2015 National Content Test

2015 NCT Race & Origin Reinterview Spec
Front Version 1.0

12/24/2014

BLKWebCATIFront
Tag / Name
Field Description
Universe
Form Pane Label
Question Text

A1 INTRO
Interviewer asks to speak to the Census respondent.
Intro
Read if incoming call: Thank you for returning our call.
Hello, I’m (your Name) from the U.S. Census Bureau. We recently conducted
the 2015 National Content Test. Now we’re doing a study to find out how well
we did our job. This interview should take about 7 minutes to complete.
May I speak with >?

Spanish question

Read if incoming call: Gracias por devolvernos la llamada.
Buenos días/Buenas tardes, soy (su Nombre) de la Oficina del Censo de los
EE.UU. Recientemente llevamos a cabo la Prueba Nacional del Contenido del
2015 . Ahora estamos realizando un estudio para saber cuan bien hicimos
nuestro trabajo. Debe tomar alrededor de 7 minutos completar esta entrevista.

Input Options

Spanish input

Fill Instructions

Spanish fill
instructions
Skip Instructions

¿Puedo hablar con >?
1-Yes, speaking with the correct person.
2- Yes, correct person comes to the phone.
3-No, correct person is not available now
4-Census Respondent permanently unavailable
5-Other outcome
Don’t Know
Refused
Blank is not an option on this screen.
1- Sí, hablo con la persona correcta.
2- Sí, la persona correcta viene al teléfono.
3- No, la persona correcta no está disponible ahora.
4- Respondedor del Censo no está disponible permanentemente.
5- Otro resultado.
If RNAME = blank, display “the person who completed the 2015 National
Content Test form”
Else display “”
If RNAME = blank, display “la persona que completó el formulario de la Prueba
Nacional del Contenido del 2015 ”
Else display “”
Set Instructions
Set CONTACTCOUNT = CONTACTCOUNT + 1 if valid response given
Skip Instructions:
If <1,2> GOTO RESIDENT
Else if <4> GOTO KNOWL_RESP
Else if <3, DK, RF> and CONTACTCOUNT > 1 GOTO KNOWL_RESP

2015 NCT Race & Origin Reinterview Spec
Front Version 1.0

12/24/2014

Else if <3, DK, RF> and CONTACTCOUNT <1, > GOTO CALLBACK
Else if <5> GOTO THANK
Special
Instructions

Can RNAME come from SCIF or back of instrument? Do I need a separate variable
name for the name from the SCIF or the name collected when scheduling an
appointment?
Can we get the data from the instrument front and back in the output data files?

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

A2 – KNOWL_RESP
Determine if knowledgeable respondent is available
INTRO <3, DK, RF> and CONTACTCOUNT>1
OR INTRO=4
Someone else
I need to speak with someone at least 15 years old who lives here and knows
about the people in this household. Would that be you?

Spanish question

Necesito hablar con alguien que tenga al menos 15 años de edad, que viva
aquí y conozca acerca de las personas en este hogar. ¿Sería usted esa
persona?
Input Options

Spanish input

Fill Instructions
Skip Instructions

1-Yes, knowledgeable person is on phone
2-Yes, new person comes to phone
3-Yes, but not available now
4-No
Don’t Know
Refused
Blank is not an option on this screen.
1- Sí, persona conocedora está en el teléfono
2- Sí, nueva persona viene al teléfono
3- Sí, pero no está disponible ahora
4-No
Skip Instructions:
−
If KNOWL_RESP=1,2, goto RESIDENT
−
If KNOWL_RESP= 4, DK, RF, goto SOMEONE_ELSE
−

Special
Instructions

Else, goto CALLBACK

2015 NCT Race & Origin Reinterview Spec
Front Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

A3 – RESIDENT
Determine if respondent lived at address
INTRO <1, 2> or KNOWL_RESP <1, 2>
Lived at address

Did you live or stay at on September 1, 2015?

Spanish question

Input Options

Spanish input
Fill Instructions

Spanish fill
instructions

Skip Instructions

¿Vivía o se quedaba usted en el 1 de septiembre de 2015 ?
1-Yes
2 - No
Don’t Know
Refused
Blank is not an option on this screen.
1 – Sí
2 - No
If INTRO = 2 or KNOWL_RESP=2 display “Hello, I’m (your Name) from the
U.S. Census Bureau. We recently conducted the 2015 National Content Test.
Now we’re doing a study to find out how well we did our job. This interview
should take about 7 minutes to complete.”
Else display blank
If INTRO = 2 or KNOWL_RESP=2 display “Buenos días/Buenas tardes, soy (su
Nombre) de la Oficina del Censo de los EE.UU. Recientemente llevamos a cabo
la Prueba Nacional del Contenido del 2015. Ahora estamos realizando un
estudio para saber cuan bien hicimos nuestro trabajo. Debe tomar alrededor de
7 minutos completar esta entrevista.”
Else display blank
Skip Instructions:
−
If RESIDENT=1 goto INTRO2
−

Special
Instructions

Else, goto SOMEONE_ELSE

2015 NCT Race & Origin Reinterview Spec
Front Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

A4 – SOMEONE_ELSE
Determine if someone who lived at address is available
KNOWL_RESP <4, DK, RF> or RESIDENT <2, DK, RF>
Anyone at address
Is there anyone living or staying there now who stayed at on
September 1, 2015?

Spanish question

¿Actualmente vive o se queda ahí alguna persona que se quedó en
el 1 de septiembre de 2015?

Input Options

1-Yes, new person comes to phone
2-Yes, but not available now
3-No
Don’t Know
Refused

Spanish input
options
Skip Instructions

Blank is not an option on this screen.
1- Sí, nueva persona viene al teléfono
2- Sí, pero no está disponible ahora
3-No
Skip Instructions:
−
If SOMEONE_ELSE=1, goto INTRO2
−
If SOMEONE_ELSE=3, goto THANK
−

Special
Instructions

Else, goto CALLBACK

2015 NCT Race & Origin Reinterview Spec
Front Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

A5 INTRO2
Survey introduction.
RESIDENT = 1 or SOMEONE_ELSE = 1
Received letter

This interview may be recorded for quality assurance purposes. Do I have your
permission to record this interview?
♦ If respondent indicates they do not wish to be recorded, please click on XXXX
stop recording button located in your CTI Toolkit Agent Desktop.
♦ Enter 1 to continue.

Spanish question

< Buenos días/Buenas tardes, soy (su Nombre) de la Oficina del Censo de los
EE.UU. Recientemente llevamos a cabo la Prueba Nacional del Contenido del
2015. Ahora estamos realizando un estudio para saber cuan bien hicimos
nuestro trabajo. Debe tomar alrededor de 7 minutos completar esta entrevista.>
Esta entrevista se podrá grabar con el fin de garantizar la calidad. ¿Me da
permiso para grabar esta entrevista?
♦Si el respondedor indica que no quiere que lo graben, haga clic en XXXX el botón
de detener la grabación que se encuentra en su CTI Toolkit Agent Desktop.

♦ Entre 1 para continuar.

Input Options

Spanish input
Fill Instructions

1-Continue
Don’t Know
Refused
Blank is not an option on this screen.
1- Continúe
If SOMEONE_ELSE=1 display “Hello, I’m (your Name) from the U.S. Census
Bureau. We recently conducted the 2015 National Content Test. Now we’re
doing a study to find out how well we did our job. This interview should take
about 7 minutes to complete.”
Else display blank

Spanish Fill
Instructions

If SOMEONE_ELSE=1 display “Buenos días/Buenas tardes, soy (su Nombre) de
la Oficina del Censo de los EE.UU. Recientemente llevamos a cabo el Censo del
2010. Ahora estamos realizando un estudio para saber cuan bien hicimos
nuestro trabajo. Debe tomar alrededor de 7 minutos completar esta entrevista.”

2015 NCT Race & Origin Reinterview Spec
Front Version 1.0

Else display blank
Skip Instructions
Special
Instructions

Skip Instructions:
GOTO TITLE13

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Front Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

A6 TITLE13
Confidentiality information.
INTRO2 = 2, DK, RF
Title 13
Your response to this survey is protected by law under Title 13 of the United
States Code. This is the same law that protects your privacy. No one outside
the Census Bureau will see your answers. This survey is voluntary and will take
about 7 minutes.
♦ Enter 1 to continue.

Spanish question
Conforme con el Título 13 del Código de los Estados Unidos, su respuesta a esta
encuesta está protegida por la ley. Ésta es la misma ley que protege su
privacidad. Nadie fuera de la Oficina del Censo puede ver sus respuestas. Esta

encuesta es voluntaria y tomará alrededor de 7 minutos.
♦ Entre 1 para continuar.
Input Options

Spanish input
Fill Instructions
Skip Instructions
Special
Instructions

1-Continue
Blank is not an option on this screen.
1- Continúe

Skip Instructions:
GOTO ROSTER1

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

BLKPreDemo.BLKName
Tag / Name
Field Description
Universe
Form Pane Label

B1a – FNAME
Collect roster first names.

Question Text

First Name

♦ Enter First Name.
♦ If there are no additional people, type 999 in the first name and press enter.

Spanish Question

♦ Entre el primer nombre.
♦ Si no hay que listar personas adicionales, entre 999 para continuar.
Input Options
Fill Instructions

String 20.
If LNO=1, display:
We need to make a list people of living or staying there on September 1, 2015. We
want to list people where they usually live and sleep. For example, college students
and armed forces personnel should be listed where they live and sleep most of the
time.

Let’s start with you, what is your first name?

If ROOMATE=1 or RELATIVE=1 or NO_PERM=1, display:
Anyone else?
What is that person’s first name?

If BABY=1, display:
Any other children?
What is that child’s first name?

Else if LNO=2, display:
What is the first name of the next person who was living and sleeping

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

there on September 1, 2015?
Else display:
Anyone else?
What is that person’s first name?
Spanish Fill
Instructions

If LNO=1, display:
Tenemos que hacer una lista de las personas que vivían o se quedaban allí el 1 de
septiembre de 2015. Queremos listar a las personas donde usualmente viven y
duermen. Por ejemplo, los estudiantes universitarios y los miembros de las Fuerzas
Armadas deben listarse donde viven y duermen la mayor parte del tiempo.

Vamos a empezar con usted, ¿cuál es su nombre?
If ROOMATE=1 or RELATIVE=1 or NO_PERM=1, display:
¿Hay alguien más?
¿Cuál es el nombre de esa persona?
If BABY=1, display:
¿Algún otro niño?
¿Cuál es el nombre de ese(a) niño(a)?

Else if LNO=2, display:
¿Cuál es el nombre de la siguiente persona que vivía y dormía allí el 1 de
septiembre de 2015?
Else display,

¿Hay alguien más?

¿Cuál es el nombre de esa persona?
Skip Instructions

Set Instructions:
ROSFLG
−
Set ROSFLG=2 for all persons collected here
DELETE

2015 NCT Race & Origin Reinterview Spec
Roster Version 1.0
−

Set DELETE=0 for all persons collected here

LNO:
−
Set LNO= previous LNO + 1
Skip Instructions:
−
If FNAME =999 GOTO next BLKPreDemo.BLKRoster question
−
Else GOTO MNAME
Special
Instructions

First Name: Store as FNAME, 20 Characters, alphanumeric

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label

B1b – MNAME
Collect middle initials.

Question Text

Middle name?

MI

♦ Enter Middle Initial.
Spanish Question

¿ Segundo nombre?

♦ Entre la inicial del segundo nombre.
Input Options

String 20.
Blank, Don’t Know, and Refused are options.

Fill Instructions
Skip Instructions
Special
Instructions

Skip Instructions:
−
GOTO LNAME
Middle Initial: Store as MNAME, 20 Characters, alphanumeric
Don’t know and refused values are stored as blanks.

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label

B1 – LNAME
Collect roster last names.

Question Text

Last name?

Spanish Question

♦ Enter Last Name.
¿Apellido?

Last Name

♦ Entre el apellido.
Input Options
Fill Instructions
Skip Instructions
Special
Instructions

String 20.
Skip Instructions:
−
Create new row to collect name and GOTO FNAME of new row
Last Name: Store as LNAME, 20 Characters, alphanumeric

12/24/2014

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

B3 - BABY
Add any additional children staying the at sample address to the roster.
ROSTER2=2, DK, RF -ORROSTER3=999
Babies or foster children
We do not want to miss any people who might have been staying there on April
1. Were there any additional people that you didn’t mention, for example:
Babies or foster children?

Spanish Question

Input Options

Spanish Input

No queremos dejar de contar a ninguna persona que pudiera haber estado
quedándose allí el 1 de abril. ¿Hubieron algunas personas adicionales a las
cuales usted no mencionó, por ejemplo:
¿Bebés o hijos de crianza del programa foster del gobierno?
1-Yes
2-No
Don’t know
Refused
Blank is not an option on this screen.
1 – Sí

2 - No
Fill Instructions
Skip Instructions

−
−

Special
Instructions

If BABY=1, goto FNAME

Else if BABY=2, DK, RF, goto RELATIVE
Help: H_B3_BABY

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish question

Input Options

Spanish input
Fill Instructions
Skip Instructions

B5 -RELATIVE
Add any additional relatives staying at the sample address
BABY=2, DK, RF -ORFNAME and BABY=1,2,DK, RF
Additional relatives
Were there any additional people staying there on April 1 that you haven’t
mentioned, for example:
Any other relatives?
¿Hubieron alguna personas adicionales a las cuales usted no mencionó, por
ejemplo:
¿Algún otro pariente?
1-Yes
2-No
Don’t Know
Refused
Blank is not an option on this screen.
1 – Sí
2 - No
−
−

Special
Instructions

If RELATIVE=1, goto FNAME

Else if RELATIVE=2, DK, RF, goto ROOMMATE
Help: H_B4_RELATIVE

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

I don’t think this screen is needed. Can they just go back to FNAME like BABIES
does?

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish question

Input Options

Spanish input
Fill Instructions
Skip Instructions

B6 - ROOMMATE
Add any additional relatives staying at the sample address
RELATIVE=2, DK, RF -ORNAME_REL=999
Roommates
Were there any additional people staying there on April 1 that you haven’t
mentioned, for example:
Roommates or other nonrelatives?
¿Hubieron alguna personas adicionales a las cuales usted no mencionó, por
ejemplo:
¿Compañeros de cuarto o algún otro no pariente?
1-Yes
2-No
Don’t Know
Refused
Blank is not an option on this screen.
1 – Sí
2 - No
−
−

Special
Instructions

If ROOMMATE=1, goto FNAME

Else if ROOMATE=2, DK, RF, goto NO_PERM
Help: H_B6_ROOMMATE

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text
Spanish question

Input Options

Spanish input
Fill Instructions
Skip Instructions

B8 - NO_PERM
Add any additional relatives staying at the sample address
ROOMMATE=2, DK, RF -ORNAME_ROOMMATE=999
No permanent place
How about anyone staying there on September 1st who had no other permanent
place to live?
¿Y había alguien quedándose allí el 1 de septiembre que no tuviera otro lugar
permanente donde vivir?
1-Yes
2-No
Don’t Know
Refused
Blank is not an option on this screen.
1 – Sí
2 - No
−
−

Special
Instructions

If NO_PERM=1, goto FNAME

Else if NO_PERM=2, DK, RF, goto COLLEGE
Help: H_B8_NO_PERM

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe

Form Pane Label
Question Text

Spanish question

Input Options

Spanish input
Fill Instructions
Spanish fill
instructinos
Skip Instructions

B9 -COLLEGE
Are any people on roster living at college
NO_PERM=2, DK, RF -ORNAME_NO_PERM=999 -ORLNO=49
Away college or military
Now, thinking of all the people you just mentioned, in September, living in college housing or away for the military?
Ahora, pensando en todas las personas que usted acaba de mencionar, en
septiembre ¿vivía (usted/alguien) en una vivienda universitaria o en otro lugar
para servicio militar?
1-Yes
2-No
Don’t Know
Refused
Blank is not an option on this screen.
1 – Sí
2 - No
If max LNO=1 display: were you
Else display: was anyone
If max LNO=1 display: usted
Else display: alguien
−
If COLLEGE=1 and max LNO>1, goto COLLEGE_NAME
−
−

Special
Instructions

Else if COLLEGE=1 and max LNO=1, goto THANK

Else if COLLEGE=2, DK, RF, goto INST
Help: H_B9_COLLEGE

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

B9a –COLLEGE_NAME
Name of person living at college
COLLEGE=1 and more than one person on roster
Who is at college or military
Who was living in college housing or away for the military?
Read names aloud if necessary.
Enter all that apply, separate with commas.
If no one is away, enter 50 to continue.

Spanish question

Input Options
Fill Instructions
Skip Instructions

Special
Instructions

¿Quién vivía en una residencia universitaria o en otro lugar mientras estaba
en el servicio militar?
Lea en voz alta si fuera necesario.
Entre todos los que apliquen, separados por comas.
Si no hay nadie fuera, entre 50 para continuar.
1-49, more than one value accepted or 50 only
Set Instructions:
DELETE:
−
Set DELETE=1 for each person selected.
Skip Instructions:
Goto INST
Display roster with person number, first name, middle name and last name.

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish question
Input Options

Spanish input
Fill Instructions
Spanish fill
instructions
Skip Instructions

B10 -INST
Are any people on roster institutionalized
COLLEGE=2, DK, RF -ORCOLLEGE_NAME=<1-49 or 999>
Institutionalized
On September 1, 2015, in a place like a nursing home
or a jail or prison?
El 1 de septiembre de 2015, ¿se encontraba en un lugar como
un hogar de convalecencia, cárcel o prisión?
1-Yes
2-No
Don’t Know
Refused
Blank is not an option on this screen.
1 – Sí
2 - No
If max LNO=1 display: were you
Else display: was anyone
If max LNO=1 display: usted
Else display: alguien
−
If INST=1 and max LNO>1, goto INST_NAME
−
−

Special
Instructions

If INST=1 and max LNO=1, goto THANK

Else if INST=2, DK, RF, goto RANDOMSCREEN
Help: H_B11_INST

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

B10a –INST_NAME
Name of institutionalized
INST = 1
Who institutionalized
Who was living away in a place like a nursing home or jail or prison?
Read names aloud if necessary.
Enter all that apply, separate with commas.
If no one is away, enter 50 to continue.

Spanish question

Input Options
Fill Instructions
Skip Instructions

Special
Instructions

¿Quién vivía en otra parte, en un lugar como un hogar de convalecencia, o una
cárcel o prisión?
Lea en voz alta si fuera necesario.
Entre todos los que apliquen, separados por comas.
Si no hay nadie fuera, entre 50 para continuar.
1-49, more than one value accepted or 50 only
Set Instructions:
DELETE:
−
Set DELETE=3 for each person selected.
Skip Instructions:
Goto RANDOMSCREEN
Display roster with person number, first name, middle name and last name.
If DELETE=1, 2 for a person, display name in gray and do not allow that person to
be selected.
Else display name in black.

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe

Form Pane Label
Question Text

Spanish question

Input Options
Fill Instructions
Skip Instructions

B11 –RANDOMSCREEN
Warn interviewer of person selection
LNO=49 OR
INST=2, DK, RF
INST_NAME=<1-49 or 999>
Random selection screen
♦
The instrument will now randomly select one other person in the household
to collect some additional information.
♦

If there are changes that need to be made to the household, BACKUP and
make the necessary changes.

♦

Enter “1” if there are NO MORE CHANGES to the household roster.

♦

Ahora el instrumento seleccionará al azar a otra persona en la vivienda para
recopilar información adicional.

♦

Si existen cambios que necesitan hacerse con respecto a la vivienda,
RETROCEDA y haga los cambios necesarios.

♦

Entre “1” si NO HAY MÁS CAMBIOS a la lista de los miembros del
hogar.

1
Goto SELECT

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

B12 –SELECT
Select 2nd person to interview
RANDOMSCREEN
.

♦ Read if necessary: We have randomly selected from your
household. We are selecting only one other person because we want to keep the
interview short. >
♦ Enter 1 to continue.
Spanish question

.

♦ Lea si es necesario: Hemos seleccionado a al azar de
su hogar. Solamente estamos seleccionando a una otra persona porque
queremos que la entrevista sea corta.>
♦ Entre 1 para continuar.
Input Options
Fill Instructions

1
Fill 1
If PERCOUNT>2 display “We are going to ask for information about you
and one other person in the household, .
Read if necessary: We have randomly selected from your
household. We are selecting only one other person because we want to keep the
interview short.”
If PERCOUNT=1, 2 display blank.
Fill 2
Display

Spanish fill
instructions

Fill 1
If PERCOUNT>2 display “We are going to ask information about you and
one other person in the household, .

♦ Lea si es necesario: Hemos seleccionado a al azar de
su hogar. Solamente estamos seleccionando a una otra persona porque
queremos que la entrevista sea corta.”
If PERCOUNT=1, 2 display blank.
Fill 2

Skip Instructions

Display
Set Instructions:

If PERCOUNT=2 set NAME_RANDOM=[First Name Middle Name Last
Name] of randomly LNO2.
If PERCOUNT>2 set NAME_RANDOM = [First Name Middle Name Last Name]

2015 NCT Race & Origin Reinterview Spec

12/24/2014

Roster Version 1.0

of randomly selected person.
PERCOUNT: Count of people on the roster.
−
Set PERCOUNT=last person number (for a valid person, not last person row)
minus the number of people where DELETE=<1, 2, 3, 4>
Skip Instructions:
goto AGE

−

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

BLKAQE
Tag / Name
Field Description
Universe
Form Pane Label
Question Text

C1 – AGE
Respondent age
SELECT
Age
What was your age on September 1, 2015?
♦ Read aloud when necessary: If you don’t know the exact age, please estimate.
♦ Make sure the respondent gives the age in completed years as of September 1,
2015. Do not round up.
♦ Do not enter age in months.
♦ For babies less than 1 year old, enter 0 as the age.

Spanish question
text

¿Cuál era la edad de usted el 1 de septiembre de 2015?
♦ Lea en voz alta cuando sea necesario: Si no conoce la edad exacta, haga el
favor de dar un estimado.
♦ Asegúrese de que el respondedor le dé la edad en años completos al 1 de

seeptiembre de 2015. No redondee la cifra.
♦ No entre la edad en meses.

♦ Para bebés menores de 1 año, entre 0 para la edad.
Input Options
Fill Instructions

Skip Instructions

Special
Instructions

Allow ages 0-125, Don’t Know, and Refused.

−

If the PERCOUNT=1, goto RACE_ORIGIN

−

Else goto AGE_2

Help: H_AGE
Only one response allowed.

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

C1a – AGE_2
Age of randomly selected person
PERCOUNT>1 and AGE
Age
How about ? (What was ’s age on
September 1, 2015?)
♦ Read aloud when necessary: If you don’t know the exact age, please estimate.
♦ Make sure the respondent gives the age in completed years as of September 1,
2015. Do not round up.
♦ Do not enter age in months.
♦ For babies less than 1 year old, enter 0 as the age.

Spanish question
text

¿Y ? (¿Cuál era la edad de el 1 de septiembre de
2015?)
♦ Lea en voz alta cuando sea necesario: Si no conoce la edad exacta, haga el
favor de dar un estimado.
♦ Asegúrese de que el respondedor le dé la edad en años completos al 1 de

septiembre de 2015. No redondee la cifra.
♦ No entre la edad en meses.

♦ Para bebés menores de 1 año, entre 0 para la edad.
Input Options
Fill Instructions

Allow ages 0-125, Don’t Know, and Refused.
1. Fill 1
Display:

Skip Instructions

−

Special
Instructions

Help: H_AGE

Goto REL

Only one response allowed.

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
C2 – REL
Field Description Obtain relationship for HH member in multi-person HH.
Universe
AGE_2
Form Pane Label

Relationship

Question Text

How is related to you? Is your opposite-sex husband,
wife, or spouse; opposite-sex unmarried partner; same-sex husband, wife, or spouse;
same-sex unmarried partner; son or daughter; brother or sister; father or mother;
grandchild; or something else?

Spanish question
text
Input Options

Spanish input
optinos

Fill Instructions

¿Cómo está relacionado(a) con usted?
1-Opposite-sex husband/wife/spouse
2-Opposite-sex unmarried partner
3-Same-sex husband/wife/spouse
4-Same-sex unmarried partner
5-Son or daughter
6- Brother or sister
7- Father or mother
8-Grandchild
9-Other
Don’t Know
Refused
Blank is not an option on this screen.
1-Esposo/esposa del sexo opuesto
2-Pareja no casada del sexo opuesto
3-Esposo/esposa del mismo sexo
4-Pareja no casada del mismo sexo
5-Hijo o hija
6- Hermano(a)
7- Padre o madre
8-Nieto(a)
9-Otro
Fill 1
•

Set Instructions
Skip Instructions

−
−
−
−

Display:

If REL=2, goto REL2
If REL=9, goto REL3
Else goto SEX

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Special
Instructions

Help: H_RELATIONSHIP

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
C2a – REL2
Field Description Obtain more information on relationship in a telephone interview
Universe
REL=2
Form Pane Label Type of Child
Question Text

♦ Ask or verify.

Is your biological son or daughter, adopted son or
daughter, OR stepson or stepdaughter?

Spanish question
text

♦ Pregunte o verifique.

¿Es su hijo o hija biológico(a), hijo o hija adoptivo(a), o
hijastro(a)?
Input Options

Spanish input
options

Fill Instructions

Set Instructions
Skip Instructions
Special
Instructions

1-Biological son or daughter
2- Adopted son or daughter
3- Stepson or stepdaughter
4-Foster son or daughter (DO NOT READ)
Don’t Know
Refused
Blank is not an option on this screen.
1- Hijo o hija biológico(a)
2- Hijo o hija adoptivo(a)
3- Hijastro(a)
4- Hijo(a) de crianza (NO LEA)
1. Fill 1
•
Display:

−
Goto SEX
Help: H_CHILD

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
C2b – REL3
Field Description Obtain more information on relationship in a telephone interview
Universe
REL=9
Form Pane Label Type of Other relationship
Question Text

♦ Ask or verify.

Is your parent-in-law, son-in-law or daughter-in-law,
other relative, roomer or boarder, housemate or roommate, foster child, or
other nonrelative?

Spanish question
text

♦ Pregunte o verifique.

¿Es su suegro(a), yerno o nuera, otro pariente,
inquilino(a), compañero(a) de casa o de cuarto, hijo de crianza U otra persona
que no es pariente?
Input Options

Spanish input
options

Fill Instructions

Set Instructions
Skip Instructions
Special

1-Parent-in-law
2- Son-in-law or daughter-in-law
3- Other relative
4-Roomer or boarder
5-Housemate or roommate
6-Foster child
7-Other nonrelative
Don’t Know
Refused
Blank is not an option on this screen.
1-Suegro(a)
2- Yerno o nuera
3- Otro pariente
4-Inquilino(a)
5-Compañero(a) de casa o de cuarto
6-Hijos de crianza del programa Foster del gobierno
7-Otra persona que no es pariente
2. Fill 1
•
Display:

−
Goto SEX
Help: H_CHILD

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Instructions

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe

C3 – SEX
Obtain sex of 1st person on roster
REL NE <2, 9> -ORREL2 – OR- REL3

Form Pane Label
Question Text

Sex1
♦ Ask or verify sex. Do not enter/record sex based upon observation or
responses to other items.
Are you male or female?

Spanish question
text

♦ Pregunte o verifique el sexo de todas las personas. No entre/registre el sexo
basándose en la observación o la respuesta a otras preguntas.
¿Es usted de sexo masculino o femenino?

Input Options

Spanish input
options

1-Male
2-Female
Don’t Know
Refused
Blank is not an option on this screen.
1-Sexo masculino
2-Sexo feminino

Fill Instructions

1. Fill 1
•
Display:

Skip Instructions

−

Special
Instructions

Help: H_SEX

Goto SEX_2

Only allow one response

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe

C3 – SEX_2
Obtain sex of randomly selected person.
REL NE 2 -ORREL2

Form Pane Label
Question Text

Sex2
♦ Ask or verify sex. Do not enter/record sex based upon observation or
responses to other items.
Is male or female?

Spanish question
text

♦ Pregunte o verifique el sexo de todas las personas. No entre/registre el sexo
basándose en la observación o la respuesta a otras preguntas.
¿Es de sexo masculino o femenino?

Input Options

Spanish input
options

1-Male
2-Female
Don’t Know
Refused
Blank is not an option on this screen.
1-Sexo masculino
2-Sexo feminino

Fill Instructions

2. Fill 1
•
Display:

Skip Instructions

−

Special
Instructions

Help: H_SEX

Goto RACE_ORIGIN

Only allow one response

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish question
text

12/24/2014

D1 – RACE_ORIGIN
Open-ended race or origin
PERCOUNT=1 and AGE
Or PERCOUNT>1 and SEX_2
Race or origin
What is your race or origin? You can provide more than one.
♦ Enter all that apply, separate with commas.
¿Cuál es la raza u origen de usted? Puede dar más de una respuesta.

♦ Entre todas las que apliquen, separadas por comas.
Input Options
Fill Instructions
Skip Instructions

String 100.

Special
Instructions

Help: H_RACE_ORIGIN

If PERCOUNT=1, goto E_INTRO
Else, goto RACE_ORIGIN_2

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

D2 – RACE_ORIGIN_2
Open-ended race or origin for person 2
PERCOUNT>1 and (RACE_ORIGIN)
Race or origin
What is ’s race or origin? You can provide more than one.

Spanish question
text

♦ Enter all that apply, separate with commas.
¿Cuál es la raza u origen de ? Puede dar más de una
respuesta.

♦ Entre todas las que apliquen, separadas por comas.
Input Options
Fill Instructions

String 100.
Fill 1
Display:

Skip Instructions
Special
Instructions

goto E_INTRO
Help: H_RACE_ORIGIN

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

−

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish question
text

E1 E_INTRO
Yes/no introduction
PERCOUNT=1 and RACE_ORIGIN
Or PERCOUNT>1 and RACE_ORIGIN_2
Continue
Now I am going to ask you a series of questions about race and origin and
would like you to respond to each one. You may say yes to as many as you wish.
These questions may seem repetitive, but it is important that we ask them of
each person to measure the quality of our census.
♦ Enter 1 to continue.
Ahora, le voy a hacer una serie de preguntas sobre raza y origen, y me gustaría
que respondiera a cada una de ellas. Usted se puede identificar con tantas razas
y/o tantos orígenes como desee. Estas preguntas pueden parecer repetitivas,
pero es importante que se las hagamos a cada persona para medir la calidad de
nuestro censo.

♦ Entre 1 para continuar.
Input Options
Fill Instructions
Skip Instructions
Special
Instructions

goto WHITE

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

E2 – WHITE
White
E_INTRO
White
Are you White?

Spanish question
text
Input Options

¿Es usted blanco(a)?

Spanish input
options
Fill Instructions
Skip Instructions
Special
Instructions

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Goto BLACK
Help: H_WHITE

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

E3 – HISPANIC
Hispanic
WHITE
Hispanic
Are you of Hispanic, Latino, or Spanish origin, for example, Mexican, Mexican
American, or Chicano; Puerto Rican; Cuban; or another Hispanic, Latino, or
Spanish origin?

Spanish question
text

Spanish input
options

¿Es usted de origen hispano, latino o español; por ejemplo, mexicano(a),
mexicano(a) americano(a), o chicano(a); puertorriqueño(a); cubano(a); o algún
otro origen hispano, latino o español?
1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Fill Instructions
Skip Instructions

Goto BLACK

Input Options

Special
Instructions

Help: H_HISPANIC

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

E4 – BLACK
Black
HISPANIC
Black
Are you Black or African American?

Spanish question
text
Input Options

¿Es usted negro(a) o africano(a) americano(a)?

Spanish input
options
Fill Instructions
Skip Instructions
Special
Instructions

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Goto ASIAN
Help: H_BLACK

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

•

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

MOVED TO AFTER ASIAN

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text
Spanish question
text
Input Options

Spanish input
options

E5 – ASIAN
Asian
BLACK
Asian
Are you Asian/?
¿Es usted asiático(a)?
1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Fill Instructions
Skip Instructions

Goto AIAN
Special
Instructions

Help: H_ASIAN

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text
Spanish question
text
Input Options

E6 – AIAN
American Indian or Alaska Native
ASIAN
American Indian or Alaska Native
Are you American Indian or Alaska Native?
¿Es usted indígena de las Américas o nativo(a) de Alaska?

Spanish input
options

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Fill Instructions
Skip Instructions

Goto MENA

Special
Instructions

Help: H_AIAN

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text
Spanish question
text
Input Options

E7 – MENA
Middle Eastern or North African
ASIAN
Middle Eastern or North African
Are you Middle Easetern or North African?
¿ Es usted del Medio Oriente o del Norte de África?

Spanish input
options

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Fill Instructions
Skip Instructions

Goto NHOPI

Special
Instructions

Help: H_MENA

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text
Spanish question
text
Input Options

E8 – NHOPI
Native Hawaiian or Other Pacific Islander
MENA
Native Hawaiian or Pacific Islander
Are you Native Hawaiian or other Pacific Islander?
¿Es usted nativo(a) de Hawaii o de otra raza u origen de las islas del Pacífico?

Spanish input
options

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Fill Instructions
Skip Instructions

Goto OTHER

Special
Instructions

12/24/2014

Help: H_NHOPI

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe

E9 – OTHER
Some other race
NHOPI

Form Pane Label
Question Text

Some other race
Are you some other race or origin that I haven’t mentioned?

Spanish question
text
Input Options

¿Es usted de alguna otra raza u origen que no haya mencionado?

Spanish input
options

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Fill Instructions
Skip Instructions

If <1> goto F_INTRO

Special
Instructions

Help: H_SOR

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish questino
text
Input Options
Fill Instructions

F1 - F_INTRO
Yes/no introduction second person
USUAL and PERCOUNT>1
Continue
Now I’m going to ask you some questions about .
♦ Enter 1 to continue.
Ahora le voy a hacer algunas preguntas sobre .

♦ Entre 1 para continuar.
Fill 1
Display:

Skip Instructions
Special
Instructions

goto WHITE_2

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

F2 – WHITE_2
White
H1
White
Is White?

Spanish question
text
Input Options

¿Es <él/ella/NAME_RANDOM> blanco(a)?

Spanish input
options
Fill Instructions

Spanish fill
instructions

Skip Instructions
Special
Instructions

12/24/2014

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No
Fill 1
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 1
If SEX_2=1, display: él
If SEX_2=2, display: ella

If SEX_2=DK, RF, display:
Goto HISPANIC_2
Help: H_WHITE

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

F3 – HISPANIC_2
Hispanic
WHITE_2
Hispanic
Is of Hispanic, Latino, or Spanish origin?

Spanish question
text
Input Options

¿Es <él/ella/NAME_RANDOM> de origen hispano, latino o español?

Spanish input
options
Fill Instructions

Spanish fill
instructions

Skip Instructions
Special
Instructions

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No
Fill 1
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 1
If SEX_2=1, display: él
If SEX_2=2, display: ella

If SEX_2=DK, RF, display:
Goto BLACK_2
Help: H_HISPANIC

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

F4 – BLACK_2
Black
HISPANIC_2
Black
Is Black or African American?

Spanish question
text
Input Options

¿Es <él/ella/NAME_RANDOM> negro(a) o africano(a) americano(a)?

Spanish input
options
Fill Instructions

Spanish fill
instructions

Skip Instructions
Special
Instructions

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No
Fill 1
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 1
If SEX_2=1, display: él
If SEX_2=2, display: ella

If SEX_2=DK, RF, display:
Goto ASIAN_2
Help: H_BLACK

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

•

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text
Spanish question
text
Input Options

Spanish input
options
Fill Instructions

Spanish fill
instructions

Skip Instructions
Special
Instructions

F5 – ASIAN_2
Asian
BLACK_2
Asian
Is Asian?
¿Es < él /ella/NAME_RANDOM> asiático(a)?
1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No
Fill 1
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 1
If SEX_2=1, display: él
If SEX_2=2, display: ella

If SEX_2=DK, RF, display:
Goto AIAN_2
Help: H_ASIAN

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

F6 – AIAN_2
American Indian or Alaska Native
ASIAN_2
American Indian or Alaska Native
Is American Indian or Alaska Native?

Spanish question
text

¿Es <él/ella/NAME_RANDOM> indígena de las Américas o nativo(a) de
Alaska?

Input Options

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Spanish input
options
Fill Instructions

Spanish fill
instructions

Fill 1
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 1
If SEX_2=1, display: él
If SEX_2=2, display: ella

Skip Instructions

If SEX_2=DK, RF, display:
Goto MENA_2

Special
Instructions

Help: H_AIAN

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

F7 – MENA_2
Middle Easetern or North African
AIAN_2
Middle Easetern or North African
Is Middle Eastern or North African?

Spanish question
text
Input Options

¿Es <él/ella/NAME_RANDOM> del Medio Oriente o del Norte de África?

Spanish input
options
Fill Instructions

Spanish fill
instructions

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No
Fill 1
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 1
If SEX_2=1, display: él
If SEX_2=2, display: ella

Skip Instructions

If SEX_2=DK, RF, display:
Goto NHOPI_2

Special
Instructions

Help: H_MENA

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe

F8 – NHOPI_2
Native Hawaiian or Other Pacific Islander

Form Pane Label
Question Text

Native Hawaiian or Pacific Islander
Is Native Hawaiian or other Pacific Islander?

Spanish question
text

¿Es <él /ella/NAME_RANDOM> nativo(a) de Hawaii o de otra raza u origen de
las islas del Pacífico?

Input Options

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

MENA_2

Spanish input
options
Fill Instructions

Spanish fill
instructions

Skip Instructions
Special
Instructions

Fill 1
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 1
If SEX_2=1, display: él
If SEX_2=2, display: ella

If SEX_2=DK, RF, display:
Goto OTHER_2
Help: H_NHOPI

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

F9 – OTHER_2
Some other race
NHOPI_2
Some other race
Is some other race or origin that I haven’t
mentioned?

Spanish question
text

¿Es <él /ella/NAME_RANDOM> de otra raza u origen de que no haya
mencionado todavía?

Input Options

1-Yes
2-No
Don’t Know
Refused
1- Sí
2-No

Spanish input
options
Fill Instructions

Spanish fill
instructions

Fill 1
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 1
If SEX_2=1, display: él
If SEX_2=2, display: ella

If SEX_2=DK, RF, display:
Skip Instructions

Goto G_INTRO
Special
Instructions

Help: H_SOR

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish question
text
Input Options
Fill Instructions
Skip Instructions

G1 – G_INTRO
Followup questions introduction
PERCOUNT=1 and OTHER
Or OTHER_2
Continue
Now, I just have a few more questions about you.
♦ Enter 1 to continue.
Sólo tengo algunas preguntas más sobre usted.

♦ Entre 1 para continuar
If WHITE =1, goto WHITE_ORIGIN
Else if, HISPANIC =1, goto HISPANIC_ORIGIN
Else if, BLACK = 1, goto BLACK_ORIGIN
Else if, ASIAN=1, goto ASIAN_ORIGIN
Else if, AIAN=1, goto AIAN_ORIGIN
Else if, MENA=1, goto MENA_ORIGIN
Else if, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN

If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO
Special
Instructions

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G2 - WHITE_ORIGIN
White origin
G1 and WHITE=1
White origin
Earlier you said you were White. What is your specific origin or origins? For
example, German, Irish, English, Italian, Polish, French, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Antes usted dijo que era blanco(a). ¿Cuál es su origen u orígenes
específico?Por ejemplo, alemán, irlandés, inglés, italiano, polaco, francés
, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions
Spanish fill
instructions
Skip Instructions

String 100.

If HISPANIC=1, goto HISPANIC_ORIGIN
Else if Black=1, goto BLACK_ORIGIN
Else if, ASIAN=1, goto ASIAN_ORIGIN
Else if, AIAN=1, goto AIAN_ORIGIN
Else if, MENA=1, goto MENA_ORIGIN
Else if, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN
Else if PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G3 - HISPANIC_ORIGIN
Hispanic origin
G1 and HISPANIC=1
Hispanic origin
Earlier you said you were Hispanic, Latino, or Spanish origin. What is your
specific origin or origins? For example, Mexican or Mexican American, Puerto
Rican, Cuban, Dominican, Salvadoran, Columbian, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que era de origen hispano, latino o español. ¿Cuál es su origen
u orígenes específicos? Por ejemplo, mexicano o mexicano americano,
puertorriqueño, cubano, dominicano, salvadoreño, colombiano, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If (WHITE, BLACK, AIAN, ASIAN, NHOPI, MENA and OTHER) all ne 1,
goto HISPANIC_RACE
Else if Black=1, goto BLACK_ORIGIN
Else if, ASIAN=1, goto ASIAN_ORIGIN
Else if, AIAN=1, goto AIAN_ORIGIN
Else if, MENA=1, goto MENA_ORIGIN
Else if, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN
Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G3a - HISPANIC_RACE
Hispanic race
G_INTRO and HISPANIC=1 and (WHITE, BLACK, AIAN, ASIAN, NHOPI,
MENA and OTHER) all ne 1
Hispanic race
People of Hispanic, Latino or Spanish origin may be of any race. , do/ Do> you consider yourself one or more of these
races, White, Black or African American, Asian, American Indian or Alaska
Native, Middle Eastern or North African, or Native Hawaiian or Other Pacific
Islander?
♦ Enter all that apply, separate with commas.

Spanish question
text

Las personas de origen hispano, latino o español pueden ser de cualquier raza.
, ¿se/¿Se> considera usted blanco(a),
negro(a) o africano(a) americana(a), asiático(a), indígena de las Américas o
nativo(a) de Alaska, del Medio Oriente o del Norte de África , o nativo(a) de
Hawaii u otra de las islas del Pacífico?
♦ Entre todas las que apliquen, separadas por comas.

Input Options

Spanish input
options

Fill Instructions
Spanish fill
instructions

1-Yes, White
2-Yes, Black or African American
3 – Yes, Asian
4-Yes, American Indian or Alaska Native
5- Yes, Middle Eastern or North African
6-Yes, Native Hawaiian or Other Pacific Islander
7-Hispanic (for example, Mexican or Mexican American, Puerto Rican, Cuban,
Dominican, Salvadoran, Columbian, etc) (DO NOT READ)
8-Other (DO NOT READ)
9-No/None of these (DO NOT READ)
Don’t Know
Refused
1- Sí Blanco(a)
2- Sí Negro(a) o Africano(a) Americano(a)
3- Sí Asiático(a)
4- Sí, indígena de las Américas o Nativo(a) de Alaska
5- Sí, del Medio Oriente o del Norte de África
6- Sí , Nativo(a) de Hawaii u otra de las islas del Pacífico
7-Hispano(a) (por ejemplo, mexicano o mexicano americano, puertorriqueño,
cubano, dominicano, salvadoreño, colombiano, etc.) (NO LEA)
8-Otra (NO LEA)
9-No/Ninguna de estas respuestas (NO LEA)

If HISPANIC_ORIGIN=(DK, RF), display “Do”
Else, display “In addition to , do”
If HISPANIC_ORIGIN=(DK, RF), display “¿Se”
Else, display “Además de , ¿se”

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Skip Instructions

If HISPANIC_RACE=(8, 9) goto HISP_RACE_OTHER
Else if Black=1, goto BLACK_ORIGIN
Else if, ASIAN=1, goto ASIAN_ORIGIN
Else if, AIAN=1, goto AIAN_ORIGIN
Else if, MENA=1, goto MENA_ORIGIN
Else if, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN
Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO
Special
Instructions

Mark all that apply

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

G3b – HISP_RACE_OTHER
Which other race or origin identifies with
HISPANIC_RACE = (8,9)
Other Race identified with
♦Specify exactly what respondent said.

Spanish question
text
Input Options
Fill Instructions

♦Especifique exactamente lo que dijo el respondedor.

Skip Instructions

If Black=1, goto BLACK_ORIGIN
Else if, ASIAN=1, goto ASIAN_ORIGIN
Else if, AIAN=1, goto AIAN_ORIGIN
Else if, MENA=1, goto MENA_ORIGIN
Else if, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN

String 100.

Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO
Special
Instructions

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G4 - BLACK_ORIGIN
Black origin
G1 and BLACK=1
Black origin
Earlier you said you were Black or African American. What is your specific
origin or origins? For example, African American, Jamaican, Haitian, Nigerian,
Ethiopian, Ghanaian, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que era negro(a) o afroamericano(a). ¿Cuál es su origen u
orígenes específicos? Por ejemplo, afroamericano, jamaiquino, haitiano,
nigeriano, etiope, ghanés, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, ASIAN=1, goto ASIAN_ORIGIN
Else if, AIAN=1, goto AIAN_ORIGIN
Else if, MENA=1, goto MENA_ORIGIN
Else if, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN
Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G5 - ASIAN_ORIGIN
Asian origin
G1 and ASIAN=1
Asian origin
Earlier you said you were Asian. What is your specific origin or origins? For
example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, and so
on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que es asiático(a). ¿Cuál es su origen u orígenes específicos?
Por ejemplo, chino, filipino, indio asiático, vietnamita, coreano, japonés,
etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, AIAN=1, goto AIAN_ORIGIN
Else if, MENA=1, goto MENA_ORIGIN
Else if, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN
Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G6 - AIAN_ORIGIN
AIAN origin
G1 and AIAN=1
AIAN origin
Earlier you said you were American Indian or Alaska Native. What is your
tribe or tribes? For example, Navajo Nation, Blackfeet Tribe, Muscogee Creek
Nation, Mayan, Nome Eskimo Community, Native Village of Barrow Inupiat
Traditional Government, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que era indígena de las Américas o nativo(a) de Alaska. ¿Cuál
es su tribu o tribus? Por ejemplo, Navajo Nation, Blackfeet Tribe,
Muscogee Creek Nation, Mmaya, Nome Eskimo Community, Native
Village of Barrow Inupiat Traditional Government, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, MENA=1, goto MENA_ORIGIN
Else if, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN
Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G7 - MENA_ORIGIN
MENA origin
G1 and MENA=1
MENA origin
Earlier you said you were Middle Eastern or North African. What is your
specific origin or origins? For example, Lebanese, Iranian, Egyptian, Syrian,
Moroccan, Algerian, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que era del Medio Oriente o del Norte de África. ¿Cuál es su
origen u orígenes específicos? Por ejemplo, libanés, iraní, egipcio, sirio,
marroquí, argelino, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, NHOPI=1, goto NHOPI_ORIGIN
Else if, OTHER=1, goto OTHER_ORIGIN
Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G8 - NHOPI_ORIGIN
NHOPI origin
G1 and NHOPI=1
NHOPI origin
Earlier you said you were Native Hawaiian or Other Pacific Islander. What is
your specific origin or origins? For example, Native Hawaiian, Samoan,
Chamorro, Tongan, Fijian, Marshallese, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que era nativo(a) de Hawaii o de otra de las islas del Pacífico.
¿Cuál es su origen u orígenes específicos? Por ejemplo, nativo de Hawaii,
samoano, guameño o Chamorro, tongano, fiyiano, de las islas Marshall,
etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, OTHER=1, goto OTHER_ORIGIN
Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

G9 - OTHER_ORIGIN
Other origin
G1 and OTHER=1
OTHER origin
Earlier you said you were Some other race or origin. What is that race or
origin?
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que era de alguna otra raza u origen. ¿Cuál es esa raza u
origen?
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions
Spanish fill
instructions
Skip Instructions

Special
Instructions

String 100.

If OTHER_ORIGIN= (biracial, multiracial, mixed, mestizo, biracial,
multiracial, mixto), goto OTHER_ORIGIN_SPEC
Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

G10 - OTHER_ORIGIN_SPEC
Other origin specify
OTHER_ORIGIN = (biracial, multiracial, mixed, mestizo, biracial, multiracial,
mixto)
OTHER origin
Can you be more specific?
♦ Enter all that apply, separate with commas.

Spanish question
text

¿ Puede ser más específico?
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

Else If PERCOUNT=1, goto I_INTRO
Else, goto H_INTRO

Special
Instructions

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish question
text
Input Options
Fill Instructions
Skip Instructions

H1 – H_INTRO
Followup questions introduction Person 2
PERCOUNT>1
Continue
Now, I just have a few more questions about < NAME_RANDOM>.
♦ Enter 1 to continue.
Sólo tengo algunas preguntas más sobre .

♦ Entre 1 para continuar
If WHITE_2 =1, goto WHITE_ORIGIN_2
Else if, HISPANIC_2 =1, goto HISPANIC_ORIGIN_2
Else if, BLACK_2 = 1, goto BLACK_ORIGIN_2
Else if, ASIAN_2=1, goto ASIAN_ORIGIN_2
Else if, AIAN_2=1, goto AIAN_ORIGIN_2
Else if, MENA_2=1, goto MENA_ORIGIN_2
Else if, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2

Else, goto I_INTRO
Special
Instructions

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H2 - WHITE_ORIGIN_2
White origin Person 2
H1 and WHITE_2=1
White origin
Earlier you said was White. What is
’s specific origin or origins? For example, German, Irish,
English, Italian, Polish, French, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Antes usted dijo que es blanco(a). ¿Cuál es el
origen u orígenes específico de ? Por ejemplo,
alemán, irlandés, inglés, italiano, polaco, francés , etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions
Spanish fill
instructions
Skip Instructions

String 100.

If HISPANIC_2=1, goto HISPANIC_ORIGIN_2
Else if BLACK_2=1, goto BLACK_ORIGIN_2
Else if, ASIAN_2=1, goto ASIAN_ORIGIN_2
Else if, AIAN_2=1, goto AIAN_ORIGIN_2
Else if, MENA_2=1, goto MENA_ORIGIN_2
Else if, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2
Else, goto I_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H3 - HISPANIC_ORIGIN_2
Hispanic origin Person 2
H1 and HISPANIC_2=1
Hispanic origin
Earlier you said was Hispanic, Latino, or Spanish origin.
What is ’s specific origin or origins? For example,
Mexican or Mexican American, Puerto Rican, Cuban, Dominican, Salvadoran,
Columbian, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que es de origen hispano, latino o
español. ¿Cuál es el origen u orígenes específicos de ?
Por ejemplo, mexicano o mexicano americano, puertorriqueño, cubano,
dominicano, salvadoreño, colombiano, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If (WHITE_2, BLACK_2, AIAN_2, ASIAN_2, NHOPI_2, MENA_2 and
OTHER_2) all ne 1, goto HISPANIC_RACE_2
Else if BLACK_2=1, goto BLACK_ORIGIN_2
Else if, ASIAN_2=1, goto ASIAN_ORIGIN_2
Else if, AIAN_2=1, goto AIAN_ORIGIN_2
Else if, MENA_2=1, goto MENA_ORIGIN_2
Else if, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2
Else, goto I_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H3a - HISPANIC_RACE_2
Hispanic race Person 2
H_INTRO and HISPANIC_2=1 and (WHITE_2, BLACK_2, AIAN_2, ASIAN_2,
NHOPI_2, MENA_2 and OTHER_2) all ne 1
Hispanic race
People of Hispanic, Latino or Spanish origin may be of any race. , does/ Does> >
consider one or more of these races, White,
Black or African American, Asian, American Indian or Alaska Native, Middle
Eastern or North African, or Native Hawaiian or Other Pacific Islander?
♦ Enter all that apply, separate with commas.

Spanish question
text

Las personas de origen hispano, latino o español pueden ser de cualquier raza.
, ¿se/¿Se> considera
<él/ella/ blanco(a), negro(a) o africano(a) americana(a),
asiático(a), indígena de las Américas o nativo(a) de Alaska, del Medio Oriente o
del Norte de África , o nativo(a) de Hawaii u otra de las islas del Pacífico?
♦ Entre todas las que apliquen, separadas por comas.

Input Options

Spanish input
options

Fill Instructions

1-Yes, White
2-Yes, Black or African American
3 – Yes, Asian
4-Yes, American Indian or Alaska Native
5- Yes, Middle Eastern or North African
6-Yes, Native Hawaiian or Other Pacific Islander
7-Hispanic (for example, Mexican or Mexican American, Puerto Rican, Cuban,
Dominican, Salvadoran, Columbian, etc) (DO NOT READ)
8-Other (DO NOT READ)
9-No/None of these (DO NOT READ)
Don’t Know
Refused
1- Sí Blanco(a)
2- Sí Negro(a) o Africano(a) Americano(a)
3- Sí Asiático(a)
4- Sí, indígena de las Américas o Nativo(a) de Alaska
5- Sí, del Medio Oriente o del Norte de África
6- Sí , Nativo(a) de Hawaii u otra de las islas del Pacífico
7-Hispano(a) (por ejemplo, mexicano o mexicano americano, puertorriqueño,
cubano, dominicano, salvadoreño, colombiano, etc.) (NO LEA)
8-Otra (NO LEA)
9-No/Ninguna de estas respuestas (NO LEA)

Fill 1
If HISPANIC_ORIGIN_2=(DK, RF), display “Does”
Else, display “In addition to , does”

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Fill 2
If SEX_2=1, display: he
If SEX_2=2, display: she
If SEX_2=DK, RF, display:
Fill 3
If SEX_2=1, display: himself
If SEX_2=2, display: herself
If SEX_2=DK, RF, display: himself or herself
Spanish fill
instructions

Fill 1
If HISPANIC_ORIGIN_2=(DK, RF), display “¿Se”
Else, display “Además de , ¿se”
Fill 2
If SEX_2=1, display: él
If SEX_2=2, display: ella
If SEX_2=DK, RF, display:

Skip Instructions

If HISPANIC_RACE_2=(8, 9) goto HISP_RACE_OTHER_2
Else if BLACK_2=1, goto BLACK_ORIGIN_2
Else if, ASIAN_2=1, goto ASIAN_ORIGIN_2
Else if, AIAN_2=1, goto AIAN_ORIGIN_2
Else if, MENA_2=1, goto MENA_ORIGIN_2
Else if, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2
Else, goto I_INTRO
Special
Instructions

Mark all that apply

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

H3b – HISP_RACE_OTHER_2
Which other race or origin Person 2 identifies with
HISPANIC_RACE_2 = (8,9)
Other Race identified with
♦Specify exactly what respondent said.

Spanish question
text
Input Options
Fill Instructions

♦Especifique exactamente lo que dijo el respondedor.

Skip Instructions

If BLACK_2=1, goto BLACK_ORIGIN_2
Else if, ASIAN_2=1, goto ASIAN_ORIGIN_2
Else if, AIAN_2=1, goto AIAN_ORIGIN_2
Else if, MENA_2=1, goto MENA_ORIGIN_2
Else if, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2

String 100.

Else, goto I_INTRO
Special
Instructions

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H4 - BLACK_ORIGIN_2
Black origin Person 2
H1 and BLACK_2=1
Black origin
Earlier you said was Black or African American. What is
’s origin or origins? For example, African American,
Jamaican, Haitian, Nigerian, Ethiopian, Ghanaian, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que es negro(a) o afroamericano(a).
¿Cuál es el origen u orígenes específicos de ? Por
ejemplo, afroamericano, jamaiquino, haitiano, nigeriano, etiope, ghanés,
etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, ASIAN_2=1, goto ASIAN_ORIGIN_2
Else if, AIAN_2=1, goto AIAN_ORIGIN_2
Else if, MENA_2=1, goto MENA_ORIGIN_2
Else if, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2
Else, goto I_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H5 - ASIAN_ORIGIN_2
Asian origin Person 2
H1 and ASIAN_2=1
Asian origin
Earlier you said was Asian. What is
’s specific origin or origins? For example, Chinese,
Filipino, Asian Indian, Vietnamese, Korean, Japanese, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que es asiático(a). ¿Cuál es el origen u
orígenes específicos de ? Por ejemplo, chino,
filipino, indio asiático, vietnamita, coreano, japonés, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, AIAN_2=1, goto AIAN_ORIGIN_2
Else if, MENA_2=1, goto MENA_ORIGIN_2
Else if, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2
Else, goto I_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H6 - AIAN_ORIGIN_2
AIAN origin Person 2
H1 and AIAN_2=1
AIAN origin
Earlier you said was American Indian or Alaska Native.
What is ’s tribe or tribes? For example, Navajo Nation,
Blackfeet Tribe, Muscogee Creek Nation, Mayan, Nome Eskimo Community,
Native Village of Barrow Inupiat Traditional Government, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que es indígena de las Américas o
nativo(a) de Alaska. ¿Cuál es la tribu o tribus de ?
Por ejemplo, Navajo Nation, Blackfeet Tribe, Muscogee Creek Nation,
Mmaya, Nome Eskimo Community, Native Village of Barrow Inupiat
Traditional Government, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, MENA_2=1, goto MENA_ORIGIN_2
Else if, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2
Else, goto I_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H7 - MENA_ORIGIN_2
MENA origin Person 2
H1 and MENA_2=1
MENA origin
Earlier you said was Middle Eastern or North African.
What is ’s specific origin or origins? For example,
Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian, and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que es del Medio Oriente o del Norte de
África. ¿Cuál es el origen u orígenes específicos de ?
Por ejemplo, libanés, iraní, egipcio, sirio, marroquí, argelino, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, NHOPI_2=1, goto NHOPI_ORIGIN_2
Else if, OTHER_2=1, goto OTHER_ORIGIN_2
Else, goto I_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H8 - NHOPI_ORIGIN_2
NHOPI origin Person 2
H1 and NHOPI_2=1
NHOPI origin
Earlier you said wasNative Hawaiian or Other Pacific
Islander. What is ’s specific origin or origins? For
example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese,
and so on.
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que es nativo(a) de Hawaii o de otra de
las islas del Pacífico. ¿Cuál es el origen u orígenes específicos de
? Por ejemplo, nativo de Hawaii, samoano, guameño
o Chamorro, tongano, fiyiano, de las islas Marshall, etc.
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

If, OTHER_2=1, goto OTHER_ORIGIN_2
Else, goto I_INTRO

Special
Instructions

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

H9 - OTHER_ORIGIN_2
Other origin Person 2
H1 and OTHER_2=1
Other origin
Earlier you said was Some other race or origin. What is
that race or origin?
♦ Enter all that apply, separate with commas.

Spanish question
text

Usted dijo que es de alguna otra raza u origen. ¿Cuál
es esa raza u origen?
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions
Spanish fill
instructions
Skip Instructions

Special
Instructions

String 100.

If OTHER_ORIGIN_2= (biracial, multiracial, mixed, mestizo, biracial,
multiracial, mixto), goto OTHER_ORIGIN_SPEC_2
Else, goto I_INTRO

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

H10 - OTHER_ORIGIN_SPEC_2
Other origin specify Person 2
OTHER_ORIGIN_2 = (biracial, multiracial, mixed, mestizo, biracial, multiracial,
mixto)
OTHER origin
Can you be more specific?
♦ Enter all that apply, separate with commas.

Spanish question
text

¿ Puede ser más específico?
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

Goto I_INTRO

Special
Instructions

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

Spanish question
text

I1 – I_INTRO
Final Questions Intro
PERCOUNT>0
Continue
Now, I have a couple questions about how you view yourself and how you are
perceived by other people.
♦ Enter 1 to continue.
Ahora tengo algunas preguntas sobre cómo se ve usted y cómo lo perciben otras
personas.

♦ Entre 1 para continuar
Input Options
Fill Instructions
Skip Instructions
Special
Instructions

12/24/2014

Goto IDENTIFY

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

12/24/2014

I2 – IDENTIFY
Think about self
I_INTRO
Think about self
Earlier, you identified as
.
Do these answers fit the way you think about yourself always, sometimes or
never?

Spanish question
text

Usted se identificó como
.
¿Estas respuestas reflejan la manera que usted piensa sobre sí mismo(a)?

Input Options

Spanish input
options

Fill Instructions

1-Always
2-Sometimes
3-Never
Don’t Know
Refused
1-Siempre
2-A veces
3-Nunca
Display all that apply from below:
If WHITE=1 display “White”
If HISPANIC=1 display “Hispanic, Latino, or Spanish”
If BLACK=1 display “Black or African American”
If ASIAN=1 display “Asian”
If AIAN=1 display “American Indian or Alaska Native”
If MENA=1 display “Middle Eastern or North African”
If NHOPI=1 display “Native Hawaiian or Other Pacific Islander”
If OTHER=1 display “”

Spanish Fill
Instructions

Display all that apply from below:
If WHITE=1 display “Blanco(a)”
If HISPANIC=1 display “de origen hispano, latino o español”
If BLACK=1 display “negro(a) or afroamericano(a)”
If ASIAN=1 display “asiático(a)”
If AIAN=1 display “indígena de las Américas o nativo(a) de Alaska”
If MENA=1 display “del Medio Oriente o del Norte de África”
If NHOPI=1 display “nativo(a) de Hawaii o de otra de las islas del Pacífico”
If OTHER=1 display “”

Skip Instructions
Special
Instructions

Goto PERCEIVED

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

12/24/2014

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

I3 – PERCEIVED
Perceived as other race or origin
IDENTIFY
Perceived as other race or origin
Have you ever been perceived as another race or origin you did not identify
with?

Spanish question
text
Input Options

¿Alguna vez lo(a) han percibido como de una raza u origen con el que usted no
se identifica?
1-Yes
2-No
Don’t Know
Refused
1-Sí
2-No

Spanish input
options
Fill Instructions
Spanish Fill
Instructions
Skip Instructions
Special
Instructions

If <1>, goto PERCEIVED_SPEC
Else, goto THANK

2015 NCT Race & Origin Reinterview Spec
Middle Version 1.0

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

I4 – PERCEIVED_SPEC
Perceived as other specify
PERCEIVED = 1
Perceived as other specify
What race or origin would that be?
♦ Enter all that apply, separate with commas.

Spanish question
text

¿Cuál sería esa raza u origen?
♦ Entre todas las que apliquen, separadas por comas.

Input Options
Fill Instructions

String 100.

Spanish fill
instructions
Skip Instructions

Goto THANK_COMP

Special
Instructions

12/24/2014

2015 NCT Race & Origin Reinterview Spec
Back Version 10

12/24/2014

BLKWebCATIBack
Tag / Name
Field Description
Universe

Form Pane Label
Question Text

J1 - CALLBACK
Best callback time for Census Respondent
INTRO = 3, DK, RF and CONTACTCOUNT = 1
Or KNOWL_RESP = 3
Or SOMEONE_ELSE = 2, DK, RF
Callback
I’d like to schedule a date to conduct the interview. What date and time would
be the best to call back?
♦ Enter the appointment time in WebCATI.

Spanish question

Input Options

Spanish input
Fill Instructions
Skip Instructions

Quisiera hacer una cita para llevar a cabo la entrevista. ¿Qué día y hora sería
mejor para llamar de nuevo?
♦ Enter the appointment time in WebCATI.
1-Callback time provided
Don’t Know
Refused
Blank is not an option on this screen.
1-Callback time provided
Skip Instructions:
If <1, DK, RF> GOTO RNAME

Special
Instructions

117 of 123

2015 NCT Race & Origin Reinterview Spec
Back Version 10

Tag / Name
Field Description
Universe
Form Pane Label
Question Text

J2 - RNAME
Name of the Census respondent.
CALLBACK
Callback name
Whom should I ask for when I call back?

Spanish question
Input Options

¿Por quién debo preguntar cuando llame de nuevo?
String 42

12/24/2014

Don’t Know and Refused are options on this screen, but they can’t be used with
other responses. Blank is not an option on this screen.
Fill Instructions
Skip Instructions

Special
Instructions

goto THANK

Text field – 42 characters

118 of 123

2015 NCT Race & Origin Reinterview Spec
Back Version 10

Tag / Name
Field Description
Universe

J3 – THANK
Thanks respondent.
RNAME or SOMEONE_ELSE=3 or INTRO = 5

Form Pane Label
Question Text

Thank
Thank you for your time.

Spanish question
Input Options

Gracias por su tiempo.
1 Continue

Spanish input
Fill Instructions
Skip Instructions

12/24/2014

Blank, Don’t Know, and Refused are not options on this screen.
1 Continúe

Goto CLOSE

Special
Instructions

119 of 123

2015 NCT Race & Origin Reinterview Spec
Back Version 10

Tag / Name
Field Description
Universe

J3a – EXIT_WEBCATI
Exit to WebCATI
RF or
KNOWL_RESP=RF or
RESIDENT=RF or
SOMEONE_ELSE=RF

Form Pane Label
Question Text

Exit to WebCATI
♦ Once in WebCATI, set appropriate status.

Spanish question

♦ Once in WebCATI, set appropriate status.

Input Options

1 Continue

Spanish input
Fill Instructions

Blank, Don’t Know, and Refused are not options on this screen.
1 Continúe
If INTRO=5, display BLANK
Else, display “refusal”

Skip Instructions

Goto CLOSE

12/24/2014

Special
Instructions

120 of 123

2015 NCT Race & Origin Reinterview Spec
Back Version 10

12/24/2014

Tag / Name
Field Description
Universe*

J4 – THANK_COMP
Thanks respondent for completing survey.
PERCEIVED=<2, DK, RF>
OR PERCEIVED_SPEC

Form Pane Label
Question Text

Thank complete
This concludes our interview. Thank you very much for your cooperation.

Spanish question
Input Options

Con esto termina nuestra entrevista. Muchas gracias por su cooperación.
1 Continue

Spanish input
Fill Instructions
Skip Instructions
Special
Instructions

Blank, Don’t Know, and Refused are not options on this screen.
1 Continúe

Goto LANGUAGE

121 of 123

2015 NCT Race & Origin Reinterview Spec
Back Version 10

12/24/2014

Tag / Name
Field Description
Universe

J5 - LANGUAGE
Asks the enumerator which language the majority of the interview was conducted in.
THANK_COMP

Form Pane Label
Question Text

Language
What language was the majority of the interview conducted in?

Spanish question
Input Options

¿En qué idioma se llevó a cabo la mayor parte de la entrevista?
1. English
2. Spanish
3. Another language
4. Did not speak with anyone
1. Inglés
2. Español
3. Otro idioma
4. No hablé con nadie

Spanish input

Fill Instructions
Skip Instructions
Special
Instructions

goto CLOSE
Household level
Can we get rid of thise because WebCATI collects this information now?

122 of 123

2015 NCT Race & Origin Reinterview Spec
Back Version 10

Tag / Name
Field Description
Universe
Form Pane Label
Question Text
Input Options
Fill Instructions
Skip Instructions
Special
Instructions

12/24/2014

J6 - CLOSE
Set Outcome codes.
THANK or LANGUAGE

If THANK_COMP, set OUTCOME=001 (complete)
If

123 of 123