Demographics
This first set of questions is about you and your household.
IQ1. In what month and year were you born?
IQ2. What is your current age?
|__|__|
IQ2a. (IF DK or REFUSED to IQ2) Are you… (CATI READ CATEGORIES 1-8)
1. Under 18 years old
2. 18 to 24 years old
3. 25 to 29 years old
4. 30 to 39 years old
5. 40 to 49 years old
6. 50 to 59 years old
7. 60 to 64 years old
8. 65 years old or above
(IF GEN POP ACASI, AND AGE<18 or >49 OR IF HIGH RISK AND AGE<18 OR >39 OR IF SERVICE PROVIDER OR CATI AND AGE<18, INTERVIEWER READ: Thank you for your time today. We are conducting this study with women ages (18 to 39/18 to 49/18 and older). You are not eligible for participation in the study.
IQ3. What is your current marital status? Are you …. (CATI READ CATEGORIES 1-5)
1 Now married –SKIP to IQ6
2 Widowed
3 Divorced
4 Separated
5 Never married
IQ4. Are you currently living in this household with a girlfriend, boyfriend or romantic partner?
1 Yes – SKIP TO IQ6
2 No
IQ5. In the last year, have you been involved in a romantic relationship?
1 Yes
2 No
IQ6. What is the highest level of school you have completed or the highest degree you have received? (DO NOT READ CATEGORIES)
1 Never attended
2 Elementary (grades 1 – 8)
3 High school (grades 9 – 11)
4 12th grade (No diploma)
5 High school graduate or GED (Diploma or equivalent)
6 Some college, trade or vocational school (No Degree)
7 Associate’s degree or trade/vocational school diploma
8 Bachelor’s degree (e.g., BA, AB, BS)
9 Master’s degree (e.g., MA, MS, MEng, MSW, MBA)
10 Professional school degree (e.g., MD, DDS, DVM, LLB, JD)
11 Doctorate degree (e.g., PhD, EdD)
IQ7. Are you currently attending or enrolled in a regular school such as elementary or high school or enrolled either full-time or part-time in college or university, trade, or vocational school?
1 Elementary or high school – GO TO IQ9
2 College/University/Graduate school – GO TO IQ8
3 Trade School– GO TO IQ9
5 Vocational school– GO TO IQ9
6 None of the above schools– GO TO IQ9
IQ8. (IF ATTENDING COLLEGE OR UNIVERSITY) Are you currently a member of a sorority?
1 Yes
2 No
IQ9. Are you currently, or have you ever served on active duty in the military?
Yes currently
Yes, in the past
No, never
IQ9a. Did you have a job or work at a business LAST WEEK? (Do not include volunteer work or work around the house.)
1 Yes
2 No
IQ10. Are you Hispanic, Latina, or of Spanish origin?
1 YES – GO TO IQ11
2 NO – GO TO IQ12
IQ11. What is your origin? Please choose all that apply. (CATI READ CATEGORIES 1-4)
1 Mexican, Mexican American, Chicano or Chicana
2 Puerto Rican
3 Cuban
4 Another Hispanic, Latina, or Spanish origin
IQ12. What is your race? Please choose all that apply. (CATI READ CATEGORIES 1-5)
1 White
2 Black or African American
3 American Indian or Alaska Native
4 Asian
5 Native Hawaiian or Other Pacific Islander
IQ13. The next questions are about your USUAL activities. We have found that people’s lifestyles may be related to their overall safety. On average, during the last 12 months, how often have you gone shopping? For example at drug, clothing, grocery, hardware and convenience stores? (CATI READ CATEGORIES 1-5)
1 Almost every day (or more frequently)
2 At least once a week
3 At least once a month
4 Less often
5 Never
IQ14. On average, during the last 12 months, how often have you spent the evening out away from home - for work, school or entertainment? (CATI READ CATEGORIES 1-5)
1 Almost every day (or more frequently)
2 At least once a week
3 At least once a month
4 Less than once a month
5 Never
IQ15. On average, during the last 12 months, how often did you use public transportation? (CATI READ CATEGORIES 1-5)
1 Almost every day (or more frequently)
2 At least once a week
3 At least once a month
4 Less often
5 Never
CATI ONLY: (IF SPEAKING TO RESPONDENT ON LANDLINE, CONTINUE. ELSE SKIP TO NOTE BEFORE IQ17)
IQ16. I won't ask you for the number, but do you have a working cell phone?
Yes - CONTINUE
No – SKIP TO IQ20
(ACASI ONLY)
IQ16a. What is the area code of that cell phone?
____________ - SKIP TO IQ20
CATI ONLY:
(IF SPEAKING TO RESPONDENT ON CELL PHONE, CONTINUE. ELSE SKIP TO PROGRAMMER NOTE BEFORE IQ19)
IQ17. Is there a regular or landline telephone in your household?
Yes
No
IQ18. Is that telephone for personal use or business use only?
Personal use only
Business use only
Both personal and business use
IF LANDLINE RESPONDENT HAS CELL PHONE OR CELL PHONE RESPONDENT HAS LANDLINE IS FOR PERSONAL USE OR LANDLINE IS FOR BOTH PERSONAL AND BUSINESS USE , CONTINUE;
ELSE SKIP TO IQ20.
IQ19. Of all the telephone calls that you receive, are …(CATI READ CATEGORIES 1-3)
1 All or almost all calls received on cell phones
2 Some received on cell phones and some on regular phones, or
3 Very few or none on cell phones
IQ20. Is this home….(CATI READ CATEGORIES 1-3)
1 Owned by you or someone in this household free and clear?
2 Rented?
3 Occupied without payment of rent?
IQ21. How long have you lived at this address?
_________ years (enter 0 if less than 1 year)
if IQ21 is DK or refused go to IQ22. Else Go to IQ23
IQ22. Have you lived here….(CATI READ CATEGORIES 1-4)
1 Less than 6 months
2 6 months to less than a year
3 One year to less than 5 years
4 5 years or more
IQ23. What was the total income from ALL household members during 2013, before taxes. Include income from all sources such as work, investments, child support and public assistance. Was it ..
IQ23a Less than $25,000?
Yes
No Skip to IQ23e
IQ23b Less than $20,000?
Yes
No Skip to SV Screener
IQ23c Less than $15,000?
Yes
No Skip to SV Screener
IQ23d Less than $10,000?
Yes Skip to SV Screener
No Skip to SV Screener
IQ23e Less than $35,000?
Yes Skip to SV Screener
No Skip to IQ23f
IQ23f Less than $50,000?
Yes Skip to SV Screener
No Skip to IQ23g
IQ23g Less than $75,000?
Yes Skip to SV Screener
No Skip to IQ23h
IQ23h $75,000 or more?
Yes Skip to SV Screener
No Skip to SV Screener
98 (VOL) DK
99 (VOL) RF
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Aaron Maitland |
File Modified | 0000-00-00 |
File Created | 2021-01-28 |