SNMCS Individuals

N3. CHILD-YOUTH INTERVIEW (IN-PERSON INTERVIEW)

This page has been left blank for double-sided copying.

ID#: | | | | | | | | |

SFA:

City and State:

OMB Clearance Number: 0584-xxxx

Expiration Date: xx/xx/xxxx

Child/Youth Interview

Questionnaire

January 29, 2013

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 10 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.

SCHOOL ID: | | | | | | | | |

DATE OF INTERVIEW: | | | / | | | / 2015

Month Day Year

CHILD ID #: | | | | | | | | |

* NOTE: CHILD ID# INDICATES IF RESPONDENT IS A CHILD (6-11) OR A YOUTH (12-18).

CHILD’S NAME:

DAY OF WEEK:

Monday 1

Tuesday 2

Wednesday 3

Thursday 4

Friday 5

Saturday 6

DATE OF BIRTH: | | | /| | | / | | | | |

Month Day Year

GRADE: | | |

GENDER:

MALE 1

FEMALE 2

SCHOOL BREAKFAST SERVED?

YES 1

NO 0

COMPLETE AM/PM FIRST.

Now I’m going to ask you some questions about what you eat and about what you like and dislike about the meals served at school.

1. Let me start by asking what grade you are in?

| | | RECORD GRADE

(NUMBER RANGE)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF CONDITION (e.g. GT 20); Soft check statement/question

HARD CHECK: IF CONDITION (e.g. LT 5); Hard check statement/question

ASK Q.2a IF IN GRADES 1-3; ASK Q.2b IF IN GRADES 4 AND OLDER

2a. Thinking back to the last full week of school, how often did you eat breakfast? That is breakfast anywhere, at home or at school or somewhere else. Would you say you ate breakfast every day, most days, some days, or never?

EVERY DAY 1

MOST DAYS 2

SOME DAYS 3

NEVER 4 GO TO Q.12

DON’T KNOW d

REFUSED r

2b. Thinking back to the last full week of school, how often did you eat breakfast? That is breakfast anywhere, at home or at school or somewhere else. Would you say you ate breakfast every school day, ate breakfast on 3 or 4 school days, ate breakfast on 1 or 2 school days, or did not eat breakfast on any school days?

EVERY SCHOOL DAY 1

3 TO 4 SCHOOL DAYS 2

1 TO 2 SCHOOL DAYS 3

NO SCHOOL DAYS 0

DON’T KNOW d

REFUSED r

PROGRAMMER BOX 2b

GO TO Q.12 IF SCHOOL DOES NOT SERVE BREAKFAST

3. Did you eat the regular school breakfast (today/yesterday)?

YES 1 GO TO Q.6

NO 0

DON’T KNOW d

REFUSED r

4. Do you ever eat a school breakfast? By school breakfast we mean a complete breakfast provided by your school, not something from home.

YES 1 GO TO Q.6

NO 0

DON’T KNOW d GO TO Q.7

REFUSED r

5. Why don’t you eat the school breakfast?

PROBE FOR ADDITIONAL REASONS BY ASKING: “Any other reason?

CODE UP TO 3 REASONS

EAT BREAKFAST AT HOME 1

LONG LINES, NOT ENOUGH TIME 2

FOODS OFFERED ARE NOT APPEALING/NOT TASTY 3

MONETARY REASONS 4

TRANSPORTATION ISSUE 5

NOT CONVENIENT 6

NOT NUTRITIOUS ENOUGH 7

BUSY WITH SCHOOL ACTIVITIES 8

OTHER (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): Insert Other specify statement/question

PROGRAMMER BOX 5

GO TO Q.12

6. What is the number one reason you eat school breakfasts?

EASY/CONVENIENT TO GET 1

FOOD IS GOOD 2 GO TO Q.8

I AM HUNGRY 3

PARENTS MAKE ME 4

NO OTHER CHOICE 5

FRIENDS EAT THERE 6

PRICES ARE GOOD 7

OTHER (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): Insert Other specify statement/question

7. What do you think about school breakfast? Do you like it, think it is only okay, or don’t like it?

INTERVIEWER: SHOW HAND CARDS WITH SMILEY FACES FOR CHILDREN IN GRADE 1-3 WHILE READING ANSWER CATEGORIES.

LIKE IT 1

O

SHOW CARD #1

NLY OKAY 2

DON’T LIKE IT 3

DON’T KNOW d

REFUSED r

8. Is there enough time to eat the school breakfast before classes begin?

YES 1

NO 0

DON’T KNOW d

REFUSED r

9. Do you think school breakfast is served too early in the day, too late, or is the time it is served okay?

TOO EARLY 1

TOO LATE 2

OKAY 3

DON’T KNOW d

REFUSED r

ASK IF IN GRADES 1-3

10a. Do you usually eat a school breakfast three or more times a week?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ASK IF IN GRADES 4 AND OLDER

10b. How many days a week do you usually eat a school breakfast?

NONE-DON’T USUALLY EAT SCHOOL BREAKFAST 0

ONE 1

TWO 2

THREE 3

FOUR 4

FIVE 5

DON’T KNOW d

REFUSED r

11. Where do you usually eat school breakfast?

CAFETERIA 1

CLASSROOM 2 GO TO Q.13

GYMNASIUM 3

OUTDOORS 4

OTHER (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): Insert Other specify statement/question

ASK IF Q.10a = NO (CHILD) OR 10b = 0, 1, 2, 3 (YOUTH), OTHERWISE GO TO Q.13.

12. Would you eat breakfast at school (more often) if it was served in your classroom?

YES 1

NO 0

NO, ALREADY SERVED IN CLASSROOM 2

ALREADY EAT BREAKFAST EVERY DAY 3

DON’T KNOW d

REFUSED r

13. Now I’d like to ask you about lunch. What time is your lunch period?

INTERVIEWER: IF RESPONDENT SAYS IT VARIES BY DAY, ASK FOR TODAY/YESTERDAY.

| | | : | | |

HOUR MINUTES

(RANGE) (RANGE)

AM 1

PM 2

DON’T KNOW d

REFUSED r

SOFT CHECK: IF CONDITION (e.g. GT 20); Soft check statement/question

HARD CHECK: IF CONDITION (e.g. LT 5); Hard check statement/question

14. Did you eat the regular school lunch (today/yesterday)? By regular school lunch, I mean a complete meal—such as salad, soup, a sandwich, or a hot meal—not just milk, snacks, cookies, or ice cream, and not a lunch you brought from home.

YES 1

NO 0 GO TO 14.b

DON’T KNOW d GO TO 15

REFUSED r GO TO 15

14a. Did you buy any other foods in school to go along with your regular school lunch, such as a drink, French fries, pizza, fruit, ice cream or cookies?

YES 1

NO 0

DON’T KNOW d

REFUSED r

PROGRAMMER BOX 14A

GO TO Q.17

14b. Did you stay at school for lunch, go home, go off the school grounds, or did you do something else for lunch?

SCHOOL 1

HOME 2

OFF SCHOOL GROUNDS 3

OTHER (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): Insert Other specify statement/question

15. Do you ever eat the regular school lunch?

YES 1 GO TO Q.17

NO 0

DON’T KNOW d GO TO Q.19

REFUSED r GO TO Q.19

16. Why don’t you eat the school lunch?

PROBE FOR ADDITIONAL REASONS BY ASKING “Any other reason?”

CODE UP TO 3 REASONS

BRING LUNCH FROM HOME 1

DON’T LIKE SCHOOL LUNCH/TASTE IN GENERAL 2

MONETARY REASONS 3

EAT LUNCH OFF CAMPUS 4

NOT HUNGRY, DON’T FEEL LIKE EATING 5

NO TIME, LONG LINES 6

WANT A LA CARTE ITEM 7

NOT ENOUGH VARIETY, TIRED OF WHAT’S OFFERED 8

BUSY WITH SCHOOL ACTIVITIES 9

PARENT PROHIBITS/LIMITS HOW OFTEN EAT SCHOOL LUNCH 10

NOT NUTRITIOUS 11

LEAVE SCHOOL BEFORE LUNCH IS SERVED 12

SPECIAL DIET (VEGETARIAN RELIGIOUS RESTRICTIONS, WEIGHT LOSS) 13

DON’T EAT ANY LUNCH 14 GO TO Q.41

PORTIONS NOT BIG ENOUGH/NOT ENOUGH FOOD 15

OTHER (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): Insert Other specify statement/question

PROGRAMMER BOX 16

GO TO Q20.

17. What is the number one reason you eat the school lunch?

INTERVIEWER: IF MORE THAN ONE REASON, PROBE FOR MAIN REASON.

HUNGRY 1

LIKE THE FOOD (GENERAL) 2

LIKE TODAY’S/YESTERDAY’S MEAL 3

EASY/CONVENIENT TO GET 4

PARENTS WANT ME TO/NO OTHER CHOICE 5

NO ONE AT HOME TO MAKE LUNCH 6

NO TIME TO MAKE LUNCH 7

IT’S FREE/PRICES ARE GOOD 8

OTHER (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): Insert Other specify statement/question

ASK IF IN GRADES 1-3

18a. Do you usually eat a regular school lunch three or more times a week?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ASK IF IN GRADES 4 AND OLDER

18b. How many days a week do you usually eat a regular school lunch?

NONE-DON’T USUALLY EAT SCHOOL LUNCH 0

ONE 1

TWO 2

THREE 3

FOUR 4

FIVE 5

DON’T KNOW d

REFUSED r

19. What do you think about school lunch? Do you like it, think it is only okay, or don’t like it?

INTERVIEWER: SHOW HAND CARDS WITH SMILEY FACES FOR CHILDREN IN GRADE 1-3 WHILE READING ANSWER CATEGORIES.

LIKE IT 1

O

SHOW

CARD

#1

NLY OKAY 2

DON’T LIKE IT 3

DON’T KNOW d

REFUSED r

20. Are you required to take certain foods or put certain foods on your tray such as milk, when you get the regular school lunch or can you turn down foods you don’t want?

REQUIRED TO TAKE CERTAIN FOODS 1

CAN TURN DOWN FOODS 2

DON’T KNOW d

REFUSED r

21. Do you think your lunch period is too early in the day, too late, or is your lunch period time about right?

TOO EARLY 1

TOO LATE 2

ABOUT RIGHT 3

DON’T KNOW d

REFUSED r

I want to ask you some questions about the place where you eat your lunch, like the cafeteria, (gym, classroom) or wherever you eat your lunch.

22. Would you say the place you eat your lunch is usually too noisy, too quiet, or about right?

TOO NOISY 1

TOO QUIET 2

ABOUT RIGHT 3

DON’T KNOW d

REFUSED r

23. Would you say the tables are always, usually sometimes, or never clean?

ALWAYS 1

USUALLY 2

SOMETIMES 3

NEVER 4

DON’T KNOW d

REFUSED r

24. Would you say the floor is always, usually, sometimes, or never clean?

ALWAYS 1

USUALLY 2

SOMETIMES 3

NEVER 4

DON’T KNOW d

REFUSED r

25. Would you say there are usually plenty of seats and tables, or not enough seats and tables?

USUALLY PLENTY 1

NOT ENOUGH 2

DON’T KNOW d

REFUSED r

26. Would you say most of the time there are long lines, short lines, no lines, or it depends on what is served?

LONG 1

SHORT 2

NO LINES 3

DEPENDS ON WHAT IS SERVED 4

DON’T KNOW d

REFUSED r

ASK ONLY IF EVER ATE SCHOOL LUNCH (Q.14 = YES OR Q.15 = YES). ALL OTHERS GO TO Q.28.

27. Do you have enough time to eat your lunch after you have your food and you are seated?

YES 1

NO 0

SOMETIMES 2

DON’T KNOW d

REFUSED r

28. Do the food servers and cashiers always, often, sometimes, or never listen to you and other students?

ALWAYS 1

USUALLY 2

SOMETIMES 3

NEVER 4

DON’T KNOW d

REFUSED r

29. Do the food servers and cashiers always, often, sometimes, or never smile and say hello to you when you're getting school breakfast or lunch?

ALWAYS 1

USUALLY 2

SOMETIMES 3

NEVER 4

DON’T KNOW d

REFUSED r

30. Do you get to pick where you sit and who you can eat with during your lunch period?

YES 1

NO 0

DON’T KNOW d

REFUSED r

31. Now I’d like to ask you about the food served at lunch by the school.

INTERVIEWER: SHOW HAND CARD WITH PICTURES OF ADVERBS OF FREQUENCY TO CHILDREN IN GRADES 1-3 WHILE READING ANSWER CATEGORIES.

SHOW CARD #2

	ALWAYS	OFTEN	SOMETIMES	NEVER	DON’T KNOW	REFUSED
a. Do you always, often, sometimes, or never like the taste of the food?	1	2	3	4	d	r
b. Do you always, often, sometimes, or never like the smell of the food?	1	2	3	4	d	r
c. Do you always, often, sometimes, or never like the way the food looks?	1	2	3	4	d	r
d. Not counting French fries, do the vegetables on the serving line always, often, sometimes, or never look good?	1	2	3	4	d	r
e. Not counting French fries, do you always, often, sometimes, or never like the vegetables on the serving line?	1	2	3	4	d	r
f. Do the fruits on the serving line always, often, sometimes, or never look good?	1	2	3	4	d	r
g. Do you always, often, sometimes, or never like the fruits on the serving line?	1	2	3	4	d	r
h. Does the serving line always, often, sometimes, or never have the kind of milk you like?	1	2	3	4	d	r

32. READ IF IN GRADES 1-3: Whole grain foods are darker in color. Examples are brown bread or brown pizza crust instead of white bread or crust, brown rice instead of white rice, and brown spaghetti instead of white spaghetti.

READ IF IN GRADES 4 and ABOVE: Examples of whole grains are whole wheat bread, pizza crust, or tortillas, whole grain pasta, and brown rice.

Do you always, often, sometimes, or never like the whole grain foods in the serving line?

SHOW CARD #2

INTERVIEWER: SHOW HAND CARD WITH PICTURES OF ADVERBS OF FREQUENCY TO CHILDREN IN GRADES 1-3 WHILE READING ANSWER CATEGORIES.

ALWAYS 1

OFTEN 2

SOMETIMES 3

NEVER 4

DON’T KNOW d

REFUSED r

33. Do you think the amount of food they give you is too much, too little, or about right?

TOO MUCH 1

TOO LITTLE 2

ABOUT RIGHT 3

DON’T KNOW d

REFUSED r

33a. Do you think that the food served, is too salty, not salty enough, or about right?

SHOW CARD #2

TOO SALTY 1

NOT SALTY ENOUGH 2

ABOUT RIGHT 3

DON’T KNOW d

REFUSED r

34. Does the school menu always, often, sometimes, or never include foods you like?

INTERVIEWER: SHOW HAND CARD WITH PICTURES OF ADVERBS OF FREQUENCY TO CHILDREN IN GRADES 1-3 WHILE READING ANSWER CATEGORIES.

ALWAYS 1

OFTEN 2

SOMETIMES 3

NEVER 4

DON’T KNOW d

REFUSED r

35. Does the school lunch always, often, sometimes, or never have enough choices of food?

INTERVIEWER: SHOW HAND CARD WITH PICTURES OF EACH ADVERB OF FREQUENCY TO CHILDREN IN GRADES 1-3 WHILE READING ANSWER CATEGORIES.

A

SHOW CARD #2

LWAYS 1

OFTEN 2

SOMETIMES 3

NEVER 4

DON’T KNOW d

REFUSED r

ASK ONLY IF EVER ATE SCHOOL LUNCH (Q.14 = YES OR Q.15 = YES). ALL OTHERS GO TO Q.38.

36. What is your favorite school lunch?

IF NEEDED, PROBE: The main course.

(STRING (NUM))

DESCRIPTION

NO FAVORITE FOOD 0

DON’T KNOW d

REFUSED r

ASK ONLY IF EVER ATE SCHOOL LUNCH (Q.14 = YES OR Q.15 = YES). ALL OTHERS GO TO Q.38.

37. What is your least favorite school lunch?

IF NEEDED, PROBE: The main course.

(STRING (NUM))

DESCRIPTION

LIKE ALL THE FOODS, NO LEAST FAVORITE FOOD 0

DON’T KNOW d

REFUSED r

38. Do all kids that get the regular school lunch pay the same amount for the lunch, or do some kids pay less or get it for free?

ALL PAY THE SAME AMOUNT 1

EVERYONE GETS IT FOR FREE 2

SOME PAY LESS/ SOME GET IT FREE 3 GO TO Q.39

DON’T KNOW d

REFUSED r

PROGRAMMER SKIP BOX 38.

IF Q.38 is 1, 2, d, or r, YOUTH GO TO Q.41; YOUNGER CHILDREN END, GO TO CLOSING

39. Can you tell who is getting the regular school lunches for free or less than the full price?

YES 1

NO 0

DON’T KNOW d

REFUSED r

PROGRAMMER SKIP BOX 39.

IF Q.39 is 0, d, or r, YOUTH GO TO Q.41; YOUNGER CHILDREN END, GO TO CLOSING

40. How do you know?

AMOUNT PAID TO CASHIER 1

FORM OF PAYMENT (TICKET, TOKEN, ETC.) 2

PERSONAL KNOWLEDGE 3

CASHIER CHECKS LIST OR SAYS SOMETHING TO STUDENT 4

SEPARATE LINE 5

APPEARANCE OR BEHAVIOR 6

CAN SEE ON REGISTER/SCREEN 7

OTHER (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): Insert Other specify statement/question

PROGRAMMER SKIP BOX 40.

END OF INTERVIEW FOR YOUNGER CHILDREN. GO TO CLOSING.

YOUTH CONTINUE TO Q.41

41. How many nights a week do you and your family typically sit down together to have dinner as a family?

EVERY NIGHT 1

5 OR 6 NIGHTS A WEEK 2

3 OR 4 NIGHTS A WEEK 3

1 OR 2 NIGHTS A WEEK 4

NEVER 5

DON’T KNOW d

REFUSED r

42. During the past 30 days, did you eat less food, fewer calories, or foods low in fat or carbohydrates to lose weight or to keep from gaining weight?

YES 1

NO 0

DON’T KNOW d

REFUSED r

43. How often do you take any vitamins in pill or liquid form such as multi-vitamins or Vitamin C? Would you say every day or almost every day, every so often, or not at all?

EVERY DAY/ALMOST EVERY DAY 1

EVERY SO OFTEN 2

NOT AT ALL 3

DON’T KNOW d

REFUSED r

44. (Other than multi-vitamins with minerals) How often do you take (additional) minerals such as calcium or zinc? Would you say every day or almost every day, every so often, or not at all?

EVERY DAY/ALMOST EVERY DAY 1

EVERY SO OFTEN 2

NOT AT ALL 3

DON’T KNOW d

REFUSED r

45. How often do you take any herbal products or sports supplements like Echinacea or alfalfa extract? Would you say every day or almost every day, every so often, or not at all?

EVERY DAY/ALMOST EVERY DAY 1

EVERY SO OFTEN 2

NOT AT ALL 3

DON’T KNOW d

REFUSED r

46. In a typical week when you are in school, on how many days do you go to physical education classes?

0 DAYS 0

1 DAY 1

2 DAYS 2

3 DAYS 3

4 DAYS 4

5 DAYS 5

DON’T KNOW d

REFUSED r

47. During the past 12 months, on how many sports teams did you play? Count any teams run by your school or community groups, such as soccer, tennis, golf, cheerleading, or dance.

0 TEAMS 0

1 TEAM 1

2 TEAMS 2

3 OR MORE TEAMS 3

DON’T KNOW d

REFUSED r

48. On an average school day, about how many hours do you spend watching TV or DVDs?

INTERVIEWER: IF RANGE GIVEN, TAKE THE MID POINT. ROUND TO NEAREST HALF HOUR.

| | | . | | HOURS

(NUMBER RANGE)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF CONDITION (e.g. GT 20); Soft check statement/question

HARD CHECK: IF CONDITION (e.g. LT 5); Hard check statement/question

49. And on an average school day, about how many hours do you use a computer, go online, or play video or computer games for something that is not school work?

PROBE: Count time spent on things such as Xbox, PlayStation, an iPod, an iPad or other tablet, a smartphone, YouTube, Facebook or other social networking tools, and the Internet.

INTERVIEWER: IF RANGE GIVEN, TAKE THE MID POINT. ROUND TO NEAREST HALF HOUR.

| | | . | | HOURS

(NUMBER RANGE)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF CONDITION (e.g. GT 20); Soft check statement/question

HARD CHECK: IF CONDITION (e.g. LT 5); Hard check statement/question

50. Compared to other (boys/girls) the same age, would you say you are less active, about as active, more active, or much more active?

LESS ACTIVE 1

ABOUT AS ACTIVE 2

MORE ACTIVE 3

MUCH MORE ACTIVE 4

DON’T KNOW d

REFUSED r

51. During the past 7 days, on how many days were you physically active for a total of at least 60 minutes per day? Add up all the time you spent in any kind of physical activity that increased your heart rate and made you breathe hard some of the time. Examples of these activities are competitive sports, running, biking, brisk walking, swimming laps, dancing or pushing a lawn mower.

0 days 0

1 day 1

2 days 2

3 days 3

4 days 4

5 days 5

6 days 6

7 days 7

DON’T KNOW d

REFUSED r

52. During the past month, on how many days did you smoke cigarettes?

PROBE: Your best estimate is fine.

| | | DAYS

(NUMBER RANGE)

NEVER 0

DON’T KNOW d

REFUSED r

SOFT CHECK: IF CONDITION (e.g. GT 20); Soft check statement/question

HARD CHECK: IF CONDITION (e.g. LT 5); Hard check statement/question

53. And finally, we would like to follow-up with your parent or guardian in order to better understand their feelings about the meals served at this school. In order to do this, I will need you to give me some contact information.

First, which adult tends to prepare most of the meals in your home?

INTERVIEWER: READ LIST ONLY IF NECESSARY.

MOTHER/FATHER/PARENT 01

PARENT’S SPOUSE OR PARTNER 02

GRANDPARENT 03

OTHER RELATIVE 04

LEGAL GUARDIAN 05

OTHER (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d GO TO 58

REFUSED r GO TO 58

IF OTHER SPECIFY (99): Insert Other specify statement/question

53a. And, what is (HIS/HER)’s first name?

(STRING (NUM))

FIRST NAME

DON’T KNOW d

REFUSED r

53b. And, what is (HIS/HER)’s last name?

(STRING (NUM))

LAST NAME

DON’T KNOW d

REFUSED r

54a. What is [HIS/HER]’s home phone number?

| | | | - | | | | - | | | | |

(RANGE) (RANGE) (RANGE)

DOESN’T HAVE HOME PHONE NUMBER n

DON’T KNOW d

REFUSED r

54b. And, what is your [HIS/HER]’s cellular phone number?

| | | | - | | | | - | | | | |

(RANGE) (RANGE) (RANGE)

DOESN’T HAVE CELLULAR PHONE NUMBER n

DON’T KNOW d

REFUSED r

54c. And, what is [HIS/HER]’s work phone number?

| | | | - | | | | - | | | | |

(RANGE) (RANGE) (RANGE)

DOESN’T HAVE WORK PHONE NUMBER n

DON’T KNOW d

REFUSED r

SOFT CHECK: IF CONDITION (e.g. Exchange = 555); Soft check statement/question

HARD CHECK: IF CONDITION (e.g. Area code LE 200); Hard check statement/question

PROGRAMMER BOX 54c.

If no PHONE numberS provided (54a, 54b, and 54c are all blank) GO TO Q.58.

55. What is the best time to reach [HIM/HER]?

| | | : | | |

(RANGE) (RANGE)

AM 1

PM 2

DON’T KNOW d

REFUSED r

SOFT CHECK: IF CONDITION (e.g. GT 20); Soft check statement/question

HARD CHECK: IF CONDITION (e.g. LT 5); Hard check statement/question

56. If we are unable to reach [HIM/HER] then, what is the next best time to reach [HIM/HER]?

| | | : | | |

(RANGE) (RANGE)

AM 1

PM 2

DON’T KNOW d

REFUSED r

SOFT CHECK: IF CONDITION (e.g. GT 20); Soft check statement/question

HARD CHECK: IF CONDITION (e.g. LT 5); Hard check statement/question

57. Finally, which of the phone numbers that you gave me should I use to reach your [HIM/HER] when I call?

| | | | - | | | | - | | | | |

(RANGE) (RANGE) (RANGE)

DON’T KNOW d

REFUSED r

58. Those are all the questions I have today. You’ve done great. Thanks for all your help.

PROGRAMMER BOX 58.

THANK CHILD AND GIVE GIFT.

ASK IF THEY NEED A PASS TO GET BACK INTO CLASS.