HHS/ACF/OPRE Head Start Classroom-based Approaches and Resources for Emotion and Social skill promotion (CARES) project: Impact and Implementation Studies- Follow-up Parent Survey

Appendix A.2: Head Start CARES Follow-up Parent Survey

OMB #: 0970-0364

Expiration Date: XX/XX/2012

KINDERGARTEN FOLLOW-UP PARENT SURVEY FOR

HEAD START CARES

Thank you for your participation in the Head Start CARES research study. As part of this study, we would like you to answer some questions about you and (INSERT CHILD’S NAME). This information is crucial in helping us understand the impacts of Head Start CARES on children. Your participation is completely voluntary and you may, without penalty, skip any questions you do not wish to answer. However, we hope you will try to answer as many as you can.

Please know that the answers to these questions will be kept completely private and will be used for research purposes only. To make sure we keep your information as private to the extent permitted by law, all electronic data files that we have will be password-protected. This survey will take approximately 20 minutes to complete. You will receive $20 for completing this survey, to reimburse you for your time and effort. Thank you!

I am going to ask you some questions about yourself, your child (INSERT CHILD’S NAME) who was enrolled in Head Start last year, and your family. You are allowed to skip any question you do not wish to answer and please remember that your answers to my questions will be kept private to the extent permitted by law.

The following questions ask about [CHILD] and his/her current school.

127. What school is [CHILD] currently attending?

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128. What is the address of the school?

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ZIPCODE |__|__|__|__|__|

129. What is [CHILD]’s teacher’s name?

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130. What grade is [CHILD] currently in?

Preschool ¦₁

Kindergarten ¦₂

Transition grade ¦₃

First grade ¦₄

Don’t know ¦₁₆

Refused ¦₁₇

131. What type of school is [CHILD] currently enrolled in?

Public ¦₁

Private ¦₂

Parochial ¦₃

Don’t know ¦₁₆

Refused ¦₁₇

132. Does [CHILD] receive special education services?

YES 1

NO 0

DON’T KNOW d

REFUSED r

133. Does [CHILD] receive ESOL/ELL/ESL services?

(If respondent is unsure, say: ESOL means English for Speakers of Other Languages; ELL means English Language Learners; ESL means English as a Second Language)

YES 1

NO 0

DON’T KNOW d

REFUSED r

In this section, I will ask you some questions about your interactions with the people at [CHILD]’s current school.

Items 1-10 below = items 32-41 in the final survey. Item 11 = 134.

Item 12 = 135; Item 13 = 137; Item 14 = 139; Item 15 = 141

The following questions ask more about your experience with [CHILD]’s current school.

On a scale of 1 to 5, with 1 being “strongly disagree” and 5 indicating “strongly agree”, please rate how you feel about the following:

135. My school has been a good place for my child to be.

Strongly disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly agree 5

DON’T KNOW d

REFUSED r

136. I worry about crime and violence in my child’s school.

Strongly disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly agree 5

DON’T KNOW d

REFUSED r

137. The people at my child’s school are doing good things for her or him.

Strongly disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly agree 5

DON’T KNOW d

REFUSED r

138. Students are often threatened or bullied at my child’s school.

Strongly disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly agree 5

DON’T KNOW d

REFUSED r

139. I have confidence in the people at my child’s school.

Strongly disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly agree 5

DON’T KNOW d

REFUSED r

140. Most students in my child’s school think it is ok to fight if someone insults them.

Strongly disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly agree 5

DON’T KNOW d

REFUSED r

141. My child’s teacher is doing a good job of preparing her or him for next year.

Strongly disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly agree 5

DON’T KNOW d

REFUSED r

142. My child’s school is a safe place.

Strongly disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly agree 5

DON’T KNOW d

REFUSED r

143. During this school year at your child’s school, have children brought weapons to school?

YES 1

NO 0

DON’T KNOW d

REFUSED r

144. During this school year at your child’s school, have children or teachers been physically attacked or involved in fights?

YES 1

NO 0

DON’T KNOW d

REFUSED r

Now I am going to ask you some questions about [CHILD]. The next statements describe the behavior of many children. Tell me how often [CHILD] displays certain social skills.

Each question is answered on a three-point scale: 0 – Never, 1 – Sometimes, 2 – Very Often

[CHILD]…

1. Follows instructions

2. Helps you with household tasks without being asked

3. Attempts household tasks before asking for your help

4. Uses free time at home in an acceptable way

5. Responds appropriately when hit or pushed by other children

6. Volunteers to help family members with tasks

7. Avoids situations that are likely to result in trouble

8. Keeps room clean and neat without being reminded

9. Completes household tasks within a reasonable time

10. Controls temper in conflict situations with you

11. Controls temper when arguing with other children

12. Follows game rules

13. Attends to instructions

14. Puts away toys or other household property

15. Waits turn in games

16. Congratulates family members on accomplishments

17. Follows rules

18. Ends disagreements with you calmly

19. Communicates problems

20. Speaks in appropriate tone of voice at home

Please tell me whether the statement has been OFTEN true, SOMETIMES true, or NOT true of [CHILD] since the beginning of the school year? Items 1-28 below = items 56-83 in the final survey. (Do not administer 29-32)

Having a child can sometimes be stressful. The next questions are about how stressful having [CHILD] has been for you and the ways in which you have had to adjust your life. Please tell us the degree to which you agree or disagree with the following statements by telling me the one that best matches how you feel.

1 – Strongly agree

2 – Agree

3 – Not sure

4 – Disagree

5 – Strongly disagree

R – Refused

(Mark “Not Sure” for “Don’t Know”)

1. You often have the feeling that you cannot handle things very well.

2. You find yourself giving up more of your life to meet your children’s needs than you ever expected.

3. You feel trapped by your responsibilities as a parent.

4. Since having this child you have been unable to do new and different things.

5. Since having a child you feel that you are almost never able to do things that you like to do.

6. There are quite a few things that bother you about your life.

7. Having a child has caused more problems than you expected in your relationship with your spouse (male/female friend).

8. You feel alone and without friends.

9. When you go to a party you usually expect not to enjoy yourself.

10. You are not as interested in people as you used to be.

11. You don’t enjoy things as you used to.

12. How would describe yourself as a parent? Do you feel that you are:

A very good parent/caregiver? 1

A better than average parent/caregiver? 2

An average parent/caregiver? 3

A person who has some trouble being a parent/caregiver? 4

Not very good at being a parent/caregiver? 5

DON’T KNOW d

REFUSED r

The following questions ask about how you have been feeling during the past 30 days. For each question, please tell us the answer that best describes how often you had this feeling.

19. During the past 30 days, about how often did you feel…

(Read responses as necessary).

Now I would like to ask you some more questions about you and your family. All of your answers will be kept private and you should feel free to skip any questions you don’t feel comfortable answering.

104. Including yourself, how many adults age 18 and older live in your household?

|___|___| NUMBER

DON’T KNOW d

REFUSED r

145. How many times has your family moved in the last year?

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106. Including [CHILD], how many children age 17 and younger live in your household?

|___|___| NUMBER

DON’T KNOW d

REFUSED r

Raising children is a really important job. Some parents work additionally outside the home for pay. The following questions help us to understand your family’s financial situation. All of your answers will be kept private and you should feel free to skip any questions you don’t feel comfortable answering.

Include instructions for the interviewer: “your best estimate is fine” here

118. Are you currently working for pay?

By working, we mean a formal job – a job that has a pay stub, self-employment, or a casual pay job – a job that is “under the table” or “off the books.” Please don’t count unpaid experience.

₁ Yes

₂ Yes, currently on leave

₃ No (skip to question # 124)

₄ Laid off

₅ OMIT

₆ DON’T KNOW

₇ REFUSED

120. What is your hourly wage earned at this job?

(IF RESPONDENT IS HAVING TROUBLE WITH THEIR ANSWER SAY: “YOUR BEST ESTIMATE IS FINE”)

$ ____ ____ ____ . ____ ____ PER HOUR Don’t Know or Refused

121. Including overtime, how many total hours per week do you usually work at your current job(s)?

_____________ HOURS PER WEEK Don’t Know or Refused

124. We would like to know about other kinds of income and support you and members of your household are currently receiving. Do you or any other household members currently receive…

	Yes	No
OMIT	1	2
A check or income from TANF (formerly AFDC) for welfare for families with children?	1	2
OMIT	1	2
Unemployment insurance benefits?	1	2
Food stamps?	1	2
Medicaid or medical assistance, such as SCHIP or other free health insurance for child? (SPECIFY:________________________________________________________)	1	2
OMIT	1	2

125. What was the total income of all members of your household including yourself from all sources in the last month and including Food Stamp benefits, before taxes?

(IF RESPONDENT IS HAVING TROUBLE WITH THEIR ANSWER SAY: “YOUR BEST ESTIMATE IS FINE”)

$ ___ ___ ___ ,___ ___ ___ per month

AMOUNT

Don’t know or Refused – SKIP TO 125a

125a.    Would you say that it was more or less than $1,500 a month?  [CHOOSE ONE]

            1          More than $1,500        SKIP TO 125b

            2          Exactly $1,500             SKIP TO END

            3          Less than $1,500         SKIP TO 125c

            8          Don’t know (VOL)      SKIP TO END

            9          Refused (VOL)            SKIP TO END

125b.    Would you say that it was . . . [CHOOSE ONE]

            1          More than $1,500 but less than $2,000   SKIP TO END

            2          At least $2,000 but less than $2,500       SKIP TO END

            3          $2,500 or more?                                      SKIP TO END

            8          Don’t know (VOL)                                 SKIP TO END

            9          Refused (VOL)                                       SKIP TO END

125c.    Would you say that it was . . . [CHOOSE ONE]

            1          At least $1,200 but less than $1,500

            2          At least $800 but less than $1,200

            3          Less than $800?

            8          Don’t know   (VOL)

 9          Refused         (VOL)

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