Various Demographic Area Pretesting Activities

ID Assigned:

Location:

Recruiter Initials:

Date:

Ad running in R’s area (if ad):

1. Tenuous (couch surfer)

2. No address

3. Homeless (street)

4. Vacation/2^nd home

5. Moved

6. Parents of college

7. Vacancy

8. Custody

9. Tenuous (homeowner)

10. College Dorm (GQ)

11. Homeless shelter (QG)

12. Other ad:___________

2020 Census Coverage Study Screener

Round 3 - Full Set of Questions

May 9, 2013

Narrative FAQ: Let me tell you a little bit about this study. The Census Bureau is conducting research to make the 2020 Census work better. They would like to understand more about how people answer Census questions as well as how well the census forms work and how to improve them. If you qualify for this study, we will pay you $40 to complete the interview. The interview needs to be face to face, but our interviewer can meet with you at a time and location convenient to you. The interview takes about 60 minutes. All your answers are confidential and protected by law. I have a few questions for you to make sure you qualify.

Bulleted FAQs:

• Purpose: The Census Bureau is conducting research to make the 2020 Census work better. They would like to understand more about how people respond to the census as well as how well the census forms work and how to improve them.

• Incentive: If you qualify for this study, we would like to pay you $40 to help us complete this research.

• RTI/RSS: RTI International is a nonprofit research organization (or RSS is a contract research firm). The Census Bureau contracted with us to conduct this research. We have assisted the Census Bureau with several research studies in the past.

• Interviews: An interviewer would conduct an interview with you. Because of the importance of this study, the interview needs to be face to face, but our interviewer can meet with you at a time and location convenient to you. The interview takes on average 60 minutes. The interviewer will use an interview guide designed by the Census Bureau and ask you some questions about how you respond to the census.

• HOUSEHOLD SELECTION: [Generally only used for those who were selected through purchased lists] Your household was selected because we have interviewers in this area.

• CONFIDENTIALITY: The study is protected by US Code Title 13. Anyone working at RTI (OR RSS), including the interviewer or me, will either go to jail or pay a fine up to $250,000 if we divulge any information about you.

• VERIFICATION: You can call the study’s project manager Dr. Murrey Olmsted at RTI. His number is (919) 485- 5586. I can also have researchers at the Census Bureau who designed this study contact you.

• [WHEN APPROPRIATE] INTERVIEWER: I’m not sure which interviewer will be calling you, the names of the interviewers in this area are [NAME], [NAME], [NAME], but my supervisor assigns the interviewer to the case.

[Note Concerns or Questions]

Initial qualifying info (ASK ALL):

1. What is your name?

2. Are you male or female?

1. Male

2. Female

2. And how did you hear about this study?

   1. CRAIGSLIST

   2. RTI CLASSIFIEDS/RTI EMPLOYEE

   3. FRIEND

   4. FLYER

   5. NEWSPAPER AD

   6. LETTER

   7. GQ Administrator/personnel

   8. Google Ad/Website

   9. OTHER, SPECIFY:

3. You said that you [saw] the ad on [way heard]; Can you tell me about your situation and why you thought you might qualify for the study? (Probe: Length of stay/household ownership/other relevant data?)

(response)______________________________________________________________________________________

1. R noted situation and QUALIFIES for reason heard

2. R noted situation but DOES NOT qualify for reason heard BUT QUALIFIES for another reason

3. R noted but does not qualify for any reason, although thinks s/he might

4. R was calling to participate without any situation

Eligible for incentive (ASK ALL):

4. Do you work for the United States federal government?

1. YES  Explain: Unfortunately you cannot be paid for your study participation but we would still like you to participate if you qualify. Also, other household members who do not work for the federal government might qualify and could be paid.

2. NO

Broad Household characteristics (ASK ALL)

5. Do you live in a house, an apartment or condo, or do you live in some other type of housing? [Instruction: If R responds with more than one circle ALL that apply; make note of any specific response. For other type of housing, be as detailed as possible. If type of housing isn’t clear, ask for name and address for lookup.]

1. ONE House/mobile home (Circle one) [Probe for detail/length if Q3=no address/tenuous/doubled]

2. ONE Apartment/condo (Circle one) [Probe for detail/length if Q3=no address/tenuous/doubled]

3. TWO homes – House/house

4. TWO homes house/condo

5. TWO homes Condo/condo

6. Homeless Shelter – TEMPORARY – (different bed every night)

7. Homeless Shelter – GQ/Semi-Permanent – (Same bed/several weeks/months)

8. Other GQ for Tenuous such as Rehab/Halfway House/etc _____________________

9. STREET/car/train/Non-residential/homeless

10. College Dorm/On Campus Housing (Probe: do you also stay/visit your home/parent’s home/how frequently/how close)

11. Multiple places – Couch surfer/multiple friend’s places

12. Other [Probe: Details on length of stay, type of place]___________________

[IF MORE THAN ONE PLACE IN Q5] For the next questions I’m going to ask you about who lives with you, if there are different people at your different homes, please let me know for all places and be sure to tell me which one.

6. How many people live in [your household/that facility]?

1. 1st. HOUSEHOLD:_____________

2. 2^nd HOUSEHOLD______________

7. [ASK FOR 5 a-e ONLY and IF MORE THAN 1 PERSON IN Q6] Just so I get a full picture of the household(s), could you tell me how they relate to you? For example spouse, sibling, friend… PROBE: Anyone else, even someone you don’t consider part of your family? [For b, c, d Probe for ownership/tenancy] Check ONLY ONE based on response:

1. Nuclear family permanent only (mom/dad/their kids only)

2. Extended family

3. Includes both extended family AND Non-family (e.g., housemates/roommates, renters, boarders) Specify:______________________________________________________

4. Non-family only

5. Other--Specify: _____________________________________________

8. [ASK FOR 5a-e ONLY] Is there anyone else who stays at this home sometimes, such as children with shared custody, family or friends who come for an extended visit, or a friend who crashes on the couch or stays part time? [probe: for length of time and WHEN visit occurred]

1. YES, Child custody

2. YES, Other – Including June 1, 2013 (probe if necessary)

3. YES, Other – Not including June 1, 2013

4. NO

9. [Ask for 5f-l ONLY]: You said you lived in [5f-l] do you have any family members who live with you at [5f-l]?

1. YES [Probe for detail]____________________________________________

2. NO

[Selection of the following questions will be asked based on advertising for that week in that region and the need to fill certain cells – these will change weekly or even daily depending on the needs of the project to fill certain targets – order will remain the same]

[RECRUITER CHECK: If screener is being used on identified homeless or tenuously attached or GQ Go to Q15 PO Box, otherwise continue to Q10.]

10. Is there anyone else who is away right now or is sometimes away part of the year but you consider part of the household? Like someone who’s on active duty in the military or in college or boarding school or away for work or in jail or prison or anything like that?

1. Yes- College students living away

2. Yes - Military deployment

3. Yes - Maintains other residence to be closer to work

4. Yes - Jail or prison

5. Yes -Other eligible situation (describe):

6. Yes - Other non-eligible situation (describe):__________

7. No

11. And what about you, is there any other place you stay part of the time? [PROBE: Like do you have or rent a vacation or second home /or do you stay any length of time anywhere else during the year?]

1. Vacation or second home--Specify (Distance/length of stay): ____________________________

2. Highly mobile (e.g., moves around a lot, bounces from place to place, constantly crashing with friends)—Specify lengths of stay: _________________________________

3. Maintains a residence closer to work: Specify Distance/length of stay_____________________

4. Other--Specify Distance/Location/Purpose/Length of Stay: _____________________

5. No/none

12. Has anyone in the household moved recently? [PROBE: For example, within the last few months? / IF YES PROBE FOR WHO AND WHEN]

1. YES full household move May 1^st to May 30th^th

2. YES partial household move May 1^st to May 30th^th

3. Yes FULL household move June 1 and after

4. Yes  Partial household move June 1 and after

5. No

13. [Ask Only If Q5 = House or Other Specify is relevant] Is there anyone else living on the same property that’s not part of your household? Like in a separate apartment or an in-law apartment or renters or boarders, anyone like that?

1. Yes [PROBE for specifics, including length of stay]

2. No

14. Do you have any exchange students or international visitors or family staying with you? [PROBE for specifics, including length of stay]

1. Yes Present June 1st

2. Yes Current but not present June 1st

3. Yes – Prior to June 1st

4. No

15. Do you get your mail through a mail slot or mailbox, at a PO Box, given to you by someone else who has to pass it on or somewhere else?

1. Home- through mail slot / Mail Box

2. PO Box Only  PROBE: Why do you use a PO BOX rather than where you live?

3. Someone else has to pass it on [PROBE if necessary for specifics]

4. Somewhere else only – [PROBE for specifics]

Demographic and Scheduling Information (ASK ALL):

I have just a few questions about you and then I’ll collect your contact information so if you qualify for the study we can reach to set up an interview

16. What is your age? ___________________

    1. Under 35

    2. 35 and older

17. Are you of Hispanic or Latino origin?

1. Yes

2. No

18. What is your race or races?

1. American Indian or Alaska Native

2. Asian

3. Black/African American

4. Native Hawaiian or other Pacific Islander

5. White

19. What is your highest level of education completed

1. Some high school

2. High school / GED

3. Some college

4. Associates Degree

5. Bachelor’s Degree

6. Post bachelor’s degree (Masters/PhD/MD/Other Professional)

20. Do you live in an urban (city), suburban, or rural area?

1. Urban (city)

2. Suburban

3. Rural area

21. In general how comfortable are you using touch screen tablets, such as an iPad or a Galaxy?

    1. Very Comfortable

    2. Somewhat Comfortable

    3. Not at All Comfortable

22. In general how comfortable are you using a ‘Smart’ Cell phone, like the kind that you can use to download applications or check the internet or email?

    1. Very Comfortable

    2. Somewhat Comfortable

    3. Not at All Comfortable—SKIP TO 24

23. When you say you are [VERY/SOMEWHAT] comfortable, are you thinking of an iPhone, Android or Blackberry smart phone or some other kind?

    1. iPhone

    2. Android

    3. Blackberry/something else

24. What is the best phone number for me to contact you at if you qualify for the study?

Phone: ____________________________ Is there another number as well? ____________________________

25. If you are scheduled for an interview, do you want me to send you a reminder by email, if so I’ll need your email address: ___________________________________________________

26. In case you qualify for the study, I want to pass on to the interviewer some information about your general location. In what neighborhood or town do you live in? [Probe if necessary for subdivision/cross-streets/local library, if you do not know the area get cross streets (i.e. in DC/SD)]

Location: ___________________________________________________________________________________

___________________________________________________________________________________________

27. Are there any days and times of the week you are unavailable, and any days that are best for you? [Record Days and times that are good for the person.]

DAYS: MON TUE WED THU FRI SAT SUN

TIMES: MORNING AFTERNOON EVENING ALL DAY

OR SPECIFY: __________________________________________________

Thank you for your information. I’m going to pass it on to my supervisor [this evening/Monday/etc.] who will let me know if you qualify for the study. If you do [I will call you back and let you know/an interviewer will also call you to set up an interview].

Screener 2020 Coverage Study (May 9, 2013) OMB Control Number: 0607-0725; Expiration: August 31, 2013 11