Attachment C - 3M Cognitive Interview Instrument for High School Aged Youth

Attachment C - 3M Cognitive Interview Instrument for High School Aged Youth_Updated Nov 2014.docx

Pre-testing of Evaluation Surveys

Attachment C - 3M Cognitive Interview Instrument for High School Aged Youth

OMB: 0970-0355

Document [docx]
Download: docx | pdf

Cognitive Interview Questionnaire

PLEASE DO NOT OPEN UNTIL YOU ARE ASKED TO DO SO


















The Paperwork Reduction Act Burden Statement: This collection of information is voluntary and will be used to learn more about questions that may be used in healthy marriage and relationship education programming and evaluation. Public reporting burden for this collection of information is estimated to average 90 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. 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 0970-0355 and it expires 01/31/2015.

Question 1:

Please indicate whether you agree or disagree with the following statements. Would you say you strongly disagree, disagree, agree, or strongly agree with each statement?

Question 1

Strongly Disagree

Disagree

Agree

Strongly

Agree

  1. Love is not enough to form a lasting relationship.

  1. Being in love is enough reason to get married.

  1. Marriages are happy or unhappy and there is not much you can do to change it.

  1. If you are happily married, you don’t need to work on your relationship.

  1. Marriage is lifelong.

  1. You should stay in a marriage for the kids.

  1. It is okay to live with a boyfriend/girlfriend without being married.

  1. It is okay to live with a boyfriend/girlfriend without a plan to be married.

  1. It is okay to have kids without being married.

  1. It is okay to have kids without a plan to be married.



Question 2:

In a healthy romantic relationship, how important is it that couples…

Question 2

Not important

Somewhat important

Very important

Extremely important

  1. Do not cheat.

  1. Do not call each other names.

  1. Do not argue.

  1. Give each other gifts.

  1. Encourage each other when life is hard.

  1. Support each other.

  1. Enjoy spending time together.

  1. Enjoy spending time with family.

  1. Enjoy spending time with friends.




Question 3:

Avoiding bad romantic relationships as a teenager will help teens:

Question 3

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. Achieve their goals in life.

  1. Have better lives.

  1. Have a healthy marriage someday.



Question 4:

Please indicate whether you agree or disagree with the following statements. Please select strongly disagree, disagree, agree, or strongly agree.

Question 4

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. You can learn from all romantic relationships, even if they end.

  1. Ending a bad romantic relationship is a good thing.

  1. A romantic partner should help me achieve my goals.

  1. A good romantic relationship should bring out the best in me.




Question 5:

Now please indicate whether you strongly disagree, disagree, agree, or strongly agree with the statements below.


A teen couple in a relationship should not:

Question 5

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. Date other people.

  1. Have sex with other people.



Question 6:

Question 6

Not at all important

A little important

Somewhat important

Very important

How important do you think being faithful - that is not cheating on your partner by seeing other people - is for you?





Question 7:

Please indicate whether you agree or disagree with the following statements. Please select strongly disagree, disagree, agree, or strongly agree.

Question 7

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. Children should be raised by parents in a stable, healthy relationship.

  1. Being raised by single parents is hard on kids.




Question 8:

When you think of your future, how likely is it that:

Question 8

Not at all

A Little

Somewhat

Probably

Definitely

  1. You will be married to one person for life?

  1. You will live with a boyfriend/girlfriend without being married?



Question 9:

When you think about your future before age 25, how likely is it that:

Question 9

Not at all

A Little

Somewhat

Probably

Definitely

  1. You will be married.

  1. You will have kids.



Question 10:

Please indicate how much you agree or disagree with the following statements. Would you say you strongly disagree, disagree, agree, or strongly agree that…

Question 10

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. My partner can trust me to keep their secrets.

  1. I lie to my partner.

  1. I listen to my partner when they talk about something that is important to them.

  1. We are able to talk about things that really matter in life.




Question 11:

When you have a serious disagreement or argument how often do you:

Question 11

Never

Hardly Ever

Sometimes

Often

  1. Stay mad at one another after an argument.

  1. Scream or yell at your partner when you are angry.

  1. Discuss your disagreements respectfully.



Question 12:

When you have a serious disagreement or argument how often are you:

Question 12

Never

Hardly Ever

Sometimes

Often

  1. Honest and truthful with your partner.

  1. Good at working out differences between you and your partner.

  1. Mean to your partner when you disagree.

  1. Able to talk about anything with your partner.



Question 13:

When you have a serious disagreement with your partner, how often do you:

Question 13

Never

Hardly Ever

Sometimes

Often

    1. Find a way to work things out.

    1. Discuss a problem without making things worse.

    1. Respect your partner’s point of view.

    1. Just walk away.

    1. Storm out.

    1. Avoid talking about it.

    1. Feel that there is no point talking about it.

    1. Get so angry you want to break or smash something.

    1. Feel uncomfortable talking about your thoughts and feelings.





Question 14:

Please indicate how much the items below sound like you.

Question 14

Not at all like me


A little like me


Somewhat like me


A lot like me


Exactly like me


  1. I help my partner be the best they can be.

  1. I support my partner in doing well in school.

  1. I help my partner avoid making mistakes that hurt them in life.

  1. I help my partner make good decisions.

  1. I help my partner achieve their goals in life.

  1. I help my partner have a good reputation.




Question 15:

Please indicate how often you have done the following in the past week:

Question 15

Not at all

Once

Once every few days

Once a day

More than once a day

  1. How often did you talk to your partner in person?


  1. How often did you communicate with your partner using technology?



1

Attachment C- 3M Cognitive Interview Instrument for High School Aged Youth

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
Authorshickman
File Modified0000-00-00
File Created2021-01-26

© 2024 OMB.report | Privacy Policy