Household / NRFU – Automated Protocol (Round 3)
INTERVIEW ID: ____________________
INTERVIEW DATE: ____/____/____ START TIME: ___________ AM / PM
Hello, my name is ___________. I work for RTI/RSS a research company that has been hired by the Census Bureau to conduct research on the census forms. Thanks for agreeing to help us today. Let me start by telling you a little about what we will be doing. Every ten years the United States conducts a census, or count, of everyone who is living in the United States. The form we’re working on today is the kind you might access online, using a computer, tablet, or smartphone if you thought you had not been counted in the census.
Permission to Record:
Because it would be hard to keep track of everything you say today, I would like to record this session. [HAND RESPONDENT THE CONSENT FORM IF YOU HAVE NOT ALREADY.] Please read over this consent form and let me know if you have any questions. When you are ready, please sign the form. I want you to know that your responses will be kept strictly confidential and will only be seen by members of the project team and the Census Bureau. Your participation in this study is completely voluntary and you can decline to answer any particular question. At the end of the study, we will delete any record of your responses from our machines. Your name will never be used in any reports.
Think-out-loud Instructions:
What I’ll ask you to do today is to fill the questionnaire out, just as you would if you accessed it online. But, so I can keep track of what you are doing, I’d like you to describe what you are doing and thinking as you go along. For example, I may ask you a question that seems relatively simple such as “How many cars do you have?” Instead of just providing a number, tell me what you were thinking when you answered it. For example, my response would be “Well I have an SUV that I drive every day and I also have an old truck. But the truck does not currently run. I assume that you mean working cars, so…one. I just have one car.” This kind of response will help me understand how you understood and interpreted the question so that we can see what each question means to you. I may remind you to think aloud as we go along. After some of the questions, I will ask you some additional questions about your answers to the Census. Some of these questions may sound a little strange. For example, I might ask you what a certain word means to you or how you came up with your answer. Again, the reason for this is to see how people understand each question. Even though some of these questions may sound like I am giving you a test, there are no right or wrong answers. We are interested in how these questions work for you.
Do you have any questions before we begin?
IF CONSENT WAS GIVEN, START TAPE RECORDER AND DEVICE RECORDER.
Logon TO APP (PASSWORD: CSM##2012).
[GIVE DEVICE TO R AND SAY: So that I can follow along more easily, please read the survey questions aloud and tell me your answers.]
[administer scripted probes after respondent has answered all questions in the section; note usability issues as they occur. Administer debriefing probes after scripted probes.]
Roster Questions (1-4) |
|
We need to count everyone where they were living or staying on Census Day, which was June 1, 2013. It should take about 10 minutes to complete this survey. [Calendar with June 1 circled] |
Q0 USABILITY:
|
Yes – Go to newQ No – Go to 1a |
Q1 USABILITY:
|
1x Is [ADDRESS 1] a vacation or seasonal home? Yes – Go to Q1f No – Go to Q2
|
Q1x USABILITY:
|
1a. Did anyone live or stay at 1234 Home Address on October 1, 2012? Yes – Go to 1c No – Continue to 1b DK – Go to 1aa |
Q1a USABILITY: |
1b. On October 1, 2012 was 1234 Home Address uninhabitable, for example, open to the elements, condemned, under construction, destroyed by a fire, demolished? Yes, Open to the elements (for example an old house that is decaying from neglect) – Go to 1aa Yes, Condemned – Go to 1aa Yes, Under construction – Go to 1b-a Yes, Destroyed by a fire, demolished or otherwise destroyed – Go to 1aa No – Go to 1d |
Q1b USABILITY:
|
1b-a. Were the exterior windows and doors and the final flooring installed by June 1, 2013? Yes – Go to 1aa No – Go to 1aa
|
Q1b-a USABILITY:
|
1c. What are the full names of the people who lived or stayed at 1234 Home Address on June 1, 2013? [Name fields: First Middle Last]
[Name fields: First Middle Last]
[Name fields: First Middle Last]
Add additional name
Go to Q1aa
|
Q1c USABILITY:
|
1d. On June 1, 2013 was [Address 1] a business, a storage facility, a model home, an empty site in a mobile home/trailer park or another type of nonresidential unit? Yes, Business or commercial – Go to 1aa Yes, Storage facility – Go to 1aa Yes, Model home – Go to 1aa Yes, an empty site in a mobile home/trailer park – Go to 1aa Yes, Other nonresidential – Go to 1aa No – Continue to 1e
|
Q1d USABILITY:
|
1e. Please select the reason why no one was living or staying at this address on June 1, 2013? The unit was - For rent – Go to 1aa Rented, not occupied – Go to 1aa For sale – Go to 1aa Sold, not occupied – Go to 1aa For seasonal, recreation, or occasional use – Go to 1f For migrant workers – Go to 1aa Other, please specify – Go to 1aa |
Q1e USABILITY:
|
1f. Is [Address 1] anyone's usual residence? Yes Go to Q1g No Go to Q1aa
|
Q1f USABILITY:
|
1g. Who usually lives at 1234 Seasonal Address? [Name fields: First Middle Last]
[Name fields: First Middle Last]
[Name fields: First Middle Last]
Add additional name
|
Q1g USABILITY:
|
1aa. On June 1, 2013, where did you live or stay? ADDRESS FIELDS
|
Q1aa USABILITY:
|
2. What is your full name? [Name fields: First Middle Last]
|
Q2 USABILITY:
|
3. On June 1, 2013, was there anyone else living or staying at [ADDRESS 1]? Yes Go to Q3a No Go to Q4 |
Q3 USABILITY:
|
3a. What are the full names of the other people who were living or sleeping at [Address 1] on June 1, 2013?
[Name fields: First Middle Last]
[Name fields: First Middle Last]
[Name fields: First Middle Last]
Add additional name
|
Q3a USABILITY:
|
4. On June 1, 2013, were there any additional people living or staying at [Address 1] who you did not include yet? For example
Babies or young children? [ ] Yes [ ] No Foster children? [ ] Yes [ ] No Any other relatives? [ ] Yes [ ] No Roommates or people [ ] Yes [ ] No not related to you?
|
Q4 USABILITY:
PROBE ON RELATIONSHIP TO R. determine if these are the same people R thought of in answering Q3a or additional people.
|
4a. What are their full names? [Name fields: First Middle Last]
[Name fields: First Middle Last]
[Name fields: First Middle Last]
Add additional name (max 9 names)
|
Q4a USABILITY:
|
5. On June 1, 2013, was there anyone else staying or sleeping at [Address 1] who had no permanent place to live? Yes – Go to 5a No – Go to 6
|
Q5 USABILITY:
|
5a. What are full the names of the people who had no permanent place to live? [Name fields: First Middle Last]
[Name fields: First Middle Last]
[Name fields: First Middle Last]
Add additional name
|
Q4F USABILITY:
|
|
I would like to stop here for a moment to ask you a few follow-up questions about the items you just answered.
A1. Is there anyone you listed or thought about listing for any question, but you were unsure whether he or she should be included on the census or not? [Tell me more about that?]
A2. Was there anyone you included as living or staying here, who was actually away on June 1. For example away on a business trip, for vacation, or for another reason? [How did you know to include this person?]
A3. I see that you provided ________________ as your name. Is that a full name or a nickname? NOTE DIFFERENCES WITHOUT USING PII.
A4. Would you ever use a different version of your name on a form like this?
IF YES: How else might you list your name? NOTE DIFFERENCES WITHOUT USING PII.
IF YES: How do you decide which way to write it on different forms?
IF HISPANIC: Do you have two surnames? IF YES, ASK: How did you decide which surname to provide on the Census form?
A5. IF MIDDLE NAME BLANK OR JUST INITIAL: Did you see that you were supposed to provide your [full] middle name? Do you have a middle name? How did you decide to [leave it blank/just provide an initial]?
Now let’s review the names of the other people you listed.
A6a. I see that you wrote ___________ as his/her name. Is that a full name or a nickname? NOTE DIFFERENCES
WITHOU USING PII.
A6b. Would you ever use a different version of his/her name on a form like this?
IF YES: How else might you list this name? How do you decide which way to write on different forms? NOTE DIFFERENCES WITHOUT USING PII.
IF HISPANIC: Does he or she have two surnames? IF YES, ASK: How did you decide which surname to provide on the Census form?
A6c. How did you decide how to list their name?
A6d. IF MIDDLE NAME BLANK OR JUST INITIAL: Did you see that you were supposed to provide his or her
[full] middle name? Does he or she have a middle name? How did you decide to [leave it blank/just
provide an initial]?
Person |
Probe A6a |
Probe A6b |
Probe A6c |
Probe A6d |
2 |
|
|
|
|
3 |
|
|
|
|
4 |
|
|
|
|
5 |
|
|
|
|
6 |
|
|
|
|
Those are all the follow-up questions I have for this part. Let’s continue with the rest of the interview.
Demographic Questions (7-11): |
|
|
|
7. The next few questions will be about the people who lived or stayed at [ADDRESS] on [Census Day]. Based on your previous responses, this is who we have listed. [Name; Name] Are these names correct? |
Q7 USABILITY:
|
8. If [ADDRESS] is a house apartment or mobile home, is it: Owned by you or someone else in this household with a mortgage or loan (including home equity loans)? - Go to 8a Owned free and clear (without a mortgage or loan)? – Go to Q8a Rented? – Go to 8a Occupied without payment of rent? –Go to Q9
|
Q8 USABILITY:
|
8a. Of the people who live here at [ADDRESS], who owns or rents this house? [NAMES] Go to Q9 |
Q8a USABILITY:
|
9. Next, we need to record each person’s relationship to [Person 1].
Using the categories on the screen, [NAME] is [Person 1]’s .
• Opposite-sex husband/wife/spouse • Opposite-sex unmarried partner • Same-sex husband/wife/spouse • Same-sex unmarried partner • Biological son or daughter • Adopted son or daughter • Stepson or stepdaughter • Brother or sister • Father or mother • Grandchild • Parent-in-law • Son-in-law or daughter-in-law • Other relative • Roomer or boarder • Housemate or roommate • Foster child • Other nonrelative |
Q9 USABILITY:
|
10. Are you/Is [NAME] male or female? Male Female What is your date of birth? [DATE: mm-dd-yyyy] If date of birth is unknown- What was your age on [Census Day]? |
Q10 USABILITY:
|
11. Using the categories on the screen, what is your / [NAME]’s race or origin? White – For example, German Irish, Lebanese, Egyptcian, and so on. Go to 11a Black or African Am. – For example, African American, Haitian, Nigerian, and so on. Go to 11b Hispanic, Latino, or Spanish origin – For example, Mexican, Mexican Am., Puerto Rican, Cuban, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on. Go to 11c American Indian or Alaska Native – For example, Navajo, Mayan, Tlingit, and so on. Go to 11d Asian – For example, Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on. Go to 11e Native Hawaiian or Other Pacific Islander – For example, Native Hawaiian, Guamanian or Chamorro, Somoan, Fijian, Tongan, and so on. Go to 11f Some other race or origin. Go to 11g
|
Q11 USABILITY:
|
11a. You said you are / [NAME] is white. Enter your specific origin(s) - For example, German, Irish, Lebanese, Egyptian, and so on. |
Q11a USABILITY:
|
11b. You said you are/ [NAME] is black or African Am. Enter your specific origin(s) - For example, African American, Haitian, Nigerian and so on. |
Q11b USABILITY:
|
11c. You said you are / [NAME] is Hispanic, Latino or of Spanish origin. Enter your specific origin(s) - For example, Mexican, Mexican Am., Puerto Rican, Cuban, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on. |
Q11c USABILITY:
|
11d. You said you are / [NAME] is American Indian or Alaska Native. Enter your specific origin(s) - For example, Navajo, Mayan, Tlingit and so on. |
Q11d USABILITY:
|
11e. You said you are / [NAME] is Asian. Enter your specific origin(s) - For example, Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Hmong, Laotian, Thai, Pakistani, Cambodian and so on. |
Q11e USABILITY:
|
11f. You said you are / [NAME] is Native Hawaiian or Other Pacific Islander. Enter your specific origin(s) - For example, Native Hawaiian, Guamanian or Chamorro, Samoan, Fijian, Tongan and so on. |
Q11f USABILITY:
|
11g. You said you have / [NAME] has some other race or origin. Enter your specific origin(s). |
Q11g USABILITY:
|
Question 12-16 Series (“you”) |
|
12. Did you move into or out of [ADDRESS] AFTER May?
Yes, moved into [ADDRESS]- Go to 12a Yes, moved out of [ADDRESS]– Go to 12a No- Go to Q13
|
Q12 USABILITY:
|
12a. On what date did you move [into/out of] [ADDRESS]?
[Date: mm-dd-yyyy] |
Q12 USABILITY:
|
12b What is the address you moved [out of / into]? Please provide as much information as you know. [ ] SAMPLE ADDRESS [ ] OTHER ADDRESSES [ ] NEW ADDRESS
|
Q12b USABILITY:
|
13. Besides [Address 1], do you sometimes live or stay at another address:
For college, the military, or a job? []Yes [] No At another home, like a seasonal or second residence? []Yes [] No With a parent, grandparent, []Yes [] No friend, or other person ?
|
Q13 USABILITY:
|
13a. What is the address where you stayed for college, military, or a job? Please provide as much information as you know.
|
Q13a USABILITY:
|
13b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13b. USABILITY:
|
13c. What is the address where you stayed at another home, like a seasonal or second home? Please provide as much information as you know. |
Q13c USABILITY:
|
13d. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13d. USABILITY:
|
13e. What is the address where you stayed with a parent, grandparent, friend or other person? Please provide as much information as you know.
|
Q13e USABILITY:
|
13f. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13f. USABILITY:
|
14. On [Census Day], did you stay in any of the following facilities?
Shelter or group home [] Yes [] No Nursing home [] Yes [] No Jail or prison [] Yes [] No Other facility [] Yes [] No
|
Q14a USABILITY (FOR ALL PERSONS)::
|
14a. What is the address of the facility where you stayed? Please provide as much information as you know.
|
Q14a USABILITY:
|
14b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q14n. USABILITY:
|
15. Where do you live and sleep most of the time? Here at this residence Go to Q16 ALTERNATE ADDRESS 1 Go to Q16 (ADDITIONAL ALT ADDR) Go to Q16 In above places about equally Q16 Some other place Go to Q15a
|
Q15. USABILITY: P53. IF ADD’L ADDRESSES PROVIDED: How did you determine where you live and sleep most of the time? P55. If I had asked, “Around June 1, 2013, where did you live and sleep most of the time?” would that have changed your answer? How so?
|
15a. What is the adress of the other place?
|
Q15a. USABILITY:
|
16. On June 1, 2013, where were you staying? Here at this residence next Person ALTERNATE ADDRESS 1 next Person (ADDITIONAL ALT ADDR) next Person Some other place Go to Q16a
|
Q16 USABILITY: P57. IF ANSWER IS DIFFERENT THAN WHAT YOU WOULD EXPECT: How did you come up with your answer to this question? |
16a. What is the adress of the other place?
|
Q16a. USABILITY:
|
INTERVIEWER:
|
|
Question 12-16 Series (Person 2) |
|
12. Did you move into or out of [ADDRESS] AFTER May?
Yes, moved into [ADDRESS]- Go to 12a Yes, moved out of [ADDRESS]– Go to 12a No- Go to Q13
|
Q12 USABILITY:
|
12a. On what date did you move [into/out of] [ADDRESS]?
[Date: mm-dd-yyyy] |
Q12 USABILITY:
|
12b What is the address you moved [out of / into]? Please provide as much information as you know. [ ] SAMPLE ADDRESS [ ] OTHER ADDRESSES [ ] NEW ADDRESS
|
Q12b USABILITY:
|
13. Besides [Address 1], do you sometimes live or stay at another address:
For college, the military, or a job? []Yes [] No At another home, like a seasonal or second residence? []Yes [] No With a parent, grandparent, []Yes [] No friend, or other person ?
|
Q13 USABILITY:
|
13a. What is the address where you stayed for college, military, or a job? Please provide as much information as you know.
|
Q13a USABILITY:
|
13b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13b. USABILITY:
|
13c. What is the address where you stayed at another home, like a seasonal or second home? Please provide as much information as you know. |
Q13c USABILITY:
|
13d. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13d. USABILITY:
|
13e. What is the address where you stayed with a parent, grandparent, friend or other person? Please provide as much information as you know.
|
Q13e USABILITY:
|
13f. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13f. USABILITY:
|
14. On [Census Day], did you stay in any of the following facilities?
Shelter or group home [] Yes [] No Nursing home [] Yes [] No Jail or prison [] Yes [] No Other facility [] Yes [] No
|
Q14a USABILITY (FOR ALL PERSONS)::
|
14a. What is the address of the facility where you stayed? Please provide as much information as you know.
|
Q14a USABILITY:
|
14b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q14n. USABILITY:
|
15. Where do you live and sleep most of the time? Here at this residence Go to Q16 ALTERNATE ADDRESS 1 Go to Q16 (ADDITIONAL ALT ADDR) Go to Q16 In above places about equally Q16 Some other place Go to Q15a
|
Q15. USABILITY: P53. IF ADD’L ADDRESSES PROVIDED: How did you determine where you live and sleep most of the time? P55. If I had asked, “Around June 1, 2013, where did you live and sleep most of the time?” would that have changed your answer? How so?
|
15a. What is the adress of the other place?
|
Q15a. USABILITY:
|
16. On June 1, 2013, where were you staying? Here at this residence next Person ALTERNATE ADDRESS 1 next Person (ADDITIONAL ALT ADDR) next Person Some other place Go to Q16a
|
Q16 USABILITY: P57. IF ANSWER IS DIFFERENT THAN WHAT YOU WOULD EXPECT: How did you come up with your answer to this question? |
16a. What is the adress of the other place?
|
Q16a. USABILITY:
|
INTERVIEWER:
|
|
Question 12-16 Series (Person 3) |
|
12. Did [NAME] move into or out of [ADDRESS] AFTER May?
Yes, moved into [ADDRESS]- Go to 12a Yes, moved out of [ADDRESS]– Go to 12a No- Go to Q13
|
Q12 USABILITY:
|
12a. On what date did [NAME] move [into / out of] [ADDRESS]?
[Date: mm-dd-yyyy] |
Q12 USABILITY:
|
12b What is the address [NAME] moved [out of / into]? Please provide as much information as you know. [ ] SAMPLE ADDRESS [ ] OTHER ADDRESSES [ ] NEW ADDRESS
|
Q12b USABILITY:
|
13. Besides [Address 1], does [NAME] sometimes live or stay at another address:
For college, the military, or a job? []Yes [] No At another home, like a seasonal or second residence? []Yes [] No With a parent, grandparent, []Yes [] No friend, or other person ?
|
Q13 USABILITY:
|
13a. What is the address where [NAME] stayed for college, military, or a job? Please provide as much information as you know.
|
Q13a USABILITY:
|
13b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13b. USABILITY:
|
13c. What is the address where [NAME] stayed at another home, like a seasonal or second home? Please provide as much information as you know. |
Q13c USABILITY:
|
13d. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13d. USABILITY:
|
13e. What is the address where [NAME] stayed with a parent, grandparent, friend or other person? Please provide as much information as you know.
|
Q13e USABILITY:
|
13f. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13f. USABILITY:
|
14. On [Census Day], did [NAME] stay in any of the following facilities?
Shelter or group home [] Yes [] No Nursing home [] Yes [] No Jail or prison [] Yes [] No Other facility [] Yes [] No
|
Q14a USABILITY (FOR ALL PERSONS)::
|
14a. What is the address of the facility where [NAME] stayed? Please provide as much information as you know.
|
Q14a USABILITY:
|
14b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q14n. USABILITY:
|
15. Where does [NAME] live and sleep most of the time? Here at this residence Go to Q16 ALTERNATE ADDRESS 1 Go to Q16 (ADDITIONAL ALT ADDR) Go to Q16 In above places about equally Q16 Some other place Go to Q15a
|
Q15. USABILITY:
|
15a. What is the adress of the other place?
|
Q15a. USABILITY:
|
16. On June 1, 2013, where was [NAME] staying? Here at this residence next Person ALTERNATE ADDRESS 1 next Person (ADDITIONAL ALT ADDR) next Person Some other place Go to Q16a
|
Q16 USABILITY:
|
16a. What is the adress of the other place?
|
Q16a. USABILITY:
|
INTERVIEWER:
|
|
Question 12-16 Series (Person 4) |
|
12. Did [NAME] move into or out of [ADDRESS] AFTER May?
Yes, moved into [ADDRESS]- Go to 12a Yes, moved out of [ADDRESS]– Go to 12a No- Go to Q13
|
Q12 USABILITY:
|
12a. On what date did [NAME] move [into / out of] [ADDRESS]?
[Date: mm-dd-yyyy] |
Q12 USABILITY:
|
12b What is the address [NAME] moved [out of / into]? Please provide as much information as you know. [ ] SAMPLE ADDRESS [ ] OTHER ADDRESSES [ ] NEW ADDRESS
|
Q12b USABILITY:
|
13. Besides [Address 1], does [NAME] sometimes live or stay at another address:
For college, the military, or a job? []Yes [] No At another home, like a seasonal or second residence? []Yes [] No With a parent, grandparent, []Yes [] No friend, or other person ?
|
Q13 USABILITY:
|
13a. What is the address where [NAME] stayed for college, military, or a job? Please provide as much information as you know.
|
Q13a USABILITY:
|
13b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name.
|
Q13b. USABILITY:
|
13c. What is the address where [NAME] stayed at another home, like a seasonal or second home? Please provide as much information as you know. |
Q13c USABILITY:
|
13d. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13d. USABILITY:
|
13e. What is the address where [NAME] stayed with a parent, grandparent, friend or other person? Please provide as much information as you know.
|
Q13e USABILITY:
|
13f. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13f. USABILITY:
|
14. On [Census Day], did [NAME] stay in any of the following facilities?
Shelter or group home [] Yes [] No Nursing home [] Yes [] No Jail or prison [] Yes [] No Other facility [] Yes [] No
|
Q14a USABILITY (FOR ALL PERSONS)::
|
14a. What is the address of the facility where [NAME] stayed? Please provide as much information as you know.
|
Q14a USABILITY:
|
14b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q14n. USABILITY:
|
15. Where does [NAME] live and sleep most of the time? Here at this residence Go to Q16 ALTERNATE ADDRESS 1 Go to Q16 (ADDITIONAL ALT ADDR) Go to Q16 In above places about equally Q16 Some other place Go to Q15a
|
Q15. USABILITY:
|
15a. What is the adress of the other place?
|
Q15a. USABILITY:
|
16. On June 1, 2013, where was [NAME] staying? Here at this residence next Person ALTERNATE ADDRESS 1 next Person (ADDITIONAL ALT ADDR) next Person Some other place Go to Q16a
|
Q16 USABILITY:
|
16a. What is the adress of the other place?
|
Q16a. USABILITY:
|
INTERVIEWER:
|
|
|
|
Question 12-16 Series (Person 5) |
|
12. Did [NAME] move into or out of [ADDRESS] AFTER May?
Yes, moved into [ADDRESS]- Go to 12a Yes, moved out of [ADDRESS]– Go to 12a No- Go to Q13
|
Q12 USABILITY:
|
12a. On what date did [NAME] move [into / out of] [ADDRESS]?
[Date: mm-dd-yyyy] |
Q12 USABILITY:
|
12b What is the address [NAME] moved [out of / into]? Please provide as much information as you know. [ ] SAMPLE ADDRESS [ ] OTHER ADDRESSES [ ] NEW ADDRESS
|
Q12b USABILITY:
|
13. Besides [Address 1], does [NAME] sometimes live or stay at another address:
For college, the military, or a job? []Yes [] No At another home, like a seasonal or second residence? []Yes [] No With a parent, grandparent, []Yes [] No friend, or other person ?
|
Q13 USABILITY:
|
13a. What is the address where [NAME] stayed for college, military, or a job? Please provide as much information as you know.
|
Q13a USABILITY:
|
13b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13b. USABILITY:
|
13c. What is the address where [NAME] stayed at another home, like a seasonal or second home? Please provide as much information as you know. |
Q13c USABILITY:
|
13d. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13d. USABILITY:
|
13e. What is the address where [NAME] stayed with a parent, grandparent, friend or other person? Please provide as much information as you know.
|
Q13e USABILITY:
|
13f. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13f. USABILITY:
|
14. On [Census Day], did [NAME] stay in any of the following facilities?
Shelter or group home [] Yes [] No Nursing home [] Yes [] No Jail or prison [] Yes [] No Other facility [] Yes [] No
|
Q14a USABILITY (FOR ALL PERSONS)::
|
14a. What is the address of the facility where [NAME] stayed? Please provide as much information as you know.
|
Q14a USABILITY:
|
14b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q14n. USABILITY:
|
15. Where does [NAME] live and sleep most of the time? Here at this residence Go to Q16 ALTERNATE ADDRESS 1 Go to Q16 (ADDITIONAL ALT ADDR) Go to Q16 In above places about equally Q16 Some other place Go to Q15a
|
Q15. USABILITY:
|
15a. What is the adress of the other place?
|
Q15a. USABILITY:
|
16. On June 1, 2013, where was [NAME] staying? Here at this residence next Person ALTERNATE ADDRESS 1 next Person (ADDITIONAL ALT ADDR) next Person Some other place Go to Q16a
|
Q16 USABILITY:
|
16a. What is the adress of the other place?
|
Q16a. USABILITY:
|
INTERVIEWER:
|
|
Question 12-16 Series (Person 6) |
|
12. Did [NAME] move into or out of [ADDRESS] AFTER May?
Yes, moved into [ADDRESS]- Go to 12a Yes, moved out of [ADDRESS]– Go to 12a No- Go to Q13
|
Q12 USABILITY:
|
12a. On what date did [NAME] move [into / out of] [ADDRESS]?
[Date: mm-dd-yyyy] |
Q12 USABILITY:
|
12b What is the address [NAME] moved [out of / into]? Please provide as much information as you know. [ ] SAMPLE ADDRESS [ ] OTHER ADDRESSES [ ] NEW ADDRESS
|
Q12b USABILITY:
|
13. Besides [Address 1], does [NAME] sometimes live or stay at another address:
For college, the military, or a job? []Yes [] No At another home, like a seasonal or second residence? []Yes [] No With a parent, grandparent, []Yes [] No friend, or other person ?
|
Q13 USABILITY:
|
13a. What is the address where [NAME] stayed for college, military, or a job? Please provide as much information as you know.
|
Q13a USABILITY:
|
13b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13b. USABILITY:
|
13c. What is the address where [NAME] stayed at another home, like a seasonal or second home? Please provide as much information as you know. |
Q13c USABILITY:
|
13d. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13d. USABILITY:
|
13e. What is the address where [NAME] stayed with a parent, grandparent, friend or other person? Please provide as much information as you know.
|
Q13e USABILITY:
|
13f. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q13f. USABILITY:
|
14. On [Census Day], did [NAME] stay in any of the following facilities?
Shelter or group home [] Yes [] No Nursing home [] Yes [] No Jail or prison [] Yes [] No Other facility [] Yes [] No
|
Q14a USABILITY (FOR ALL PERSONS)::
|
14a. What is the address of the facility where [NAME] stayed? Please provide as much information as you know.
|
Q14a USABILITY:
|
14b. (if state, city or state not provided) Please provide any additional information such as major cross roads, neighborhood, or facility name. City:
State [select state picklist]
|
Q14n. USABILITY:
|
15. Where does [NAME] live and sleep most of the time? Here at this residence Go to Q16 ALTERNATE ADDRESS 1 Go to Q16 (ADDITIONAL ALT ADDR) Go to Q16 In above places about equally Q16 Some other place Go to Q15a
|
Q15. USABILITY:
|
15a. What is the adress of the other place?
|
Q15a. USABILITY:
|
16. On June 1, 2013, where was [NAME] staying? Here at this residence next Person ALTERNATE ADDRESS 1 next Person (ADDITIONAL ALT ADDR) next Person Some other place Go to Q16A
|
Q16 USABILITY:
|
16a. What is the adress of the other place?
|
Q16a. USABILITY:
|
B. Enumeration Questions 12-16 Debriefing |
INTERVIEWER: BEFORE PROCEEDING, CHECK FOR SIGNS OF R FATIGUE (SIGHS, COMMENTS). PLEASE NOTE ANY COMMENTS PROVIDED BY THE PARTICIPANT OR SIGNS OF FATIGUE BELOW THEN RESUME THE INTERVIEW AND COMPLETE THE FINAL SECTION.
B1. IF OTHERS: When you answered these questions about living or staying someplace else, were you thinking about everyone in the household [SUCH AS PEOPLE ADDED AFTER THE INITIAL ROSTER] or just some people [SUCH AS PEOPLE INCLUDED IN INTIAL ROSTER]?
B2. IF OTHERS IN HHD: How confident are you in the answers you provided for the other people in the household?
B3. Are there any other places that you (or the other people you mentioned) stay that we did not ask about or that you were not sure counted?
B4. IF APPLICABLE AND HHD: How easy or difficult was it for you to type the addresses on the device?
B5. IF APPLICABLE: How sure or unsure are you that you provided the correct address(es)? IF UNSURE: If this were the real census, what would you do? [Would you look them up, call someone, make your best guess?]
B6. IF OTHERS IN HHD: How sure or unsure are you about where the other people in your household were staying on and around June 1, 2013?
B7. IF ANY RESPONSES TO THE CENSUS QUESTIONS ARE INCONSISTENT, UNEXPECTED, OR COMPLICATED, ASK: I need to make sure I understand where you / [NAME] would have been counted. Please describe in your own words you / [NAME]’s living situation and how much time you/he/she spends at each place you have told me about?
DO NOT READ: Example 1: If the R says that he was at their usual residence around June 1, but had told you previously that he was traveling then.
Example 2: If the R says that he/she sometimes stayed somewhere in Q3 & Q14, but then did not provide addresses to the follow-up questions.
Example 3 (Be Counted only): If R said in Q2 about experiencing homelessness in a shelter but did not report staying.
|
C. FINAL DEBRIEFING |
Thanks, we’re almost finished. I have a few more questions for you.
[SCROLL BACK TO THE “This is who we have listed at [address]” QUESTION SO THAT YOU CAN SEE THE NAMES PROVIDED OR ELSE REFER TO YOUR NOTES.]
C1. Was there anything in these questions that you found sensitive or uncomfortable to answer?
C2. Was there any information for yourself or others that you would be hesitant to provide on the census form?
C3. Aside from the things we’ve talked about, were there any questions or instructions that you find confusing or difficult to answer?
C4. Did you find parts of the interview repetitive? If so, what parts?
C5. If you were going to answer your census questionnaire on your own, without an interviewer, how would you prefer to do it: CHECK ALL THAT APPLY
Yes No On a smartphone? (What kind:____________________________________________)
Yes No On a tablet? (What kind:____________________________________________)
Yes No On a laptop or desktop?
Yes No On a paper form?
FOR EACH “Yes” ANSWER CHOSEN, ASK: Why?
C6. If you don’t answer the census on your own, an interviewer might be sent to your home to get your census information. How would you feel about the interviewer using….. CHECK ALL THAT APPLY.
a smartphone to do the interview?
a tablet, like an iPad?
a laptop computer?
a paper form?
Which do you prefer and why?
C7. Now, thinking of an interviewer using a smartphone, a tablet or a laptop computer, would it make a difference to you if the interviewer used her own device or a government-issued device?
IF R SHOWED CONCERN WITH PERSONAL DEVICE: The information people give will not be saved in the personal machines. Instead, they will be encrypted through a secure internet server and the machine is just used to get to the secure server. Would this explanation assure you? (IF NOT: What should the Census Bureau say to assure you that interviewers’ personal devices work the same as government-issued devices?
C8. Do you own or have access to…
____ A smartphone? (What kind:____________________________________________)
____ A tablet? (What kind:____________________________________________)
____ A laptop or desktop?
I have one more question about technology that might be used to improve the next Census. Please look at the following. HAND R THE PRINTOUT WITH THIS QUESTION: In order to count people in the right place, the Census Bureau must collect detailed geographic information about each person's place of residence. If you were at home completing your census on a smartphone or tablet, we could determine your location easily and accurately using GPS technology. Would you allow the Census Bureau to collect GPS coordinates on a one-time-only basis to determine where to count you in the census?
C9. Tell me why/why not? [IF NECESSARY: What additional information would you want to know?]
C10. What does geographic information mean to you in this question?
End Time:________
R3 HHD/NRFU Automated Protocol
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | egeisen |
| File Modified | 0000-00-00 |
| File Created | 2021-01-29 |