NSFG 2015-2018 OMB Attachment L OMB No. 0920-0314
Interview Observation Form
Interviewer Instructions:
Circle one response number only unless otherwise indicated
The following questions are about how you perceive the respondent and the housing unit. We are asking for your best, common-sense judgment. People could have different opinions about some of these things, but we would like to know your views, since you have spent some time with the respondent. Please do the best you can. Survey experience has shown that such observations are often useful, even if they are subjective.
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Sample ID:
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Iwer ID: |
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Date: (MM/DD/YY) |
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Time: (HR:MIN) |
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PM |
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Where was the interview conducted?
Inside R’s HU
I mmediately outside R’s HU (e.g., porch) (skip to 2)
In Iwer’s car (skip to 2)
At R’s worksite (skip to 2)
In a restaurant/fast food place (skip to 2)
At a library (skip to 2)
In a HU of a neighbor, friend, or relative (skip to 2)
At another location (Specify ___________) (skip to 2)
1a. In which room(s) was the interview conducted? (Circle ALL that apply)
Living room/family room/den
Kitchen/dining room
Bedroom
Office
Foyer/hallway
Basement
Other (Specify _____________)
Mark the appropriate answer about whether other persons were within hearing range at any time during the interview:
No other person was present at any time
(skip to 5)
One or more persons were present in the interview location but were not within hearing range (skip to 5)
One or more persons were present within hearing range at some portions of the interview
One or more persons were present within hearing range during the entire interview
Relationship to the R of other people present or within hearing range during the interview (Circle ALL that apply)
Parent(s)
Spouse / significant other
Other adult(s)
Child(ren) 4-17 years old
Child(ren) under 4 years old
Other
In what ways did the other people’s presence influence the interview? (Circle ALL that apply)
P erson(s) came into the room and you paused the interview until they left
(skip to 5)
Person(s) came into the room, you or R answered their question or explained that privacy was needed, and they left (skip to 5)
Person(s) stayed in the room but did not participate in interview
Person(s) stayed in the room and offered R help with answers
Person(s) stayed but was too young to understand the interview (skip to 5)
Other (Specify: ___________________)
4a. During which, if any, of the following sections or questions were the other person(s) within hearing range? (Circle ALL that apply)
Monthly contraceptive method history (Female interview only)
# of sexual partners
Detailed questions about previous partners
None of these sections
During the interview, was the atmosphere at the interview site:
Extremely chaotic and noisy; disruptive to interview
Some noise or interruptions but interview went reasonably smoothly
Very quiet and calm, ideal for interview
What types of distractions or interruptions were present during the interview? (Circle ALL that apply)
Television on during interview but R not watching
Television on during interview with R watching at least some of the time
R received 1 or 2 phone calls
R received 3 or more phone calls
Children present needed attention
Other (Specify: ___________________)
No distractions or interruptions present
In what language did you administer the CAPI (interviewer- administered) part of the interview?
English
Mix of English and Spanish
Spanish
In general, how did the R act toward you during the interview?
Hostile
Neither hostile nor friendly
Friendly
How attentive was the R to the questions during the interview?
Not at all attentive
Somewhat attentive
Very attentive
Was the R upset during the interview?
Yes, upset because of interview content
Yes, upset but NOT related to interview content
N o, not upset (skip to 12)
Was the R still upset at the end of the interview?
Yes
No
At the end of the interview, did the R seem to be tired?
Yes, tired because of interview
Yes, tired but NOT because of interview
No, not tired
To what extent did the R use the Life History Calendar (LHC) during the interview?
Male R, no LHC in interview
Used LHC as instructed throughout
Began using LHC but stopped because it wasn’t needed
Began using the LHC but stopped because of frustration
Did not use LHC at the beginning but began using it later in the interview
Did not use LHC at all
Overall, what is your opinion of the quality of the information provided by this R? Was it of:
E xcellent quality (skip to 16)
Good quality (skip to 16)
Fair quality
Poor quality
The interview was of fair or poor quality because the R was: (Circle ALL that apply)
Bored, disinterested
Embarrassed
Hostile or suspicious
Not serious
Not truthful
Distracted / could not concentrate
Not able to remember dates
R did not understand questions due to low literacy, language problems, etc.
Other (Specify: ___________________)
For most of the CAPI part of the interview, how would you describe your seating arrangement with the R?
Next to R (facing the same way)
Next to R (facing at a right angle)
Across from R
Some other arrangement
Was the R able to see the computer screen during the CAPI part of the interview?
R could see the screen during all of CAPI
R could see the screen on most, but not all CAPI questions
R could see the screen on a few CAPI questions
R could never see the screen during CAPI
What support did you have for the laptop during the CAPI part of the interview:
Table
Lap
Other (Specify: ______________)
Did you or the R encounter any difficulty during the interview because of the CAPI application? (Circle ALL that apply)
Hardware problem
Confusion about question referent: biological vs. adoptive parent
Confusion about question referent: first sex partner vs. first consensual sex partner
R got questions that s/he should not have gotten and you couldn’t skip past them
Other (Specify:___________________)
No difficulties encountered
The next set of questions asks about the ACASI (self-administered) part of the interview. Please base your answers on the real ACASI questions, not the practice questions.
Please choose the answer that best describes your seating arrangement during the ACASI (self-administered) part of the interview.
Next to R (facing the same way)
Next to R (facing at a right angle)
Seated across from R
Some other arrangement
Were you able to see the computer screen during the ACASI part of the interview?
I could see the screen during all of ACASI
I could see the screen on most, but not all ACASI questions
I could see the screen on a few ACASI questions
I could never see the screen during ACASI
What support did the R have for the laptop during the ACASI part of the interview?
Table
L ap
Other (Specify:_______________)
After you helped R with the practice questions, please indicate the level of assistance you provided to R during ACASI
R completed ACASI section with no assistance from me (skip to 25)
R completed ACASI section, but needed assistance on a few screens
R completed ACASI section, but needed assistance on many screens
I administered the ACASI section
(skip to 25)
What type of assistance did you provide to R? (Circle ALL that apply)
Read one or more questions to R
Helped with headphones
Helped R adjust volume
Helped R enter one or more answers
Helped R move to next screen
Helped R back up to previous screen
Helped R hide question text
Helped R replay audio
Answered questions about what a question meant
Other (Specify:_______________)
Please tell us about R’s use of headphones during ACASI.
R did not wear headphones for any ACASI questions
R wore headphones at start of ACASI, but removed them part way through
R did not wear headphones at start of ACASI, but put them on part way through
R wore headphones for all ACASI questions
Other (Specify:_______________)
Do you think that the R used the Audio in addition to the text during ACASI?
Unable to tell whether R was using audio
R turned audio off and used text only
R used both text and audio
R appeared to use audio only
Did the R make any comment(s) about the ACASI voice?
1. Yes, positive comment(s)
2. Yes, neutral comment(s)
3. Yes, negative comment(s)
4 . No (skip to 29)
What comment(s) did the R make? ___________________________________________________________________________________________________________________________________________________________________________________________________
How would you describe your mood at the beginning of this interview?
1. Happy
2. Neutral
3. Sad/Unhappy
Why do you think the R completed the interview? ___________________________________________________________________________________________________________________________________________________________________________________________________
NSFG Cycle 8
File Type | application/msword |
File Title | INTERVIEW OBSERVATION FORM |
Author | sarrahb |
Last Modified By | Jo Jones |
File Modified | 2015-01-20 |
File Created | 2014-10-03 |