................................................. ) 2=no 7=not applicable 9=unknown/refused to answer |
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| E12. | With whom was this information shared? Do not read options; Coding instructions: 1=yes, 2=no, 8=unknown. Select all applicable options. 01=no one 02=parents 03=other family 04=peers 05=school staff 06=other medical/mental health professional 66=other Specify 77=not applicable 88=unknown 99=refused to answer |
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| QUESTIONS about Victim: | SCHOOL INTERVIEW | |||||
| V12a. | What group(s) were they affiliated with? Code later .................................................................................................................................................................................................................................................................................................................................................................. |
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| V13. | In the year prior to this event, did the victim leave an existing peer group? Do not read options _ 1=yes Specify____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
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| V15a. | What types of substances did the victim use? Code later .................................................................................................................................................................................................................................................................................................... |
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| V17. | At the time of death, was the victim perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| V27. | In the last year was the victim expelled from his or her school? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| V29. | Did the victim experience any school-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| V29a. | Please briefly describe the specific school-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| V30. | Was a school-related crisis or traumatic event imminent within two weeks of this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| V30a. | Please briefly describe the specific school-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| V31. | Did any the victim experience any community-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| V31a. | Please briefly describe the specific community-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| V32. | Was a community-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| V32a. | Please briefly describe the specific community-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| V33. | Did any the victim experience any family-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| V33a. | Please briefly describe the specific family-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| V34. | Was a family-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| V34a. | Please briefly describe the specific family-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| V39. | Had the victim ever received professional treatment for any other mental health problem? Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| V40. | If yes, What specific kinds of emotional or mental health problems were treated? To be coded later ........................................................................................................................................................................................................................................................................................................................................................ |
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| V42. | Did this victim suffer… Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code {V42.a} physical child abuse {V42.b} sexual child abuse {V42.c} emotional / psychological abuse as a child {V42.d} neglect {V42.e} victimization in intimate partner violence_/ teen dating violence {V42.f} victimization in sexual violence |
Added | ||||
| V47. | Did perceptions about the victim being gay, bisexual, or transgendered contribute to their victimization? Do not read options 1=homosexual 2=heterosexual 3=bisexual 4=transgender 5=questioning 7=not applicable 8=unknown 9=refused to answer |
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| QUESTIONS about ALLEGED OFFENDER | SCHOOL INTERVIEW | |||||
| O09. | Had this alleged offender ever been arrested before the victim's death? _ Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
Added | ||||
| O10a. | What types of charges did the alleged offender face? Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O10b. | Which charges resulted in convictions? Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O11a. | What groups were they affiliated with? Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O12. | In the year prior to this event, did the offender leave an existing peer group? Do NOTread options 1=yes Specify _________________________ 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O14a. | What types of substances did the alleged offender use? Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O15a. | At the time of death, was the alleged offender perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O26. | Had this alleged offender been expelled from his or her school, in the 12 months preceding the event? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| O28. | Did any the offender experience any school-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| O28a. | Please briefly describe the specific school-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
|||||
| O29. | Was a school-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| O29a. | Please briefly describe the specific school-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O30. | Did any the offender experience any community-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| O30a. | Please briefly describe the specific community-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
|||||
| O31. | Was a community-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options _ 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| O31a. | Please briefly describe the specific community-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O32. | Did the alleged offender experience any family-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| O32a. | Please briefly describe the specific family-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
|||||
| O33. | Was a family-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
|||||
| O33a. | Please briefly describe the specific family-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O39. | Had the alleged offender ever received professional treatment for any other emotional or mental health problem? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| O39a | If yes, what specific kinds of emotional or mental health problems were treated? to be coded later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O45. | Was this alleged offender fatally injured during the event? Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
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| O46. | What was the date of the injury event? Record month/date/year, code leading zeros (code four-digit years)_ _/_ _/_ _ _ _ |
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| O47. | What was the time of the injury event? Record in military time _ _ _ _ |
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| O48. | What was the date of death? Record month/date/year, code leading zeros (code four-digit years)_ _/_ _/_ _ _ _ |
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| O49. | What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable motives. Motive Code a) single suicide b) suicide pact c) victim killed by law enforcement or security personnel d) victim killed by civilian during commission of a crime e) other specify |
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| O50. | Briefly describe the circumstances of the fatal injury and events leading up to it, including history of prior conflicts between the principles, etc. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| O51. | What was the method of fatal injury? Weapon a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
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| O52. | Did perceptions about the offender being gay, bisexual, or transgendered contribute to their perpetration? Do NOT read options _ 1=homosexual 2=heterosexual 3=bisexual 4=transgender 5=questioning 7=not applicable 8=unknown 9=refused to answer |
Added | ||||
| Revision Nature Of Items | Items | Old question format | |
| Revised to capture positions of additional respondents. | G02. | What is (are) your current position(s) in this school/district? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .................................................................................. ) f) police official _ g) other _ (specify .................................................................................. ) |
|
| Revised to capture positions of additional respondents. | G03. | What was (were) your position(s) during the period in which this event took place? Do NOT read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .................................................................................. ) f) police official _ g) other _ (specify .................................................................................. ) |
|
| Questions about the School: SCHOOL INTERVIEW | |||
| Replaced with items that capture specific information on the kinds of security measures potentially used in the school context. See SH 2012, item number S06. | S19. | Does the school currently use any of the following security measures? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors _ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify..............................................................................................) |
|
| Revised to include more security measures. See SH 2012, item numbers SOC05. | S25 | Were any of the following security measures operating at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors ___ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify..............................................................................................) |
Added |
| Questions about the EVENT: SCHOOL INTERVIEW | |||
| Revised to include more campus locations. See SH 2012, item numbers E02. | E02. | Where on the campus did the injury event occur? Read options - can list more than one response; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown, 9=refused to answer 01= in a classroom __ 02= in a hallway __ 03= in a cafeteria __ 04= in a gymnasium __ 05= in a locker room __ 06= in an office __ 07= on campus lawn or gardens __ 08= on sporting fields or playground __ 09= in a parking lot __ 10= in a driveway __ 66= other indoor __ (specify..............................................................................................) 67= other outdoor __ (specify............................................................................................) |
|
| Revised to include more campus locations. See SH 2012, item numbers E02-E03. | E03. | Where did the off-campus injury event occur? _ _ Read options; code written responses later; code leading zeros 01= on the street, sidewalk, footpath 02= on a bus or public transport vehicle 03= waiting for or alighting from bus or public transport vehicle 04= in a privately-owned vehicle 05= on private property 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
|
| Revised to include more contexts. See SH 2012, item number E03. | E04. | Which of the following best describes the context in which the injury event occurred? _ _ Read options; code written responses later; code leading zeros 01= on a day when no classes or school events were held 02= on a school day before classes began 03= while classes were being held 04= on a school day during lunch, recess or other break, including class changes 05= immediately after school 06= on a school day during after-school practice or detention 07= on a school day after official activities 08= at a school sporting activity 09= at another official school-sponsored activity 10= on the way to or from a school-sponsored activity 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
|
| Revised to include additional motives. See SH 2012, item number E04. | E07. | What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) single suicide _ b) suicide pact _ c) drug related _ d) gang related _ e) robbery, attempted robbery _ f) rape, attempted sex crime _ g) dispute over money or property _ h) dispute over romantic relationship _ i) dispute related to sporting event _ j) dispute, other or unspecified _ k) racially or hate crime motivated _ l) victim killed by police or security personnel _ m) victim killed by civilian during commission of a crime _ n) random victim _ o) unintentional injury _ p) other _ (specify..............................................................................................) |
|
| Revised to include additional methods. See SH 2012, item number E06. | E09. | What was the method of fatal injury? _ _ Read options; code leading zeros 01= firearm (specify..............................................................) 02= knife, razor, box cutter or other blade 03= beaten with club, bat, other object 04= beaten, no weapon used 05= motor vehicle 06= hanging/strangulation 07= poisoning, solid or liquid 08= asphyxiation by gas 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
|
| Revised to include more categories of media through which intentions may have been communicated. See SH 2012, item number E07. | E10. | After a tragedy such as this people look for things, such as comments, notes, threats, or actions that took place prior to the incident that could have signaled a potential risk for this type of behavior. Which of the following did any of the offenders, or victims in the case of suicide, leave as signs that they were considering this action? Please include as many signs as you can think of even if they were things that nobody could have recognized as a sign at the time they happened. Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {E10a} notes ____ {E10b} journal entry ___ {E10c} threats___ {E10d} other actions (specify.................................................................) |
|
| QUESTIONS about theVictim : SCHOOL INTERVIEW | |||
| Word fatal removed as all injuries may not be immediately lethal (e.g., deaths may occur days or years later). SH 2012, item number V02. | V02. | What was the date of the fatal injury? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | |
| Word fatal removed as all injuries may not be immediately lethal (e.g., deaths may occur days or years later). See SH 2012, item number V03. | V03. | What was the time of the fatal injury? Record in military time _ _ _ _ | |
| Age extended beyond 65 to allow coding of actual age. Values for not applicable, unknown, and refused to answer extended outside range for chronological age. See SH 2012, item number V06. | V07. | What was this victim's age in years at the time of death? _ _ Do NOT read options, code leading zero 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
|
| Revised to include transgender as an option. See SH 2012, item number V07. | V08. | What was this victim's gender? _ _ Do NOT read options 1=male 2=female 7=not applicable 8=unknown 9=refused to answer |
|
| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number V08. | V09. | What was the victim's race? _ Do NOT read Options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
|
| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number V09. | V10. | Was this victim of Latino or Hispanic origin? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
|
| Option for lives with legal guardian added. See SH 2012, item number V10. | V11. | Which of the following best describes the victim's family structure/living arrangements at the time of death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
|
| Revised to open ended format. Will allow specific groups to be noted explicitly and coded according to type later. See SH 2012, item numbers V12-V12a. | Vp01. | Youth often affiliate with distinct peer groups. With which one of the following groups would you say this victim was most closely affiliated? _ _ Read options 01= street gang 02= tagging crew (spray paint graffiti of groups logo or “tag” around the neighborhood) 03= Wannabes (dress and act like gang members without actually belonging to a street gang) 04= Druggies or Stoners 05= Hip-Hop 06= Gothic 07= Punkers 08= Skaters/Surfers 09= Rockers 10= Cowboys/girls 11= Brains 12= Jocks, Athletes 13= Preppies 14= Geeks 15= Band 16= Hackers 17= Bible study 18= Granolas 19= Loner 20= Not a loner but no particular group 66= other (specify...........................................) 77= not applicable 88=unknown 99=refused to answer |
|
| Revised to indicate specific type of change experienced if any. Entry to new peer group or existing existing peer group. See SH 2012, item numbers V13-V14.. | Vp02. | In the year prior to this event, was there a change in this victim’s peer group? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Removed reference to at least once a week. This question could not be answered reliably. See SH 2012, item number V15. | V15. | Did the victim use alcohol or other drugs at least once a week? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Additional items revised weapon listing. See SH 2012, item number V23. | VW03. | For the most recent event prior to the date of fatal injury, which of the following types of weapons was the victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify.....................................................................) e) other _ (specify........................................................................) |
Added |
| Revised to include additional methods to obtain weapons, such as home made. See SH 2012, item number V19. | V19. | At the time of the fatal injury, which of the following types of weapon was this victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
Added |
| Revised to include additional methods to obtain weapons, such as home made. See SH 2012, item number V20. | V20. | Where did this victim obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) from home _ (specify weapon................................) b) from friend or relative outside household _ (specify weapon........................) c) purchased for himself/herself _ (specify weapon................................) d) stolen _ (specify weapon................................) e) from the victim (specify weapon................................)_ f) other _ (specify weapon................................) |
Added |
| Added additional options such as former student at the school and family member of staff member. See SH 2012 item number V22.. | V22. | What was the victim's affiliation with the school associated with this death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified victim* 66=other* (specify.............................................................................................................) 77=not applicable* 88=unknown* 99=refused to answer* |
|
| Revised to include in school suspensions. See SH 2012, item number V26. | V25. | How many times in the last year was the victim suspended or expelled from his or her school? _ Do NOT read options 0=none, never suspended 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
|
| Additional items added reflecting new behaviors. See SH 2012, item number V35. | Vr01. | To the best of your knowledge, in the 12 months prior to this event was the victim reported to the principal’s office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr01a} disobeying authority figure__ {Vr01b} namecalling or teasing peers __ {Vr01c} physical fighting with peers _ {Vr01d} damaging another's personal property_ _ {Vr01e} stealing another's personal property __ |
|
| Additional items added reflecting new behaviors. See SH 2012, item number V36a. | Vr01a. | To the best of your knowledge, in the 12 months prior to this event was this individual victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr01a} called names by peers__ {Vr01b} bullied by peers __ {Vr01c} had personal property damaged or stolen _ {Vr01d} physically threatened by peers __ _ {Vr01e} physically assaulted by peers __ |
|
| Additional items added reflecting broader range of services. See SH 2012, item number V37. | Vm01. | In the year prior to this event, did this victim receive school-sponsored psychological counseling services? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
Revised |
| Additional items added to distinguish specific types of victimization experiences. See SH 2012, item number V42. | Vm03a | Did this victim have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vm03a} alcoholism _ {Vm03b} drug abuse _ {Vm03c} child abuse/neglect __ {Vm03d} intimate partner violence_ |
|
| Reworded to refer to persons who suffered non-fatal injuries. See SH 2012, item number V49. | Vi02. | How many nonfatal injuries occurred at the time of this event? _ _ 01-##=actual number of nonfatal injuries 77=not applicable 88=unknown 99=refused to answer |
|
| QUESTIONS about Alleged Offender: SCHOOL INTERVIEW | |||
| Age extended beyond 65 to allow coding of actual age. Values for not applicable, unknown, and refused to answer extended outside range for chronological age. See SH 2012, item number O03. | X07. | What was this offender's age in years at time of victim's death? _ _ Do NOT read options, code leading zero 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
|
| Revised to include transgender as an option. See SH 2012, item number O04. | X08. | What was this offender's gender? _ _ Do NOT read options 1=male 2=female 7=not applicable 8=unknown 9=refused to answer |
|
| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number "O05. | X09. | What was this offender's race? _ Do NOT read options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
|
| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number O06. | X10. | Was this offender of Latino or Hispanic origin? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
|
| Option for lives with legal guardian added. See SH 2012, item number O07. | X11. | Which of the following best describes this offender's family structure or living arrangements at the time of the victim's death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
|
| Revised to open ended format. Will allow specific groups to be noted explicitly and coded according to type later. See SH 2012, item numbers O11-O11a. | Xp01. | Youth often affiliate with distinct peer groups. With which one of the following groups would you say the offender was most closely affiliated? _ _ Read options 01= Member of an identified street gang 02= Member of a tagging crew (spray paint graffiti of groups logo or “tag” around the neighborhood) 03= Wannabes (dress and act like gang members without actually belonging to a street gang) 04= Druggies or Stoners 05= Hip-Hop 06= Gothic 07= Punkers 08= Skaters/Surfers 09= Rockers 10= Cowboys/girls 11= Brains 12= Jocks, Athletes 13= Preppies 14= Geeks 15= Band 16= Hackers 17= Bible study 18= Granolas 19= Loner 20= Not a loner but no particular group 66= other (specify...........................................) 77= not applicable 88=unknown 99=refused to answer |
|
| Revised to indicate specific type of change experienced if any. Entry to new peer group or existing existing peer group. See SH 2012, item numbers O11-O11a. | Xp02. | In the year prior to this event, was there a change in this offender’s peer group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Removed reference to at least once a week. This question could not be answered reliably. See SH 2012, item numbers O14. | X15. | Did this offender use alcohol or other drugs at least once a week at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Additional items added reflecting new behaviors. See SH 2012, item number O23. | XW03. | For the most recent event prior to the date of fatal injury, was this offender carrying any of the following types of weapon? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
Added |
| Additional items added reflecting new behaviors. See SH 2012, item number O18. | X19. | At the time of the fatal injury, which of the following types of weapon was this offender carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
Added |
| Additional items added reflecting new behaviors. See SH 2012, item number O19. | X20 | Where did this offender obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) from home _ (specify weapon................................) b) from friend or relative outside household _ (specify weapon................................) c) purchased for himself/herself _ (specify weapon................................) d) stolen _ (specify weapon................................) e) from the victim (specify weapon................................)_ f) other _ (specify weapon................................) |
Added |
| Revised to include in school suspensions. See SH 2012, item number O25. | X25. | How many times was this offender suspended or expelled from his or her school? _ Do NOT read options 0=none, never suspended or expelled 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
|
| Additional items added reflecting new behaviors. See SH 2012, item number O34. | Xr01. | To the best of your knowledge, in the 12 months prior to this event was this offender reported to the office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr01a} disobeying authority figure__ {Xr01b} name calling or teasing peers _ {Xr01c} physical fighting with peers _ {Xr01d} damaging another's personal property_ _ {Xr01e} stealing another's personal property __ |
|
| Additional items added reflecting new behaviors. See SH 2012, item number O35. | Xr01a. | To the best of your knowledge, in the 12 months prior to this event was this offender victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr01a} called names by peers__ {Xr01b} bullied by peers __ {Xr01c} had personal property damaged or stolen _ {Xr01d} physically threatened by peers __ _ {Xr01e} physically assaulted by peers __ |
|
| Additional items added reflecting broader range of services. See SH 2012, item number O37. | Xm01. | In the year prior to this event, did this offender receive school-sponsored psychological counseling services? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
|
| Additional items added to distinguish specific types of victimization experiences. See SH 2012, item number O40. | Xm03a | Did this offender have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xm03a} alcoholism _ {Xm03b} drug abuse _ {Xm03c} child abuse/neglect __ {Xm03d} intimate partner violence_ |
| General Questions SCHOOL INTERVIEW | ORIGINAL | REVISION | ||||
| Revised to capture positions of additional respondents. | G02. What is (are) your current position(s) in this school/district? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .................................................................................. ) f) police official _ g) other _ (specify .................................................................................. ) |
G01. What is (are) your current position(s) in this school/district? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown. Up to five respondents can be captured using the items below. Coding should reflect actual participant number up to five. G01a. Respondent 1 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G01b. Respondent 2 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G01c. Respondent 3 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G01d. Respondent 4 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G01e. Respondent 5 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) |
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| Revised to capture positions of additional respondents. | G03. What was (were) your position(s) during the period in which this event took place? Do NOT read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .................................................................................. ) f) police official _ g) other _ (specify .................................................................................. ) |
G02. What was (were) your position(s) during the period in which this event took place? Do NOT read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Up to five respondents can be captured using the items below. Coding should reflect actual participant number up to five. G02a. Respondent 1 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G02b. Respondent 2 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G02c. Respondent 3 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G02d. Respondent 4 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G02e. Respondent 5 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) |
||||
| Questions about the School: SCHOOL INTERVIEW | ||||||
| Replaced with items that capture specific information on the kinds of security measures potentially used in the school context. See SH 2012, item number S06. | S19. Does the school currently use any of the following security measures? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors _ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify..............................................................................................) |
S06. Were any of the following security measures in use at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Measure Location or Type of Measure Code S06a) Walk Through Metal Detectors S06a1) If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never S06a2)Where were the walk through metal detectors used? S06a2.a) Main entry S06a2.b) Secondary entries S06a2.c) Other Specify S06b) Hand Held Metal Detectors S06b1) If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never S06b2) Where were the walk through metal detectors used? S06b2.a) Main entry S06b2.b) Secondary entries S06b2.c) Other Specify S06c) Surveillance Cameras S06c1)If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 5 After official activities 6 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) 7 Cameras only used as visual detterent S06c2)Where were the surveillance cameras used? S06c2.a) Entry/exit areas – exterior S06c2.b) Athletic areas S06c2.c) Entry/exit areas – interior S06c2.d) Corridors S06c2.e) Other Specify S06d) Communication Devices S06d.1) 2-way radios S06d.2) 2-way intercom in most classrooms S06d.3) Other Specify S06e) Access Restrictions S06e.1) Proximity or card swipe access for staff S06e.2) Intrusion Alarm Systems S06e3)If yes, where? S06e3.a) Main building(s) / areas S06e3.b) Parking lot(s) S06e3.c) Other Specify S06e4) If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) |
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| Revised to include more security measures. See SH 2012, item numbers SOC05. | S25. Were any of the following security measures operating at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors ___ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify.....................................................................) |
SOC05. Were any of the following security measures in use at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Measure Location or Type of Measure Code SOC05a) Walk Through Metal Detectors SOC05a1 If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never SOC05a2 Where were the walk through metal detectors used? SOC05a2.a) Main entry SOC05a2.b) Secondary entries SOC05a2.c) Other Specify SOC05b) Hand Held Metal Detectors SOC05b1 If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never SOC05b2 Where were the walk through metal detectors used? SOC05b2.a) Main entry SOC05b2.b) Secondary entries SOC05b2.c) Other Specify SOC05c) Surveillance Cameras SOC05c1 If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) 9 Cameras only used as visual detterent SOC05c2 Where were the surveillance cameras used? SOC05c2.a) Entry/exit areas – exterior SOC05c2.b) Athletic areas SOC05c2.c) Entry/exit areas – interior SOC05c2.d) Corridors SOC05c2.e) Other Specify SOC05d) Communication Devices SOC05d.1) 2-way radios SOC05d.2) 2-way intercom in most classrooms SOC05d.3) Other Specify SOC05e) Access Restrictions SOC05e.1) Proximity or card swipe access for staff SOC05e.2) Intrusion Alarm Systems SOC05e3 If yes, where? SOC05e3.a) Main building(s) / areas SOC05e3.b) Parking lot(s) SOC05e3.c) Other Specify SOC05e4 If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) |
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| Questions about the EVENT: SCHOOL INTERVIEW | ||||||
| Revised to include more campus locations. See SH 2012, item numbers E01 | E02. Where on the campus did the injury event occur? Read options - can list more than one response; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown, 9=refused to answer 01= in a classroom __ 02= in a hallway __ 03= in a cafeteria __ 04= in a gymnasium __ 05= in a locker room __ 06= in an office __ 07= on campus lawn or gardens __ 08= on sporting fields or playground __ 09= in a parking lot __ 10= in a driveway __ 66= other indoor __ (specify.............................................) 67= other outdoor __ (specify............................................) |
E01. Where on the campus did the injury event occur? Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable locations 01= in a classroom 02= in a hallway 03= in a cafeteria 04= in a gymnasium 05= in a locker room 06= in an office 07= in a stairwell 08= in a restroom 09= in a break room or lounge 10= in an auditorium 11= on campus lawn or gardens 12= on sporting fields or playground 13= in a parking lot 14= in a driveway 15= at a bus pickup or drop off point 66= other indoor location Specify. 67= other outdoor location Specify 77= not applicable 88= unknown 99= refused to answer |
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| Revised to include more campus locations. See SH 2012, item numbers E02. | E03. Where did the off-campus injury event occur? _ _ Read options; code written responses later; code leading zeros 01= on the street, sidewalk, footpath 02= on a bus or public transport vehicle 03= waiting for or alighting from bus or public transport vehicle 04= in a privately-owned vehicle 05= on private property 66= other (specify.....................................) 77= not applicable 88= unknown 99= refused to answer |
E02. Where did the off-campus injury event occur? _ _ Read options; code written responses later; code leading zeros 01= on the street, sidewalk, footpath 02= on a bus or public transport vehicle 03= waiting for or getting on or off a bus or public transport vehicle 04= in a privately-owned vehicle / car 05= on private property (specify________________________) 06= at a sporting complex (pool, stadium, off campus gym, rec center etc…) 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
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| Revised to include more contexts. See SH 2012, item number E03. | E04. Which of the following best describes the context in which the injury event occurred? _ _ Read options; code written responses later; code leading zeros 01= on a day when no classes or school events were held 02= on a school day before classes began 03= while classes were being held 04= on a school day during lunch, recess or other break, including class changes 05= immediately after school 06= on a school day during after-school practice or detention 07= on a school day after official activities 08= at a school sporting activity 09= at another official school-sponsored activity 10= on the way to or from a school-sponsored activity 66= other (specify..........................................) 77= not applicable 88= unknown 99= refused to answer |
E03. Which of the following best describes the context in which the injury event occurred? _ _ Read options; code written responses later; code leading zeros 01= on a day when no classes or school events were held (e.g., a weekend, holiday, or an official school break) 02= on a school day before classes began 03= while classes were being held 04= during a school assembly 04= on a school day during lunch, recess or other break, including class changes 05= immediately after school 06= on a school day during after-school practice or detention 07= on a school day after official activities 08= at a school sporting activity 09= at another official school-sponsored activity 10= on the way to or from a school-sponsored activity 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
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| Revised to include additional motives. See SH 2012, item number E04. | E07. What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) single suicide _ b) suicide pact _ c) drug related _ d) gang related _ e) robbery, attempted robbery _ f) rape, attempted sex crime _ g) dispute over money or property _ h) dispute over romantic relationship _ i) dispute related to sporting event _ j) dispute, other or unspecified _ k) racially or hate crime motivated _ l) victim killed by police or security personnel _ m) victim killed by civilian during commission of a crime _ n) random victim _ o) unintentional injury _ p) other _ (specify...................................................................) |
E04. What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable motives. Motive Code a) single suicide b) suicide pact c) drug related d) gang related e) robbery, attempted robbery f) rape, attempted sex crime g) dispute over money or property h) dispute over romantic relationship i) dispute related to sporting event j) dispute, other or unspecified k) racially or hate crime motivated l) victim killed by law enforcement or security personnel m) victim killed by civilian during commission of a crime n) act of terrorism o) random victim p) victim was a bystander q) victim was intervener assisting a crime victim r) other Specify |
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| Revised to include additional methods. See SH 2012, item number E06. | E09. What was the method of fatal injury? _ _ Read options; code leading zeros 01= firearm (specify.................................................) 02= knife, razor, box cutter or other blade 03= beaten with club, bat, other object 04= beaten, no weapon used 05= motor vehicle 06= hanging/strangulation 07= poisoning, solid or liquid 08= asphyxiation by gas 66= other (specify................................................) 77= not applicable 88= unknown 99= refused to answer |
E06. What was the method of fatal injury? Read options; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable methods utilized. 01= firearm Specify 02= knife, razor, box cutter or other blade 03= beaten with club, bat, pipe, chain, or other object 04= beaten, no weapon used 05= motor vehicle 06= hanging/strangulation/asphyxiation by hanging 07= poisoning, solid or liquid 08= asphyxiation by gas 09= other asphyxiation 66= other Specify 77= not applicable 88= unknown 99= refused to answer |
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| Revised to include more categories of media through which intentions may have been communicated. See SH 2012, item number E07. | E10. After a tragedy such as this people look for things, such as comments, notes, threats, or actions that took place prior to the incident that could have signaled a potential risk for this type of behavior. Which of the following did any of the offenders, or victims in the case of suicide, leave as signs that they were considering this action? Please include as many signs as you can think of even if they were things that nobody could have recognized as a sign at the time they happened. Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {E10a} notes ____ {E10b} journal entry ___ {E10c} threats___ {E10d} other actions (specify.................................................................) |
E07. After a tragedy such as this people look for things, such as comments, notes, threats, or actions that took place prior to the incident that could have signaled a potential risk for this type of behavior. Which of the following did any of the offenders, or victims in the case of suicide, leave as signs that they were considering this action? Please include as many signs as you can think of even if they were things that no one could have recognized as a sign at the time they happened. Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code all applicable signs. Sign Code {E07a} notes {E07b} journal entry {E07c} social media (e.g. blogs, Twitter, wall postings on social networking sites) {E07d} verbal threats___ {E07e} electronic media (e.g., email messages, IM, or texts via cellphone, voice mail, video ect..) {E07f} other actions (e.g., playful suggestion that person might commit act, voiced suicidal thoughts) Specify |
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| QUESTIONS about theVictim : SCHOOL INTERVIEW | ||||||
| Word fatal removed as all injuries may not be immediately lethal (e.g., deaths may occur days or years later). SH 2012, item number V02. | V02. What was the date of the fatal injury? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | V02. What was the date of the injury? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | ||||
| Word fatal removed as all injuries may not be immediately lethal (e.g., deaths may occur days or years later). See SH 2012, item number V03. | V03. What was the time of the fatal injury? Record in military time _ _ _ _ | V03. What was the time of the injury? Record in military time _ _ _ _ | ||||
| Age extended beyond 65 to allow coding of actual age. Values for not applicable, unknown, and refused to answer extended outside range for chronological age. See SH 2012, item number V06. | V07. What was this victim's age in years at the time of death? _ _ Do NOT read options, code leading zero 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
V06. What was this victim's age in years at the time of death? _ _ _ Do NOT read options, code leading zero 01-∞=actual age in years 777=not applicable 888=unknown 999=refused to answer |
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| Revised to include transgender as an option. See SH 2012, item number V07. | V08. What was this victim's gender? _ _ Do NOT read options 1=male 2=female 7=not applicable 8=unknown 9=refused to answer |
V07. What was this victim's gender? _ Do NOT read options 1=male 2=female 3=transgender 7=not applicable 8=unknown 9=refused to answer |
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| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number V08. | V09. What was the victim's race? _ Do NOT read Options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
V08. What was the victim's race? _ _ Do NOT read Options 1 White 2 Black or African American 3 American Indian or Alaska Native 4 Asian Indian 5 Chinese 6 Filipino 7 Japanese 8 Korean 9 Vietnamese 10 Other Asian 11 Native Hawaiian 12 Guamanian or Chamorro 13 Samoan 14 Other Pacific Islander 15 Other (Specify) ______________ 88 Unknown—a person’s race is unknown 99 Refused to Answer |
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| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number V09. | V10. Was this victim of Latino or Hispanic origin? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
V09. Was this victim of Hispanic, Latino/a ,or Spanish Origin? (One or more categories may be selected) origin? _ Do NOT read options 1 Not Hispanic or Latino/a or Spanish origin 2 Yes, Mexican, Mexican American, Chicano/a 3 Yes, Puerto Rican 4 Yes, Cuban 5 Yes, another Hispanic, Latino, or Spanish origin 8 Unknown if victim is of Hispanic or Latino origin 9 Refused to Answer |
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| Option for lives with legal guardian added. See SH 2012, item number V10. | V11. Which of the following best describes the victim's family structure/living arrangements at the time of death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
V10. Which of the following best describes the victim's family structure/living arrangements at the time of death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives with legal guardian 05= lives independently 06= foster care 07= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
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| Revised to open ended format. Will allow specific groups to be noted explicitly and coded according to type later. See SH 2012, item numbers V12. | Vp01. Youth often affiliate with distinct peer groups. With which one of the following groups would you say this victim was most closely affiliated? _ _ Read options 01= street gang 02= tagging crew (spray paint graffiti of groups logo or “tag” around the neighborhood) 03= Wannabes (dress and act like gang members without actually belonging to a street gang) 04= Druggies or Stoners 05= Hip-Hop 06= Gothic 07= Punkers 08= Skaters/Surfers 09= Rockers 10= Cowboys/girls 11= Brains 12= Jocks, Athletes 13= Preppies 14= Geeks 15= Band 16= Hackers 17= Bible study 18= Granolas 19= Loner 20= Not a loner but no particular group 66= other (specify...........................................) 77= not applicable 88=unknown 99=refused to answer |
V12. Individuals often affiliate with distinct peer groups. To your knowledge, was the victim associated with any distinct peer group? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused* |
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| Revised to indicate specific type of change experienced if any. Entry to new peer group or existing existing peer group. See SH 2012, item numbers V13-V14.. | Vp02. In the year prior to this event, was there a change in this victim’s peer group? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V14. In the year prior to this event, did the victim join a new peer group? Do not read options 1=yes Specify____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Removed reference to at least once a week. This question could not be answered reliably. | V15. Did the victim use alcohol or other drugs at least once a week? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V15. Did the victim use alcohol or other drugs? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Removed reference to other. This question could not be answered reliably | V16. Was there evidence that the victim was intoxicated with alcohol or other drugs at the time of death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V16. Was there evidence that the victim was intoxicated with alcohol or drugs at the time of death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Revised to include additional methods to obtain weapons, such as home made. See SH 2012, item number V19. | V19. At the time of the fatal injury, which of the following types of weapon was this victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
V19. At the time of the fatal injury, which of the following types of weapon was this victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapon Code a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
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| Revised to include additional methods to obtain weapons, such as home made. See SH 2012, item number V20. | V20. Where did this victim obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) from home _ (specify weapon................................) b) from friend or relative outside household _ (specify weapon..............) c) purchased for himself/herself _ (specify weapon................................) d) stolen _ (specify weapon................................) e) from the victim (specify weapon................................)_ f) other _ (specify weapon................................) |
V20. Where did this victim obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapons source Code a) from home specify weapon b) from friend or relative outside household specify weapon c) purchased for himself/herself specify weapon d) stolen specify weapon e) home-made weapon f) weapon of opportunity (used weapon already present in environment / used object in environment as weapon) g) from the victim specify weapon h) other _ specify weapon |
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| Added additional options such as former student at the school and family member of staff member. See SH 2012 item number V21. | V22. What was the victim's affiliation with the school associated with this death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified victim* 66=other* (specify.............................................................................................................) 77=not applicable* 88=unknown* 99=refused to answer* |
V21. What was the victim's affiliation with the school associated with this death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified victim* 66=other* (specify..................................................................................) 77=not applicable* 88=unknown* 99=refused to answer* |
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| Additional items revised weapon listing. See SH 2012, item number V23. | VW03. For the most recent event prior to the date of fatal injury, which of the following types of weapons was the victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify.....................................................................) e) other _ (specify........................................................................) |
V23. For the most recent event prior to the date of fatal injury, which of the following types of weapons was the victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapon Code a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
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| Revised to include in school suspensions. See SH 2012, item number V26. | V25. How many times in the last year was the victim suspended or expelled from his or her school? _ Do NOT read options 0=none, never suspended 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
V26. How many times in the last year was the victim suspended from his or her school? _ (including in-school suspensions) Do NOT read options 0=none, never suspended 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
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| Additional items added reflecting new behaviors. See SH 2012, item number V35. | Vr01. To the best of your knowledge, in the 12 months prior to this event was the victim reported to the principal’s office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr01a} disobeying authority figure__ {Vr01b} namecalling or teasing peers __ {Vr01c} physical fighting with peers _ {Vr01d} damaging another's personal property_ _ {Vr01e} stealing another's personal property __ |
V35. In the 12 months prior to this event was the victim reported to the principal’s office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Behavior Code {V35a} disobeying authority figure {V35b} namecalling, taunting, or teasing peers V35b.1 Face to face? V35b.2 Using Electronic means? {V35c} verbal threats {V35d} sent written threats {V35e} sent electronic threats {V35f} bullied peers {V35f} physically threatened peers {V35g} physical fought with peers {V35h} damaged another's personal property {V35i} damaged school property (tagging, vandalism etc…) {V35j}stole another's personal property {V35k} truancy (skipped school) {V35l} possessed / used illegal substances {V35m}possessed a weapon |
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| Additional items added reflecting new behaviors. See SH 2012, item number V36a. | Vr01a. To the best of your knowledge, in the 12 months prior to this event was this individual victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr01a} called names by peers__ {Vr01b} bullied by peers __ {Vr01c} had personal property damaged or stolen _ {Vr01d} physically threatened by peers __ _ {Vr01e} physically assaulted by peers __ |
V36a. To the best of your knowledge, in the 12 months prior to this event was this individual victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Type Code {V36a.1} called names by peers {V36a.2} bullied by peers {V36a.3} had personal property damaged or stolen {V36a.4}verbally threatened by peers {V36a.5}received written threats {V36a.6} electronic threats {V36a.7}physically threatened by peers {V36a.8}physically assaulted by peers |
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| Additional items added reflecting broader range of services. See SH 2012, item number V37. | Vm01. In the year prior to this event, did this victim receive school-sponsored psychological counseling services? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V37. In the year prior to this event, did this victim receive any of the following services? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Services Code V37.a) guidance counseling / advising V37.b) psychological counseling V37.c) psychiatric or mental health services V37.d) social services V37.e) supplemental educational services (including efforts to address learning disabilities) V37.f) other services Specify |
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| Additional items added to distinguish specific types of victimization experiences. See SH 2012, item number V41. | Vm03a Did this victim have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vm03a} alcoholism _ {Vm03b} drug abuse _ {Vm03c} child abuse/neglect __ {Vm03d} intimate partner violence_ |
V41. Did this victim have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code {V41.a } alcoholism {V41.b} drug abuse {V41.c} intimate partner violence {V41.d} sexual violence {V41.e}attempted / completed suicide {V41.f} arrests / convictions for violent offenses (e.g., assault, homicide etc…) |
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| QUESTIONS about Alleged Offender: SCHOOL INTERVIEW | ||||||
| Age extended beyond 65 to allow coding of actual age. Values for not applicable, unknown, and refused to answer extended outside range for chronological age. See SH 2012, item number O03. | X07. What was this offender's age in years at time of victim's death? _ _ Do NOT read options, code leading zero 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
O03. What was this alleged offender's age in years at time of victim's death? _ _ Do NOT read options, code leading zero 01-100=actual age in years 777=not applicable 888=unknown 999=refused to answer |
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| Revised to include transgender as an option. See SH 2012, item number O04. | X08. What was this offender's gender? _ _ Do NOT read options 1=male 2=female 7=not applicable 8=unknown 9=refused to answer |
O04. What was this alleged offender's gender? _ Do NOT read options 1=male 2=female 3=transgender 7=not applicable 8=unknown 9=refused to answer |
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| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number "O05. | X09. What was this offender's race? _ Do NOT read options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
O05. What was this alleged offender's race? _ Do NOT read options 1 =White 2 =Black or African American 3 =American Indian or Alaska Native 4 =Asian Indian 5 =Chinese 6=Filipino 7=Japanese 8=Korean 9=Vietnamese 10=Other Asian 11=Native Hawaiian 12=Guamanian or Chamorro 13=Samoan 14=Other Pacific Islander 15=Other (Specify) ______________ 88 =Unknown—a person’s race is unknown 99=Refused to Answer |
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| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number O06. | X10. Was this offender of Latino or Hispanic origin? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
O06. Was this alleged offender of Hispanic, Latino/a, or Spanish Origin? _ (One or more categories may be selected) Do NOT read options 1 =Not Hispanic or Latino/a or Spanish origin 2 =Yes, Mexican, Mexican American, Chicano/a 3=Yes, Puerto Rican 4=Yes, Cuban 5=Yes, another Hispanic, Latino, or Spanish origin 9 =Unknown if elder is of Hispanic or Latino origin |
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| Option for lives with legal guardian added. See SH 2012, item number O07. | X11. Which of the following best describes this offender's family structure or living arrangements at the time of the victim's death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
O07. Which of the following best describes this alleged offender's family structure or living arrangements at the time of the victim's death? _ _ |
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| Revised to open ended format. Will allow specific groups to be noted explicitly and coded according to type later. See SH 2012, item numbers O11- | Xp01. Youth often affiliate with distinct peer groups. With which one of the following groups would you say the offender was most closely affiliated? _ _ Read options 01= Member of an identified street gang 02= Member of a tagging crew (spray paint graffiti of groups logo or “tag” around the neighborhood) 03= Wannabes (dress and act like gang members without actually belonging to a street gang) 04= Druggies or Stoners 05= Hip-Hop 06= Gothic 07= Punkers 08= Skaters/Surfers 09= Rockers 10= Cowboys/girls 11= Brains 12= Jocks, Athletes 13= Preppies 14= Geeks 15= Band 16= Hackers 17= Bible study 18= Granolas 19= Loner 20= Not a loner but no particular group 66= other (specify...........................................) 77= not applicable 88=unknown 99=refused to answer |
O11. Individuals often affiliate with distinct peer groups. To your knowledge, was the alleged offender associated with any distinct peer group? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
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| Revised to indicate specific type of change experienced if any. Entry to new peer group or existing existing peer group. See SH 2012, item numbers O13. | Xp02. In the year prior to this event, was there a change in this offender’s peer group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O13. In the year prior to this event, did the offender or join a new peer group? Do NOT read options 1=yes Specify_____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Removed reference to at least once a week. This question could not be answered reliably. See SH 2012, item number O14. | X15. Did this offender use alcohol or other drugs at least once a week at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O14. Did this alleged offender use alcohol or other drugs at the time of the victim's death? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Additional items added reflecting new behaviors. See SH 2012, item number O23. | Xw03. For the most recent event prior to the date of fatal injury, was this offender carrying any of the following types of weapon? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
O23. For the most recent event prior to the date of fatal injury, was this alleged offender carrying any of the following types of weapon? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapon Code a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
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| Additional items added reflecting new behaviors. See SH 2012, item number O18. | X19. At the time of the fatal injury, which of the following types of weapon was this offender carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
O18. At the time of the fatal injury, which of the following types of weapon was this alleged offender carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapon Code a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
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| Additional items added reflecting new behaviors. See SH 2012, item number O19. | X20. Where did this offender obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) from home _ (specify weapon................................) b) from friend or relative outside household _ (specify weapon................................) c) purchased for himself/herself _ (specify weapon................................) d) stolen _ (specify weapon................................) e) from the victim (specify weapon................................)_ f) other _ (specify weapon................................) |
O19. Where did this alleged offender obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapons source Code a) from home specify weapon b) from friend or relative outside household specify weapon c) purchased for himself/herself specify weapon d) stolen specify weapon e) home-made weapon f) weapon of opportunity (used weapon already present in environment / used object in environment as weapon) g) from the victim specify weapon h) other _ specify weapon |
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| Revised to include in school suspensions. See SH 2012, item number O25. | X25. How many times was this offender suspended or expelled from his or her school? _ Do NOT read options 0=none, never suspended or expelled 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
O25. How many times was this alleged offender suspended from his or her school? (including in school suspensions) _ Do NOT read options 0=none, never suspended or expelled 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
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| Removed reference to at least once a week. This question could not be answered reliably.See SH 2012, item number O34. | Xr01. To the best of your knowledge, in the 12 months prior to this event was this offender reported to the office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr01a} disobeying authority figure__ {Xr01b} name calling or teasing peers _ {Xr01c} physical fighting with peers _ {Xr01d} damaging another's personal property_ _ {Xr01e} stealing another's personal property __ |
O34. To the best of your knowledge, in the 12 months prior to this event did the alleged offender engage in any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Behavior Code {O34a} disobeying authority figure {O34b} name-calling, taunting, or teasing peers O34b.1 Face to face? O34b.2 Using Electronic means? {O34c} verbal threats {O34d} sent written threats {O34e} sent electronic threats {O34f} bullied peers {O34g} physically threatened peers {O34h} physical fought with peers {O34i}damaged another's personal property {O34j} damaged school property (tagging, vandalism etc…) {O34k}stole another's personal property {O34l} truancy (skipped school) {O34m} possessed / used illegal substances {O34n}possessed a weapon |
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| Removed reference to at least once a week. This question could not be answered reliably. See SH 2012, item number O35. | Xr01a. To the best of your knowledge, in the 12 months prior to this event was this offender victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr01a} called names by peers__ {Xr01b} bullied by peers __ {Xr01c} had personal property damaged or stolen _ {Xr01d} physically threatened by peers __ _ {Xr01e} physically assaulted by peers __ |
O35. To the best of your knowledge, in the 12 months prior to this event was this alleged offender victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Type Code {O35.a} called names by peers {O35.b} bullied by peers {O35.c} had personal property damaged or stolen {O35.d}verbally threatened by peers {O35.e}received written threats {O35.f} electronic threats {O35.g}physically threatened by peers {O35.h}physically assaulted by peers |
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| Additional items added reflecting broader range of services. See SH 2012, item number O37. | Xm01. In the year prior to this event, did this offender receive school-sponsored psychological counseling services? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O37. In the year prior to this event, did this alleged offender receive any of the following services? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Services Code O37.a guidance counseling / advising O37.b psychological counseling O37.c Psychiatric or mental health services O37.d social services O37.e supplemental educational services (including efforts to address learning disabilities) O37.f other services Specify |
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| Additional items added to distinguish specific types of victimization experiences. See SH 2012, item number O40. | Xm03a Did this offender have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xm03a} alcoholism _ {Xm03b} drug abuse _ {Xm03c} child abuse/neglect __ {Xm03d} intimate partner violence_ |
O40. Did this alleged offender have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code {O39.1} alcoholism {O39.2} drug abuse {O39.3} intimate partner violence {O39.4.} sexual violence {O39.5}attempted / completed suicide {O39.6} arrests / convictions for violent offenses (e.g., assault, homicide etc…) |
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| ITEMS | PREVIOUS SCHOOL INTERVIEW | ITEMS | REVISED SCHOOL INTERVIEW | |
| General Questions | General Questions | |||
| Eliminated original question | G01. | How many individuals are providing information for this interview? Indicate actual number _ _ |
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| Revised to capture positions of additional respondents. See SHQ2012 item G01. | G02. | What is (are) your current position(s) in this school/district? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .................................................................................. ) f) police official _ g) other _ (specify .................................................................................. ) |
G01. | What is (are) your current position(s) in this school/district? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Up to five respondents can be captured using the items below. Coding should reflect actual participant number up to five. G01a. Respondent 1 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G01b. Respondent 2 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G01c. Respondent 3 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G01d. Respondent 4 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G01e. Respondent 5 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) |
| Revised to capture positions of additional respondents. See SHQ2012 item G02. | G03. | What was (were) your position(s) during the period in which this event took place? Do NOT read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .................................................................................. ) f) police official _ g) other _ (specify .................................................................................. ) |
G02. | What was (were) your position(s) during the period in which this event took place? Do NOT read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Up to five respondents can be captured using the items below. Coding should reflect actual participant number up to five. G02a. Respondent 1 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G02b. Respondent 2 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G02c. Respondent 3 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G02d. Respondent 4 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) G02e. Respondent 5 a) principal _ b) teacher _ c) counselor _ d) superintendent _ e) school support staff _ (specify .......................................................) f) law enforcement official _ g) other _ (specify .......................................................) |
| New Question | G03. | Where did the injury event occur? Read options 1= on school property 2= on the way to or from the campus* 3= at an off-campus school-sponsored event* 4= on the way to or from a school sponsored event* 6= other* (specify..............................................................................................) 8= unknown* 9= refused to answer |
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| QUESTIONS about the school | QUESTIONS about the school | |||
| Eliminated - already captured on 1st page. | Case ID. | To be assigned by study coordinator, record 5-digit number _ _ _ _ _ | ||
| Eliminated original question | S01. | Is the school associated with this death a public, private or charter school? _ Do NOT read options 1=public 2=private 3=charter 8=unknown 9=refused to answer |
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| No Change in question - renumbered as S01. | S02. | Is the school associated with this death an alternative school? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
S01. | Is the school associated with this death an alternative school? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| New Question | S02 | Our study defines a school associated violent death as a suicide, homicide or legal intervention related death that occurred on school property, on the way to or from school, or at or on the way to or from a school sponsored event. Has this school ever experienced another violent death that meets this definition? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| New Question | S03 | Did this school recently experience an increase in the size of the student population due to a merger with another school / with other schools? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| New Question | S04 | During the time when the event of interest occurred, did the school regularly use paid law enforcement or security services--- Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Code S04.a) At any time during school hours S04.b) While students were arriving and/or leaving S04.c) At selected school activities (e.g., athletic and social events, open houses, science fairs) S04.d) When school/school activities not occurring S04.e) Other (please specify) |
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| Eliminated original question and replaced with a NEW question. | S05. | Has there ever been another violent death associated with this school? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
S05. | At the time when the event occurred did the school use full-time security personnel? _ 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
| New Question | S05a | Number of School Resource Officers/Sworn Law Enforcement Officers __ | ||
| New Question | S05b | Number of Private Security Officers __ | ||
| Eliminated original question | S06. | What grade levels are served by this school? Write K thru 12...to be coded later ________ | ||
| Eliminated original question | S15. | What is the school's average daily attendance rate? ____________________ | ||
| Eliminated original question | S18. | How many students, if any, withdrew from school in the month following the death? To be coded later _____________________ |
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| Replaced with items that capture specific information on the kinds of security measures potentially used in the school context. See SH 2012, item number S06. | S19. | Does the school currently use any of the following security measures? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors _ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify..............................................................................................) |
S06. | Were any of the following security measures in use at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Measure Location or Type of Measure Code S06a) Walk Through Metal Detectors S06a1) If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never S06a2)Where were the walk through metal detectors used? S06a2.a) Main entry S06a2.b) Secondary entries S06a2.c) Other Specify S06b) Hand Held Metal Detectors S06b1) If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never S06b2) Where were the walk through metal detectors used? S06b2.a) Main entry S06b2.b) Secondary entries S06b2.c) Other Specify S06c) Surveillance Cameras S06c1)If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 5 After official activities 6 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) 7 Cameras only used as visual detterent S06c2)Where were the surveillance cameras used? S06c2.a) Entry/exit areas – exterior S06c2.b) Athletic areas S06c2.c) Entry/exit areas – interior S06c2.d) Corridors S06c2.e) Other Specify S06d) Communication Devices S06d.1) 2-way radios S06d.2) 2-way intercom in most classrooms S06d.3) Other Specify S06e) Access Restrictions S06e.1) Proximity or card swipe access for staff S06e.2) Intrusion Alarm Systems S06e3)If yes, where? S06e3.a) Main building(s) / areas S06e3.b) Parking lot(s) S06e3.c) Other Specify S06e4) If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) |
| Eliminated original question | S20. | Does the school currently have a violence prevention curriculum and is it required? _ Read options 1= yes, there is a REQUIRED curriculum 2= yes, there is an ELECTIVE curriculum 3= no such instruction* 7= not applicable* 8=unknown* 9=refused to answer* |
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| Eliminated original question | S21a. | Is the curriculum used commercially available? _ Do NOT read options 1=yes (specify product name.............................................................................) 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | S21. | Is the violence prevention curriculum taught separately or as part of another course? _ Do NOT read options 1=a separate course 2=part of another course (specify course............................................................. ) 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | S22a. | How long has the violence prevention curriculum been in place? _ Do NOT read options 1=less than one year 2=one to five years 3=greater than five years 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | S22. | How many students are exposed to the violence prevention curriculum each academic year? To be coded later _____________________ |
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| Eliminated original question | S23. | For those student who participate, what is the total number of violence prevention course hours or class periods provided in one school year? To be coded later _____________________ | ||
| Eliminated original question | S24 | Which of the following components does the violence prevention curriculum include? a) how to avoid conflicts _ b) how to manage anger _ c) how to settle conflicts without physical fighting _ d) how to handle stress in healthy ways _ e) risks associated with physical fighting _ f) risks associated with carrying and using weapons _ g) risks associated with gang activities _ h) what to do if someone is thinking about suicide _ i) statistics on adolescent deaths from violence and suicide _ j) social norms on violence-related risk behaviors _ (PROBE: norms=socially accepted attitudes) k) other components _ (specify.............................................................................................) |
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| Revised to include more security measures. See SH 2012, item numbers SOC05. | S25 | Were any of the following security measures operating at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors ___ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify..............................................................................................) |
SOC05. | Were any of the following security measures in use at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Measure Location or Type of Measure Code SOC05a) Walk Through Metal Detectors SOC05a1 If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never SOC05a2 Where were the walk through metal detectors used? SOC05a2.a) Main entry SOC05a2.b) Secondary entries SOC05a2.c) Other Specify SOC05b) Hand Held Metal Detectors SOC05b1 If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never SOC05b2 Where were the walk through metal detectors used? SOC05b2.a) Main entry SOC05b2.b) Secondary entries SOC05b2.c) Other Specify SOC05c) Surveillance Cameras SOC05c1 If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) 9 Cameras only used as visual detterent SOC05c2 Where were the surveillance cameras used? SOC05c2.a) Entry/exit areas – exterior SOC05c2.b) Athletic areas SOC05c2.c) Entry/exit areas – interior SOC05c2.d) Corridors SOC05c2.e) Other Specify SOC05d) Communication Devices SOC05d.1) 2-way radios SOC05d.2) 2-way intercom in most classrooms SOC05d.3) Other Specify SOC05e) Access Restrictions SOC05e.1) Proximity or card swipe access for staff SOC05e.2) Intrusion Alarm Systems SOC05e3 If yes, where? SOC05e3.a) Main building(s) / areas SOC05e3.b) Parking lot(s) SOC05e3.c) Other Specify SOC05e4 If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) |
| Eliminated original question | S26A | Did the school have a violence prevention curriculum in place at the time of this event? _ Do NOT read options 1=yes (specify.............................................................................) 2=no 7=not applicable 8=unknown 9=refused to answer |
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| New Question | S07. | At the time of the event, was it a policy of the school to do any of the following? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown School Policies Code S07.a) Require visitors to sign or check in S07.b) Require visitors to sign or check out S07.c) Control access to school buildings during school hours (e.g., locked or monitored doors) S07.d) Control access to school grounds during school hours (e.g., locked or monitored gates) S07.e) Require students to pass through metal detectors each day S07.f) Require visitors to pass through metal detectors S07.g) Perform one or more random metal detector checks on students S07.h) Require most students to stay on campus at lunchtime S07.i) Perform one or more random sweeps for contraband (e.g., drugs or weapons) S07.j) Require drug testing for any students S07.k) Require students to wear uniforms S07.l) Enforce a dress code S07.m) Provide a printed code of student conduct to students S07.n) Provide a printed code of student conduct to parents S07.o) Provide school lockers to students S07.p) Require clear book bags on school grounds S07.q) Ban book bags on school grounds S07.r) Require students to wear badges or picture IDs S07.s) Require faculty and staff to wear badges or picture IDs S07.t) Provide telephones in most classrooms S07.u) Prohibit all tobacco use on school grounds. S07.v) Does the school have a written policy about bullying? (if NO skip to Q6.2) S07.w) Is the written bullying policy included in a student handbook that goes home for student and parental review? |
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| No Change in question - renumbered as S08. | S27 | What actions did the school take in response to the death. (PROBE FOR: immediate, long-term, policy, environmental, social, curricular) to be coded later, please note sources ...................................................................................................................................................................................................................................................................................................................................... |
S08. | What actions did the school take in response to the death. (PROBE FOR: immediate, long-term, policy, environmental, social, curricular) to be coded later, please note sources ...................................................................................................................................................................................................................................................................................................................................... |
| No Change in question - renumbered as S09. | SW01 | How many incidents of student weapon carrying were identified by school staff during the year in which the incident took place? (Excluding this event) _ _ 00-##=actual number 77=not applicable 88=unknown 99=refused to answer |
S09. | How many incidents of student weapon carrying were identified by school staff during the year in which the incident took place? (Excluding this event) _ _ 00-##=actual number 77=not applicable 88=unknown 99=refused to answer |
| Eliminated original question | SW02 | How many weapons were confiscated from students during the school year in which the incident took place? (Please indicate the number of each type of weapon confiscated) (Excluding this event) a) Handguns ___ b) Long guns ___ c) Knives, razors, box cutters, or other blades ___ d) Mace, pepper spray ___ e) Other (specify ____________) |
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| Eliminated original question | SW03 | At the time the incident took place, did the school have an official policy regarding student weapon carrying? _ Do not read options 1=yes* 2=no** 7=not applicable 8=unknown 9=refused to answer |
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| No Change in question - renumbered as S10. | SW04 | Please describe what actions the policy stipulated should be taken by the school when a student was identified with a weapon while under the supervision of the school? ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... | S10. | Please describe what actions the school policy stipulated should be taken by the school when a student was identified with a weapon while under the supervision of the school? ...................................................................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................... |
| Eliminated original question | SW05 | If no, please describe what actions were typically taken by the school when a student was identified with a weapon while under the supervision of the school? ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... | ||
| Eliminated original question | S28 | How well do you know this school and its history? _ Read options 1= extensive knowledge of school 2= some knowledge of school 3= little knowledge of school 4= no knowledge of school |
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| New Section Added | QUESTIONS about off-campus school sponsored events: SCHOOL INTERVIEW | |||
| New Question | SOC01. | Our study defines a school associated violent death as a suicide, homicide or legal intervention related death that occurred on school property, on the way to or from school, or at or on the way to or from a school sponsored event. Has this school ever experienced another violent death that meets this definition? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| New Question | SOC02. | During the time when the event of interest occurred, did the school regularly use paid law enforcement or security services at selected school activities (e.g., athletic and social events, open houses, science fairs)? _ Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
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| New Question | SOC03. | Please indicate the Number of Sworn Law Enforcement Officers used. _ _ _ Do NOT read options, code leading zero 00-∞=actual number 777=not applicable 888=unknown 999=refused to answer |
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| New Question | SOC04. | Please indicate the Number of Private Security Officers used _ _ _ Do NOT read options, code leading zero 00-∞=actual number 777=not applicable 888=unknown 999=refused to answer |
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| Revised to include more security measures. See SH 2012, item numbers SOC05. | S25 | Were any of the following security measures operating at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) walk through metal detectors _ b) hand held metal detectors ___ c) armed police or security guards _ d) unarmed security guards _ e) locker searches _ f) ban on book bags and back packs _ g) no lockers issued _ h) hall monitors _ i) other (specify..............................................................................................) |
SOC05. | Were any of the following security measures in use at the time of this event? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Measure Location or Type of Measure Code SOC05a) Walk Through Metal Detectors SOC05a1 If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never SOC05a2 Where were the walk through metal detectors used? SOC05a2.a) Main entry SOC05a2.b) Secondary entries SOC05a2.c) Other Specify SOC05b) Hand Held Metal Detectors SOC05b1 If yes, how often? 1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Never SOC05b2 Where were the walk through metal detectors used? SOC05b2.a) Main entry SOC05b2.b) Secondary entries SOC05b2.c) Other Specify SOC05c) Surveillance Cameras SOC05c1 If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) 9 Cameras only used as visual detterent SOC05c2 Where were the surveillance cameras used? SOC05c2.a) Entry/exit areas – exterior SOC05c2.b) Athletic areas SOC05c2.c) Entry/exit areas – interior SOC05c2.d) Corridors SOC05c2.e) Other Specify SOC05d) Communication Devices SOC05d.1) 2-way radios SOC05d.2) 2-way intercom in most classrooms SOC05d.3) Other Specify SOC05e) Access Restrictions SOC05e.1) Proximity or card swipe access for staff SOC05e.2) Intrusion Alarm Systems SOC05e3 If yes, where? SOC05e3.a) Main building(s) / areas SOC05e3.b) Parking lot(s) SOC05e3.c) Other Specify SOC05e4 If yes, When were they used? (Check all that apply) 1 on school days before classes or official school activities began 2 While classes were being held 3 During lunch, recess, or other breaks, 4 During class changes 5 immediately after school 6 During after school practice or detention 7 After official activities 8 On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks) |
| QUESTIONS about the event: SCHOOL INTERVIEW | QUESTIONS about the event: SCHOOL INTERVIEW | |||
| Eliminated original question | E01 | Where did the injury event occur? Read options - can list more than one response; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown, 9=refused to answer 1= on school property __ 2= on the way to or from the campus* __ 3= at an off-campus school-sponsored event* __ 4= on the way to or from a school sponsored event* __ 6= other* (specify..............................................................................................) |
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| Revised to include more campus locations. See SH 2012, item numbers E01 | E02 | Where on the campus did the injury event occur? Read options - can list more than one response; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown, 9=refused to answer 01= in a classroom __ 02= in a hallway __ 03= in a cafeteria __ 04= in a gymnasium __ 05= in a locker room __ 06= in an office __ 07= on campus lawn or gardens __ 08= on sporting fields or playground __ 09= in a parking lot __ 10= in a driveway __ 66= other indoor __ (specify..............................................................................................) 67= other outdoor __ (specify............................................................................................) |
E01. | Where on the campus did the injury event occur? Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable locations 01= in a classroom 02= in a hallway 03= in a cafeteria 04= in a gymnasium 05= in a locker room 06= in an office 07= in a stairwell 08= in a restroom 09= in a break room or lounge 10= in an auditorium 11= on campus lawn or gardens 12= on sporting fields or playground 13= in a parking lot 14= in a driveway 15= at a bus pickup or drop off point 66= other indoor location Specify. 67= other outdoor location Specify 77= not applicable 88= unknown 99= refused to answer |
| Revised to include more campus locations. See SH 2012, item numbers E02. | E03 | Where did the off-campus injury event occur? _ _ Read options; code written responses later; code leading zeros 01= on the street, sidewalk, footpath 02= on a bus or public transport vehicle 03= waiting for or alighting from bus or public transport vehicle 04= in a privately-owned vehicle 05= on private property 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
E02. | Where did the off-campus injury event occur? _ _ Read options; code written responses later; code leading zeros 01= on the street, sidewalk, footpath 02= on a bus or public transport vehicle 03= waiting for or getting on or off a bus or public transport vehicle 04= in a privately-owned vehicle / car 05= on private property (specify________________________) 06= at a sporting complex (pool, stadium, off campus gym, rec center etc…) 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
| Revised to include more contexts. See SH 2012, item number E03. | E04 | Which of the following best describes the context in which the injury event occurred? _ _ Read options; code written responses later; code leading zeros 01= on a day when no classes or school events were held 02= on a school day before classes began 03= while classes were being held 04= on a school day during lunch, recess or other break, including class changes 05= immediately after school 06= on a school day during after-school practice or detention 07= on a school day after official activities 08= at a school sporting activity 09= at another official school-sponsored activity 10= on the way to or from a school-sponsored activity 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
E03. | Which of the following best describes the context in which the injury event occurred? _ _ Read options; code written responses later; code leading zeros 01= on a day when no classes or school events were held (e.g., a weekend, holiday, or an official school break) 02= on a school day before classes began 03= while classes were being held 04= during a school assembly 04= on a school day during lunch, recess or other break, including class changes 05= immediately after school 06= on a school day during after-school practice or detention 07= on a school day after official activities 08= at a school sporting activity 09= at another official school-sponsored activity 10= on the way to or from a school-sponsored activity 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
| Eliminated original question | E05. | At the time of fatal injury were any the victims in some place they ought not to have been? _ Do NOT read options (PROBE: an area of restricted access) 1=yes (specify........................................................................................................... ) 2=no 7=not applicable 9=unknown/refused to answer |
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| Eliminated original question | E06 | At the time of fatal injury were any of the offenders in some place they ought not to have been? _ Do NOT read options (PROBE: an area of restricted access) 1=yes (specify........................................................................................................... ) 2=no 7=not applicable 9=unknown/refused to answer |
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| Revised to include additional motives. See SH 2012, item number E04. | E07 | What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) single suicide _ b) suicide pact _ c) drug related _ d) gang related _ e) robbery, attempted robbery _ f) rape, attempted sex crime _ g) dispute over money or property _ h) dispute over romantic relationship _ i) dispute related to sporting event _ j) dispute, other or unspecified _ k) racially or hate crime motivated _ l) victim killed by police or security personnel _ m) victim killed by civilian during commission of a crime _ n) random victim _ o) unintentional injury _ p) other _ (specify..............................................................................................) |
E04 | What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable motives. Motive Code a) single suicide b) suicide pact c) drug related d) gang related e) robbery, attempted robbery f) rape, attempted sex crime g) dispute over money or property h) dispute over romantic relationship i) dispute related to sporting event j) dispute, other or unspecified k) racially or hate crime motivated l) victim killed by law enforcement or security personnel m) victim killed by civilian during commission of a crime n) act of terrorism o) random victim p) victim was a bystander q) victim was intervener assisting a crime victim r) other Specify |
| No Change in question - renumbered as E05. | E08 | Briefly describe the circumstances of the fatal injury and events leading up to it, including history of prior conflicts between the principles, etc. Code later ...................................................................................................................................................................................................................................................................................................................................... |
E05. | Briefly describe the circumstances of the fatal injury and events leading up to it, including history of prior conflicts between the principles, etc. Code later .......................................................................................................................................................................................................................................................................................................................................................................... |
| Revised to include additional methods. See SH 2012, item number E06. | E09 | What was the method of fatal injury? _ _ Read options; code leading zeros 01= firearm (specify..............................................................) 02= knife, razor, box cutter or other blade 03= beaten with club, bat, other object 04= beaten, no weapon used 05= motor vehicle 06= hanging/strangulation 07= poisoning, solid or liquid 08= asphyxiation by gas 66= other (specify..............................................................................................) 77= not applicable 88= unknown 99= refused to answer |
E06. | What was the method of fatal injury? Read options; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable methods utilized. 01= firearm Specify 02= knife, razor, box cutter or other blade 03= beaten with club, bat, pipe, chain, or other object 04= beaten, no weapon used 05= motor vehicle 06= hanging/strangulation/asphyxiation by hanging 07= poisoning, solid or liquid 08= asphyxiation by gas 09= other asphyxiation 66= other Specify 77= not applicable 88= unknown 99= refused to answer |
| Revised to include more categories of media through which intentions may have been communicated. See SH 2012, item number E07. | E10 | After a tragedy such as this people look for things, such as comments, notes, threats, or actions that took place prior to the incident that could have signaled a potential risk for this type of behavior. Which of the following did any of the offenders, or victims in the case of suicide, leave as signs that they were considering this action? Please include as many signs as you can think of even if they were things that nobody could have recognized as a sign at the time they happened. Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {E10a} notes ____ {E10b} journal entry ___ {E10c} threats___ {E10d} other actions (specify.................................................................) |
E07. | After a tragedy such as this people look for things, such as comments, notes, threats, or actions that took place prior to the incident that could have signaled a potential risk for this type of behavior. Which of the following did any of the offenders, or victims in the case of suicide, leave as signs that they were considering this action? Please include as many signs as you can think of even if they were things that no one could have recognized as a sign at the time they happened. Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code all applicable signs. Sign Code {E07a} notes {E07b} journal entry {E07c} social media (e.g. blogs, Twitter, wall postings on social networking sites) {E07d} verbal threats___ {E07e} electronic media (e.g., email messages, IM, or texts via cellphone, voice mail, video ect..) {E07f} other actions (e.g., playful suggestion that person might commit act, voiced suicidal thoughts) Specify |
| New Question | E08. | Did anyone know about the possibility of this event before it happened? _ Do NOT read options 1=yes (specify................................................... ) 2=no* 7=not applicable 9=unknown/refused to answer |
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| New Question | E09. | What information was known by the bystander(s) in advance of the attack? Instructions: Capture information for up to five bystanders. E09a. Code later ________________________________________________________________________________________________________________________________________________E09b. Code later ________________________________________________________________________________________________________________________________________________E09c. Code later ________________________________________________________________________________________________________________________________________________ E09d. Code later ________________________________________________________________________________________________________________________________________________ E09e. Code later ________________________________________________________________________________________________________________________________________________ |
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| New Question | E10. | What relationship did the bystander have to the perpetrator(s)? _ _ Read options; code written responses later E10a. Bystander #1 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer E10b. Bystander #2 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer E10c. Bystander #3 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer E10d. Bystander #4 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer E10e. Bystander #5 01= relatives (specify..................) 02= romantic partner 03= close friend 04= classmate 05= faculty/staff 06= fellow student at school, but not classmate 07= community / neighborhood acquaintance 08= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
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| New Question | E11. | Did the bystander share the information he or she learned of the planned violence with others? Do NOT read options 1=yes (specify........................................................................................................... ) 2=no 7=not applicable 9=unknown/refused to answer |
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| New Question | E12. | With whom was this information shared? Do not read options; Coding instructions: 1=yes, 2=no, 8=unknown. Select all applicable options. 01=no one 02=parents 03=other family 04=peers 05=school staff 06=other medical/mental health professional 66=other Specify 77=not applicable 88=unknown 99=refused to answer |
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| Eliminated original question | E12 | Based on the information you have regarding the timing of precipitating factors and the amount of preparation required, how much time do you think that this offender (victim if suicide) spent planning this incident? Do not read options; complete information for minutes, hours and days; code later a) minutes ___ b) hours ___ c) days ___ |
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| Eliminated original question | ESC01 | Did any of the following events occur during the 2 weeks before or after this incident? Please note all that apply: Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown {Esc01a} Prom/dance/social event _ {Esc01b} Graduation _ {Esc01c} Homecoming _ {Esc01d} Rivalry game between schools _ {Esc01e} Holiday break _ {Esc01f} Report card distribution _ {Esc01g} Other _ (specify __________________________) |
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| Eliminated original question | ESC03 | Was the victim cited or disciplined for disruptive behavior during the 2 weeks before the event? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | ESC04 | Was the offender cited for disruptive behavior during the 2 weeks before the event? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | E13 | How well do you know the details of this event? _ Read options 1= extensive knowledge of event 2= some knowledge of event 3= little knowledge of event 4= no knowledge of event |
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| QUESTIONS about the Victim: SCHOOL INTERVIEW | QUESTIONS about the Victim: SCHOOL INTERVIEW | |||
| No Change | CASEID | Case ID Number To be assigned by study coordinator, record 5-digit number _ _ _ _ _ | CASEID | Case ID Number To be assigned by study coordinator, record 5-digit number _ _ _ _ _ |
| No Change | V01 | How many victims were fatally injured in this event? Write in actual number _ _ | V01 | How many victims were fatally injured in this event? Write in actual number _ _ |
| No Change | V01A | Victim Number Number for this victim, is assigned by the primary data collector. _ | V01A | Victim Number Number for this victim, is assigned by the primary data collector. _ |
| Word fatal removed as all injuries may not be immediately lethal (e.g., deaths may occur days or years later). SH 2012, item number V02. | V02 | What was the date of the fatal injury? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | V02 | What was the date of the injury? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ |
| Word fatal removed as all injuries may not be immediately lethal (e.g., deaths may occur days or years later). See SH 2012, item number V03. | V03 | What was the time of the fatal injury? Record in military time _ _ _ _ | V03 | What was the time of the injury? Record in military time _ _ _ _ |
| No Change | V04 | What was the date of death? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | V04 | What was the date of death? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ |
| Eliminated original question | V05 | What was the time of death? Record in military time _ _ _ _ | ||
| No Change in question - renumbered as V05. | V06 | What was this victim's date of birth? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ | V05. | What was this victim's date of birth? Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _ |
| Age extended beyond 65 to allow coding of actual age. Values for not applicable, unknown, and refused to answer extended outside range for chronological age. See SH 2012, item number V06. | V07 | What was this victim's age in years at the time of death? _ _ 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
V06. | What was this victim's age in years at the time of death? _ _ _ Do NOT read options, code leading zero 01-∞=actual age in years 777=not applicable 888=unknown 999=refused to answer |
| Revised to include transgender as an option. See SH 2012, item number V07. | V08 | What was this victim's gender? _ _ Do NOT read options 1=male 2=female 7=not applicable 8=unknown 9=refused to answer |
V07. | What was this victim's gender? _ Do NOT read options 1=male 2=female 3=transgender 7=not applicable 8=unknown 9=refused to answer |
| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number V08. | V09 | What was the victim's race? _ Do NOT read Options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
V08. | What was the victim's race? _ _ Do NOT read Options 1 White 2 Black or African American 3 American Indian or Alaska Native 4 Asian Indian 5 Chinese 6 Filipino 7 Japanese 8 Korean 9 Vietnamese 10 Other Asian 11 Native Hawaiian 12 Guamanian or Chamorro 13 Samoan 14 Other Pacific Islander 15 Other (Specify) ______________ 88 Unknown—a person’s race is unknown 99 Refused to Answer |
| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number V09. | V10 | Was this victim of Latino or Hispanic origin? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
V09. | Was this victim of Hispanic, Latino/a ,or Spanish Origin? (One or more categories may be selected) origin? _ Do NOT read options 1 Not Hispanic or Latino/a or Spanish origin 2 Yes, Mexican, Mexican American, Chicano/a 3 Yes, Puerto Rican 4 Yes, Cuban 5 Yes, another Hispanic, Latino, or Spanish origin 8 Unknown if victim is of Hispanic or Latino origin 9 Refused to Answer |
| Option for lives with legal guardian added. See SH 2012, item number V10. | V11 | Which of the following best describes the victim's family structure/living arrangements at the time of death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
V10. | Which of the following best describes the victim's family structure/living arrangements at the time of death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives with legal guardian 05= lives independently 06= foster care 07= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
| Eliminated original question | V13 | Had the victim ever been charged with a crime before the fatal injury? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
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| No Change in question - renumbered as V11. | V21 | What was the highest grade or year of school this victim completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
V11. | What was the highest grade or year of school this victim completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency(GED) 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
| Revised to open ended format. Will allow specific groups to be noted explicitly and coded according to type later. See SH 2012, item numbers V12. | VP01 | Youth often affiliate with distinct peer groups. With which one of the following groups would you say this victim was most closely affiliated? _ _ Read options 01= street gang 02= tagging crew (spray paint graffiti of groups logo or “tag” around the neighborhood) 03= Wannabes (dress and act like gang members without actually belonging to a street gang) 04= Druggies or Stoners 05= Hip-Hop 06= Gothic 07= Punkers 08= Skaters/Surfers 09= Rockers 10= Cowboys/girls 11= Brains 12= Jocks, Athletes 13= Preppies 14= Geeks 15= Band 16= Hackers 17= Bible study 18= Granolas 19= Loner 20= Not a loner but no particular group 66= other (specify...........................................) 77= not applicable 88=unknown 99=refused to answer |
V12. | Individuals often affiliate with distinct peer groups. To your knowledge, was the victim associated with any distinct peer group? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused* |
| New Question | V12a. | What group(s) were they affiliated with? Code later .................................................................................................................................................................................................................................................................................................................................................................. |
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| New Question | V13. | In the year prior to this event, did the victim leave an existing peer group? Do not read options _ 1=yes Specify____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Revised to indicate specific type of change experienced if any. Entry to new peer group or existing existing peer group. See SH 2012, item numbers V13 - V14. | VP02 | In the year prior to this event, was there a change in this victim’s peer group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V14. | In the year prior to this event, did the victim join a new peer group? Do not read options 1=yes Specify____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
| Removed reference to at least once a week. This question could not be answered reliably.See SH 2012, item numbers V15. | V15. | Did the victim use alcohol or other drugs at least once a week? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V15. | Did the victim use alcohol or other drugs? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| New Question | V15a. | What types of substances did the victim use? Code later .................................................................................................................................................................................................................................................................................................... |
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| Removed reference to other. This question could not be answered reliably. See SH 2012, item numbers V16. | V16 | Was there evidence that the victim was intoxicated with alcohol or other drugs at the time of death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V16. | Was there evidence that the victim was intoxicated with alcohol or drugs at the time of death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| New Question | V17. | At the time of death, was the victim perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | VW01 | During the year prior to this incident, had the victim ever been found carrying a weapon on school grounds or on the way to or from school? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| No Change in question - renumbered as V18. | V18. | Was the victim carrying a weapon at the time of the fatal injury? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
V18. | Was the victim carrying a weapon at the time of the fatal injury? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
| Revised to include additional methods to obtain weapons, such as home made. See SH 2012, item number V19. | V19. | At the time of the fatal injury, which of the following types of weapon was this victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
V19. | At the time of the fatal injury, which of the following types of weapon was this victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapon Code a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
| Revised to include additional methods to obtain weapons, such as home made. See SH 2012, item number V20. | V20. | Where did this victim obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) from home _ (specify weapon................................) b) from friend or relative outside household _ (specify weapon..............) c) purchased for himself/herself _ (specify weapon................................) d) stolen _ (specify weapon................................) e) from the victim (specify weapon................................)_ f) other _ (specify weapon................................) |
V20. | Where did this victim obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapons source Code a) from home specify weapon b) from friend or relative outside household specify weapon c) purchased for himself/herself specify weapon d) stolen specify weapon e) home-made weapon f) weapon of opportunity (used weapon already present in environment / used object in environment as weapon) g) from the victim specify weapon h) other _ specify weapon |
| No Change in question - renumbered as V11. | V21 | What was the highest grade or year of school this victim completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
V11. | What was the highest grade or year of school this victim completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency(GED) 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
| No Change in question - renumbered as V21. | V22. | What was the victim's affiliation with the school associated with this death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified victim* 66=other* (specify.............................................................................................) 77=not applicable* 88=unknown* 99=refused to answer* |
V21. | What was the victim's affiliation with the school associated with this death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified victim* 66=other* (specify.............................................................................................) 77=not applicable* 88=unknown* 99=refused to answer* |
| No Change in question - renumbered as V22. | VW02 | During the year prior to this incident, how many times had the victim been found carrying a weapon on school grounds or on the way to or from school? _ _ 01-##=actual number of times the victim carried a weapon 77=not applicable 88=unknown 99=refused to answer |
V22 | During the year prior to this incident, how many times had the victim been found carrying a weapon on school grounds or on the way to or from school? _ _ 01-##=actual number of times the victim carried a weapon 77=not applicable 88=unknown 99=refused to answer |
| Additional items revised weapon listing. See SH 2012, item number V23. | VW03 | For the most recent event prior to the date of fatal injury, which of the following types of weapons was the victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify.....................................................................) e) other _ (specify........................................................................) |
V23. | For the most recent event prior to the date of fatal injury, which of the following types of weapons was the victim carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapon Code a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
| No Change in question - renumbered as V24. | VW04 | What, if any, actions did the school take in response to the victim’s most recent incident of weapon carrying? ...................................................................................................................................................................................................................................................................................................................................................... | V24. | What, if any, actions did the school take in response to the victim’s most recent incident of weapon carrying? ...................................................................................................................................................................................................................................................................................................................................................... |
| No Change in question - renumbered as V25. | V23 | How many years had the victim attended his or her school? _ _ Do NOT read options; code leading zeros 00=less than one school year 01-12=number of years 13=more than 12 years 77=not applicable 88=unknown 99=refused to answer |
V25. | How many years had the victim attended his or her school? _ _ Do NOT read options; code leading zeros 00=less than one school year 01-12=number of years 13=more than 12 years 77=not applicable 88=unknown 99=refused to answer |
| Revised to include in school suspensions. See SH 2012, item number V26. | V25 | V25. How many times in the last year was the victim suspended or expelled from his or her school? _ Do NOT read options 0=none, never suspended 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
V26. | How many times in the last year was the victim suspended from his or her school? _ (including in-school suspensions) Do NOT read options 0=none, never suspended 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
| New Question | V27 | In the last year was the victim expelled from his or her school? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| No Change in question - renumbered as V27. | V27. | What extracurricular activities was the victim involved in? To be coded later ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... |
V28. | What extracurricular activities was the victim involved in? To be coded later .................................................................................................................................................................................................................................................. |
| New Question | V29. | Did the victim experience any school-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | V29a. | Please briefly describe the specific school-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | V30. | Was a school-related crisis or traumatic event imminent within two weeks of this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | V30a. | Please briefly describe the specific school-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | V31. | Did any the victim experience any community-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | V31a. | Please briefly describe the specific community-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | V32. | Was a community-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | V32a. | Please briefly describe the specific community-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | V33. | Did any the victim experience any family-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | V33a. | Please briefly describe the specific family-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | V34. | Was a family-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | V34a. | Please briefly describe the specific family-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| Additional items added reflecting new behaviors. See SH 2012, item number V35. | VR01 | To the best of your knowledge, in the 12 months prior to this event was the victim reported to the principal’s office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr01a} disobeying authority figure__ {Vr01b} namecalling or teasing peers __ {Vr01c} physical fighting with peers _ {Vr01d} damaging another's personal property_ _ {Vr01e} stealing another's personal property __ |
V35. | In the 12 months prior to this event was the victim reported to the principal’s office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Behavior Code {V35a} disobeying authority figure {V35b} namecalling, taunting, or teasing peers V35b.1 Face to face? V35b.2 Using Electronic means? {V35c} verbal threats {V35d} sent written threats {V35e} sent electronic threats {V35f} bullied peers {V35f} physically threatened peers {V35g} physical fought with peers {V35h} damaged another's personal property {V35i} damaged school property (tagging, vandalism etc…) {V35j}stole another's personal property {V35k} truancy (skipped school) {V35l} possessed / used illegal substances {V35m}possessed a weapon |
| Additional items added reflecting new behaviors. See SH 2012, item number V36a. | VR01A | To the best of your knowledge, in the 12 months prior to this event was this individual victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr01a} called names by peers__ {Vr01b} bullied by peers __ {Vr01c} had personal property damaged or stolen _ {Vr01d} physically threatened by peers __ _ {Vr01e} physically assaulted by peers __ |
V36a. | To the best of your knowledge, in the 12 months prior to this event was this individual victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Type Code {V36a.1} called names by peers {V36a.2} bullied by peers {V36a.3} had personal property damaged or stolen {V36a.4}verbally threatened by peers {V36a.5}received written threats {V36a.6} electronic threats {V36a.7}physically threatened by peers {V36a.8}physically assaulted by peers |
| Eliminated original question | VR02 | To the best of your knowledge, did the victim experience any of the following events in the last 12 months? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vr02a} family moved to an new home or apartment _ {Vr02b} parents divorced_ {Vr02c} family had a new baby _ {Vr02d} anyone moved out of the house _ ( specify..............................................................)_ {Vr02e} family member died ( specify...........................................................................) {Vr02f} a close relative or friend died ( specify.....................................................................)_ {Vr02g} family member became seriously ill, badly injured or was admitted to the hospital (specify.........) {Vr02h} a close relative or friend beaten or attacked _ ( specify............................................) {Vr02i} saw someone beaten, attacked or shot _ ( specify ......................................................) {Vr02j} changed where they went to school _ {Vr02k} romantic breakup _ |
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| Eliminated original question | VR03A | At the time of the event, was this victim demonstrating symptoms, such as impulsivity, short attention span, and distractibility, consistent with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | VR03 | At the time of the event, was the victim medically diagnosed with an Attention Deficit or a Hyperactivity Disorder? Do not read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | VR04 | Was the victim being treated in any of the following ways for this problem? _ Read options 1= medication alone 2= behavioral/environmental modification alone 3= both medication and behavioral/environmental modification 4= no treatment 6= other (specify..............................................................................................) 7= not applicable 8= unknown 9= refused to answer |
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| No Change in question - renumbered as VR05. | VR05 | At the time of the event, did this victim have a diagnosed Learning Disability? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
VR05 | At the time of the event, did this victim have a diagnosed Learning Disability? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| Additional items added reflecting broader range of services. See SH 2012, item number V37. | VM01 | In the year prior to this event, did this victim receive school-sponsored psychological counseling services? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V37. | In the year prior to this event, did this victim receive any of the following services? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Services Code V37.a) guidance counseling / advising V37.b) psychological counseling V37.c) psychiatric or mental health services V37.d) social services V37.e) supplemental educational services (including efforts to address learning disabilities) V37.f) other services Specify |
| No Change in question - renumbered as V38. | VM02 | In the year prior to this event, was this victim ever treated for depression? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
V38. | In the year prior to this event, was this victim ever treated for depression? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| New Question | V39. | Had the victim ever received professional treatment for any other mental health problem? Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| New Question | V40. | If yes, What specific kinds of emotional or mental health problems were treated? To be coded later ........................................................................................................................................................................................................................................................................................................................................................ |
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| Additional items added to distinguish specific types of victimization experiences. See SH 2012, item number V41. | VM03A | Did this victim have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vm03a} alcoholism _ {Vm03b} drug abuse _ {Vm03c} child abuse/neglect __ {Vm03d} intimate partner violence_ |
V41. | V41. Did this victim have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code {V41.a } alcoholism {V41.b} drug abuse {V41.c} intimate partner violence {V41.d} sexual violence {V41.e}attempted / completed suicide {V41.f} arrests / convictions for violent offenses (e.g., assault, homicide etc…) |
| New Question | V42. | Did this victim suffer… Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code {V42.a} physical child abuse {V42.b} sexual child abuse {V42.c} emotional / psychological abuse as a child {V42.d} neglect {V42.e} victimization in intimate partner violence_/ teen dating violence {V42.f} victimization in sexual violence |
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| Eliminated original question | VM03 | To the best of your knowledge, did this victim have a suspected family history of ..... Read only those options not above, Coding instructions: 1=yes, 2=no, 8=unknown. {Vm03a} alcoholism _ {Vm03b} drug abuse _ {Vm03c} child abuse/neglect __ {Vm03d} intimate partner violence_ |
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| Eliminated original question | VM04 | To the best of your knowledge, did this victim have a suspected family history of ..... _ _ 00= did not excel in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
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| Eliminated original question | VM05 | In what subject areas, if any, did this victim seem to have particular difficulty? _ _ 00= did not have difficulty in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
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| No Change in question - renumbered as V43. | V30 | Which of the following situations best describes this victim's death? _ _ Read options; code leading zero 01= single victim suicide 02= multiple victim suicide 03= single victim homicide; unknown number of offenders 04= single victim homicide; single offender 05= single victim homicide; multiple offenders 06= multiple victim homicide; unknown number of offenders 07= multiple victim homicide; single offender 08= multiple victim homicide; multiple offenders 09= combination murder/suicide 10= intention undetermined 66= other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
V43. | Which of the following situations best describes this victim's death? _ _ Read options; code leading zero 01= single victim suicide 02= multiple victim suicide 03= single victim homicide; unknown number of offenders 04= single victim homicide; single offender 05= single victim homicide; multiple offenders 06= multiple victim homicide; unknown number of offenders 07= multiple victim homicide; single offender 08= multiple victim homicide; multiple offenders 09= combination murder/suicide 10= intention undetermined 66= other (specify........................................................................................................) 77=not applicable 88=unknown 99=refused to answer |
| No Change in question - renumbered as V44. | VS01 | Do you have any knowledge that this victim had, in the year prior to this event exhibited any of the following signs and symptoms of suicide? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vs01a} Thoughts/threats of suicide_ {Vs01b} Plans of suicide_ {Vs01c} Previous suicide attempts_ |
V44. | Do you have any knowledge that this victim had, in the year prior to this event exhibited any of the following signs and symptoms of suicide? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Vs01a} Thoughts/threats of suicide_ {Vs01b} Plans of suicide_ {Vs01c} Previous suicide attempts_ |
| No Change in question - renumbered as V45. | VS02 | To whom was this suicidal behavior reported? _ _ Do not read options 01=no one 02=parents 03=other family 04=peers 05=school staff 06=other medical/mental health professional 66=other (specify...........................................) 77=not applicable 88=unknown 99=refused to answer |
V45. | To whom was this suicidal behavior reported? _ _ Do not read options 01=no one 02=parents 03=other family 04=peers 05=school staff 06=other medical/mental health professional 66=other (specify...........................................) 77=not applicable 88=unknown 99=refused to answer |
| No Change in question - renumbered as V46. | VS03 | What, if any, actions were taken by the school in response to this suicidal behavior? .................................................................................................................................................................................................................................................................................................................................................................................. |
V46. | What, if any, actions were taken by the school in response to this suicidal behavior? .................................................................................................................................................................................................................................................................................................................................................................................. |
| New question | V47. | Did perceptions about the victim being gay, bisexual, or transgendered contribute to their victimization? Do not read options 1=homosexual 2=heterosexual 3=bisexual 4=transgender 5=questioning 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | VM08 | What was the perceived sexual orientation of this victim? _ Do not read options 1=homosexual 2=heterosexual 3=bisexual 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | V32 | How well do you know the background of this victim? _ Read options 1= extensive knowledge of this victim 2= some knowledge of this victim 3= little knowledge of this victim 4= no knowledge of this victim |
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| No Change in question - renumbered as V48. | VI01 | Were there any victims that suffered nonfatal injuries at the time of this event? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
V48. | Were there any victims that suffered nonfatal injuries at the time of this event? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
| No Change in question - renumbered as V49. | VI02 | How many nonfatal injuries occurred at the time of this event? _ _ 01-##=actual number of nonfatal injuries 77=not applicable 88=unknown 99=refused to answer |
V49. | How many nonfatal injuries occurred at the time of this event? _ _ 01-##=actual number of nonfatal injuries 77=not applicable 88=unknown 99=refused to answer |
| No Change in question - renumbered as V50. | VI03 | How many victims that suffered nonfatal injuries required hospital admission? _ _ 00-##=actual number of nonfatal injuries that required hospital admission 77=not applicable 88=unknown 99=refused to answer |
V50. | How many victims that suffered nonfatal injuries required hospital admission? _ _ 00-##=actual number of nonfatal injuries that required hospital admission 77=not applicable 88=unknown 99=refused to answer |
| No Change in question - renumbered as V51. | V33 | How many alleged offenders were responsible for the victim's death? _ Do NOT read options (PROBE: alleged offender = legally charged as offender) 0=none, death was self-inflicted 1-5=actual number of offenders* 6=more than 5* 7=not applicable 8=unknown 9=refused to answer |
V51. | How many alleged offenders were responsible for the victim's death? _ Do NOT read options (PROBE: alleged offender = legally charged as offender) 0=none, death was self-inflicted 1-5=actual number of offenders* 6=more than 5* 7=not applicable 8=unknown 9=refused to answer |
| QUESTIONS about Alleged Offender: SCHOOL INTERVIEW | ||||
| No Change in question | CASEID | Case ID Number Case number is assigned by study coordinator. _ _ _ _ _ | CASEID | Case ID Number Case number is assigned by study coordinator. _ _ _ _ _ |
| No Change in question - renumbered as O01. | X01 | How many offenders were officially charged for this incident? Write in actual number. _ _ | O01 | How many offenders were officially charged for this incident? Write in actual number. _ _ |
| No Change in question - renumbered as O01A. | X01A | Offender Number Number for this offender is assigned by the primary data collector. _ | O01A | Offender Number Number for this offender is assigned by the primary data collector. _ |
| No Change in question - renumbered as O06. | X06 | What was this offender's date of birth? Record month/date/year, code leading zeros, code four-digit years _ _/_ _/_ _ _ _ |
O02. | What was this offender's date of birth? Record month/date/year, code leading zeros, code four-digit years _ _/_ _/_ _ _ _ |
| Age extended beyond 65 to allow coding of actual age. Values for not applicable, unknown, and refused to answer extended outside range for chronological age. See SH 2012, item number O03. | X07 | What was this offender's age in years at time of victim's death? _ _ Do NOT read options, code leading zero 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
O03. | What was this alleged offender's age in years at time of victim's death? _ _ Do NOT read options, code leading zero 01-100=actual age in years 777=not applicable 888=unknown 999=refused to answer |
| Revised to include transgender as an option. See SH 2012, item number O04. | X08 | What was this offender's gender? _ _ Do NOT read options, code leading zero 01-65=actual age in years 66=age 66 years and older 77=not applicable 88=unknown 99=refused to answer |
O04. | What was this alleged offender's gender? _ Do NOT read options 1=male 2=female 3=transgender 7=not applicable 8=unknown 9=refused to answer |
| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number "O05. | X09 | What was this offender's race? _ Do NOT read options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
O05. | What was this alleged offender's race? _ Do NOT read options 1 =White 2 =Black or African American 3 =American Indian or Alaska Native 4 =Asian Indian 5 =Chinese 6=Filipino 7=Japanese 8=Korean 9=Vietnamese 10=Other Asian 11=Native Hawaiian 12=Guamanian or Chamorro 13=Samoan 14=Other Pacific Islander 15=Other (Specify) ______________ 88 =Unknown—a person’s race is unknown 99=Refused to Answer |
| Revised to reflect HHS standards associated with the ACA https://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. See SH 2012, item number O06. | X10 | Was this offender of Latino or Hispanic origin? _ Do NOT read options 1=white 2=black 3=Asian/Pacific Islander 4=Native American, AK or HA Native 6=other races 7=not applicable 8=unknown 9=refused to answer |
O06. | Was this alleged offender of Hispanic, Latino/a, or Spanish Origin? _ (One or more categories may be selected) Do NOT read options 1 =Not Hispanic or Latino/a or Spanish origin 2 =Yes, Mexican, Mexican American, Chicano/a 3=Yes, Puerto Rican 4=Yes, Cuban 5=Yes, another Hispanic, Latino, or Spanish origin 9 =Unknown if elder is of Hispanic or Latino origin |
| Option for lives with legal guardian added. See SH 2012, item number O07. | X11 | Which of the following best describes this offender's family structure or living arrangements at the time of the victim's death? _ _ Read options 01= two-parent nuclear family 02= single parent household 03= lives with adult relative other than parent 04= lives independently 05= foster care 06= residential institution 66= other (specify:...................) 77=not applicable 88=unknown 99=refused to answer |
O07. | Which of the following best describes this alleged offender's family structure or living arrangements at the time of the victim's death? _ _ |
| No Change in question - renumbered as O20. | X21 | What was the highest grade or year of school this offender completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify..................) 77=not applicable 88=unknown 99=refused to answer |
O08. | What was the highest grade or year of school this alleged offender completed? _ _ Do NOT read options, code leading zero 00-12=last completed grades K-12 13=high school equivalency 14=some college or trade school 15=college graduate or more 16=never attended 66=other (specify..................) 77=not applicable 88=unknown 99=refused to answer |
| New question | O09. | Had this alleged offender ever been arrested before the victim's death? _ Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
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| No Change in question - renumbered as O10. | X13 | Had this alleged offender ever been charged with a crime before the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O10. | Had this alleged offender ever been charged with a crime before the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| New Question | O10a. | What types of charges did the alleged offender face? Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | O10b. | Which charges resulted in convictions? Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| Revised to open ended format. Will allow specific groups to be noted explicitly and coded according to type later. See SH 2012, item numbers O11-O11a. | XP01 | Youth often affiliate with distinct peer groups. With which one of the following groups would you say the offender was most closely affiliated? _ _ Read options 01= Member of an identified street gang 02= Member of a tagging crew (spray paint graffiti of groups logo or “tag” around the neighborhood) 03= Wannabes (dress and act like gang members without actually belonging to a street gang) 04= Druggies or Stoners 05= Hip-Hop 06= Gothic 07= Punkers 08= Skaters/Surfers 09= Rockers 10= Cowboys/girls 11= Brains 12= Jocks, Athletes 13= Preppies 14= Geeks 15= Band 16= Hackers 17= Bible study 18= Granolas 19= Loner 20= Not a loner but no particular group 66= other (specify...........................................) 77= not applicable 88=unknown 99=refused to answer |
O11. | Individuals often affiliate with distinct peer groups. To your knowledge, was the alleged offender associated with any distinct peer group? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused |
| New Question | O11a. | What groups were they affiliated with? Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | O12. | In the year prior to this event, did the offender leave an existing peer group? Do NOTread options 1=yes Specify _________________________ 2=no 7=not applicable 8=unknown 9=refused to answer |
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| Revised to indicate specific type of change experienced if any. Entry to new peer group or existing existing peer group. See SH 2012, item numbers O11-O11a. | XP02 | In the year prior to this event, was there a change in this offender’s peer group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O13. | In the year prior to this event, did the offender or join a new peer group? Do NOT read options 1=yes Specify_____________ 2=no 7=not applicable 8=unknown 9=refused to answer |
| Removed reference to at least once a week. This question could not be answered reliably. | X15 | X15. Did this offender use alcohol or other drugs at least once a week at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O14 | Did this alleged offender use alcohol or other drugs at the time of the victim's death? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| New Question | O14a. | What types of substances did the alleged offender use? Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| No Change in question - renumbered as O16. | X16 | Was there evidence that this offender was intoxicated with alcohol or other drugs at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O15 | Was there evidence that this offender was intoxicated with alcohol or other drugs at the time of the victim's death? _ Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| New Question | O15a. | At the time of death, was the alleged offender perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| No Change in question - renumbered as O16. | X17 | What was the relationship of this to the victim? _ _ Read options; code written responses later 01= relatives (specify..................) 02= romantic partner 03= close friend 04= casual acquaintances 05= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
O16. | What was the relationship of this alleged offender to the victim? _ _ Read options; code written responses later 01= relatives (specify..................) 02= romantic partner 03= close friend 04= casual acquaintances 05= strangers 66= other (specify......................) 77=not applicable 88=unknown 99=refused to answer |
| No Change in question - renumbered as O17. | X18 | Was this offender carrying a weapon at the time of the fatal injury? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
O17. | Was this alleged offender carrying a weapon at the time of the fatal injury? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
| Additional items added reflecting new behaviors. See SH 2012, item number O18. | X19 | At the time of the fatal injury, which of the following types of weapon was this offender carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
O18. | At the time of the fatal injury, which of the following types of weapon was this alleged offender carrying? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapon Code a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
| Additional items added reflecting new behaviors. See SH 2012, item number O19. | X20 | Where did this offender obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) from home _ (specify weapon................................) b) from friend or relative outside household _ (specify weapon................................) c) purchased for himself/herself _ (specify weapon................................) d) stolen _ (specify weapon................................) e) from the victim (specify weapon................................)_ f) other _ (specify weapon................................) |
O19. | Where did this alleged offender obtain these weapons? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapons source Code a) from home specify weapon b) from friend or relative outside household specify weapon c) purchased for himself/herself specify weapon d) stolen specify weapon e) home-made weapon f) weapon of opportunity (used weapon already present in environment / used object in environment as weapon) g) from the victim specify weapon h) other _ specify weapon |
| No Change in question - renumbered as O20. | X22 | What was this offender's affiliation with the school associated with the victim's death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified offender* 66=other* (specify..................) 77=not applicable 88=unknown 99=refused to answer |
O20. | What was this offender's affiliation with the school associated with the victim's death? _ _ Do NOT read options, code leading zero 01=a student at this school 02=a student at another school 03=a teacher at this school* 04=administrator at this school* 05=other staff at this school* 06=security guard or police officer* 07=family member of a student* 08=resident of surrounding community* 09=not associated with the school or community* 10=unidentified offender* 66=other* (specify..................) 77=not applicable 88=unknown 99=refused to answer |
| No Change in question - renumbered as O21. | XW01 | During the year prior to this incident, had the offender ever been found carrying a weapon on school grounds or on the way to or from school? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
O21 | During the year prior to this incident, had the offender ever been found carrying a weapon on school grounds or on the way to or from school? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
| No Change in question - renumbered as O22. | XW02 | During the year prior to this incident, how many times had this offender been found carrying a weapon on school grounds or on the way to or from school? _ _ Do NOT read options, code leading zeros 01-##=actual number of times the victim carried a weapon 77=not applicable 88=unknown 99=refused to answer |
O22 | During the year prior to this incident, how many times had this offender been found carrying a weapon on school grounds or on the way to or from school? _ _ Do NOT read options, code leading zeros 01-##=actual number of times the victim carried a weapon 77=not applicable 88=unknown 99=refused to answer |
| Additional items added reflecting new behaviors. See SH 2012, item number O23. | XW03 | For the most recent event prior to the date of fatal injury, was this offender carrying any of the following types of weapon? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown a) rope or wire _ b) club or bat _ c) knife, razor, box cutter, or other blade _ d) firearm _ (specify....................) e) other _ (specify......................) |
O23. | For the most recent event prior to the date of fatal injury, was this alleged offender carrying any of the following types of weapon? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Weapon Code a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
| No Change in question - renumbered as O24. | XW04 | What, if any, actions did the school take in response to this offender’s most recent incident of weapon carrying? ...................................................................................................................................................................................................................................................................................................................................... | O24. | What, if any, actions did the school take in response to this offender’s most recent incident of weapon carrying? ...................................................................................................................................................................................................................................................................................................................................... |
| Eliminated original question | X23 | For how many years has this offender attended his or her school? _ _ Do NOT read options; code leading zeros 00=less than one school year 01-12=number of years 13=more than 12 years 77=not applicable 88=unknown 99=refused to answer |
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| Revised to include in school suspensions. See SH 2012, item number O25. | X25 | How many times was this offender suspended or expelled from his or her school? _ Do NOT read options 0=none, never suspended or expelled 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
O25. | How many times was this alleged offender suspended from his or her school? (including in school suspensions) _ Do NOT read options 0=none, never suspended or expelled 1-5=actual number of times 6=more than five times 7=not applicable 8=unknown 9=refused to answer |
| New Question | O26. | Had this alleged offender been expelled from his or her school, in the 12 months preceding the event? _ Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| No Change in question - renumbered as O27. | X27 | What extracurricular activities was this offender involved in at the time of the victim's death? to be coded later; please note the sources. ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... |
O27. | What extracurricular activities was this offender involved in at the time of the victim's death? to be coded later; please note the sources. ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... |
| New Question | O28. | Did any the offender experience any school-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | O28a. | Please briefly describe the specific school-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | O29. | Was a school-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | O29a. | Please briefly describe the specific school-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | O30. | Did any the offender experience any community-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | O30a. | Please briefly describe the specific community-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | O31. | Was a community-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options _ 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | O31a. | Please briefly describe the specific community-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | O32. | Did the alleged offender experience any family-related crises or traumatic events during the 2 weeks before or after this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | O32a. | Please briefly describe the specific family-related crises or traumatic events experienced. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | O33. | Was a family-related crisis or traumatic event imminent within two weeks of the this incident? Do NOT read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| New Question | O33a. | Please briefly describe the specific family-related crises or traumatic events that may have been imminent. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| Removed reference to at least once a week. This question could not be answered reliably.See SH 2012, item number O34. | XR01 | To the best of your knowledge, in the 12 months prior to this event was this offender reported to the office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr01a} disobeying authority figure__ {Xr01b} name calling or teasing peers _ {Xr01c} physical fighting with peers _ {Xr01d} damaging another's personal property_ _ {Xr01e} stealing another's personal property __ |
O34. | O34. To the best of your knowledge, in the 12 months prior to this event did the alleged offender engage in any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Behavior Code {O34a} disobeying authority figure {O34b} name-calling, taunting, or teasing peers O34b.1 Face to face? O34b.2 Using Electronic means? {O34c} verbal threats {O34d} sent written threats {O34e} sent electronic threats {O34f} bullied peers {O34g} physically threatened peers {O34h} physical fought with peers {O34i}damaged another's personal property {O34j} damaged school property (tagging, vandalism etc…) {O34k}stole another's personal property {O34l} truancy (skipped school) {O34m} possessed / used illegal substances {O34n}possessed a weapon |
| Removed reference to at least once a week. This question could not be answered reliably. See SH 2012, item number O35. | XR01A | To the best of your knowledge, in the 12 months prior to this event was this offender victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr01a} called names by peers__ {Xr01b} bullied by peers __ {Xr01c} had personal property damaged or stolen _ {Xr01d} physically threatened by peers __ _ {Xr01e} physically assaulted by peers __ |
O35. | To the best of your knowledge, in the 12 months prior to this event was this alleged offender victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Type Code {O35.a} called names by peers {O35.b} bullied by peers {O35.c} had personal property damaged or stolen {O35.d}verbally threatened by peers {O35.e}received written threats {O35.f} electronic threats {O35.g}physically threatened by peers {O35.h}physically assaulted by peers |
| Eliminated original question | XR02 | To the best of your knowledge, did this offender experience any of the following events in the last 12 months? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xr02a} family moved to a new home or apartment _ {Xr02b} parents divorced_ {Xr02c} family had a new baby _ {Xr02d} anyone moved out of the house ( specify..............................................................)_ {Xr02e} family member died (specify....................................................)_ {Xr02f} a close relative or friend died ( specify....................................................................)_ {Xr02g} family member became seriously ill, badly injured or was admitted to the hospital(spec.)_ {Xr02h} a close relative or friend beaten or attacked ( specify ............................................)_ {Xr02i} saw someone beaten, attacked or shot (specify .......................................................)_ {Xr02j} changed where they went to school _ {Xr02k} romantic breakup _ |
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| Eliminated original question | XR03A | At the time of the event, was this offender demonstrating symptoms, such as impulsivity, short attention span, and distractibility, consistent with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| Eliminated original question | XR03 | At the time of the event, was this offender medically diagnosed with an Attention Deficit or a Hyperactivity Disorder? _ Do not read options 1=yes 2=no* 7=not applicable* 8=unknown* 9=refused to answer* |
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| Eliminated original question | XR04 | Were they being treated in any of the following ways for this problem? _ Read options 1= medication alone 2= behavioral/environmental modification alone 3= both medication and behavioral/environmental modification 4= no treatment 7=not applicable 8=unknown 9=refused to answer |
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| No Change in question - renumbered as O36. | XR05 | At the time of the event, did this offender have a diagnosed Learning Disability? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O36. | At the time of the event, did this offender have a diagnosed Learning Disability? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| Additional items added reflecting broader range of services. See SH 2012, item number O37. | XM01 | Xm01. In the year prior to this event, did this offender receive school-sponsored psychological counseling services? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O37. | In the year prior to this event, did this alleged offender receive any of the following services? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Services Code O37.a guidance counseling / advising O37.b psychological counseling O37.c Psychiatric or mental health services O37.d social services O37.e supplemental educational services (including efforts to address learning disabilities) O37.f other services Specify |
| No Change in question - renumbered as O38. | XM02 | In the year prior to this event, was this offender ever treated for depression? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O38. | In the year prior to this event, was this offender ever treated for depression? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| New Question | O39. | Had the alleged offender ever received professional treatment for any other emotional or mental health problem? Do NOT read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
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| New Question | O39a. | If yes, what specific kinds of emotional or mental health problems were treated? to be coded later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| Additional items added to distinguish specific types of victimization experiences. See SH 2012, item number O40. | XM03A | Did this offender have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xm03a} alcoholism _ {Xm03b} drug abuse _ {Xm03c} child abuse/neglect __ {Xm03d} intimate partner violence_ |
O40. | Did this alleged offender have a documented family history of ..... Read options, Coding instructions: 1=yes, 2=no, 8=unknown. Code {O39.1} alcoholism {O39.2} drug abuse {O39.3} intimate partner violence {O39.4.} sexual violence {O39.5}attempted / completed suicide {O39.6} arrests / convictions for violent offenses (e.g., assault, homicide etc…) |
| Eliminated original question | XM03 | To the best of your knowledge, did this offender have a suspected family history of ..... Read only those options not confirmed above, Coding instructions: 1=yes, 2=no, 8=unknown. {Xm03a} alcoholism _ {Xm03b} drug abuse _ {Xm03c} child abuse/neglect __ {Xm03d} intimate partner violence_ |
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| Eliminated original question | XM04 | In what subject area, if any, did this offender seem to excel? _ _ 00= did not excel in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
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| Eliminated original question | XM05 | In what subject areas, if any, did this offender seem to have particular difficulty? _ _ 00= did not have difficulty in any area 01= art 02= music 03= science 04= mathematics 05= social sciences 06= computer sciences 07= language arts 08= vocational/industrial arts 66= other (specify...............................) 77=not applicable 88=unknown 99=refused to answer |
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| No Change in question - renumbered as O42. | XS01 | Do you have any knowledge that this offender had, in the year prior to this event exhibited any of the following signs and symptoms of suicide? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xs01a} Thoughts/threats of suicide*_ {Xs01b} Plans of suicide*_ {Xs01c} Previous suicide attempts*_ |
O42. | Do you have any knowledge that this offender had, in the year prior to this event exhibited any of the following signs and symptoms of suicide? Read options, Coding instructions: 1=yes, 2=no, 8=unknown. {Xs01a} Thoughts/threats of suicide*_ {Xs01b} Plans of suicide*_ {Xs01c} Previous suicide attempts*_ |
| No Change in question - renumbered as O43. | XS02 | Xs02. To whom was this suicidal behavior reported? _ _ Do not read options 01=no one 02=parents 03=other family 04=peers 05=school staff 06=other medical/mental health professional 66=other (specify...........................................) 77=not applicable 88=unknown 99=refused to answer |
O43. | Xs02. To whom was this suicidal behavior reported? _ _ Do not read options 01=no one 02=parents 03=other family 04=peers 05=school staff 06=other medical/mental health professional 66=other (specify...........................................) 77=not applicable 88=unknown 99=refused to answer |
| No Change in question - renumbered as O44. | XS03 | What, if any, actions were taken by the school in response to this suicidal behavior? To be coded later .................................................................................................................................................................................................................................................................................................................................................................. |
O44. | What, if any, actions were taken by the school in response to this suicidal behavior? To be coded later .................................................................................................................................................................................................................................................................................................................................................................. |
| New Question | O45. | Was this alleged offender fatally injured during the event? Do NOT read options 1=yes 2=no* 7=not applicable 8=unknown 9=refused to answer |
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| New Question | O46. | What was the date of the injury event? Record month/date/year, code leading zeros (code four-digit years)_ _/_ _/_ _ _ _ |
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| New Question | O47. | What was the time of the injury event? Record in military time _ _ _ _ |
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| New Question | O48. | What was the date of death? Record month/date/year, code leading zeros (code four-digit years)_ _/_ _/_ _ _ _ |
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| New Question | O49. | What were the motives for the fatal injury? Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable motives. Motive Code a) single suicide b) suicide pact c) victim killed by law enforcement or security personnel d) victim killed by civilian during commission of a crime e) other specify |
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| New Question | O50. | Briefly describe the circumstances of the fatal injury and events leading up to it, including history of prior conflicts between the principles, etc. Code later ...................................................................................................................................................................................................................................................................................................................................................................................... |
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| New Question | O51. | What was the method of fatal injury? Weapon a) firearm Specify b) knife, razor, box cutter or other blade c) bat, pipe, chain, or other object d) rope or wire e) other Specify |
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| New Question | O52. | Did perceptions about the offender being gay, bisexual, or transgendered contribute to their perpetration? Do NOT read options _ 1=homosexual 2=heterosexual 3=bisexual 4=transgender 5=questioning 7=not applicable 8=unknown 9=refused to answer |
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| Eliminated original question | XM08 | What was the perceived sexual orientation of this offender? _ Do not read options 1=homosexual 2=heterosexual 3=bisexual 7=not applicable 8=unknown 9=refused to answer |
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| No Change in question - renumbered as O53. | XM09 | Was there evidence that this offender was targeting a specific person or group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
O53. | Was there evidence that this offender was targeting a specific person or group? _ Do not read options 1=yes 2=no 7=not applicable 8=unknown 9=refused to answer |
| Eliminated original question | X32 | How well do you know the background of this offender? _ Read options 1= extensive knowledge of this offender 2= some knowledge of this offender 3= little knowledge of this offender 4= no knowledge of this offender |
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| No Change in question - renumbered as O54. | X31 | Was there another offender, in addition to the one we just discussed, involved in this event? _ Read options 1= extensive knowledge of this offender 2= some knowledge of this offender 3= little knowledge of this offender 4= no knowledge of this offender |
O54. | Was there another offender, in addition to the one we just discussed, involved in this event? _ Read options 1= extensive knowledge of this offender 2= some knowledge of this offender 3= little knowledge of this offender 4= no knowledge of this offender |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |