OMB #XXXXXX Exp Date:XXXXXXX
INSTITUTE OF MUSEUM AND LIBRARY SERVICES (IMLS)
QUESTIONNAIRE:
PUBLIC NEEDS FOR LIBRARY AND MUSEUM SERVICES (PNLMS) SURVEY
INTRODUCTION AND RESPONDENT SELECTION
Hello, I'm _________ calling for the Institute of Museum and Library Services, an agency of the United States Government, about a national research study. The Institute of Museum and Library Services is conducting a voluntary and confidential study about the libraries and museums in your area. I would like to ask you some questions about your experiences so we can create strong libraries and museums. This is not a sales call.
[READ ONLY IF NECESSARY]: Routine uses of this information will be in accordance with the System of Records Notice that applies to this interview. The information will be protected from disclosure under the Freedom of Information Act (5 U.S.C. section 552) and the Privacy Act (5 U.S.C. section 552a) to the extent provided by law.
The OMB control number, XXXX-XXXX expires on X/XX/XXXX. The Institute of Museum and Library Services may not conduct or sponsor, and a person is not required to respond to, the information collection unless it displays a currently valid OMB control number.
S1. Is this phone for a home, a business, or both?
Home - go to S2
Business
Both home and business - go to S2
88. DON’T KNOW
99. REFUSED/MISSING
If S1=2 (Business): Thank you, but I’m trying to reach a residence. Goodbye.
TERMINATE CALL
INTERVIEWER: IF DON'T KNOW OR REFUSED, THANK AND TERMINATE
S2. May I please speak to the household member at least 18 years of age and who has the next birthday?
[If Needed: Household members include people who think of this household as their primary place of residence. It includes persons who usually stay in the household but are temporarily away on business, vacation, in a hospital, or living at school in a dorm, fraternity, or sorority.]
1. Person answering phone is 18 or older, a household member and has the next birthday (GO TO S5)
2. Qualified household member did not initially answer phone but is available now (GO TO S3A)
3. No – Not Available now (Schedule Callback – GO TO S3B)
4 No – There are none (no household member that is at least 18 years of age).
88. Don’t Know
99. Refused
If respondent answers 4, 88, or 99 – THANK AND TERMINATE
S3A. (Speaking to the selected respondent now) Hello, I'm _________ calling for the Institute of Museum and Library Services, an agency of the United States Government, about a national research study. The Institute of Museum and Library Services is conducting a voluntary and confidential study about the libraries and museums in your area. I would like to ask you some questions about your experiences so we can create strong libraries and museums. This is not a sales call.
Continue Interview (GO TO S5)
Schedule Call back (GO TO S3B)
Refused (Thank and Terminate)
S3B. When would be a good time to call back to speak with that person (or you)?
SCHEDULE CALL BACK
REPEAT Intro (OMITTING HAVE I REACHED [TELEPHONE NUMBER]?) IF NECESSARY (e.g., INTERVIEWER IS SPEAKING WITH A NEW PERSON AT THIS POINT).
S4. ADDRESS QUESTIONS OR USE REFUSAL CONVERSION TECHNIQUES
(MESSAGE TO BE LEFT ON ANSWERING MACHINES)
Hello, this is (interviewer name) calling for the Institute of Museum and Library Services, an agency of the United States government. We are conducting an important nationwide survey about libraries and museums and would like to interview a household member who is at least 18 years of age. Please call 1-800-XXX-XXXX to speak to one of our interviewers between 9AM and 11PM Eastern Time. The Institute of Museum and Library services appreciates your assistance with this important survey. Again, the call-in number is 1-800-XXX-XXXX.
(MESSAGE WHEN RESPONDENT CALLS IN TO TOLL-FREE NUMBER)
S4a. Thank you for calling the Institute of Museum and Library Services survey line. Can I have the phone number that we called you on, please?
(INTERVIEWER ACCESS RESPONDENT SAMPLE AND BEGIN SURVEY)
S4b. IS RESPONDENT WILLING TO CONTINUE?
Yes (Go to S5)
No - THANK RESPONDENT AND TERMINATE
(FOR CELL PHONE ONLY SAMPLE)
Hello, I'm _________ calling for the Institute of Museum and Library Services, an agency of the United States Government, about a national research study. The Institute of Museum and Library Services is conducting a voluntary and confidential study about the libraries and museums in your area. I would like to ask you some questions about your experiences so we can create strong libraries and museums. To show our appreciation for completing the survey, we will send you a $5 Gift Card. This is not a sales call.
SCP1. Are you 18 years of age or older?
Yes (Continue)
No - THANK RESPONDENT AND TERMINATE
[READ ONLY IF NECESSARY]: Routine uses of this information will be in accordance with the System of Records Notice that applies to this interview. The information will be protected from disclosure under the Freedom of Information Act (5 U.S.C. section 552) and the Privacy Act (5 U.S.C. section 552a) to the extent provided by law.
The OMB control number, XXXX-XXXX expires on X/XX/XXXX. The Institute of Museum and Library Services may not conduct or sponsor, and a person is not required to respond to, the information collection unless it displays a currently valid OMB control number.
SCP2. Your safety is important. Are you currently driving or involved in an activity that might distract you or jeopardize your safety?
Yes (Schedule Call Back – Go to SCP3)
No (Go to S5)
88. Don’t know (Terminate)
99. Refused (Terminate)
SCP3. Thank you very much. When would be a better time to contact you about this survey?
Scheduled Call Back
Unscheduled Call Back
S5. Excellent. This voluntary study will take about 18 minutes to complete but often can take less time. It is authorized by Chapter 72 of Title 20 of the United States Code. There are no penalties for refusing to answer any question, so if we come to one that you don’t want to answer, I will skip it. Do you have any questions before we begin?
Yes (Interviewer will address concerns)
NO
S6. For quality purposes, this call may be monitored or recorded.
Respondent objects-code as refusal
Proceed with survey (tacit or verbal acknowledgement)
PROGRAMMER: Randomize presentation of Module II (Adult Library User) and Module III (Adult Museum User). Approximately 50% of respondents should receive the Library Module first, 50% receive the Museum Module first.
ADULT LIBRARY USER MODULE
PROGRAMMER: [1-MONTH DATE] is the actual date that is one month prior to the interview date. [1-MONTH DATE] is the same throughout the questionnaire.
For the next few questions, I’ll be asking you to think about your activities during the past month, that is, since [1-MONTH DATE].
L01A. A public library is a library that provides free services to the people in a community, typically a city or county library. Have you visited a public library in-person in the past month, since [1-MONTH DATE]?
1. YES (SKIP TO L02)
2. NO (SKIP TO L01B)
88. DON’T KNOW
99. REFUSED/MISSING
L01B. When was your most recent in-person visit to the public library?
INTERVIEWER: Allow respondent to answer. If necessary, use prompts.
1. More than 1 but less than 3 months ago
2. More than 3 but less than 6 months ago
3. More than 6 months but less than 1 year ago
4. More than one year ago
5. I have never been to a public library.
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Go to L09A1 (SKIP TO LIBRARY REMOTE VISIT SECTION (QUESTION L09A1).
L02. About how many in-person visits did you make to public libraries in the past month, since [1-MONTH DATE]?
Numerical response, up to 2 digits….._ _
8888. DON’T KNOW
9999. REFUSED
L03. Which of the following have you done at a public library in the past month? Since [1-MONTH DATE], have you…?
[READ LIST]
Checked out a book
Read a book, magazine, or newspaper in the library
Checked out a video, DVD, CD, or audiotape
Searched a library catalog
Asked a librarian for help
Attended a library-sponsored program for adults
Attended a library-sponsored program for children
Attended a meeting at the library
Received technology training
Used a library computer
Used your own computer in the library
Other (Specify) ____________
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Randomize a thru k
Now I’m going to ask you some general questions about your most recent in-person visit to a public library.
L04. What was the date of your most recent in-person visit to the public library?
PROGRAMMER: Use a calendar to get an exact date. The response date will be referenced in other questions as [LAST VISIT LIB].
INTERVIEWER: If respondent gives a general response, like “3 weeks ago,” use the calendar to get a specific date.
Date Response: MM/DD/YYYY
88/88/8888. DON’T KNOW
99/99/9999. REFUSED/MISSING
PROGRAMMER:
If the respondent indicates they have been to a library in the last month in both L01A &L04, CONTINUE to L05. If the responses conflict in L01A & L04 with respect to the 1 month window, RE-ASK L01A. If the respondent indicates it has been more than 1 month since last visit in L01A & L04, correct L01A to NO (=2) and SKIP to L09A1 (remote library).
L05. On your most recent visit to the public library, on [LAST VISIT LIB], who went with you?
By myself (If needed, read “By Yourself”)
With family
With friends
With colleagues or people I (Read: “You”) work with
With a class, tour, group, etc.
With others, specify ____________
PROGRAMMER: Single response only
INTERVIEWER:
Read response options only if needed
Stop at first “yes”
L06A. On your most recent visit, on [LAST VISIT LIB], did you use a library computer or the library’s internet connection?
1. YES
2. NO (SKIP TO L07)
88. DON’T KNOW
99. REFUSED/MISSING
L06B. What did you use the library computer or library’s internet connection for?
Response: ______________
[INTERVIEWERS SHOULD RECORD VERBATIM.]
88. DON’T KNOW
99. REFUSED/MISSING
L07. Overall, how satisfied were you with your most recent public library visit?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: REVERSE ORDER OF THE FIRST 5 ANSWER OPTIONS FOR 50% OF THE RESPONDENTS
INTERVIEWER: Do not read 88/99 options.
L08. For your most recent visit, on [LAST VISIT LIB], about how long did it take to get from your home to the public library?
If your most recent visit was part of a vacation or business trip, let me know that, too.
(INTERVIEWER NOTE: IF RESPONDENT INDICATES THEY DID NOT GO DIRECTLY TO THE LIBRARY FROM THEIR HOME, ASK: How long would it take if you traveled directly to the library from your home on your most recent visit?)
PROGRAMMER / INTERVIEWER: Record time in hours and minutes, or in minutes, according to the response. A maximum number of 120 can be entered in the minute field.
______HOURS (1-digit number)
______ MINUTES (3-digit number)
777. PART OF A VACATION OR BUSINESS TRIP
888. DON’T KNOW
999. REFUSED
L09A / L09A1
PROGRAMMER: For L01 = “1” (YES), use L09A (for people who have been to the library in the past month in person). For L01 = “2” (NO), use L09A1 (for people who have not been to the library in the past month.
L09A. Other than while you were at the library, have you accessed a public library website since [1-MONTH DATE]?
1. YES
2. NO (SKIP TO L11)
88. DON’T KNOW
99. REFUSED/MISSING
L09B. About how many times have you accessed a public library website in the past month, since [1-MONTH DATE]?
Numerical response, up to 2 digits….._ _
8888. DON’T KNOW
9999. REFUSED
L09C. Which of the following did you do on a public library website in the past month? Please answer yes or no to each option. Since [1-MONTH DATE], did you…?
[READ LIST]
Download an e-book, audio-book, podcast, or music
Download government forms, applications, or other materials
Search a library catalog
Access online journals, newspapers, or magazines
Access online research tools
Ask a question or talk with a librarian
Look up information about library events
Manage library materials, such as checking due dates or renewing items
Pay a library fine
Request an item for hold
Plan your visit, such as checking hours or address
Other (Specify) _________
PROGRAMMER: Randomize a thru k
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Go to L10
L09A1. Have you accessed a public library website in the past month, since [1-MONTH DATE]?
1. YES
2. NO (SKIP to Module IV – Adult Library Non-User)
88. DON’T KNOW
99. REFUSED/MISSING
L09B1. About how many times have you accessed a public library website in the past month, since [1-MONTH DATE]?
Numerical response, up to 2 digits….._ _
8888. DON’T KNOW
9999. REFUSED
L09C1. Which of the following did you do on a public library website in the past month? Please answer yes or no to each option. Since [1-MONTH DATE], did you…?
[READ LIST]
Download an e-book, audio-book, podcast, or music
Download government forms, applications, or other materials
Search a library catalog
Access online journals, newspapers, or magazines
Access online research tools
Ask a question or talk with a librarian
Look up information about library events
Manage library materials, such as checking due dates or renewing items
Pay a library fine
Request an item for hold
Plan your visit, such as checking hours or address
Other (Specify) _________
PROGRAMMER: Randomize a thru k
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
L10. Do you have a library card?
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
L11. On a scale from 0 to 10, with 10 being most important and 0 being least important, please indicate how important it is for public libraries to provide: [READ LIST]
Print or physical media, such as books, CDs, DVDs
Electronic or digital media, such as downloadable e-books, audio, podcasts, or music
Public access to library computers and the Internet
Trained library staff to help people find information or materials
Programs for children
Programs for teenagers and young adults
Programs for older adults
PROGRAMMER: Randomize a thru g
Response: 2 digit number from 0 to 10.
88. DON’T KNOW
99. REFUSED
L12. When was the last time you donated any money, goods, or services to a library?
Within the last month
More than 1 but less than 3 months ago
More than 3 but less than 6 months ago
More than 6 months but less than a year ago
More than a year ago
Never donated to library
88. DON’T KNOW
99. REFUSED/MISSING
INTERVIEWER:
To be read if needed: This includes Friends of the Library memberships, volunteer work, and other donation
Instruction: This does not include overdue or service fines or bookstore purchases.
PROGRAMMER: If Module II (Adult Library Users) was administered first, proceed to Module III (Adult Museum Users). If Module II was administered second, proceed to VI (Child – General).
PROGRAMMER: Randomize presentation of Module II (Adult Library User) and Module III (Adult Museum User). Approximately 50% of respondents should receive the Library Module first, 50% receive the Museum Module first.
ADULT MUSEUM USER MODULE
For the next series of questions, I’ll be asking you about your activities during the past month, that is, since [1-MONTH DATE].
M01A. You may be surprised about what is considered a museum. Have you visited any of the following types of museums or locations in-person in the past month, since [1-MONTH DATE]?
Please answer “Yes” or “No” to each type of museum. [READ LIST]
Science or technology center or museum
Children’s or Youth museum
Natural History or anthropology museum
Art museum or gallery
History museum, historic house, or historical society
Arboretum or Botanical Garden
Zoo or Aquarium
Nature Center
General Museum
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Randomize order of presentation of items (a) to (i).
M01A_OTH. Did you go to any other museum since [1-MONTH DATE]?
1. YES
2. NO (SKIP TO M02)
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER:
This question gets asked of all respondents, regardless of whether they already specified a type of museum above.
IF no to specific types of museums and no to this question, skip to remote museum visit section (Question M05)
If "YES" ASK M01_OTH2
M01A_OTH2. What type of museum was it? _______________
INTERVIEWER: Enter answer verbatim.
88. DON’T KNOW
99. REFUSED/MISSING
M01_N.
PROGRAMMER: If any response to M01A is “YES” (=1), including a through I and M01_OTH, do not ask M01B and skip to M02. If all responses to M01A (a through I and M01A_OTH are “NO” (=2), then ask M01B.
M01B. When was your most recent in-person visit to a museum? Was it…
INTERVIEWER: Allow respondent to answer. If necessary, use prompts. Re-read types of museums if necessary.
1. More than 1 but less than 3 months ago
2. More than 3 but less than 6 months ago
3. More than 6 months but less than 1 year ago
4. More than one year ago
5. I have never been to a museum.
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Go to M10B (SKIP TO MUSEUM REMOTE VISIT SECTION (QUESTION M10B).
M02. About how many in-person visits did you make to museums in the past month, that is, since [1-MONTH DATE]?
Numerical response, up to 2 digits….._ _
8888. DON’T KNOW
9999. REFUSED
M03. Which of the following have you done at a museum in the past month? Since [1-MONTH DATE], have you…?
[READ LIST]
Browsed on your own
Viewed a specific exhibit, collection, or display
Spoke
with a museum employee
or
guide about the exhibit or collection
Participated in a guided tour
Purchased items from the gift shop
Attended a special event, lecture, class, or workshop
Completed an academic assignment or research
Visited the museum restaurant or coffee shop
Visited an IMAX or movie theater
Other (Specify) __________
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Randomize presentation order of items a thru j.
Now I'm going to ask you some questions about your most recent in-person visit to a museum.
M04. What was the date of your most recent in-person visit to a museum?
PROGRAMMER: Use a calendar to get an exact date. The response date will be referenced in other questions as [LAST VISIT MUSE].
INTERVIEWER: If respondent gives a general response, like “3 weeks ago,” use the calendar to get a specific date.
Date Response: MM/DD/YYYY
88/88/8888. DON’T KNOW
99/99/9999. REFUSED/MISSING
PROGRAMMER:
If the respondent indicates they have been to a library in the last 12 months in M01, M01_OTH, &M05, CONTINUE to M06. If the responses conflict in M01, M01_OTH, &M05 with respect to the 12 month window, RE-ASK M01. If the respondent indicates it has been more than 12 months since last visit in M01, M01_OTH, &M05, SKIP to next module.
M05. On your most recent visit to a museum, on [LAST VISIT MUSE], what type of museum did you visit?
PROGRAMMER: ONLY SHOW CHOICES IDENTIFIED IN M01 AND M01_OTH2)
Science or technology center or museum
Children’s or Youth museum
Natural History or anthropology museum
Art museum or gallery
History museum, historic house, or historical society
Arboretum or Botanical Garden
Zoo or Aquarium
Nature Center
General Museum
Other (specify: []M01A_OTH2])
INTERVIEWER:
Allow for respondent to answer first. Read list if needed and stop at first “yes”
PROGRAMMER:
Randomize except “other”
Response is a one or two-digit number that corresponds to the museum type categories above.
Response to this question will be referenced in other questions as [MUSEUM TYPE]
M06. On your most recent visit to a [MUSEUM TYPE], on [LAST VISIT MUSE], who went with you?
1. By myself (If needed, read “By Yourself”)
2. With family
3. With friends
4. With colleagues or people I (Read: ‘You”) work with
5. With a class, tour, group, etc.
6. With others, specify ____________
PROGRAMMER: Single response only
88. DON’T KNOW
99. REFUSED
INTERVIEWER:
Read response options only if needed
Stop at first “yes”
M07. Overall, how satisfied were you with your most recent museum visit, to the [MUSEUM TYPE] on [LAST VISIT MUSE]?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
PROGRAMMER: REVERSE ORDER OF THE FIRST 5 ANSWER OPTIONS FOR 50% OF THE RESPONDENTS
88. DON’T KNOW
99. REFUSED
M08. About how long did it take to get from your home to the [MUSEUM TYPE] on your most recent visit? If your most recent visit was part of a vacation or business trip, let me know that, too.
(INTERVIEWER NOTE: IF RESPONDENT INDICATES THEY DID NOT GO DIRECTLY TO THE MUSEUM FROM THEIR HOME, ASK: How long would it take if you traveled directly from your home to the museum on your most recent visit?)
______HOURS (1-digit number)
______ MINUTES (3-digit number, maximum 120)
PROGRAMMER / INTERVIEWER: Record time in hours and minutes, or in minutes, according to the response. A maximum number of 120 can be entered in the minute field.
777. PART OF A VACATION OR BUSINESS TRIP
888. DON’T KNOW
999. REFUSED
M09. On your most recent visit, on [LAST VISIT MUSE], how much did you pay for your admission to the [MUSEUM TYPE]?
Nothing, because it was free
Nothing, because you are a member
Less than $5.00
$5.00 or more, but less than $10.00
$10.00 or more, but less than $20.00
$20 or more
88. DON’T KNOW
99. REFUSED/MISSING
M10A / M10A1
PROGRAMMER: For M01A = “1” (YES), use M10A (for people who have been to the museum in the past month in person). For M01A = “2” (NO), use M10A1 (for people who have not been to the museum in the past month.
M10A. Other than while you were at a museum, have you accessed a museum website in the past month, since [1-MONTH DATE]?
1. YES
2. NO (SKIP TO M11)
88. DON’T KNOW
99. REFUSED/MISSING
M10B. About how many times have you accessed a museum website in the past month, since [1-MONTH DATE]? [DO NOT READ LIST]
Numerical response, up to 2 digits….._ _
8888. DON’T KNOW
9999. REFUSED
INTERVIEWER: Do not read response options
M10C. Which of the following did you do on a museum website in the past month? Please answer yes or no to each option. Since [1-MONTH DATE], did you…?
[READ LIST]
Search the collection online or view an online exhibit
Plan your visit, such as checking hours, parking, or admission fees
Learn about a specific topic in the collection
Access educational materials, including teacher and student resources
Purchase items from the museum store or gift shop
Download a podcast or audio tour
Contact or talk with museum staff
Leave a comment
Other (Specify) _____________
PROGRAMMER: Randomize a thru h
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Go to M11.
M10A1. Have you accessed a museum website in the past month, since [1-MONTH DATE]?
1. YES
2. NO (SKIP to Module V – Adult Museum Non-User)
88. DON’T KNOW
99. REFUSED/MISSING
M10B1. About how many times have you accessed a museum website in the past month, since [1-MONTH DATE]? [DO NOT READ LIST]
Numerical response, up to 2 digits….._ _
8888. DON’T KNOW
9999. REFUSED
INTERVIEWER: Do not read response options
M10C1. Which of the following did you do on a museum website in the past month? Please answer yes or no to each option. Since [1-MONTH DATE], did you…?
[READ LIST]
Search the collection online or view an online exhibit
Plan your visit, such as checking hours, parking, or admission fees
Learn about a specific topic in the collection
Access educational materials, including teacher and student resources
Purchase items from the museum store or gift shop
Download a podcast or audio tour
Contact or talk with museum staff
Leave a comment
Other (Specify) _____________
PROGRAMMER: Randomize a thru h
88. DON’T KNOW
99. REFUSED/MISSING
M11. Do you have a membership to a museum?
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
M12.
On a scale from 0 to 10, with 10 being the most
important
and 0 being least important, please indicate how important it is for
museums to provide [READ
LIST]:
Material objects to view and learn about
Electronic or digital media about their collections
Conservation of and care for collections of artifacts
Trained museum staff to help people find and learn about collections
Programs for children
Programs for teenagers and young adults
Programs for older adults
PROGRAMMER: Randomize a thru g
Response: 2 digit number from 0 to 10.
88. DON’T KNOW
99. REFUSED
M14. When was the last time you donated any money, goods, or services to a museum?
Within the last month
More than 1 but less than 3 months ago
More than 3 but less than 6 months ago
More than 6 months but less than a year ago
More than a year ago
Never donated to museum
88. DON’T KNOW
99. REFUSED/MISSING
INTERVIEWER:
To be read if needed: This includes memberships, volunteer work, and other donations
Instruction: This does not include ticket prices, gift shop, or purchases at a museum restaurant or café.
PROGRAMMER: If Module III (Adult Museum Users) was administered first, proceed to Module II (Adult Library Users). If Module III was administered second, proceed to VI (Child – General).
Programmer: Module IV administered only to people who visited a library either in person or online in the past month (L01 and L09).
ADULT LIBRARY NON-USER MODULE
NUL01. How many years has it been since you visited a public library?
Up to a 2-digit number: __ __
INTERVIEWER: Record below if respondent volunteers these answers (i.e., do not read these response options)
777. I’ve never been to a library
888. DON’T KNOW
999. REFUSED/MISSING
NUL02. I'm going to read a list of reasons why some people do not go to libraries. Please tell me which reasons, if any, are true for you. [READ LIST]
I don't know where the nearest library is
It is difficult to get to the library using public transportation
I feel uncomfortable or out of place in the library
There is no one who would go with me to the library
I have child care responsibilities
Health problems or a disability prevent me from going
There are no libraries nearby
The location is not in a safe area
The quality of the library is poor
It is difficult to make time to go to the library
I do not have a library card
I can get what I want from a bookstore or on the Internet.
YES
NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: RANDOMIZE a to l
NUL03. People go to libraries for many reasons. Please say "yes" if you might go to the library for any of the following reasons. [READ LIST]
Attend a library-sponsored program
To support formal education or career development
Access government services, programs, or forms
Receive technology instruction
Check out materials.
Use the computer, internet, or wireless in the library
Access health and wellness information
To look for a job or information on how to start or manage a business
PROGRAMMER: Randomize a thru h
YES
NO
88. DON’T KNOW
99. REFUSED/MISSING
NUL03_OTH1. Are there any other reasons you might go?
YES (Go to NUL03_OTH2)
NO (Go to NUL04)
88. DON’T KNOW
99. REFUSED/MISSING
NUL03_OTH2. What is that reason?
Response: _____________
INTERVIEWER: Read question if needed. Type response verbatim.
88. DON’T KNOW
99. REFUSED/MISSING
NUL04. What do you value most about public libraries?
Response _______
Interviewers would record verbatim.
77. Does not value anything
88. DON’T KNOW
99. REFUSED/MISSING
NUL05. Which services offered by public libraries do you think are most important?
Providing materials, such as books, magazines, DVDs, CDs, online content
Providing services for job-seekers and businesses
Promoting literacy among children and adults
Hosting events and programs
Offering a community gathering place
Providing public access to technology, such as computers or the Internet
Some other service (Specify) ______
INTERVIEWER: Respondent can answer with one or two responses
PROGRAMMER: Randomize a thru f
88. DON’T KNOW
99. REFUSED/MISSING
Programmer: Module V administered only to people who visited a library either in person or online in the past month (M01 and M10).
ADULT MUSEUM NON-USER MODULE
NUM01. How many years has it been since you visited a museum?
Up to a 2-digit number: __ __
INTERVIEWER: Record below if respondent volunteers these answers (i.e., do not read these response options)
77. I’ve never been to a museum
88. DON’T KNOW
99. REFUSED/MISSING
NUM02. I'm going to read a list of reasons why some people do not go to museums. Please tell me which reasons, if any, are true for you. [READ LIST]
I don't know where the nearest museum is
It is difficult to get to the museum using public transportation
I feel uncomfortable or out of place in the museum
There is no one who would go with me to a museum
I have child care responsibilities
Health problems or a disability prevent me from going
There are no museums nearby
The location is not in a safe area
The quality of the museum is poor
It is difficult to make time to go to the museum
The museum is too expensive
YES
NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: RANDOMIZE a to k
NUM03. People go to museums for many reasons. Please say "yes" if you might go to a museum for any of the following reasons. [READ LIST]
Attend a special event
Attend a lecture, class, or workshop
View a specific exhibit, collection, or display
Complete an academic assignment or do research
Speak
to a museum employee
or
guide about the exhibit or collections
Participate in a guided tour.
Purchase items from the museum store or gift shop
Use the museum restaurant or coffee shop
Visit an IMAX or movie theater
YES
NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Randomize a thru i
NUM03_OTH1. Are there any other reasons you might go?
YES
NO
88. DON’T KNOW
99. REFUSED/MISSING
NUM03_OTH2. What is that reason?
Response: _____________
INTERVIEWER: Read question if needed. Record response verbatim.
88. DON’T KNOW
99. REFUSED/MISSING
NUM04. What do you value most about museums?
Response: _______
Interviewers would record verbatim.
77. Does not value anything
88. DON’T KNOW
99. REFUSED/MISSING
CHILD – GENERAL MODULE
CH01A. How many children under age 18 are in your household?
Response: 2-digit number _ _
888. DON’T KNOW
999. REFUSED/MISSING
(IF NO CHILDREN (CH01= 0), SKIP TO GC01;
IF CH01 = 1 GO TO CH02;
IF CH01 >1 GO TO CH01B)
PROGRAMMER: Ask only if more than one child in household
CH01B. Which child has the next birthday?
Response ________
PROGRAMMER: Use child’s name, from the response to CH02, in the following questions, referenced as [CHILD]. IF respondent refuses to give a name, use generic “this child”.
INTERVIEWER: Ok, please consider this child when answering the following questions.
CH02. Is [CHILD/this child] under your care?
YES
NO (SKIP TO GC01)
88. DON’T KNOW
99. REFUSED/MISSING
INTERVIEWER:
The phrase “under your care” does not require the child to be solely under the respondent’s care. Both parents in a household, a guardian, grandparent, or older adult sibling could define a child as under their care.
Divorced parents who have shared custody may or may not consider children to be under their care and in their household. Two parents with the same objective situation may define this differently, but the important thing is that it be their own perception of whether the child is under their care and in their household.
It’s up to the respondent; a divorced parent who only has the children in their household occasionally may or may not define the children as in their household or under their care.
Another example would be a grandparent. Depending how the grandparent respondent defines it, a child who does not live in their home may or may not be “in the same household” and may or may not be “under their care.”
CH03. Is [CHILD/this child] a boy or a girl?
1. Boy
2. Girl
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Use child gender for gender-specific pronouns, e.g., he/his/himself.
CH04. How old is [CHILD/this child]?
Response: 2-digit number _ _
88. Don’t Know
99. Refused/Missing
IF DON’T KNOW, MISSING OR REFUSED, ASK:
CH04B. Is [CHILD/the child]…? [INTERVIEWER: READ IF NECESSARY]
0 to 2 years old
3 to 5 years old
6 to 9 years old
10 to 13 years old
14 to 17 years old
88. Don’t Know
99. Refused/Missing
PROGRAMMER: CHILDREN LIBRARY OR MUSEUM SECTIONS SELECTED RANDOMLY – 50% receive Child Library User module first; 50% receive Child Museum User module first.
CHILD LIBRARY USER MODULE
Let’s start with public libraries. When answering the next few questions, please consider public libraries only. This does not include school libraries.
I’ll be asking about [CHILD’S/your child’s] activities during the past month, that is, since [1-MONTH DATE].
CHL01. Has [CHILD/this child] visited a public library in-person in the past month, since [1-MONTH DATE]?
YES (SKIP TO CHL02)
NO (SKIP TO CHL09)
88. DON’T KNOW
99. REFUSED/MISSING
CHL02. About how many times has [CHILD/this child] visited a public library in-person in the past month, since [1-MONTH DATE]?
Number of times _ _
8888. DON’T KNOW
9999. REFUSED/MISSING
PROGRAMMER: Library non-user respondents, SKIP TO CHL04
CHL03. Have YOU taken [CHILD/this child] to the library in the past month, since [1-MONTH DATE]?
YES (GO TO CHL04A)
NO (SKIP TO CHL04B)
88. DON’T KNOW
99. REFUSED/MISSING
Now I’m going to ask some questions about [CHILD’s/this child’s] most recent in-person visit to a public library.
CHL04A / CHL04B
PROGRAMMER: If CHL03 = 1, use CHL04A; if CHL03=2, then CHL04B.
CHL04A. What was the date of your most recent in-person visit to a public library with [CHILD/this child]?
PROGRAMMER: Use a calendar to get an exact date. The date will be referenced in other questions as [LAST VISIT CH LIB]. Provide information from adult’s last visit as a prompt, [LAST VISIT LIB], but allow for a different response.
INTERVIEWER: If respondent gives a general response, like “3 weeks ago,” use the calendar to get a specific date. Use adult’s last visit as a prompt if necessary.
Response: Date (MM/DD/YYYY)
88/88/8888. DON’T KNOW
99/99/9999 REFUSED/MISSING
CHL04B. What was the date of [CHILD’s/this child’s] most recent in-person visit to a public library?
PROGRAMMER: Use a calendar to get an exact date. The date will be referenced in other questions as [LAST VISIT CH LIB]. Provide information from adult’s last visit as a prompt, [LAST VISIT LIB], but allow for a different response.
INTERVIEWER: If respondent gives a general response, like “3 weeks ago,” use the calendar to get a specific date. Use adult’s last visit as a prompt if necessary.
Response: Date (MM/DD/YYYY)
88/88/8888. DON’T KNOW
99/99/9999 REFUSED/MISSING
CHL05. During [CHILD’s/this child’s] most recent visit to the public library, on [LAST VISIT CH LIB], which of the following activities did the [he/she/this child] do at the public library? [READ LIST]
PROGRAMMER: Randomize a thru g
Checked out books
Checked out materials other than books, such as movies or music
Read for fun
Worked on a school assignment
Used the computer or Internet
Entertainment, such as play games
Attended a program, such as story time
Other (Specify) _____________
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
CHL06. On [CHILD’s/this child’s] most recent visit to the public library, on [LAST VISIT CH LIB], who when with [him/her/this child]?
You
Your spouse or partner
Another member of your household
Another adult outside of school
An adult from school
One of this child’s friends
This child visited on his or her own
Someone else, but none of the above ____________
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER:
Randomize 1 thru 6
INTERVIEWER: Single response only
Read list only if needed and stop at first “yes”
Record #7 if verbatim response does not fit in existing categories
CHL07. Has [CHILD/this child] visited a public library in-person by [HIMSELF/HERSELF] or with friends in the past month, since [1-MONTH DATE]?
ASKED ONLY IF CHILD IS 6 TO 17
NO
YES
88. DON’T KNOW
99. REFUSED/MISSING
CHL08A/CHL08B
PROGRAMMER: For children who have been to the library in the past month, ask CHL10A. For those who have not been to the library in the past month, ask CHL10B.
CHL08A. Other than while [CHILD/this child] was at the library, has [he/she/this child] accessed a public library website in the past month, since [1-MONTH DATE]?
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
CHL08B. Has [CHILD/this child] accessed a public library website in the past month, since [1-MONTH DATE]?
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Skip to Child Museum User Module or, if already administered, to Children’s Extracurricular Module.
CHL09. When was the last time [CHILD/this child] visited the public library? Was it…
Never [DO NOT READ]
More than 1 but less than 3 months ago
More than 3 but less than 6 months ago
More than 6 months but less than a year ago
More than a year ago
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER:
If the respondent indicates the child has been to a library in the last month in both CHL01 & CHL03, CONTINUE to CHL04. If the responses conflict in CHL01 & CHL03 with respect to the 1 month window, RE-ASK CHL01. If the respondent indicates it has been more than 1 month since last visit in CHL01 & CHL03, SKIP to next module.
CHL10. Why hasn’t [CHILD/this child] gone to a public library recently?_____________________
PROGRAMMER: Verbatim response
88. DON’T KNOW
99. REFUSED/MISSING
CHILD MUSEUM USER MODULE
[Let’s start with museums./Let’s talk about museums now.] I’ll be asking about [CHILD’s/your child’s] activities during the past month, that is, since [1-MONTH DATE].
CHM01. Has [CHILD/this child] visited any of the following types of museums in-person in the past month, since [1-MONTH DATE]? Please answer either yes or no to each type. [READ LIST]
Science or technology center or museum
Children’s or Youth museum
Natural History or anthropology museum
Art museum or gallery
History museum, historic house, or historical society
Arboretum or Botanical Garden
Zoo or Aquarium
Nature Center
General Museum
YES
NO
88. DON’T KNOW
99. REFUSED/MISSING
CHM01_OTH. Did [CHILD/this child] go to any other museum since [1-MONTH DATE]?
1. YES
2. NO (SKIP TO CHM02/CHM10)
88. DON’T KNOW
99. REFUSED/MISSING
(PROGRAMMER: IF NO TO ALL, SKIP TO CHM10)
M01_OTH2. What type of museum was it? _______________
INTERVIEWER: Enter answer verbatim.
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER:
If the respondent indicates the child has been to a library in the last month in both CHL01 & CHL03, CONTINUE to CHL04. If the responses conflict in CHL01 & CHL03 with respect to the 1 month window, RE-ASK CHL01. If the respondent indicates it has been more than 1 month since last visit in CHL01 & CHL03, SKIP to next module.
CHM02. About how many times has [CHILD/this child] visited a museum in-person in the past month, since [1-MONTH DATE]?
Number of times _ _ _
8888. DON’T KNOW
9999. REFUSED/MISSING
PROGRAMMER: Library non-user respondents, SKIP TO CHL04
CHM03. Have YOU taken [CHILD/this child] to a museum in the past month, since [1-MONTH DATE]?
YES (GO TO CHL04A)
NO (SKIP TO CHL04B)
88. DON’T KNOW
99. REFUSED/MISSING
Now I’m going to ask some questions about [CHILD’s/this child’s] most recent in-person visit to a museum.
CHM04A / CHM04B
PROGRAMMER: If CHM03 = 1, then CHM04A. If CHM 03=2, then CHM04B.
CHM04A. What was the date of your most recent in-person visit to a museum with [CHILD/this child]?
PROGRAMMER: Use a calendar to get an exact date. The date will be referenced in other questions as [LAST VISIT CH MUS]. Provide information from adult’s last visit as a prompt, [LAST VISIT MUS], but allow for a different response.
INTERVIEWER: If respondent gives a general response, like “3 weeks ago,” use the calendar to get a specific date. Use adult’s last visit as a prompt if necessary.
Response: Date (MM/DD/YYYY)
88/88/8888. DON’T KNOW
99/99/9999 REFUSED/MISSING
CHM04B. What was the date of [CHILD’s/this child’s] most recent in-person visit to a museum?
PROGRAMMER: Use a calendar to get an exact date. The date will be referenced in other questions as [LAST VISIT CH MUS]. Provide information from adult’s last visit as a prompt, [LAST VISIT MUS], but allow for a different response.
INTERVIEWER: If respondent gives a general response, like “3 weeks ago,” use the calendar to get a specific date. Use adult’s last visit as a prompt if necessary.
Response: Date (MM/DD/YYYY)
88/88/8888. DON’T KNOW
99/99/9999 REFUSED/MISSING
CHM05. On [CHILD’s/this child’s] most recent visit to a museum, on [LAST VISIT CH MUS], what type of museum did [HE/SHE/this child] visit?
PROGRAMMER: ONLY SHOW CHOICES IDENTIFIED IN M01 AND M01_OTH2)
1. Science or technology center or museum
2. Children’s or Youth museum
3. Natural History or anthropology museum
4. Art museum or gallery
5. History museum, historic house, or historical society
6. Arboretum or Botanical Garden
7. Zoo or Aquarium
8. Nature Center
9. General Museum
10. (Other) [M01_OTH2]
INTERVIEWER: Allow for respondent to answer first. Read list if needed and stop at first “yes”
PROGRAMMER:
Randomize except “other”
Response is a one or two-digit number that corresponds to the museum type categories above.
Response to this question will be referenced in other questions as [CH MUSEUM TYPE]
CHM06. During [CHILD’s/this child’s] most recent visit to the [CH MUSEUM TYPE], on [LAST VISIT CH MUS], which of the following activities did the [he/she/this child] do at the museum? [READ LIST]
PROGRAMMER: Randomize a thru g
Browsed on {his/her} own or with you
Viewed a specific exhibit, collection or display
Talked
with a museum employee about an exhibit
or
how to use the museum
Participated in a guided tour, including a school field trip
Participated in a program for children or youth
Worked on a school assignment
Purchased items from the gift shop
Visited an IMAX or movie theater
Used a self-guided tour for youth
Participated in a special event, such as a festival or holiday event at the museum
Other (Specify) ________________
Programmer: Randomize a thru j
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
CHM07. On [CHILD’s/this child’s] most recent visit to the [CH MUSEUM TYPE], on [LAST VISIT CH LIB], who when with [him/her/this child]?
a. You
b. Your spouse or partner
c. Another member of your household
d. Another adult outside of school
e. An adult from school
f. One of this child’s friends
g. This child visited on his or her own
h. Someone else, but none of the above ____________
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Randomize 1 thru 6
INTERVIEWER: Single response only
Read list only if needed and stop at first “yes”;
Record #7 if verbatim response does not fit in existing categories
CHM08. Has [CHILD/this child] visited a museum in-person by [HIMSELF/HERSELF] or with friends in the past month, since [1-MONTH DATE]?
PROGRAMMER: ASK ONLY IF CHILD IS 6 TO 17
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
CHL09A/CHL09B
PROGRAMMER: For children who have been to the museum in the past month, ask CHM09A. For those who have not been to the museum in the past month, ask CHM09B.
CHL09A. Other than while [CHILD/this child] was at the museum, has [he/she/this child] accessed a museum website in the past month, since [1-MONTH DATE]?
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
CHL09B. Has [CHILD/this child] accessed a museum website in the past month, since [1-MONTH DATE]?
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Skip to Child Library User Module or, if already administered, to Children’s Extracurricular Module.
CHM10. When was the last time [CHILD/this child] visited a museum? Was it…
1. Never [DO NOT READ]
2. More than 1 but less than 3 months ago
3. More than 3 but less than 6 months ago
4. More than 6 months but less than a year ago
5. More than a year ago
88. DON’T KNOW
99. REFUSED/MISSING
CHM11. Why hasn’t [CHILD/this child] gone to a museum recently?_____________________
PROGRAMMER: Verbatim response
88. DON’T KNOW
99. REFUSED/MISSING
CHILDREN EXTRACURRICULAR SECTION
CHLM01. In a typical week, how often do you or another family member….
PROGRAMMER: Ask only for children age 0 to 8 years
Read books to [CHILD/this child]
Tell {him/her} stories
Sing songs with {him/her}
Not at all
Once or twice a week
3 to 6 times a week
Every day
88. DON’T KNOW
99. REFUSED/MISSING
INTERVIEWER:
Do not read response options.
IF NEEDED: Give me your best guess as to how often you or another family member [reads books to this child / tells him/her stories / sing songs with him/her
PROGRAMMER: RANDOMIZE options a thru c
CHLM02. Is this child attending or enrolled in school?
NO
YES
88. DON’T KNOW
99. REFUSED/MISSING
INTERVIEWER: This can include preschool, kindergarten, public, or private school.
CHLM03. What grade is the child in? [DO NOT READ LIST]
1. Preschool / Pre-kindergarten / Head Start
2. Kindergarten
3. First grame
4. Second grade
5. Third grade
6. Fourth grade
7. Fifth grade
8. Sixth grade
9. Seventh grade
10. Eighth grade
11. Ninth grade
12. Tenth grade
13. Eleventh grade
14. Twelfth grade
15. College
16. Ungraded (students not in a standard grade)
17. Home Schooled
88. DON’T KNOW
99. REFUSED/MISSING
Finally, one last question about your child:
[If child Age <5 OR (if Age < 7 (or 6 to 9 category) AND CHLM02 = 1)]
CHLM04. Is {child} now receiving care from someone other than a parent on a regular basis?
[If NEEDED: This does not include occasional babysitting or spending time with grandparents or other relatives unless this is part of a regular child-care arrangement.]
1. NO
2. YES
88. DON’T KNOW
99. REFUSED/MISSING
GENERAL COMPUTING MODULE
Thank you for your answers so far. Now I’m going to ask you a few questions about computers and technology.
GC01. Please answer yes or no to each one. Do you have a…? [READ LIST]
A desktop or laptop computer at home
A cell phone (ASKED OF LANDLINE SAMPLE ONLY)
A handheld device made primarily for e-book reading, such as a Nook or Kindle e-reader
A tablet computer, like an iPad, Samsung Galaxy, Motorola Xoom, or Kindle Fire
1. NO
2. YES
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: A “YES” SHOULD BE ENTERED ON OPTION B. FOR CELL PHONE RESPONDENTS AND THEY
SHOULD NOT BE ASKED OPTION B.
GC02. Is your cell phone a smartphone?
PROGRAMMER: ASKED OF ALL CELL PHONE RESPONDENTS;
ASKED OF LANDLINE RESPONDENTS ONLY IF THEY SAID THEY HAD A CELL PHONE IN THE PREVIOUS QUESTION.
1. NO
2. YES
88. DON’T KNOW
99. REFUSED/MISSING
[Interviewer: EXPLANATION FOR RESPONDENT, AS NEEDED ]
A smartphone is a high-end mobile phone with more advanced computing and connectivity than mobile phones that only provide basic voice communications. An iPhone or devices running the Android operating system are examples of smartphones.
GC03. Do you access the Internet from home?
NO (SKIP TO GC06)
YES
88. DON’T KNOW
99. REFUSED/MISSING
//****************
Programmer Instruction:
IF any GC01 = 2 or GC03 = 2 THEN PROCEED TO GC04
OTHERWISE PROCEED TO D01
GC04. At home, do you access the Internet using…
[READ LIST]
Fiber optic
Cable Modem Service
DSL or ADSL
Mobile broadband for a computer or cell phone, such as Wifi or WiMax
Satellite service
Dial-up (IF NEEDED: or ISDN-Integrated Services Digital Network)
SOME OTHER TYPE OF CONNECTION, specify ___________
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: Single response allowed. If GC04 =1 thru 5 skip to GC06.
INTERVIEWER: Stop at first option chosen
GC05A. What is the most important reason you do not have high-speed Internet access at home?
[DO NOT READ LIST]
FOR REPONDENTS WITHOUT HIGH SPEED INTERNET (DIAL-UP ON PREVIOUS QUESTION)
SINGLE RESPONSE QUESTION
INTERVIEWER NOTE: READ ONLY IF NEEDED: “By high-speed Internet, we mean a connection that is faster than dial-up.”
Don’t need it or not interested
Too expensive
I use my library’s Internet connection
Not available in my area
My computer is inadequate
Can use it somewhere else
Other reason, specify _________
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER:
ASK #7 IF THEY HAVEN’T CHOSEN 1 THRU 6
GC05B. What is the most important reason you do not have Internet access at home?
FOR RESPONDENTS WITH NO INTERNET ACCESS AT HOME
[DO NOT READ LIST]
INTERVIEWER: Classify volunteered responses as 1 thru 6 or write in response in “other” if the volunteered response does not fit 1 thru 6
Don’t need it or not interested
Too expensive
I use my library’s Internet connection
Not available in my area
My computer is inadequate
Can use it somewhere else
Other, specify __________
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER:
ASK #7 IF THEY HAVEN’T CHOSEN 1 THRU 6
GC06. Do you access the Internet at any of the following locations outside the home?
[READ LIST]
Workplace
School
Public library
Community center
Internet café or coffee shop in your area
Someone else’s house
While travelling for business or recreation
Another place outside the home, specify ______________
1. YES
2. NO
88. DON’T KNOW
99. REFUSED/MISSING
PROGRAMMER: RANDOMIZE ORDER OF A TO G. ALWAYS HAVE ANSWER CHOICE “H” ASKED LAST.
GC09. During the last 12 months, about how many books did you read either all or part of the way through? Please include any print, electronic, or audiobooks you may have read or listened to, not including short books read to children.
Record Actual Number: ___________
8888. DON’T KNOW
9999. REFUSED/MISSING
DEMOGRAPHICS MODULE
Now I need to ask some basic information about you and your household and we’ll be done. Thank you for your patience.
INTERVIEWER: BASED ON VOICE – DO NOT ASK UNLESS NECESSARY
D01. For verification purposes, are you male or female?
1. Male
2. Female
88. Don’t Know
99. Refused/Missing
D02. What is your age?
3-digit number (NUMBER BETWEEN 18 AND 115) ________
8888. Don’t Know
9999. Refused/Missing
IF DON’T KNOW, MISSING OR REFUSED, ASK:
D02A. Are you… [INTERVIEWER: READ IF NECESSARY]
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
88. Don’t Know
99. Refused/Missing
D03. What is your current marital status? (READ LIST)
PROGRAMMER: RANDOMIZE RESPONSES 1 THRU 5
Now Married or Partnered
Widowed
Divorced
Separated
Never married
88. Don’t Know
99. Refused/Missing
D04. What is your work situation? Are you…?
(INTERVIEWER: READ ENTIRE LIST. SELECT ONE RESPONSE.)
Employed, full time
Employed, part-time
Unemployed, looking for work
Unemployed, not looking for work
Self-employed
Retired
In school
Homemaker
Other, specify (PROGRAMMER: Go to next question)
88. Don’t Know
99. Refused/Missing
D04_OTH. Please describe your work situation: _________________________________
88. Don’t Know
99. Refused / Missing
D05. Do you consider yourself to be of Hispanic or Latino origin?
No (SKIP TO D06A)
Yes
88. Don’t Know
99. Refused / Missing
D06. Which of the following racial categories describes you? You may select more than one.
American Indian or Alaska Native
Asian
Black or African-American
Native Hawaiian or Other Pacific Islander
White (Caucasian)
(VOL) Hispanic/Latino
(VOL) Other (PROGRAMMER: skip To D06_OTH)
Don’t Know
Refused/Missing
D06_OTH. Other race category: ____________________________
D07A. Were you born in the United States?
No
Yes
88. Don’t Know
99. Refused / Missing
D07B. Was your mother born in the United States?
No
Yes
88. Don’t Know
99. Refused / Missing
D07C. Was your father born in the United States?
No
Yes
88. Don’t Know
99. Refused / Missing
D08. What language is spoken most often in your household?
English
Spanish
An Asian or Pacific Islander language such as Chinese, Japanese, Tagalog, or Vietnamese
Other, specify__________
88. Don’t Know
99. Refused/Missing
D09. Including yourself, how many people are living in your household?
Response: 2-digit number _ _
(INTERVIEWER: IF NEEDED: "Include people who usually stay in this household, but are temporarily away on business, vacation, or in the hospital. Do not include persons who are away on full-time active military duty with the armed forces, students living away from home in their own apartment, or any other family member who may be in a nursing home or other institution.")
888. Don’t Know
999. Refused/Missing
D09A. How many of these people are adults 18 years of age and older?
_____ (1 to 99)
(INTERVIEWER: IF NEEDED: "Include people who usually stay in this household, but are temporarily away on business, vacation, or in the hospital. Do not include persons who are away on full-time active military duty with the armed forces, students living away from home in their own apartment, or any other family member who may be in a nursing home or other institution.")
888. Don’t Know
D10. What is the highest grade or year of school that you have completed? _______
(INTERVIEWER: REPEAT QUESTION IF NOT UNDERSTOOD. DO NOT READ RESPONSE OPTIONS.)
No formal schooling
First grade
Second grade
Third grade
Fourth grade
Fifth grade
Sixth grade
Seventh grade
Eighth grade
Ninth grade
Tenth grade
Eleventh grade
Twelfth grade (no diploma)
High school diploma or equivalent (GED)
Vocational or Technical program after high school, but no degree
Vocational or Technical degree after high school
Some college, but no degree
Associate’s degree
Bachelor’s degree
Graduate or professional school, but no degree
Master’s degree (MA, MS, MBA)
Professional degree after Bachelor’s degree (MD, JD, DDS)
Doctorate degree (PhD, EdD)
88. Do Not Know
99. Refused/Missing
D11. In studies like this, households are sometimes grouped according to income. What was the total income, before taxes, of all persons in your household in 2012 from all sources?
(INTERVIEWER: IF NEEDED: “This includes salaries or other earnings, interest, retirement, and so on, for all household members combined. Total income includes wages, interest and dividends, rent, Social Security, other pensions, alimony or child support, unemployment compensation, public aid (welfare), armed forces or veteran's allotment.”)
(INTERVIEWER: READ LIST UNTIL RESPONDENT STOPS YOU TO SELECT A CATEGORY.)
Under $15,000
From $15,000 to less than $30,000
From $30,000 to less than $50,000
From $50,000 to less than $75,000
From $75,000 to less than $100,000
From $100,000 to less than $125,000
$125,000 or more
88. Don’t Know
99. Refused / Missing
(LANDLINE SAMPLE ONLY)
D11B. My records indicate that your zip code is [ZIP CODE from file].
Is this correct?
1. No (IF NO, CORRECT AND GO TO CLOSING)
2. Yes (GO TO CLOSING)
888888. Don’t Know
999999. Refused/Missing
INTERVIEWER: IF NEEDED: “This information will allow us to look at local library and museum resources
and relate that to your information.”)
(CELL PHONE SAMPLE ONLY)
D12A. Those are all the questions I have. May I have your mailing address so we can send you the
$5.00 gift card for participation?
May I have your name? _____________
Mailing Address:
Unit/Street: ________
City: _________
State: _________
Zip Code: __________
88. Don’t Know
99. Refused/Missing
D12B. I understand. May I have just your zip code, then?
INTERVIEWER: IF DON’T KNOW, MISSING OR REFUSED FULL ADDRESS
Zip Code: _____________
888888. Don’t Know
999999. Refused/Missing
INTERVIEWER: IF NEEDED: “This information will allow us to look at local library and museum resources
and relate that to your information.”)
CLOSING: THOSE ARE ALL THE QUESTIONS THAT WE HAVE. THANK YOU FOR YOUR TIME.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | ATTACHMENT C |
| Author | MLevy |
| File Modified | 0000-00-00 |
| File Created | 2021-01-27 |