B2: RISE Youth Interview (ages 11-19)

Attachment b2: RISE Youth assent and Interview

YOUTH ASSENT TO PARTICIPATE IN ASSESSMENT AND QUALITATIVE INTERVIEW

To be printed on Westat Letterhead

Westat, a research company, is inviting you to participate in a research study about specialized services being offered by a group working with the Los Angeles County Department of Children and Family Services (DCFS). Please read this form along with me carefully before you make a decision to participate.

What is a research study?

A research study is when people collect information to understand something better.

Why is Westat doing this study?

We want to find out if the specialized services being offered are helpful to children and youth. Your answers will help us to know if these services can possibly help other children and families.

Why are you talking to me about this study?

You and other kids were selected to participate in the study because you are eligible for the services.

What will happen if I am in this study?

If you agree to be in the study, you will meet with a researcher today who will ask you questions about yourself and your family, your experiences receiving the specialized services, and your experiences with your caseworker. After today, the researcher will come back to ask you questions about yourself and your family up to five more times. The questions will take about 1 hour to answer each time the researcher meets with you. This is not a test and there are no right or wrong answers.

Do I get anything for being in the study?

Yes. You will get a $15 gift card each time you meet with the researcher.

Are there any risks or discomforts to being in the study?

Some questions may be uncomfortable to answer. If any of the questions make you feel upset or sad, you can talk with your caseworker. You can also ask to skip any of the questions. You can end the interview at any time.

Will what I share in the study be kept private?

We will keep your information private. Nobody can know your answers unless you decide to talk to them about it later. The Westat researcher will always meet with you in a private place. We will not include any information that identifies you and your family in any reports we write.

This study has a special Privacy Certificate from the U.S. Government called a Certificate of Confidentiality. This means that no one can make us reveal your identity or give out information collected in this study. But this study will follow a Court request that was made. The Court said that if you agree to be in the study, we will need to give a signed copy of this form to DCFS. We will give a signed copy to the DCFS Evaluation Liaison. The liaison is the person who helped your caseworker complete paperwork for RISE. We will not share any other information collected during the study with your foster care caseworker. The only other time we will share information is if you tell us that someone has hurt you or that you want to hurt yourself or someone else. We will report this to the government agency that investigates these reports. To make sure the researchers are following rules when asking you questions, another researcher may sit in on your interview. If another researcher wants to sit in, we will let you know and ask you to agree first.

Do I have to be in the study?

You do not have to be in the study. No one will get mad at you if you do not want to be in the study. Your decision will not affect the services you currently receive.

What if I have questions?

If you have questions right now, please talk to the person who is reviewing this form with you. You can also contact the people below.

If you have any questions about the study, please contact: Jaymie Lorthridge, Westat Study Contact 1-800-WESTAT1 (937-8281), x5871 [email protected]

For questions about your rights as a participant in this study, contact: The Committee for the Protection of Human Subjects, (916) 326-3660.

Participation Decision

Please check one of the boxes to let us know if you do or do not want to participate. You will receive a copy of this form.

 Yes. By checking this box, I am saying that I read or listened to someone read this form that I understand what these documents say, and that I agree to be in this study.

 No. By checking this box, I am saying that I do not want to be in the study.

________________________________ ___________________________

Participant Signature Participant Printed Name

___________________________________

Date

Witness Signature

In my judgment the participant is voluntarily and knowingly agreeing to participate in this research study, and has received a copy of the Research Participant’s Bill of Rights.

_____________________________ ____ ________________________

Signature of Witness to Assent Process Date Name of witness

OFFICE USE ONLY:

Child Evaluation ID______________________

___________________________________ _______________________________________

Study representative’s signature Date

Date of IRB approval of this assent: 

Expiration date of IRB approval of this assent:

YOUTH ASSENT SCRIPT TO PARTICIPATE IN THE ASSESSMENT AND QUALITATIVE INTERVIEW

GIVE THE YOUTH A COPY OF THE ASSENT FORM AND ENCOURAGE HIM/HER TO READ ALONG WITH YOU.

Westat, a research company, is inviting you to participate in a research study about specialized services being offered by a group working with the Los Angeles County Department of Children and Family Services (DCFS). Please read this form along with me carefully before you make a decision to participate.

What is a research study?

A research study is when people collect information to understand something better.

Why is Westat doing this study?

We want to find out if the specialized services being offered are helpful to children and youth. Your answers will help us to know if these services can possibly help other children and families.

Why are you talking to me about this study?

You and other kids were selected to participate in the study because you are eligible for the services.

BEFORE I GO ON, LET ME MAKE SURE THAT WHAT I’M TELLING YOU MAKES SENSE. BASED ON WHAT I’VE SAID SO FAR…

1. WHAT IS THIS STUDY ABOUT?

CORRECT ANSWER: SPECIALIZED SERVICES BEING OFFERED

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1^ST ATTEMPT (NO REPEAT NEEDED) ☐

2^ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3^RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4^TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

Ok that’s good. Is it ok if we keep going?

What will happen if I am in this study?

If you agree to be in the study, you will meet with a researcher today who will ask you questions about yourself and your family, your experiences receiving the specialized services, and your experiences with your caseworker. After today, the researcher will come back to ask you questions about yourself and your family one more time later. The questions will take about an hour to answer each time the researcher meets with you. This is not a test and there are no right or wrong answers.

Do I get anything for being in the study?

Yes. You will get a $15 gift card each time you meet with the researcher.

Are there any risks or discomforts to being in the study?

Some questions may be uncomfortable to answer. If any of the questions make you feel upset or sad, you can talk with your caseworker. You can also ask to skip any of the questions. You can end the interview at any time.

AGAIN I WANT TO MAKE SURE THAT WHAT I’M SAYING MAKES SENSE. BASED ON WHAT I’VE SAID SO FAR…

2. WILL YOU GET ANYTHING FOR BEING IN THE STUDY?

CORRECT ANSWER: YES

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1^ST ATTEMPT (NO REPEAT NEEDED) ☐

2^ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3^RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4^TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

3. IS IT POSSIBLE THAT I MIGHT ASK A QUESTION WHICH MAKES YOU FEEL UPSET?

CORRECT ANSWER: YES

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1^ST ATTEMPT (NO REPEAT NEEDED) ☐

2^ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3^RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4^TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

4. IF A QUESTION DOES MAKE YOU FEEL UPSET, SHOULD YOU TALK TO ME ABOUT IT OR SHOULD YOU TALK TO YOUR CASEWORKER?

CORRECT ANSWER: CASEWORKER

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1^ST ATTEMPT (NO REPEAT NEEDED) ☐

2^ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3^RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4^TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

Ok thank you, can we keep going?

Will what I share in the study be kept private?

We will keep your information private. Nobody can know your answers unless you decide to talk to them about it later. The Westat researcher will always meet with you in a private place. We will not include any information that identifies you and your family in any reports we write.

This study has a special Privacy Certificate from the U.S. Government, called a Certificate of Confidentiality. This means that no one can make us reveal your identity or give out information collected in this study. But this study will follow a Court request that was made. The Court said that if you agree to be in the study it wants us to give a signed copy of this form to DCFS. We will give a signed copy to the DCFS Evaluation Liaison. The liaison is the person who helped your caseworker complete paperwork for RISE. We will not share any other information collected during the study with your foster care caseworker. The only other time we will share information is if you tell us that someone has hurt you or that you want to hurt yourself or someone else. We will report this to the government agency that investigates these reports.

To make sure the researchers are following rules when asking you questions, another researcher may sit in on your interview. If another researcher wants to sit in, we will let you know and ask you to agree first.

Do I have to be in the study?

You do not have to be in the study. No one will get mad at you if you do not want to be in the study. Your decision will not affect the services you currently receive.

JUST SO I’M ABSOLUTELY SURE THAT THIS MAKES SENSE…

5. IF YOU AGREE TO BE IN THE STUDY WILL THE DCFS EVALUATION LIAISON GET A COPY OF THIS FORM?

CORRECT ANSWER: YES

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1ST ATTEMPT (NO REPEAT NEEDED) ☐

2ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

6. WILL YOUR FOSTER CARE CASEWORKER BE TOLD ANY INFORMATION YOU SHARE DURING THE STUDY?

CORRECT ANSWER: NO

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1ST ATTEMPT (NO REPEAT NEEDED) ☐

2ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

7. OTHER THAN IN CASES WHERE YOU OR SOMEONE ELSE MAY BE IN DANGER, WILL WE KEEP THE INFORMATION YOU SHARE DURING THE STUDY PRIVATE ?

CORRECT ANSWER: YES

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1^ST ATTEMPT (NO REPEAT NEEDED) ☐

2^ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3^RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4^TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

8. DO YOU HAVE TO BE IN THE STUDY?

CORRECT ANSWER: NO

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1^ST ATTEMPT (NO REPEAT NEEDED) ☐

2^ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3^RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4^TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

9. IF YOU DO NOT WANT TO BE IN THE STUDY WILL THE SERVICES YOU CURRENTLY RECEIVE STOP?

CORRECT ANSWER: NO

RESPONDENT GAVE THE CORRECT ANSWER AFTER:

1^ST ATTEMPT (NO REPEAT NEEDED) ☐

2^ND ATTEMPT (REPEAT OF INFORMATION NEEDED) ☐

3^RD ATTEMPT (WITH PARAPHRASING/ALTERNATE LANGUAGE) ☐

4^TH ATTEMPT INDICATES LACK OF UNDERSTANDING ☐

Thank you we’re almost finished.

What if I have questions?

If you have questions right now, please talk to the person who is reviewing this form with you. You can also contact the people below.

If you have any questions about the study, please contact: Jaymie Lorthridge, Westat Study Contact 1-800-WESTAT1 (937-8281), x5871 [email protected]

For questions about your rights as a participant in this study, contact: The Committee for the Protection of Human Subjects, (916) 326-3660.

IF “4^TH ATTEMPT INDICATES LACK OF UNDERSTANDING,” IS SELECTED ONE OR MORE TIMES THANK THE YOUTH AND TELL HIM OR HER THAT HE OR SHE WILL NOT HAVE TO BE IN THE STUDY.

Thank you. Now, I’m going to check my records to see what questions you will be asked or if you will be asked any questions at all.

According to my records, you do not have to answer any more questions. But I really appreciate that you took the time to help us.

IF THE YOUTH HAS ANSWERED ALL QUESTIONS CORRECTLY WITHIN THREE ATTEMPTS CONTINUE WITH THE SECTION BELOW.

Participation Decision

Please check one of the boxes to let us know if you do or do not want to participate. You will receive a copy of this form.

 Yes. By checking this box, I am saying that I read or listened to someone read this form that I understand what these documents say, and that I agree to be in this study.

 No. By checking this box, I am saying that I do not want to be in the study.

________________________________ ___________________________

Participant Signature Participant Printed Name

___________________________________

Date

Witness Signature

In my judgment the participant is voluntarily and knowingly agreeing to participate in this research study, and has received a copy of the Research Participant’s Bill of Rights.

____________________________ ____ ________________________

Signature of Witness to Assent Process Date Name of witness

RISE YOUTH INTERVIEW

DATE: _______________________________________

EVALUATION id: ___________________________

INTERVIEWER: _______________________________________

interview task:

☐BASELINE

☐FOLLOW-UP

CHILD’S sexual orientation:

☐ LESBIAN

☐GAY

☐BISEXUAL

☐QUESTIONING

CHILD’s gender identification:

☐TRANSGENDER or GENDER NON-CONFORMING

Self-Acceptance and Comfort LGBTQ Status

[note: Read the following statement aloud to the youth:

We want to understand how youth feel about identifying as LGBTQ so I am going to ask you a few questions about how you feel about being [insert how Youth identified].

[If being administered as the follow-up measure add:]

You may remember some of these questions from the last time we talked. Don’t try to remember what you said the last time, just focus on the questions today and think about the last two months [refer to actual time (e.g. January & February, etc.)].

DO YOU HAVE ANY QUESTIONS BEFORE I BEGIN?

[GO TO SECTION 1 IF YOUTH IDENTIFIES AS L, G, OR B]

[GO TO SECTION 2 IF YOUTH IDENTIFIES AS T OR IS GENDER NON-CONFORMING]

[GO TO SECTION 3 IF YOUTH IDENTIFIES AS Q]

SECTION 1

Complete this section if youth identifies as Lesbian, Gay, or Bisexual
Please look at this card [hand the rating scale to the youth] and answer if you strongly disagree, disagree, neither agree or disagree, agree, or strongly agree with each statement. [check the box indicating the youth's response]		Strongly Disagree	Disagree	Neither Agree or Disagree	Agree	Strongly Agree
1.a	I am comfortable with being [refer to how the youth identified]
1.b	I accept the fact I am [refer to how the youth identified].
1.c	I am happy being [refer to how youth identified].
1.d	I am comfortable talking about being [refer to how youth identified].
1.e	If my heterosexual friends (those who like or attracted to the opposite sex) knew about the fact I am [refer to how youth identified], I would feel uncomfortable.
1.f	Sometimes I wish I were not [refer to how youth identified].
1.g	I do not want anyone to know I am [refer to how the youth identified].

SECTION 2

Complete this section if youth identifies as Transgender, or is gender non-conforming
Please look at this card [hand the rating scale to the youth] and answer if you strongly disagree, disagree, neither agree or disagree, agree, or strongly agree with each statement. [check the box indicating the youth's response]		Strongly Disagree	Disagree	Neither Agree or Disagree	Agree	Strongly Agree
2.a	I am comfortable with being transgender/feeling that I am really [REFER TO HOW YOUTH IDENTIFIED].
2.b	I accept the fact I am really [REFER TO HOW YOUTH IDENTIFIED].
2.c	I am happy feeling that I am [REFER TO HOW YOUTH IDENTIFIED].

SECTION 3

Complete this section if youth identifies as Questioning his/her sexual orientation
Please look at this card [hand the rating scale to the youth] and answer if you strongly disagree, disagree, neither agree or disagree, agree, or strongly agree with each statement. [check the box indicating the youth's response]		Strongly Disagree	Disagree	Neither Agree or Disagree	Agree	Strongly Agree
3a.	It’s ok that I am still figuring out my sexual orientation.
3b1.	If my heterosexual friends (those who like or attracted to the opposite sex) knew I was questioning my sexual orientation, I would feel uncomfortable.
3b2.	If my LGBT friends knew I was questioning my sexual orientation, I would feel uncomfortable.
3c.	I feel pressure to decide what my sexual orientation really is.
3d.	I am depressed/anxious because I am questioning or just not sure about my sexual orientation.
3e.	I do not want people to know that I am questioning or just not sure about my sexual orientation.
3f.	I am happy exploring my sexuality and do not want to label myself right now.
3g.	I am worried that my “true” sexual orientation may be different than what I think it is or want it to be.
3h.	I think it is good to have experiences with different types of people before deciding what sexual orientation fits me best.
3i.	I do not want to be labeled as being “gay,” “straight,” “bi,” or any other category right now. I want to just date whoever I am attracted to without worrying about “what I am.”

Items in Sections 1 & 2 of The Self-Acceptance and Comfort Scale (LGBTQ Status) was based on the work of Rosario, M., Schrimshaw, E. W., Hunter, J., & Braun, L. (2006). Sexual identity development among lesbian, gay, and bisexual youth: Consistency and change over time. Journal of Sex Research, 43(1), 46-58, and the Nungesser Homosexual Attitudes Inventory [NHAI]. Nungesser, L. G. (1983). Homosexual acts, actors, and identities. New York: Prager. Reference material was adapted to be developmentally appropriate and to include transsexual youth. Items concerning questioning youth were adapted for this scale based in part on an informal survey of internet discussion forums and the work of Diamond, L. M. (2003). Was it a phase? Young women’s relinquishment of lesbian/bisexual identities over a 5-year period. Journal of Personality and Social Psychology, 84, 352-364.“

Supporting/Rejecting Perceptions Survey

[Note: read the following statement out loud to the youth:]

We are doing a study about youth in foster care who are Lesbian, Gay, Bisexual, Transgender, or Questioning their sexual orientation. We want to know if some people these youths know accept or reject them being Lesbian, Gay, Bisexual, Transgender, or Questioning––LGBTQ for short.

[Hand the youth the rating scale card]

I am going to ask you about some people in your life. The five numbers on this card rate how much the people in your life act like they accept or reject you being [insert youth’s sexual orientation and/or gender identity ]. For each person, tell me the number that best matches how much he or she rejects or accepts you being [insert youth’s sexual orientation and/or gender identity].

NOTE: IF THIS IS A FOLLOW-UP, ASK YOUTH TO INDICATE EACH OF THE FOLLOWING PEOPLE’S REACTION TO HIS/HER BEING [INSERT YOUTH’S SEXUAL orientation and/or gender identity] IN THE LAST 2 MONTHS.

[Interviewer: point to each number and read the definition]

1= a lot of rejection,

2 = some rejection,

3 = neutral,

4 = some acceptance,

5 = a lot of acceptance.

DO YOU HAVE ANY QUESTIONS?

[If the youth does not understand, read the above script again. If the youth still does not understand use the training manual for instructions.]

[Note:] For brothers and sisters and other family below, ask about the foster family, if applicable. If youth is in a group home or other group care, ask about the director or other staff member.		[Read:] On a scale of 1-5, how much does your [insert name here] accept or reject your being [insert youth’s sexual orientation and/or Gender Identity]? [Circle the number response in the space below.]					N/A (not applicable)
1	Foster mother:	1	2	3	4	5	☐
2	Brothers in foster family (if any):	1	2	3	4	5	☐
3	Foster father:	1	2	3	4	5	☐
4	Sisters in foster family (if any):	1	2	3	4	5	☐
5	Other relatives of foster family:	1	2	3	4	5	☐
6	Best (same sex) friend who likes members of the opposite sex:	1	2	3	4	5	☐

[Read:] On a scale of 1-5, [insert phrase here] accept or reject your being [insert youth’s sexual orientation and/or gender identity]? [Circle the number response in the space below.]							N/A (not applicable)
7	How much do most (same sex) other friends who likes members of the opposite sex accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐
8	How much does your best (opposite sex) friend who likes members of the opposite sex accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐
9	How much do most (opposite sex) other friends who like members of the opposite sex accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐
10	How much do teachers accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐
11	How much do schoolmates accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐
12	How much do neighbors accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐
13	How much do caseworkers accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐
14	How much do ministers accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐
15	How much do your co-workers: (if employed) accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]? [PUT N/A IF NOT APPLICABLE]	1	2	3	4	5	☐
16	How much does your boss: (if employed) accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]? [put N/A if not applicable]	1	2	3	4	5	☐
17	How much do people attracted to members of the opposite sex in general accept or reject your being [INSERT YOUTH’S SEXUAL ORIENTATION AND/OR GENDER IDENTITY]?	1	2	3	4	5	☐

The Supporting/Rejecting Perceptions Survey was adapted for youth in foster care from the Actual Societal Reaction (SR) and Putative Societal Reaction (PSR) and Psychological Adjustment Scales by Ross, M. W. (1985). Actual and anticipated societal reaction to homosexuality and adjustment in two societies. The Journal of Sex Research, 21(1), 40-55.

Permanent Connections Inventory Child Version

[RECORD THE AGE OF YOUTH:] _____________

[NOTE: Read the following statement aloud to the youth:]

[For younger children, UNDER AGE 8:]
In your life, has there been any adult who has been especially helpful to you?

[For older children and youth, age 8+:]
I’m going to ask you about people in your life who you believe are your permanent connections. Permanent connections are adults who have been helpful to you and are committed to you to be a life-long source of support. These people can be someone such as parents, relatives, foster parents, adult siblings, close friends of the family, relatives of your foster family or former foster family, coaches, teachers, or mentors.

1. Can you think of anyone like that in your life?

□ Yes (CONTINUE)

□ No (STOP)

2. Tell me the name of one of these adults?	3. What type of relationship do you have with this person? 1 = biological parent 2 = stepparent 3 = adoptive parent 4 = guardian 5 = relative (specify ________________) 6 = foster parent 7 = adult sibling 8 = fictive kin (e.g. close friend of family, relative of foster or former foster family) (specify _________________________) 9 = mentor (teacher, coach) 10 = professional (CSW, counselor, CASA) 11 = other (specify ________________)	4. What is the likelihood that this person will be a committed source of support to you throughout your life? Would you say not at all likely, a little likely, somewhat likely, or very likely? 0 = Not at all likely 1 = A little likely 2 = Somewhat likely 3 = Very likely
Person 1.		0 1 2 3
[Is there anyone else?]
Person 2.		0 1 2 3
[Is there anyone else?]
Person 3.		0 1 2 3
[Is there anyone else?]
Person 4.		0 1 2 3
[Is there anyone else?]
Person 5.		0 1 2 3

5. For each person we just talked about, how much has that person done the following?
Would you say not at all, a little, some, or a lot?

[CIRCLE RESPONSE]	0 = Not at all 1 = A little 2 = Some 3 = A lot
	Person 1	Person 2	Person 3	Person 4	Person 5
5A. Shown that s/he cares about you and what happens to you?	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
5B. Explained things to you, told you things that you need to know, or helped you solve a problem?	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
5C. Spent time with you?	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
5D. Expressed support for your sexual orientation/gender identity/questioning about these issues? [if applicable]	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3

6. For each person we just talked about, how likely would it be that this person would do the following things with you? Would you say not at all likely, a little likely, somewhat likely, or very likely?

[CIRCLE RESPONSE]	0 = Not at all likely 1 = A little likely 2 = Somewhat likely 3 = Very likely
All Ages	Person 1	Person 2	Person 3	Person 4	Person 5
6A. Invite you for holiday dinner like Thanksgiving	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6B. Celebrate your birthday with you	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6C. Have you spend the weekend with them	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6D. Talk with you when you’re feeling bad	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6E. Listen to you when you’re crying	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6F. Be someone you could call in the middle of the night if you needed something	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6G. Give you a ride to a friend’s house	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6H. Pay for an activity you want to do like a camp or an after-school activity	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6I. Help you with your homework	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6J. Still love you when you make a mistake	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6K. Help you understand things about your family	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6L. Make you laugh	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6M. Take you with them to church or other spiritual events	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6N. Make you feel special	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3

6O. Take you with them on a vacation	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6P. Help you understand things about where you came from/ your family tree	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6Q. Make you feel loved	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6R. Take you with them to do something fun like go to a movie or the fair	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6S. Help you understand things about your culture or heritage	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6T. Make you feel safe just being with them	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6U. Make you feel like you have a place in the world where you belong	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6V. Help you see your siblings, if that was possible	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3

AGE 16 AND OLDER ☐ Yes ☐ No	0 = Not at all likely 1 = A little likely 2 = Somewhat likely 3 = Very likely
[CIRCLE RESPONSE]	Person 1	Person 2	Person 3	Person 4	Person 5
6AA. Help you fill out a job application	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6BB. Give you access to a computer	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6CC. Cosign on an apartment when you are on your own	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6DD. Help you figure out how to take out a car loan or get auto insurance	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6EE. Talk with you about your options for college	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6FF. Help you fill out a financial aid application	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6GG. Give you rides to job interviews	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6HH. Let you do your laundry at their house when you’re on your own	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6II. Tell you how to do things in your apartment like how to turn off the water on the toilet	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6JJ. Teach you to cook	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3
6KK. Take you grocery shopping	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3	0 1 2 3

The Permanent Connections Inventory- youth version was developed specifically for the Permanency Innovations Initiative and the RISE project. However, some of the items found in question 6 were adapted from the Inventory of Supportive Figures by Hunter & Everson, 1990 found in Runyan, D., Dubowitz, H., English, D.J., Kotch, J.B., Litrownik, A., Thompson, R., & The LONGSCAN Investigator Group (2011). Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) Assessments 0-14 [Dataset]. Available from National Data Archive on Child Abuse and Neglect Web site, http://www.ndacan.cornell.edu

RISE CCT Youth Debriefing Protocol

Terms used in youth instruments:

Lesbian

Gay

Bisexual

Questioning

Transgender

LGBTQ

Heterosexual

Sexuality

Gender

Gender Identity

Sexual Orientation

Debriefing Questions:

1a. In your mind, what does “gender identity” mean to you? Open

1b. Before this interview, had you ever heard the words “gender identity” before? Yes/No/I don’t know

1c. Is there another word you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that word is? Open

If the respondent showed any confusion with these terms during the interview, describe the confusion in the space below.

2a. In your mind, what does “sexual orientation” mean to you? Open

2b. Before this interview, had you ever heard the words “sexual orientation” before? Yes/No/I don’t know

2c. Is there another word you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that word is? Open

If the respondent showed any confusion with these terms during the interview, describe the confusion in the space below.

3a. In your mind, what does it mean when someone is questioning their gender identity, or sexual orientation? Open

3b. Before this interview, had you ever heard the word “questioning” used to refer to how someone feels about their gender identity, or sexual orientation? Yes/No/I don’t know

3c. Is there another word you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that word is? Open

If the respondent showed any confusion with this term during the interview, describe the confusion in the space below.

4a. Do you think the phrases “sexual identity” and “sexual orientation” mean the same thing or are they different? Same/different/don’t know

If different: In your mind, in what ways are they different? Open

4b. Do you think the phrases “sexual identity” and “gender identity” mean the same thing or are they different? Same/different/don’t know

If different: In your mind, in what ways are they different? Open

4c. Do you think the phrases “sexual orientation” and “gender identity” mean the same thing or are they different? Same/different/don’t know

If different: In your mind, in what ways are they different? Open

5a. What does it mean to say someone is “gay”? Open

5b. Before this interview, had you ever heard this word before? Yes/No/I don’t know

5c. Is there another word you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that word is? Open

6a. In your mind, what does it mean to be a boy who “likes or is attracted to” other boys? Open

6b. Do you think the phrase “a boy who likes or is attracted to other boys” is more clear, less clear, or the same as using the word “gay”? More clear/less clear/the same/don’t know

If the respondent showed any confusion with these terms during the interview, describe the confusion in the space below.

7a. What does it mean to say someone is a “lesbian”? Open

7b. Before this interview, had you ever heard this word before? Yes/No/I don’t know

7c. Is there another word you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that word is? Open

8a. In your mind, what does it mean to be a girl who “likes or is attracted to” other girls? Open

8b. Do you think the phrase “a girl who likes or is attracted to other girls” is more clear, less clear, or the same as using the word “gay” or “lesbian”? More clear/less clear/the same/don’t know

If the respondent showed any confusion with these terms during the interview, describe the confusion in the space below.

9a. What does it mean to say someone is “bisexual”? Open

9b. Before this interview, had you ever heard this word before? Yes/No/I don’t know

9c. Is there another word you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that word is? Open

10a. In your mind, what does it mean to be someone who “likes or is attracted to” both boys and girls? Open

10b. Do you think the phrase “someone who likes or is attracted to both boys and girls” is more clear, less clear, or the same as just using the word “bisexual”? More clear/less clear/the same/don’t know

If the respondent showed any confusion with these terms during the interview If confusion with terms during the interview, describe the confusion in the space below.

11a. What does it mean to say someone is transgender? Open

11b. Before this interview, had you ever heard this word before? Yes/No/I don’t know

11c. Is there another word you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that word is? Open

12a. In your mind, what does it mean when a boy feels like a girl or a girl feels like a boy? Open

12b. Do you think the description “when a boy feels like a girl or a girl feels like a boy” is more clear, less clear, or the same as using the word “transgender”? More clear/less clear/the same/don’t know

If the respondent showed any confusion with these terms during the interview, describe the confusion in the space below.

13a. In your mind, what does LGBTQ mean to you? Open

13b. Before this interview, had you ever heard that word before? Yes/No/I don’t know

13c. Is there another word you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that word is? Open

If the respondent showed any confusion with these terms during the interview, describe the confusion in the space below.

14a. I asked you about your “heterosexual friends.” In your mind, what does heterosexual mean to you? Open

14b. In your mind, what does it mean to be someone who is “attracted to the opposite sex”? Open

14c. Do you think the phrase “attracted to the opposite sex” is more clear, less clear, or the same as using the word “heterosexual”? More clear/less clear/the same/don’t know

14d. Before this interview, had you ever heard that phrase before? Yes/No/I don’t know

14e. Is there another phrase you or your friends use instead? Yes/No/I don’t know

If Yes: Can you tell me what that phrase is? Open

If the respondent showed any confusion with these terms during the interview, describe the confusion in the space below.

__________________________________________________________________________________________The collection of information described in this assent is voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is 0970-0408 and it expires XX/XX/XXXX.

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