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pdfAPPENDIX A1:
YOUTHBUILD 48-MONTH FOLLOW-UP
SURVEY
CATI VERSION
TRACKED CHANGES
OMB No.: 1203-0503
Expiration Date: 06/30/2015
YouthBuild
48 Month Follow Up Survey
CATI version
September 2015
Persons are not required to respond to this collection of information unless this survey displays a currently valid OMB control
number (OMB 1203-0503, expires 06/30/2018). Responding to this questionnaire, which seeks to help the U.S. Department of
Labor understand how YouthBuild programs are serving disadvantaged youth, is voluntary. Public reporting burden for this
collection of information is estimated to average 35 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate to Eileen Pederson, U.S. Department of Labor, Employment and Training
Administration, Office of Policy Development and Evaluation, Room N-5641, 200 Constitution Avenue, NW, Washington, DC
20210.
Preloads
Values Definitions / Format
Source
[YB PROGRAM]
Text
Grantee
REF DATE
MM/DD/YYYY
Last interview date or RA date
RAOutcome
1 = Treatment
2 = Control
RA Outcome from SMS
Comp_status
0= Did not complete 12M or 30M
survey
1 = Completed 12M survey only
2 = Completed 30M survey only
3 = Completed both 12M AND 30M
surveys
1 IF 12M Final Status is 010, 012, 020,
030, 019, 029, 039 AND 30M Final Status
<> 010, 012, 020, 030, 019, 029, 039;
2 IF 30M Final Status is 010, 012, 020,
030, 019, 029, 039 AND 12M Final Status
<> 010, 012, 020, 030, 019, 029, 039;
3 IF 12M Final Status is 010, 012, 020,
030, 019, 029, 039 AND 30M Final Status
is 010, 012, 020, 030, 019, 029, 039;
ELSE, 0
PL_dropout
1 = Ask B1
0 = Do not ask B1
0 IF W1_b1 = 1 OR 0 OR W2_b1 = 1 OR
0 (Data collected),
ELSE, 1 (did not complete any surveys
OR did not report this information).
PL_diploma
0 = Data not collected, ask B3
1 = High school diploma
2 = GED
3 = Certificate of completion
1 IF W1_B3 = 1 OR W2_B3 = 1
(Reported high school diploma at 12M),
2 IF W1_B3 = 2 OR W2_B3 = 2
(Reported GED at 12M),
3 IF W1_B3 = 3 OR W2_B3 = 3
(Reported Certificate of completion at
12M),
ELSE, 0 (did not complete any surveys
OR did not report this information or did
not have a diploma in prior surveys.).
PL_dipdate
1 = Reported diploma, but no date
0 = No education date provided
1 IF (W2_B4_month OR W2_B4_year =
M, D, R) AND Comp_Status=2 or 3;
ELSE, 0
PL_YBstatus
0 = Did not complete previous
surveys OR never reported YB status
1 = Last time reported, indicated
currently enrolled
2 = Last time reported, indicated
graduating
3 = Last time reported, indicated
stopped going to YB
1 IF Comp_status = 1 AND W1_D3 = 1,
OR
1 IF Comp_status = 2 AND W2_D3 = 1,
OR
1 IF Comp_status = 3 AND W2_D3 = 1,
OR
1 IF Comp_status = 3 AND W2_D3 = D,
R, or M AND W1_D3 = 1
2 IF Comp_status = 1 AND W1_D3 = 2
OR
2 IF Comp_status = 2 AND W2_D3 = 2
OR
2 IF Comp_status = 3 AND (W2_D3 = 2
OR W1_D3 = 2)
Preloads
Values Definitions / Format
Source
3 IF Comp_status = 1 AND W1_D3 = 3,
OR
3 IF Comp_status = 2 AND W2_D3 = 3,
OR
3 IF Comp_status = 3 AND W2_D3 = 3,
OR
3 IF Comp_status = 3 AND W2_D3 = D,
R, M, or L AND W1_D3 = 3
3 IF Comp_status = 3 AND W2_D3 = L
AND W1_D3 = 1,
ELSE 0
PL_job
1 = Had current job at last survey
0 = No reported job or no current job
at last survey
1 IF Comp_status = 1 AND W1_E1 = 1
(currently working) AND (W1_E5 or
W1_E5b) have job name
OR
1 IF (Comp_status = 2 – 3 AND (W2_EF3
= 1 (still working at 12M job at 30M) )OR
(W2_E1 = 1 (currently working) AND
(W2_E5 or W2_E5b) have job name),
ELSE, 0
[PL JOB NAME]
Text
IF Comp_status = 1 AND PL_job = 1, fill
from Dan,
IF Comp_status = 2 AND PL_job = 1
AND W2_E1 = 1 (currently working), fill
from W2_E5 OR W2_E5B,
IF Comp_status = 3 AND PL_job = 1
AND W2_EF3 = 1, fill from Dan,
IF Comp_status = 3 AND PL_job = 1
AND W2_EF3 <> 1 AND W2_E1 = 1, fill
from W2_E5 OR W2_E5B
FACEBOOK
0 = We have FB account
1 = We do not have FB account in db
0 IF Facebook account exists and we
have URL;
ELSE 1.
MYSPACE
0 = We have MS account
1 = We do not have MS account in db
0 IF MySpace account exists AND we
have URL;
ELSE 1.
TWITTER
0 = We have Twitter account
1 = We do not have Twitter account in
db
0 IF Twitter account exists AND we have
URL; ELSE 1.
OMBFlag*
Indicator for OMB approval
0=False, 1=True
*Preload only in Blaise file
CONTENTS
Section
Page
IN.
INTRODUCTION/IDENTITY VERIFICATION..............................................................1
IN.
INTRODUCTION/CALL BACK AFTER PARTIAL ......................................................16
A.
HOUSEHOLD INFORMATION .................................................................................18
B.
EDUCATIONAL ATTAINMENT .................................................................................24
C.
SERVICE RECEIPT..................................................................................................29
D.
YOUTHBUILD PROGRAM EXPERIENCES .............................................................38
E.
EMPLOYMENT AND EARNINGS .............................................................................50
F.
CRIMINAL JUSTICE INVOLVEMENT AND DELINQUENCY .................................... 70
G.
SOCIAL AND EMOTIONAL DEVELOPMENT...........................................................77
H.
IDENTITY DEVELOPMENT......................................................................................80
I.
HEALTH AND WELL-BEING ....................................................................................86
J.
ADDRESS AND CONTACT INFORMATION UPDATE ............................................. 91
IN. INTRODUCTION/IDENTITY VERIFICATION
PROGRAMMER BOX IN0.
IF DIAL OUT, GO TO IN1;
IF FIELD CALL IN, GO TO IN2;
IF RESPONDENT CALL IN, GO TO IN3.
CALL OUT
IN1.
Hello, my name is [INTERVIEWER] and I’m calling from Mathematica Policy Research on
behalf of the US Department of Labor. May I please speak with [NAME]?
SPEAKING TO [NAME] ................................................................. 1
GO TO IN15
[NAME] COMES TO PHONE ......................................................... 2
GO TO IN15
PERSON ASKS WHAT CALL IS ABOUT ...................................... 3
GO TO IN4
[NAME] IS NOT AVAILABLE ......................................................... 4
GO TO IN6
[NAME] IS INCARCERATED ......................................................... 5
GO TO IN8
[NAME] HAS MOVED/HAS A DIFFERENT NUMBER .................. 6
GO TO IN9
NEVER HEARD OF [NAME] / WRONG NUMBER ........................ 7
THANKS; STATUS 530
[NAME] IS DECEASED.................................................................. 8
GO TO IN12
[NAME] DOES NOT SPEAK ENGLISH ......................................... 9
GO TO IN13
HUNG UP ....................................................................................... 10 STATUS 240
REFUSED ...................................................................................... r
STATUS 220
FIELD CALL IN
IN2.
May I have your first name?
___________________________________________________ (STRING 20)
FIRST NAME
IN2 = ANSWERED (FIELD CALL IN)
IN2a.
And your last name?
___________________________________________________ (STRING 30)
LAST NAME
Prepared by Mathematica Policy Research
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IN2a = ANSWERED (FIELD CALL IN)
IN2b.
May I have your field interviewer ID number?
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(0000 - 99999)
IN2b = ANSWERED (FIELD CALL IN)
IN2c.
CODE PURPOSE OF FIELD CALL IN
CALLED TO COMPLETE INTERVIEW ........................................ 1
GO TO IN15
CALLED TO SAY [NAME] IS DECEASED .................................... 2
GO TO IN12
CALLED TO SAY [NAME] IS INCARCERATED ........................... 3
GO TO IN8
RESPONDENT CALL IN
IN3.
Thank you for calling. My name is _______________ from Mathematica Policy Research. May
I have your name?
SPEAKING TO RESPONDENT ([NAME]) ..................................... 1
GO TO IN15
SOMEONE ELSE CALLED TO COMPLETE
INTERVIEW ................................................................................... 2
GO TO IN5
CALLED TO ASK WHY WE CALLED ............................................ 3
GO TO IN4
CALLED TO SET APPOINTMENT ................................................ 4
GO TO IN6
CALLED TO REFUSE.................................................................... 5
STATUS 240
CALLED TO SAY [NAME] MOVED/HAS A DIFFERENT
NUMBER ........................................................................................ 6
GO TO IN9
CALLED TO SAY [NAME] IS DECEASED .................................... 7
GO TO IN12
CALLED TO SAY [NAME] IS INCARCERATED ........................... 8
GO TO IN8
CALLED TO SAY NEVER HEARD OF [NAME] /
WRONG NUMBER ........................................................................ 9
THANKS; STATUS 530
HUNG UP ....................................................................................... 10 STATUS 240
Prepared by Mathematica Policy Research
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IN1 = 3 OR IN3 = 3 (WHAT IS CALL ABOUT)
FILL $40 IF PayExperiment = 1 AND (Today – SampleLoadDate LE 30 days); ELSE $25
FILL we last spoke to (him / her) IF Comp_status NE 0: IF Comp_Status = 0, FILL he/she
consented…
IN4.
I would like to speak with [NAME] about a research study on behalf of the US Department
of Labor. I want to ask [NAME] some questions about how [he / she] is doing since [we last
spoke with (him / her) / [he / she] consented to join the study]. [NAME] will be paid
[$25/$40] for [his / her] time.
May I please speak with [NAME]?
SPEAKING TO [NAME] ................................................................. 1
GO TO IN15
[NAME] COMES TO PHONE ......................................................... 2
GO TO IN15
[NAME] IS NOT AVAILABLE ......................................................... 3
GO TO IN6
[NAME] IS INCARCERATED ......................................................... 4
GO TO IN8
[NAME] HAS MOVED/HAS A DIFFERENT NUMBER .................. 5
GO TO IN9
NEVER HEARD OF [NAME] / WRONG NUMBER ........................ 6
THANKS; STATUS 530
[NAME] IS DECEASED.................................................................. 7
GO TO IN12
[NAME] DOES NOT SPEAK ENGLISH ......................................... 8
GO TO IN13
HUNG UP ....................................................................................... 9
STATUS 240
REFUSED ...................................................................................... r
STATUS 220
IN3 = 2 (SOMEONE ELSE CALLED IN TO COMPLETE INTERVIEW)
IN5.
I’m sorry, but I need to speak to [NAME]. May I please speak with [NAME]?
[NAME] COMES TO PHONE ......................................................... 1
GO TO IN15
[NAME] IS NOT AVAILABLE ......................................................... 2
GO TO IN6
[NAME] IS INCARCERATED ......................................................... 3
GO TO IN8
[NAME] HAS MOVED/HAS A DIFFERENT NUMBER .................. 4
GO TO IN9
NEVER HEARD OF [NAME] / WRONG NUMBER ........................ 5
THANKS; STATUS 530
[NAME] IS DECEASED.................................................................. 6
GO TO IN12
[NAME] DOES NOT SPEAK ENGLISH ......................................... 7
GO TO IN13
HUNG UP ....................................................................................... 8
STATUS 240
REFUSED ...................................................................................... r
STATUS 220
Prepared by Mathematica Policy Research
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IN1 = 4 OR IN3 = 4 OR IN4 = 3 OR IN5 = 2 (NOT AVAILABLE; SET APPOINTMENT)
IN6.
When would be a good time to call back?
[NAME] COMES TO PHONE ......................................................... 1
GO TO IN15
SET APPOINTMENT ..................................................................... 2
GO TO IN7
IN6 = 2 (SET APPOINTMENT)
IN7.
When would be a good time to call back?
INTERVIEWER:
SET AN APPOINTMENT USING THE APPOINTMENT TAB ABOVE
IN1 = 5 OR IN2c = 3 OR IN3 = 8 OR IN4 = 4 OR IN5 = 3 (INCARCERATED)
IN8.
What is the name of the place where [NAME] is being held?
___________________________________________________ (STRING 200)
NAME OF PRISON
DON’T KNOW ................................................................................ d
REFUSED ...................................................................................... r
GO TO BOX IN8d.1
IN8 = ANSWERED, d
IN8a.
In what city or town is that located?
___________________________________________________ (STRING 50)
NAME OF CITY/TOWN
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
IN8 = ANSWERED, d
IN8b.
In what state is that located?
________________________________ (STRING 20)
NAME OF STATE
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
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IN8 = ANSWERED, d
IN8c.
When is [NAME] expected to be released?
PROBE:
I just need a month and year. Your best estimate is fine.
INTERVIEWER:
ENTER MONTH ON NEXT SCREEN OR CODE DON’T KNOW
PROGRAMMER:
COLLECT DATE WITH SEPARATE FIELDS
ENTER DATE ON NEXT SCREEN ............................................... 1
SERVING A LIFE SENTENCE ...................................................... 2
GO TO IN8d
IN8c_month & IN8c_year
When is [NAME] expected to be released?
PROBE: I just need a month and year. Your best estimate is fine.
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|/|
(1-12)
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(2012- 2099)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
IN8 = ANSWERED, d
IN8d.
And do you know [NAME]’s inmate number?
INTERVIEWER:
ENTER NUMBER OR CODE DON’T KNOW
___________________________________________________ (STRING 20)
INMATE NUMBER
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER SKIP BOX IN8d.1
GO TO THANKS AND END INTERVIEW.
STATUS CASE 541 (PRISON).
IN1 = 6 OR IN3 = 6 OR IN4 = 5 OR IN5 = 4 (MOVED; HAS DIFFERENT PHONE)
IN9.
Do you or does anyone there know how we can reach [NAME]?
YES ................................................................................................ 1
GO TO IN10
NO .................................................................................................. 0
THANKS; STATUS 530
Prepared by Mathematica Policy Research
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IN9 = 1
IN10.
May I please have [his/her] telephone number?
INTERVIEWER:
ENTER NUMBER ON NEXT SCREEN OR CODE DON’T KNOW
ENTER NUMBER .......................................................................... 1
DON’T KNOW ................................................................................ d
GO TO IN11
REFUSED ...................................................................................... r
GO TO IN11
IN10 = 1
IN10_phone.
Please give me the phone number, area code first.
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SOFT CHECK: IF IN10_phone IS NOT 10 NUM DIGITS; THE PHONE NUMBER SHOULD BE 10
NUMERIC DIGITS, NO SPACES, DASHES, PARENTHESES OR OTHER PUNCTUATION. THE
FIELD SHOULD ALSO NOT BE EMPTY.
SOFT CHECK: USE STANDARD PHONE NUMBER CHECKS.
IN9 = 1
IN11.
May I have [his/her] address?
INTERVIEWER:
ENTER ADDRESS ON NEXT SCREEN OR CODE DON’T KNOW
ENTER ADDRESS......................................................................... 1
DON’T KNOW ................................................................................ d
BOX IN11.1
REFUSED ...................................................................................... r
BOX IN11.1
Prepared by Mathematica Policy Research
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IN11 = 1
IN11_address.
What is [NAME]’s address?
___________________________________________________
STREET 1
___________________________________________________
STREET 2
___________________________________________________
STREET 3
___________________________________________________
CITY
___________________________________________________
STATE
___________________________________________________
ZIP
PROGRAMMER SKIP BOX IN11.1
GO TO THANKS AND END.
IF IN10 = 1 (NEW NUMBER), STATUS CASE 899;
IF IN10 = D, R, STATUS CASE 530.
Prepared by Mathematica Policy Research
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IN1 = 8 OR IN2c = 2 OR IN3 = 7 OR IN4 = 7 OR IN5 = 6 (RESPONDENT IS DECEASED)
I was calling about… IF IN1 = 8 (CALL OUT)
IN12.
I am very sorry to hear that. [I was calling about a research study on behalf of the US
Department of Labor.] When did [NAME] pass away?
Thank you. Please accept my condolences. Goodbye.
PROGRAMMER:
COLLECT DATE WITH SEPARATE FIELDS
ENTER DATE ON NEXT SCREEN ...................................................................... 1
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
IN12_month & IN12_day & IN12_year
Thank you. Please accept my condolences. Goodbye.
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(1-12)
|/|
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(1 - 31)
|/|
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(2012- 2099)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER BOX IN12.1
STATUS CASE 544 (DECEASED) AND END.
Prepared by Mathematica Policy Research
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IN1 = 9 OR IN4 = 8 OR IN5 = 7 (DOES NOT SPEAK ENGLISH)
IN13.
CODE LANGUAGE NEEDED TO COMPLETE INTERVIEW.
SPANISH ....................................................................................... 1
GO TO IN14
FRENCH ........................................................................................ 2
GO TO BOX IN14.1
ARABIC .......................................................................................... 3
GO TO BOX IN14.1
SOMALI .......................................................................................... 4
GO TO BOX IN14.1
CHINESE (MANDARIN, CANTONESE, WU, YUE, MIN) .............. 5
GO TO BOX IN14.1
AMERICAN INDIAN (NAVAJO, LAKOTA, YUPIK) ........................ 6
GO TO BOX IN14.1
RESPONDENT IS DEAF ............................................................... 7
GO TO BOX IN14.1
OTHER LANGUAGE (SPECIFY) ................................................... 8
GO TO BOX IN14.1
DON’T KNOW ................................................................................ d
GO TO BOX IN14.1
SPECIFY TEXT: Please specify the language needed:
IN13 = 1
IN14.
SEEK SUPERVISOR TO FIND A BILINGUAL (SPANISH) INTERVIEWER.
IF NO ONE IS AVAILABLE, TRY TO SET AN APPOINTMENT.
ENTER 1 TO EXIT CASE ..................................................................................... 1
PROGRAMMER BOX IN14.1
STATUS CASE 401 IF IN13 = 1 (SPANISH) AND END.;
STATUS CASE 400 (OTHER LANGUAGE BARRIER) AND END IF IN13 = 2 – 8, D
Prepared by Mathematica Policy Research
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IN1 = 1 OR IN1 = 2 OR IN2c = 1 OR IN3 = 1 OR IN4 = 1 OR IN4 = 2 OR IN5 = 1 OR IN6 = 1
(SPEAKING TO RESPONDENT)
Hello, my name… IF IN1 = 2 OR IN4 = 2 OR IN5 = 1 OR IN6 = 1 (COMES TO PHONE)
I am calling IF IN1 = 1 OR IN1 = 2
I would like to speak with IF IN2c = 1 OR IN3 = 1 OR IN4 = 1 OR IN4 = 2 OR IN5 = 1 OR IN6 = 1
The interview should take around 35 minutes to complete. To thank you, we will send you a
card worth [$25/$40]. The card can be used anywhere that a credit or debit card can be used.. IF
NOT A FIELD COMPLETE
FILL we last spoke to you about a year ago IF Comp_status NE 0; FILL you joined the study IF
Comp_status = 0
$40 IF PayExperiment = 1 AND (Today – SampleLoadDate LE 30 days); ELSE $25
IN15.
[Hello, my name is [INTERVIEWER] and I’m calling from Mathematica Policy Research.]
[I’m calling / I would like to speak with] you about the YouthBuild Evaluation. You may
have received a letter recently to let you know that someone from Mathematica would be
calling to see how you are doing since [we last spoke to you / you joined the study].
[The interview should take around 35 minutes to complete. To thank you, we will send you
a card worth [$25/$40]. The card can be used anywhere that a credit or debit card can be
used.]
The YouthBuild Evaluation is a study paid for by the U.S. Department of Labor and the
Corporation for National and Community Service. The goal of the study is to learn how
YouthBuild helps youth and young adults get a GED certificate or high school diploma,
gain employment skills and find work or prepare for post-secondary training or education.
This study will provide us with important information that will help create better programs
for young people.
The U.S. Department of Labor has funded three organizations, MDRC, Mathematica Policy
Research, and Social Policy Research Associates, to work with YouthBuild programs to
run the study. As part of the study, we are asking you to complete this short interview. The
interview covers several topics, including education, planning for the future, employment,
earnings, involvement with the criminal justice system, and social and emotional
development.
Individual responses will not be matched with specific individuals. Responses to this data
collection will be used only for the purposes of the study. The reports prepared from this
survey will summarize findings across all study participants and individual forms will not
be available to anyone outside the study team, except as required by law.
START INTERVIEW ...................................................................... 1
GO TO IN18
NOT A GOOD TIME....................................................................... 2
GO TO IN16
HUNG UP ....................................................................................... 3
STATUS 640
SUPERVISOR REVIEW ................................................................ 4
SUP REVIEW
Prepared by Mathematica Policy Research
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IN15 = 2
IN16.
When would be a good time to call back?
DECIDES TO DO INTERVIEW NOW ............................................ 1
GO TO IN18
SET APPOINTMENT ..................................................................... 2
GO TO IN17
IN16 = 2
IN17.
When would be a good time to call back?
INTERVIEWER:
SET AN APPOINTMENT USING THE APPOINTMENT TAB ABOVE
IN15 = 1 OR IN16 = 1
IN18.
First, I just need to confirm that I am speaking to the right person.
INTERVIEWER:
IF R GOT MARRIED AND CHANGED NAME, CODE ‘2’ AND UPDATE
NAME.
NAME: [FILL FIRST, MIDDLE & LAST NAME FROM PRELOAD]
How do you spell your first name?
How do you spell your middle name?
And your last name?
NAME AND SPELLING ARE CORRECT ON THE SCREEN ....... 1
FIX SPELLING OR UPDATE NAME ............................................. 2
UPDATE NAME AND
CONTINUE TO BOX IN18.1
DON’T KNOW ................................................................................ d
REFUSED ...................................................................................... r
PROGRAMMER VERIFICATION BOX IN18.1
SET NAME_VERIFY:
IF IN18 = 1 – 2, SET NAME_VERIFY = 1 AND CONTINUE TO I18a;
IF I18 = D, R, SET NAME_VERIFY = 0 AND SKIP TO I19.
Prepared by Mathematica Policy Research
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IN18 = 1 – 2
IN18a. Are you usually called [FIRST NAME] or do you go by another name?
RESPONDENT IS CALLED [NAME] ............................................. 1
GO TO IN19
RESPONDENT GOES BY ANOTHER NAME ............................... 2
ALIAS & THEN IN19
DON’T KNOW ................................................................................ d
GO TO IN19
REFUSED ...................................................................................... r
GO TO IN19
IN18a = 2
Alias. What other name do you go by?
___________________________________________________ (STRING 20)
FIRST NAME
___________________________________________________ (STRING 20)
MIDDLE INITIAL/NAME
___________________________________________________ (STRING 30)
LAST NAME
ALL
IN19.
What is your date of birth?
PROGRAMMER:
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(1-12)
|/|
COLLECT DATE WITH SINGLE FIELD
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(1 - 31)
|/|
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(1980- 2000)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER VERIFICATION BOX IN19.1
SET DOB_VERIFY:
IF IN19 DOB MATCHES PRELOADED DOB, SET DOB_VERIFY = 1 AND SKIP TO BOX I20.2;
IF IN19 = D, R, OR IN19 DOB DOES NOT MATCH PRELOADED DOB, OR PRELOADED DOB
= M, SET DOB_VERIFY = 0 AND CONTINUE TO IN20.
Prepared by Mathematica Policy Research
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DOB_VERIFY = 0 (DOB DOES NOT MATCH)
IN20.
And what are the last 4-digits of your Social Security Number?
| | | | |
(0000- 9999)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER VERIFICATION BOX IN20.1
SET SSN_VERIFY:
IF IN20 SSN MATCHES PRELOADED SSN, SET SSN_VERIFY = 1 AND
CONTINUE TO BOX IN20.2;
IF IN20 = D, R, OR IN20 SSN DOES NOT MATCH PRELOADED SSN, OR PRELOADED SSN
= M,
SET SSN_VERIFY = 0 AND CONTINUE TO BOX IN20.2.
PROGRAMMER VERIFICATION BOX IN20.2
IF NAME_VERIFY = 1 AND (DOB_VERIFY = 1 OR SSN_VERIFY = 1), CONTINUE TO IN22;
IF NAME_VERIFY = 1 AND DOB_VERIFY = 0 AND SSN_VERIFY = 0, CONTINUE TO IN21;
IF NAME_VERIFY = 0, CONTINUE TO IN21.
Prepared by Mathematica Policy Research
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(NAME_VERIFY = 1 AND (DOB_VERIFY = 0 AND SSN_VERIFY = 0)) OR NAME_VERIFY = 0
Fill value at IN19 and IN20.
To begin the interview, please provide your date of birth or the last four digits of your Social
Security number. IF (IN19 = D or R AND IN20 = D or R) OR (IF IN19 = D or R AND SSN_VERIFY =
0) OR (IF DOB_VERIFY = 0 AND IN20 = D or R)
You said that your birthday is [IN19] and that the last four digits of your Social Security number
are [IN20]. Is that correct? IF IN19 = RESPONSE AND IN20 = RESPONSE
We last spoke with you on [REF DATE]. Can you provide me with the address you were living at
that time? IF 12M_comp = 1
Could you please give me the address you would have provided when you signed up for the
YouthBuild Evaluation? IF 12M_comp = 0
IN21a. The date of birth or Social Security number that you provided are not matching what we
have on file. [To begin the interview, please provide your date of birth or the last four
digits of your Social Security number.] [You said that your birthday is [IN19] and that the
last four digits of your Social Security number are [IN20]. Is that correct?]
INTERVIEWER NOTE: IF INCORRECT, GO BACK AND CORRECT THE DOB AND/OR SSN.
OTHERWISE, CONTINUE.
I would like to ask you for some information so that I can verify it with our records. [We
last spoke with you on [REF DATE]. Can you provide me with the address you were living
at that time? / Could you please give me the address you would have provided when you
signed up for the YouthBuild Evaluation?] Keep in mind that this might be different than
your current address.
INTERVIEWER NOTE: WRITE INFORMATION ON PROBLEM SHEET
Thank you for your information. I am going to take it to my supervisor to make sure that
we can continue. May I put you on hold for a few minutes?
IN21.
Thank you for holding.
INTERVIEWER NOTE: IF INFORMATION IS VALID, ENTER DOB ON PREVIOUS SCREEN
AND CONTINUE WITH INTERVIEW. IF INFORMATION IS INVALID,
FINISH THE CALL USING THE SCRIPT BELOW.
I’m sorry, but your information does not match our records, so we can’t proceed right
now. I will need to look into this further and contact you at a later time.
Is this the best number to reach you at? RECORD ON CONTACT SHEET
Is this best time to reach you? RECORD BEST TIME CONTACT SHEET
Thanks. We will get back to you as soon as possible. Good-bye.
I’m sorry. There seems to be a problem with my information. I need to check with my
supervisor about what to do next.
Is this the best number to reach you at? RECORD ON CONTACT SHEET
Is this best time to reach you? RECORD BEST TIME CONTACT SHEET
Thanks. We will get back to you as soon as possible. Good-bye.
ENTER 1 TO CONTINUE .............................................................. 1
Prepared by Mathematica Policy Research
14
SUP REVIEW
9-30-15
NAME_VERIFY = 1 AND (DOB_VERIFY = 1 OR SSN_VERIFY = 1)
IN22.
CODE IF RESPONDENT IS CURRENTLY INCARCERATED
YES ............................................................................................... 1
GO TO SECTION A
NO .................................................................................................. 0
GO TO SECTION A
Prepared by Mathematica Policy Research
15
9-30-15
IN. INTRODUCTION/CALL BACK AFTER PARTIAL
CALL BACK AFTER PARTIAL
Call Back.
Hello, my name is [INTERVIEWER] and I’m calling from Mathematica Policy
Research on behalf of the US Department of Labor. May I please speak with
[NAME]?
SPEAKING TO [NAME] ................................................................. 1
GO TO Continue
[NAME] COMES TO PHONE ......................................................... 2
GO TO Continue
PERSON ASKS WHAT CALL IS ABOUT ...................................... 3
GO TO WhatAbout
[NAME] IS NOT AVAILABLE ......................................................... 4
GO TO Appointment
NEVER HEARD OF [NAME] / WRONG NUMBER ........................ 6
STATUS 530
REFUSED ...................................................................................... r
REFUSAL
CALL BACK = 3 (WHAT ABOUT)
WhatAbout.
I’m calling to finish an interview we started with [NAME]. May I please speak with
[him / her]?
SPEAKING TO [NAME] ................................................................. 1
GO TO Continue
[NAME] COMES TO PHONE ......................................................... 2
GO TO Continue
[NAME] IS NOT AVAILABLE ......................................................... 3
GO TO Appointment
SUPERVISOR REVIEW ................................................................ 4
SUP REVIEW
REFUSED ...................................................................................... r
REFUSAL
(CALL BACK = 1 OR 2) OR (WhatAbout = 1 OR 2)
Hello, my name is… IF CALL BACK = 2 (COMES TO PHONE)
Continue.
IF CALL BACK = 2 OR WhatAbout = 2 (COMES TO PHONE)
Hello, my name is [INTERVIEWER] and I’m calling from Mathematica Policy
Research on behalf of the US Department of Labor.
ALL
I’m calling to finish the interview for the YouthBuild Research Project.
CONTINUE INTERVIEW ......................................................................... 1
GO TO NextQuestion
NOT A GOOD TIME................................................................................. 2
GO TO Appointment
SUPERVISOR REVIEW .......................................................................... 3
SUP REVIEW
CALL BACK = 4 OR WHATABOUT = 3 OR CONTINUE = 2
Appointment. When would be a good time to call back?
INTERVIEWER:
SET AN APPOINTMENT USING THE APPOINTMENT TAB ABOVE
Prepared by Mathematica Policy Research
16
9-30-15
A. HOUSEHOLD INFORMATION
ALL
A0.
The first questions are about your housing situation.
ENTER 1 TO CONTINUE ..................................................................................... 1
ALL
A1.
Where do you live now? If you stay in more than one place, where do you stay most often?
CODE ONE ONLY
Your parent’s home, ................................................................................................. 1
Another person’s home, ........................................................................................... 2
Your own place whether you rent or own,.............................................................. 3
A group home or halfway house, ............................................................................ 4
A dormitory (such as college or Job Corps housing), .......................................... 10
A long-term homeless shelter, ................................................................................ 5
GO TO A3
An emergency housing shelter including a domestic violence shelter, ............. 6
GO TO A3
An incarceration facility, .......................................................................................... 7
Homeless and living on the street, or ..................................................................... 8
GO TO A3
Some other arrangement? ....................................................................................... 9
___________________________________________________ (STRING 200)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
SPECIFY TEXT: Please tell me about where you live now:
IF A1 NE 5, 6, 8 (NOT CURRENTLY LIVING IN SHELTER OR HOMELESS)
A2.
Have you been homeless and living on the street or in a shelter at any time since [REF
DATE]?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
17
9-30-15
ALL
A3.
What is your marital status? Are you…
CODE ONE ONLY
married, ................................................................................................................ 1
divorced, .............................................................................................................. 2
separated, ............................................................................................................ 3
widowed, .............................................................................................................. 4
or never married?................................................................................................ 5
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER SKIP BOX A3.1
IF A1 = 1 – 6, 9,10, D, R (LIVING IN HOUSE, OTHER, DK, REF) CONTINUE;
ELSE, SKIP TO A6.
A1 = 1 – 6, 9, 10, D, R
Does your spouse currently live IF A3 = 1;
ELSE Do you have a partner who currently lives
A4.
[Does your spouse currently live / Do you have a partner who currently lives] with you?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
A1 = 1, 2, 3, 9, D, R
A5.
Including yourself, how many people currently live with you? Include everyone who usually
lives there, even if they are away from home right now.
|
| | PEOPLE
(RANGE 0-99)
DON’T KNOW....................................................................................................... d
REFUSED............................................................................................................. r
HARD CHECK: IF A5 = 0; INTERVIEWER: THIS QUESTION SHOULD NOT BE LESS THAN ONE (1).
PLEASE RE-READ QUESTION IF NECESSARY AND EMPHASIZE “INCLUDING YOURSELF.”
SOFT CHECK: IF A4 = 1 AND A5 <2; In the previous question you mentioned you live with your
spouse or partner. Including yourself and your spouse or partner, how many people currently
live with you?
Prepared by Mathematica Policy Research
18
9-30-15
ALL
A6a.
Do you have any children under 18 years of age? Please include your own or adopted
children, foster, or stepchildren. Please do not include a current pregnancy.
YES ................................................................................................ 1
NO .................................................................................................. 0
GO TO SECTION B
DON’T KNOW ................................................................................ d
GO TO SECTION B
REFUSED ...................................................................................... r
GO TO SECTION B
A6a = 1
A7.
How many children do you have? Please do not include a current pregnancy.
|
| | CHILDREN
(RANGE 00-99)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
SOFT CHECK: IF A7 = 15 – 99; I just want to be sure I recorded your answer correctly. You have
[FILL A7] children, is that correct?
SOFT CHECK: IF A7 = 0; You mentioned in a previous question that you have children. You just
mentioned that you have 0 children. Would you like to go back and change your answer about
having children or change the number of children you have?
PROGRAMMER SKIP BOX A7.1
IF A7 = 0, D, R (NO CHILDREN OR MISSING), SKIP TO SECTION B;
IF A7 = 1 (ONE CHILD), CONTINUE TO A8a;
IF A7 GT 1 (MULTIPLE CHILDREN), SKIP TO A8b.
Prepared by Mathematica Policy Research
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9-30-15
A7 = 1
A8a.
Does this child live with you?
YES ....................................................................................................................... 1
GO TO A9
NO ......................................................................................................................... 0
GO TO A9
DON’T KNOW ....................................................................................................... d
GO TO A9
REFUSED ............................................................................................................. r
GO TO A9
A7 GT 1
A8b.
How many of your children live with you?
|
| | CHILDREN
(RANGE 0-99)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
SOFT CHECK: IF A8b GT A7; You mentioned in a previous question that you have [FILL A7]
children. The number of children living with you have should not be greater than the number of
children you have. Would you like to change your answer about the number of children you
have or the number of children living with you?
A7 GT 0 (HAS CHILDREN)
A9.
IF A7 = 1:
Was this child born after [REF DATE]?
IF A7 GT 1: Were any of your children born after [REF DATE]?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER SKIP BOX A9.1
IF A7 = 1 AND A8a = 0 (ONLY CHILD IS NOT LIVING IN HOME), CONTINUE TO A10a;
IF A7 = 1 AND A8a = 1 (ONLY CHILD IS LIVING AT HOME), GO TO A11;
IF A7 = 1 AND A8a = D, R, GO TO A11;
IF A7 GT 1 AND (A7 – A8b GT 0) (NOT ALL CHILDREN LIVING IN HOME), CONTINUE TO A10a;
IF A7 GT1 AND (A7 – A8b LE 0) (ALL CHILDREN LIVING IN HOME), GO TO A11;
IF A7 GT 1 AND A8b = D, R, GO TO A11.
Prepared by Mathematica Policy Research
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9-30-15
IF (A7 = 1 AND A8a = 0) OR (A7 GT 1 AND (A7 – A8b GT 0))
child, does IF A7 = 1 AND A8a = 0;
children, do IF A7 GT 1 AND (A7 – A8b GT 1);
child, does IF A7 GT1 AND (A7 – A8b = 1)
A10a. Did you spend time with your [child / children] who [does / do] not live with you in the past
week?
YES ....................................................................................................................... 1
GO TO A10
NO ......................................................................................................................... 0
GO TO A11
DON’T KNOW ....................................................................................................... d
GO TO A11
REFUSED ............................................................................................................. r
GO TO A11
IF A10a = 1
child IF A7 = 1 AND A8a = 0;
children IF A7 GT 1 AND (A7 – A8b GT 1);
child IF A7 GT1 AND (A7 – A8b = 1)
A10.
Thinking just about the [child / children] who [does / do] not live with you, please tell me
which of the following activities you have done in the past week.
In the past week have you…
CODE ONE PER ROW
YES
NO
DK
REF
a. Read with your [child/children]?
1
0
d
r
b. Played with your [child/children], not including
sports?
1
0
d
r
c. Done arts and crafts with your [child/children]?
1
0
d
r
d. Played sports with your [child/children]?
1
0
d
r
e. Talked with or listened to your [child/children]?
1
0
d
r
f.
Attended your [child/children]’s events?
1
0
d
r
g. Helped your [child/children] with homework?
1
0
d
r
h. Picked up or dropped your [child/children] off?
1
0
d
r
1
0
d
r
i.
Done some other activities with your [child /
children]?
Prepared by Mathematica Policy Research
21
9-30-15
IF A7 GT 0
A11.
Do you have any legal agreements or child support orders that require you to provide
financial support for a child?
YES ................................................................................................ 1
NO .................................................................................................. 0
GO TO SECTION B
DON’T KNOW ................................................................................ d
GO TO SECTION B
REFUSED ...................................................................................... r
GO TO SECTION B
A11 = 1
A12.
Did you make this payment last month?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
22
9-30-15
B. EDUCATIONAL ATTAINMENT
ALL
B0.
The next questions ask about your experiences in school and your future education plans.
ENTER 1 TO CONTINUE ..................................................................................... 1
PL_dropout = 1 (DATA NOT PREVIOUSLY COLLECTED)
B1.
Did you drop out of high school before graduating?
YES ....................................................................................................................... 1
GO TO B2
NO ......................................................................................................................... 0
GO TO B3
DON’T KNOW ....................................................................................................... d
GO TO B3
REFUSED ............................................................................................................. r
GO TO B3
B1 = 1
B2.
What was the highest grade that you finished in high school before you dropped out?
Was it…
CODE ONE ONLY
8th grade or less, ................................................................................................ 1
9th grade or freshman in high school,.............................................................. 2
10th grade or sophomore in high school, or ................................................... 3
11th grade or junior in high school?................................................................. 4
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PL_diploma = 0 (DATA NOT PREVIOUSLY COLLECTED)
B3.
Do you have a high school diploma, a GED, HiSET or TASC, a Certificate of Completion, or
do you have none of these?
CODE ONE ONLY
HIGH SCHOOL DIPLOMA .................................................................................... 1
GO TO B4
GED, HiSET or TASC ........................................................................................... 2
GO TO B4
CERTIFICATE OF COMPLETION........................................................................ 3
GO TO B4
NONE OF THESE ................................................................................................. 4
GO TO B5a
DON’T KNOW ....................................................................................................... d
GO TO B5a
REFUSED ............................................................................................................. r
GO TO B5a
Prepared by Mathematica Policy Research
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9-30-15
IF B3 = 1 – 3 OR (PL_diploma = 1 – 3 AND PL_dipdate = 1)
high school diploma IF B3 = 1 OR PL_diploma = 1; GED, HISET OR TASC IF B3 = 2 OR
PL_diploma = 2; Certificate of Completion IF B3 = 3 OR PL_diploma = 3
B4.
In what month and year did you obtain your [high school diploma/GED, HiSET or
TASC/Certificate of Completion]?
PROBE:
Your best estimate is fine.
PROGRAMMER:
|
|
(1-12)
|/|
COLLECT DATE WITH SEPARATE FIELDS
|
|
|
|
(2000 - 2017)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
HARD CHECK: IF B4_Month = 0 OR GT 12
HARD CHECK: IF B4 IS AFTER TODAY (IF MONTH = DK OR R, CHECK YEAR); INTERVIEWER:
This date is in the future. Please correct the date.
HARD CHECK: IF B4 YEAR GT CURRENT YEAR (IF MONTH = DK OR R, CHECK YEAR);
INTERVIEWER: The date you provided is in the future. Please correct the date.
SOFT CHECK: IF B4 DATE IS BEFORE [REF DATE]; I just want to make sure I recorded your
answer correctly. You said you obtained your [GED, HiSET or TASC/ high school diploma /
Certification of Completion] in [FILL B4 MONTH AND YEAR]. Is this correct?
ALL
B5a.
Have you attended or enrolled in classes since [REF DATE]? Please include GED, HiSET
or TASC preparation classes, Certificate of Completion programs, and college courses.
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
GO TO B7
DON’T KNOW ....................................................................................................... d
GO TO B7
REFUSED ............................................................................................................. r
GO TO B7
Prepared by Mathematica Policy Research
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9-30-15
B5a = 1
B5b.
Where were you enrolled in or attending those classes?
CODE ONE PER ROW
YES
NO
DK
REF
a. Regular high school?
1
0
d
r
b. A charter school?
1
0
d
r
c. A special high school for persons with disabilities?
1
0
d
r
d. GED, HiSET or TASC preparation class or a Certificate of
Completion program?
1
0
d
r
e. Vocational, technical, business or trade school?
1
0
d
r
f.
1
0
d
r
g. A 4-year college or university?
1
0
d
r
h. Somewhere else?
1
0
d
r
A 2-year college or community college?
B5a = 1 (ENROLLED SINCE REF DATE)
IF B3 = 1 – 3, FILL Please do not include your [high school diploma / GED, HiSET or TASC /
Certificate of Completion].
high school diploma IF B3 = 1 OR PL_diploma = 1; GED, HISET OR TASC IF B3 = 2 OR
PL_diploma = 2; Certificate of Completion IF B3 = 3 OR PL_diploma = 3
B5c.
Have you completed any degrees since [REF DATE]? [Please do not include your [high
school diploma / GED, HiSET or TASC / Certificate of Completion]].
YES ................................................................................................ 1
NO .................................................................................................. 0
GO TO BOX B6.1
DON’T KNOW ................................................................................ d
GO TO BOX B6.1
REFUSED ...................................................................................... r
GO TO BOX B6.1
Prepared by Mathematica Policy Research
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9-30-15
B5c = 1
B6.
Which degrees have you completed?
CODE ONE PER ROW
YES
NO
DK
REF
1. Vocational, technical, business or trade school?
1
0
d
r
2. 2-year college or community college?
1
0
d
r
3. 4-year college or university?
1
0
d
r
4. Graduate school?
1
0
d
r
5. Another degree? (SPECIFY)
1
0
d
r
______________________________________ (STRING 200)
SPECIFY TEXT: Please tell me the other degree you completed:
PROGRAMMER SKIP BOX B6.1
IF B6_2, _3, OR _4 = 1(COMPLETED COLLEGE), SKIP TO SECTION C;
IF B5b_6 OR B5b_7 = 1 (TAKEN COLLEGE CLASSES) SKIP TO B8;
ELSE, CONTINUE TO B7.
((B5b_6 NE1 AND B5b_7 NE 1) AND (B6_2 NE 1 AND B6_3 NE 1 AND B6_4 NE 1)) OR B5a = 0, D,
R
B7.
How likely is it that you will attend college? Would you say…
CODE ONE ONLY
Very likely, ................................................................................................................. 1
Somewhat likely, ....................................................................................................... 2
Somewhat unlikely, or .............................................................................................. 3
Very unlikely? ............................................................................................................ 4
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
SKIP BOX B7.1
ALL RESPONSES SKIP TO SECTION C.
Prepared by Mathematica Policy Research
26
9-30-15
B5b_6 OR B5b_7 = 1
B8.
How likely is it that you will graduate from college? Would you say…
CODE ONE ONLY
Very likely, ................................................................................................................. 1
Somewhat likely, ....................................................................................................... 2
Somewhat unlikely, or .............................................................................................. 3
Very unlikely? ............................................................................................................ 4
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
27
9-30-15
C. SERVICE RECEIPT
ALL
C0.
In earlier questions, we asked you about your experiences in school and your future
education plans. The next questions are about different kinds of services you may have
received.
ENTER 1 TO CONTINUE ..................................................................................... 1
ALL
C1.
Since [REF DATE], have you participated in any of the following education related
services?
CODE ONE PER ROW
YES
NO
DK
REF
a. GED, HiSET or TASC preparation?
1
0
d
r
b. Academic tutoring not including GED, HiSET or TASC
preparation?
1
0
d
r
c. Courses to prepare for a high school diploma?
1
0
d
r
d. Standardized achievement test preparation for state or
local tests?
1
0
d
r
e. College preparation activities such as college awareness
or college guidance activities, college preparation or
transition programs, or preparing for college entrance
examinations or college applications?
1
0
d
r
f.
1
0
d
r
1
0
d
r
Help finding financial aid?
g. Another education related service? (SPECIFY)
______________________________________ (STRING 255)
SPECIFY TEXT: Please tell me the other education related service you participated in:
PROGRAMMER BOX C1.1.
IF NO C1 ITEMS = 1, SKIP TO C4;
IF ANY C1a–g = 1, CONTINUE TO C2.
Prepared by Mathematica Policy Research
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9-30-15
AT LEAST ONE AT C1
FILL RESPONSE OPTIONS (A-F) FROM C1
FILL RESPONSE G FROM C1g_specify;
IF C1g_specify IS D OR R, FILL In the other education related service you mentioned
C2.
Since [REF DATE], about how much time in total have you spent participating in the
following education related services? You can answer in hours, days, weeks, or months.
About how long have you spent… [INSERT ITEM] since [REF DATE]?
PROBE:
Your best estimate is fine. You can tell me in hours, days, weeks, or months.
PROGRAMMER:
NUMBER RANGE IS 00 – 999
PROGRAMMER:
DO NOT ALLOW DK OR REFUSED BUTTONS ON UNIT SCREENS
(FOR AMOUNT SCREEN ONLY)
INTERVIEWER:
CODE AMOUNT HERE AND UNIT ON THE NEXT SCREEN
(FOR UNIT SCREEN ONLY)
INTERVIEWER:
ENTER UNIT
NUMBER
a. In GED, HiSET or TASC preparation?
|
|
|
b. In academic tutoring not including GED, HiSET or TASC
preparation?
|
|
|
c. In courses to prepare for a high school diploma?
|
|
|
d. In preparation for standardized achievement tests, such
as state or local tests?
|
|
|
e. In college preparation activities such as college
awareness or college guidance activities, college
preparation or transition programs, or preparing for
college entrance examinations or college applications?
|
|
|
f.
|
|
|
|
|
|
Getting help finding financial aid?
g. [Fill from C1g_specify / In the other education related
service you mentioned?]
Prepared by Mathematica Policy Research
29
HOURS, DAYS,
WEEKS OR
MONTHS
HOURS ......... 1
DAYS ............ 2
WEEKS .......... 3
MONTHS ....... 4
HOURS ......... 1
DAYS ............ 2
WEEKS .......... 3
MONTHS ....... 4
HOURS ......... 1
DAYS ............ 3
WEEKS .......... 3
MONTHS ....... 4
HOURS ......... 1
DAYS ............ 2
WEEKS .......... 3
MONTHS ....... 4
HOURS ......... 1
DAYS ............ 2
WEEKS .......... 3
MONTHS ....... 4
HOURS ......... 1
DAYS ............ 2
WEEKS .......... 3
MONTHS ....... 4
HOURS ......... 1
DAYS ............ 2
WEEKS .......... 3
MONTHS ....... 4
9-30-15
AT LEAST ONE AT C1
C1a = 1, FILL: GED, HiSET or TASC preparation; C1b = 1, FILL: Academic tutoring; C1c = 1, FILL:
High school courses; C1d = 1, FILL: Standardized achievement test preparation; C1e = 1, FILL:
College preparation activities; C1f = 1, FILL: Help finding financial aid
C1g = 1, FILL: FROM C1g_specify; IF C1g_specify IS D, R, FILL: Another education related service
service IF THE NUMBER OF ITEMS SELECTED AT C1= 1;
services IF THE NUMBER OF ITEMS SELECTED AT C1 GT 1
this service most often IF THE NUMBER OF ITEMS SELECTED AT C1 = 1;
most of these services IF THE NUMBER OF ITEMS SELECTED AT C1 GT 1
[YB PROGRAM] or another IF RAOutcome = 1 (TREATMENT);
A IF RAOutcome = 2 (CONTROL)
C3.
You said you participated in the following education related [service / services]:
INTERVIEWER: READ ITEMS:
•
[FILL FIRST SELECTED ITEM]
•
[FILL SECOND SELECTED ITEM]
•
[CONTINUE FILLING]
Where did you receive [this service most often/most of these services]?
CODE ONE ONLY
A community based organization, .................................................................... 1
School, ................................................................................................................. 2
A former or current employer, ........................................................................... 3
[[YB PROGRAM] or another/A] YouthBuild program, or ................................ 4
Somewhere else? ............................................................................................... 5
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
30
9-30-15
ALL
C4.
Since [REF DATE], have you received any help enrolling or participating in any of the
following education related services?
CODE ONE PER ROW
Yes
NO
DK
REF
a. A high school diploma program?
1
0
d
r
b. English as a Second Language or ESL training?
1
0
d
r
c. Courses for college credit?
1
0
d
r
d. Another type of education activity or academic
service? (SPECIFY)
1
0
d
r
______________________________________ (STRING 255)
SPECIFY TEXT: Please tell me the other education activity or service you participated in:
ALL
C5.
Since [REF DATE], have you participated in any of the following training or job related
services?
CODE ONE PER ROW
YES
NO
DK
REF
a. A job skills training program?
1
0
d
r
b. Construction training or another on-the-job training?
1
0
d
r
c. Career counseling?
1
0
d
r
d. A job certification program?
1
0
d
r
e. Job search assistance, including help filling out an
application, writing a resume, or going for an
interview?
1
0
d
r
Help applying to a vocational training program,
including help with an application or interview?
1
0
d
r
g. Another training or job related service? (SPECIFY)
1
0
d
r
f.
______________________________ (STRING 255)
SPECIFY TEXT: Please tell me the other training or job related service you participated in:
PROGRAMMER BOX C5.1.
IF NO C5 ITEMS = 1, SKIP TO BOX C8;
IF ANY C5a-g = 1, CONTINUE TO.
Prepared by Mathematica Policy Research
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9-30-15
AT LEAST 1 AT C5
FILL RESPONSE OPTIONS (A-F) FROM C5
FILL RESPONSE G FROM C5g_specify;
IF C5g_specify IS EMPTY, FILL In the other training or job related service you mentioned?
C6.
Since [REF DATE], about how much time in total have you spent participating in the
following training or job related services? You can answer in hours, days, weeks, or
months.
About how long have you spent… [INSERT ITEM] since [REF DATE]?
PROBE:
months.
Your best estimate is fine. You can tell me in hours, days, weeks, or
PROGRAMMER:
NUMBER RANGE IS 00 – 999
PROGRAMMER:
DO NOT ALLOW DK OR REFUSED BUTTONS ON UNIT SCREENS
(FOR AMOUNT SCREEN ONLY)
INTERVIEWER:
CODE AMOUNT HERE AND UNIT ON THE NEXT SCREEN
(FOR UNIT SCREEN ONLY)
INTERVIEWER:
ENTER UNIT
NUMBER
a. In a job skills training program?
|
|
|
b. In construction training or another on-the-job training?
|
|
|
c. In career counseling?
|
|
|
d. In a job certification program?
|
|
|
e. Receiving job search assistance, including help filling out
an application, writing a resume, or going for an interview?
|
|
|
|
|
|
|
|
|
f.
Receiving help applying to a vocational training program,
including help with an application or interview?
g. [FILL D5g_specify / In the other training or job related
service you mentioned?]
Prepared by Mathematica Policy Research
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HOURS, DAYS,
WEEKS OR
MONTHS
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
9-30-15
AT LEAST 1 AT C5
C5a = 1, FILL: A job skills training program; C5b = 1, FILL: Construction training or another onthe-job training
C5c = 1, FILL: Career counseling; C5d = 1, FILL: A job certification program; C5e = 1, FILL: Job
search assistance; C5f = 1, FILL: Help applying to a vocational training program
C5g = 1, FILL: FROM C5g_specify; IF C5g_specify IS D, R, FILL: Another training or job related
service
service IF THE NUMBER OF ITEMS SELECTED AT C5= 1;
services IF THE NUMBER OF ITEMS SELECTED AT C5 GT 1
this service most often IF THE NUMBER OF ITEMS SELECTED AT C5 = 1;
most of these services IF THE NUMBER OF ITEMS SELECTED AT C5 GT 1
[YB PROGRAM] or another IF RAOutcome = 1 (TREATMENT);
A IF RAOutcome = 2 (CONTROL)
C7.
You said you participated in the following training or job related [service / services]:
INTERVIEWER:
READ ITEMS:
•
[FILL FIRST SELECTED ITEM]
•
[FILL SECOND SELECTED ITEM]
•
[CONTINUE FILLING]
Where did you receive [this service most often/most of these services]?
CODE ONE ONLY
A community based organization, .................................................................... 1
School, ................................................................................................................. 2
A former or current employer, ........................................................................... 3
[[YB PROGRAM] or another/A] YouthBuild program, or ................................ 4
Somewhere else? ................................................................................................ 5
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
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9-30-15
ALL
C8.
Since [REF DATE], have you participated in any of the following personal development
services?
CODE ONE PER ROW
YES
NO
DK
REF
a. Getting help or advice from a mentor?
1
0
d
r
b. Life skills training such as parenting skills classes,
learning how to balance a checkbook, etc.?
1
0
d
r
c. Communication or public-speaking training?
1
0
d
r
d. Leadership development training?
1
0
d
r
e. Health services?
1
0
d
r
f.
1
0
d
r
1
0
d
r
Mental health services?
g. Working with a case manager?
PROGRAMMER BOX C8.1.
IF NO C8 ITEMS = 1, SKIP TO SECTION D;
IF ANY C8a-g = 1, CONTINUE TO C9.
Prepared by Mathematica Policy Research
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9-30-15
AT LEAST ONE AT C8
FILL RESPONSE OPTIONS (A-G) FROM C8
C9.
Since [REF DATE], about how much time in total have you spent participating in the
following personal development services? You can answer in hours, days, weeks, or
months.
About how long have you spent… [INSERT ITEM] since {REF DATE]?
PROBE:
Your best estimate is fine. You can tell me in hours, days, weeks, or months.
PROGRAMMER:
NUMBER RANGE IS 00 – 999
PROGRAMMER:
DO NOT ALLOW DK OR REFUSED BUTTONS ON UNIT SCREENS
(FOR AMOUNT SCREEN ONLY)
INTERVIEWER:
CODE AMOUNT HERE AND UNIT ON THE NEXT SCREEN
(FOR UNIT SCREEN ONLY)
INTERVIEWER:
SELECT A UNIT
NUMBER
a. Getting help or advice from a mentor?
|
|
|
b. In life skills training such as parenting skills classes,
learning how to balance a checkbook, etc.?
|
|
|
c. In communication or public-speaking training?
|
|
|
d. In leadership development training?
|
|
|
e. Using health services?
|
|
|
f.
Using mental health services?
|
|
|
g. Working with a case manager?
|
|
|
Prepared by Mathematica Policy Research
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HOURS, DAYS,
WEEKS OR MONTHS
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
HOURS ........ 1
DAYS ............ 2
WEEKS ......... 3
MONTHS ....... 4
9-30-15
AT LEAST ONE AT C8
C8a = 1, FILL: Mentoring; C8b = 1, FILL: Life skills training; C8c = 1, FILL: Communication or
public-speaking training; C8d = 1, FILL: Leadership development training; C8e = 1, FILL: Health
services; C8f = 1, FILL: Mental health services; C8g = 1, FILL: Working with a case manager
service IF THE NUMBER OF ITEMS SELECTED AT C8= 1;
services IF THE NUMBER OF ITEMS SELECTED AT C8 GT 1
this service most often IF THE NUMBER OF ITEMS SELECTED AT C8= 1;
most of these services IF THE NUMBER OF ITEMS SELECTED AT C8 GT 1
[YB PROGRAM] or another IF RAOutcome = 1 (TREATMENT);
A IF RAOutcome = 2 (CONTROL)
C10.
You said you participated in the following personal development [service / services]:
•
[FILL FIRST SELECTED ITEM]
•
[FILL SECOND SELECTED ITEM]
•
[CONTINUE FILLING]
Where did you receive [this service most often/most of these services]? From…
CODE ONE ONLY
A community based organization, .................................................................... 1
School, ................................................................................................................. 2
A former or current employer, ........................................................................... 3
[[YB PROGRAM] or another/A] YouthBuild program, or ................................ 4
Somewhere else? ................................................................................................ 5
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
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9-30-15
D. YOUTHBUILD (YB) PROGRAM EXPERIENCES
ALL
D0.
The next questions are about your experiences with YouthBuild.
ENTER 1 TO CONTINUE ..................................................................................... 1
PROGRAMMER SKIP BOX D0.1
IF C3, C7, AND C10 NE 4, GO TO D1; ELSE SET D1 = 1 AND GO TO
D1a
C3, C7 AND C10 NE 4
D1.
Since [REF DATE], have you received any services from YouthBuild or participated in any
YouthBuild activities?
YES ................................................................................................ 1
NO .................................................................................................. 0
GO TO BOX D1b.1
DON’T KNOW ................................................................................ d
GO TO BOX D1b.1
REFUSED ...................................................................................... r
GO TO BOX D1b.1
C3, C7, OR C10 = 4 OR (D1 = 1)
YouthBuild services IF C3, C7, OR C10 = 4;
these services IF D1 = 1
YB PROGRAM FROM GranteeName
D1a.
Did you receive [YouthBuild services / these services] from [YB PROGRAM]?
YES ................................................................................................ 1
GO TO BOX D1b.1
NO .................................................................................................. 0
DON’T KNOW ................................................................................ d
REFUSED ...................................................................................... r
Prepared by Mathematica Policy Research
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9-30-15
D1a = 0, D, R
D1b.
What is the name, city and state of the YouthBuild program where you received services?
___________________________________________________ (STRING 80)
PROGRAM NAME
___________________________________________________
CITY
___________________________________________________
STATE
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER SKIP BOX D1b.1
(LAST REPORTED BEING STILL ENROLLED)
IF PL_YBstatus = 1 AND D1 = 1 OR C3, C7, or C10 = 4, SKIP TO D3;
IF PL_YBstatus = 1 AND D1 = 0, SKIP TO D1c;
IF PL_YBstatus = 1 AND D1 = D OR R, SKIP TO D3;
(LAST REPORTED GRADUATING)
IF PL_YBstatus = 2 AND D1 = 1 OR C3, C7, or C10 = 4, SKIP TO D8;
IF PL_YBstatus = 2 AND D1 = 0, D R, SKIP TO D12;
(LAST REPORTED STOPPED GOING)
IF PL_YBstatus = 3 AND D1 = 1 OR C3, C7, or C10 = 4, SKIP TO D3;
IF PL_YBstatus = 3 AND D1 = 0, SKIP TO D12;
IF PL_YBstatus = 3 AND D1 = D OR R, SKIP TO SECTION E;
(DID NOT COMPLETE PREVIOUS SURVEYS OR NEVER REPORTED YB STATUS)
IF PL_YBstatus = 0 AND D1 = 1 OR C3, C7, or C10 = 4, SKIP TO D3;
IF PL_YBstatus = 0 AND D1 = 0 AND RAOutcome = 1 (TREATMENT), SKIP TO D1c;
IF PL_YBstatus = 0 AND D1 = 0 AND RAOutcome = 2 (CONTROL), SKIP TO SECTION E;
IF PL_YBstatus = 0 AND D1 = D OR R, AND RAOutcome = 1 (TREATMENT), SKIP TO D3;
IF PL_YBstatus = 0 AND D1 = D OR R, AND RAOutcome = 2 (CONTROL), SKIP TO SECTION E
(PL_YBstatus = 1 AND D1 = 0) OR (PL_YBstatus = 0 AND D1 = 0 AND TREATMENT)
D1c.
Is that because you graduated from or completed the YouthBuild program?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
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9-30-15
PROGRAMMER SKIP BOX D1c.1
IF D1c = 1, SET D3 = 2 (GRADUATED) AND GO TO D4; ELSE, GO TO D2.
D1c = 0, D OR R
D2.
Why did you not participate in YouthBuild? Did you not participate because…
[INSERT ITEM]
CODE ONE PER ROW
YES
NO
DK
REF
a. You had no transportation?
1
0
d
r
b. You were incarcerated?
1
0
d
r
c. It was at a bad time of the day?
1
0
d
r
d. You got a job?
1
0
d
r
e. You moved?
1
0
d
r
1
0
d
r
g. You had health problems or an injury?
1
0
d
r
h. A family member became ill?
1
0
d
r
i.
You had pressure for your family?
1
0
d
r
j.
You did not like the program?
1
0
d
r
1
0
d
r
You did not like or get along with other
participants?
1
0
d
r
m. You were kicked out or asked to leave?
1
0
d
r
n. The program closed?
1
0
d
r
o. Some other reason (SPECIFY)?
1
0
d
r
f.
You were expecting a child or had child care
problems?
k. You did not like or get along with the program
staff?
l.
_______________________________ (STRING 255)
SPECIFY TEXT: Please tell me the reason why you did not participate:
Prepared by Mathematica Policy Research
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9-30-15
D1c = 0, D OR R
D2a.
In what month and year did you stop going to YouthBuild?
PROBE:
Your best estimate is fine
PROGRAMMER:
|
|
(1-12)
|/|
COLLECT DATE WITH SEPARATE FIELDS
|
|
|
|
(2011 - 2017)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
HARD CHECK: IF D2a_Month = 0 OR GT 12
HARD CHECK: IF D2a DATE GT CURRENT DATE INTERVIEWER: The date you provided is in the
future. Please correct the date.
HARD CHECK: IF D2a YEAR GT CURRENT YEAR (IF MONTH = DK OR R, CHECK YEAR);
INTERVIEWER: The date you provided is in the future. Please correct the date.
SOFT CHECK: IF D2a DATE IS BEFORE [REF DATE]; I just want to make sure I recorded your
answer correctly. You said you stopped going to YouthBuild in [FILL D2a MONTH AND YEAR].
Is this correct?
PROGRAMMER SKIP BOX D2a.1
ALL RESPONSES TO D2a GO TO D12.
PROGRAMMER FILL BOX.
FOR THE REST OF SECTION D, PLEASE USE THE FOLLOWING FILL LOGIC
FOR THE PROGRAM NAME [YB PROGRAM / YouthBuild]:
IF D1a = 1, FILL YB PROGRAM FROM GranteeName; ELSE, FILL YouthBuild
Prepared by Mathematica Policy Research
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9-30-15
(PL_YBstatus = 1 AND D1 = 1, D, OR R) OR (PL_YBstatus = 3 AND D1 = 1) OR (PL_YBstatus = 0
AND D1 = 1) OR (PL_YBstatus = 0 AND (D1 = D OR R) AND TREATMENT);
OR
FROM PROGRAMMER SKIP BOX D1c.1, IF D1c = 1, SET D3 = 2 (GRADUATED) INSTEAD OF
ASKING, AND CONTINUE
D3.
Which of the following best describes your current status at [YB PROGRAM] /
YouthBuild]?
CODE ONE ONLY
Currently enrolled in [YB PROGRAM / YouthBuild] and have not yet
graduated or completed the program, .................................................................... 1
Graduated from or completed the [YB PROGRAM / YouthBuild]
program, or ................................................................................................................ 2
No longer enrolled in [YB PROGRAM / YouthBuild] and did not
graduate or complete the program? ....................................................................... 3
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
PROGRAMMER SKIP BOX D3.1
IF D3 = 1, D, R, SKIP TO D6;
IF D3 = 2 – 3, CONTINUE TO D4.
Prepared by Mathematica Policy Research
41
9-30-15
IF D3 = 2 – 3
graduate or complete IF D3 = 2 (GRADUATED);
stop going to IF D3 = 3
D4.
In what month and year did you [graduate or complete / stop going to] [YB PROGRAM /
YouthBuild]?
PROBE: Your best estimate is fine
PROGRAMMER:
|
COLLECT DATE WITH SEPARATE FIELDS
| |/| | | | |
(1-12)
(2011 - 2017)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
HARD CHECK: IF D4_Month = 0 OR GT 12
HARD CHECK: IF D4 DATE GT CURRENT DATE; INTERVIEWER: The date you provided is in the
future. Please correct the date.
HARD CHECK: IF D4 YEAR GT CURRENT YEAR (IF MONTH = DK OR R, CHECK YEAR);
INTERVIEWER: The date you provided is in the future. Please correct the date.
SOFT CHECK: IF D4 DATE IS BEFORE REF DATE; I just want to make sure I recorded your
answer correctly. You said you [graduated or completed / stopped going to] the program in
[FILL D4 YEAR]. Is that correct?
SOFT CHECK: IF D4 = D or R; Your response to this question is important. Please provide a
response.
PROGRAMMER SKIP BOX D4.1
IF D3 = 2, SKIP TO D6;
IF D3 = 3, CONTINUE TO D5.
Prepared by Mathematica Policy Research
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9-30-15
IF D3 = 3
D5.
Why did you stop going to [YB PROGRAM /YouthBuild]? Did you stop going because…
[INSERT ITEM]
CODE ONE PER ROW
YES
NO
DK
REF
a. You had no transportation?
1
0
d
r
b. You were incarcerated?
1
0
d
r
c. It was at a bad time of the day?
1
0
d
r
d. You got a job?
1
0
d
r
e. You moved?
1
0
d
r
1
0
d
r
g. You had health problems or an injury?
1
0
d
r
h. A family member became ill?
1
0
d
r
i.
1
0
d
r
k. You did not like the program?
1
0
d
r
k. You did not like or get along with the program
staff?
1
0
d
r
You did not like or get along with other
participants?
1
0
d
r
m. You were kicked out or asked to leave?
1
0
d
r
n. The program closed?
1
0
d
r
o. Some other reason (SPECIFY)?
1
0
d
r
f.
l.
You were expecting a child or had child care
problems?
You had pressure from your family?
_______________________________ (STRING 255)
SPECIFY TEXT: Please tell me the reason why you stopped going:
PROGRAMMER SKIP BOX D5.1
ALL RESPONSES TO D5 CONTINUE TO D6.
Prepared by Mathematica Policy Research
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D3 = 1, 2, 3, D OR R
have you gone to IF D3 = 1, D, R
did it take you to graduate or complete IF D3 = 2;
did you go to IF D3 = 3.
D6.
How many months [have you gone to / did it take you to graduate or complete / did you go
to] [YB PROGRAM / YouthBuild]? Please do not include any time spent in Mental
Toughness Orientation or MTO or in any orientation activities prior to starting your
YouthBuild program.
INTERVIEWER:
PROBE:
|
|
IF R INSISTS ON ANSWERING IN YEARS, CONVERT TO MONTHS: 1
YEAR IS 12 MONTHS; 1.5 YEARS IS 18 MONTHS; 2 YEARS IS 24
MONTHS
Your best estimate is fine.
| MONTHS
(00-99)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
D3 = 1, 2, 3, D OR R
Do IF D3 = 1, D, R;
Did IF D3 = 2 – 3
D7.
[Do/Did] you receive a stipend or any money from [YB PROGRAM / YouthBuild] for
working in a construction site, attending classes, or other program activities?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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9-30-15
(D3 = 1, 2, 3, D OR R) OR (PL_YBstatus = 2 AND D1 = 1)
D8.
Now I’m going to read you a list of items about [YB PROGRAM / YouthBuild]. For each,
please tell me if you would rate the quality very good, good, okay, or poor. If the item does
not apply to you, just let me know.
How would you rate [YB PROGRAM / YouthBuild] with regards to its…
[INSERT ITEM]
Would you say very good, good, okay, or poor?
CODE ONE PER ROW
POOR
DOES
NOT
APPLY
DK
REF
3
4
98
d
r
2
3
4
98
d
r
2
3
4
98
d
r
VERY
GOOD
GOOD
OKAY
a. Caring staff?
1
2
b. Safe and positive
environment?
1
c. Community service?
1
Prepared by Mathematica Policy Research
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9-30-15
(D3 = 1, 2, 3, D OR R) OR (PL_YBstatus = 2 AND D1 = 1)
D9.
Now I’m going to read you a list of items about [YB PROGRAM / YouthBuild]. For each,
please tell me if you would rate the quality very good, good, okay, or poor. If the item does
not apply to you, just let me know.
How would you rate the quality of [YB PROGRAM / YouthBuild] with regards to…
[INSERT ITEM]
Would you say very good, good, okay, or poor?
CODE ONE PER ROW
POOR
DOES
NOT
APPLY
DK
REF
3
4
98
d
r
2
3
4
98
d
r
1
2
3
4
98
d
r
d. Classroom instruction?
1
2
3
4
98
d
r
e. Helping you find a job?
1
2
3
4
98
d
r
f. Helping you get into college?
1
2
3
4
98
d
r
g. Your overall YouthBuild
experience?
1
2
3
4
98
d
r
VERY
GOOD
GOOD
OKAY
a. Construction or other job
training?
1
2
b. Counseling?
1
c. Leadership training?
Prepared by Mathematica Policy Research
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9-30-15
(D3 = 1, 2, 3, D OR R) OR (PL_YBstatus = 2 AND D1 = 1)
ASK A IF D3 = 2(GRADUATED);
ASK E IF D3 = 2 OR 3 (GRADUATED OR NO LONGER IN YB)
D10.
How would you rate the quality of [YB PROGRAM / YouthBuild] staff with regards to…
[INSERT ITEM]
Would you say very good, good, okay, or poor?
CODE ONE PER ROW
VERY
GOOD
GOOD
OKAY
POOR
DK
REF
(IF D3 = 2)
a. Their attempts to keep in contact
with you after completing [YB
PROGRAM]?
1
2
3
4
d
r
b. Understanding your needs?
1
2
3
4
d
r
c. Helping you solve problems?
1
2
3
4
d
r
d. Helping you learn, either
academically, vocationally or
personally?
1
2
3
4
d
r
(IF D3 = 2 OR 3)
e. Help after leaving [YB PROGRAM /
YouthBuild]?
1
2
3
4
d
r
(D3 = 1, 2, 3, D OR R) OR (PL_YBstatus = 2 AND D1 = 1)
D11.
Do you have at least one person on [YB PROGRAM / YouthBuild] staff who really cares
about you and to whom you can go to talk about personal things?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
PROGRAMMER SKIP BOX D11.1
IF D3 = 2 OR 3 (GRADUATED OR STOPPED) OR PL_YBstatus = 2 OR
(D1c = 0, D OR R) OR (PL_YBstatus = 3 AND D1 = 0), CONTINUE TO D12;
ELSE, SKIP TO SECTION E.
Prepared by Mathematica Policy Research
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9-30-15
D3 = 2 OR 3 (GRADUATED OR STOPPED) OR PL_YBstatus = 2 OR (D1c = 0, D OR R) OR
(PL_YBstatus = 3 AND D1 = 0)
graduation IF D3 = 2 OR PL_YBstatus = 2; ELSE you stopped going
D12.
How often have you been in touch with [YB PROGRAM / YouthBuild] staff since
[graduation / you stopped going]? Would you say…
CODE ONE ONLY
More than once a month,.......................................................................................... 1
About once a month, ................................................................................................ 2
A few times per year, ............................................................................................... 3
About once per year, or ............................................................................................ 4
Not at all? ................................................................................................................... 5
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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E. EMPLOYMENT AND EARNINGS
ALL
E0.
The next questions are about your paid work experience since [REF DATE]. Please include
any part-time or full-time jobs as well as self-employment or your own business. Please
don’t include any unpaid jobs.
ENTER 1 TO CONTINUE ..................................................................................... 1
SKIP BOX E0.1
CREATE SLOTS FOR 6 JOBS. THE FIRST SLOT IS RESERVED FOR THE PRIMARY
CURRENT JOB AT THE LAST SURVEY. THE OTHER 5 SLOTS ARE FOR JOBS SINCE THE
REFERENCE DATE.
IF PL_job = 1 (WORKING AT TIME OF LAST SURVEY), CONTINUE TO EF1.
IF PL_job = 0 (NOT WORKING AT TIME OF LAST SURVEY OR DID NOT COMPLETE
12M SURVEY), SET VARIABLE FROM BOX EF3 AND GO TO E1.
PL_job = 1
EF1.
The last time we interviewed you on [REF DATE], you told us that you were working for
pay at [PL JOB NAME]. Is that correct?
YES ................................................................................................ 1
GO TO EF2
NO .................................................................................................. 0
GO TO BOX EF3
DON’T KNOW ................................................................................ d
GO TO BOX EF3
REFUSED ...................................................................................... r
GO TO BOX EF3
EF1 = 1
EF2.
Are you still working at [PL JOB NAME]?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
BOX EF2.1
STORE PRELOADED JOB IN SLOT 1. JOB NAME SHOULD ALSO BE STORED IN E5_1.
ALL RESPONSES CONTINUE TO BOX EF3 TO SET EF3.
Prepared by Mathematica Policy Research
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BOX EF3
SET VARIABLE EF3.
IF EF1 = 1 AND EF2 = 1 (STILL WORKING AT PRELOADED JOB), SET EF3 = 1;
IF EF1 = 1 AND EF2 = 0, D, R (NOT STILL WORKING AT PRELOADED JOB), SET EF3 = 2;
IF EF1 = 0, D, R (INCORRECT PRELOAD DATA), SET EF3 = 3;
ELSE (PL_job = 0) SET EF3 = 4.
SKIP BOX EF3.1
IF EF2 = 0, CONTINUE TO EF4; ELSE, SKIP TO E1.
EF2 = 0
EF4.
Why did you stop working at that job? Were you laid off, did you quit, were you fired, or
was there some other reason?
LAID OFF (INCLUDE JOB COMPLETED, SEASONAL OR TEMP WORK,
DOWNSIZING, COMPANY SOLD/.MOVED, WENT OUT OF BUSINESS,
ENLISTMENT UP) ................................................................................................ 1
QUIT ...................................................................................................................... 2
FIRED.................................................................................................................... 3
OTHER (SPECIFY) ............................................................................................... 99
___________________________________________________ (STRING 255)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
SPECIFY TEXT: INTERVIEWER: PLEASE ENTER THE OTHER REASON(S).
Prepared by Mathematica Policy Research
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ALL
In addition to [PL JOB NAME], are IF EF3 = 1; ELSE Are
another IF EF3 = 1; ELSE a
E1.
[In addition to [PL JOB NAME], are / Are] you currently working at [another / a] job for pay?
YES ................................................................................................ 1
NO .................................................................................................. 0
GO TO BOX E1a.1
DON’T KNOW ................................................................................ d
GO TO BOX E1a.1
REFUSED ...................................................................................... r
GO TO BOX E1a.1
E1 = 1
Including [PL JOB NAME], how IF EF3 = 1; ELSE How
E1a.
[Including [PL JOB NAME], how / How] many paid jobs do you currently have?
|
| NUM OF PAID JOBS
(RANGE 0-9)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
SOFT CHECK: IF E1a = 4 – 9; I just want to be sure I recorded your answer correctly. You said
that you have [FILL E1a] paid jobs. Is this correct?
HARD CHECK: IF E1a = 0; You mentioned in the previous question that you are currently
working and then just mentioned that you have 0 jobs. Would you like to go back and change
your answer about currently working or change the number of jobs you currently have?
HARD CHECK: IF EF3 = 1 AND E1 = 1 AND E1a = 1; You mentioned in a previous question that
you are currently working at [PL JOB NAME] and another job. Would you like to go back and
change your answer about currently working at [PL JOB NAME]? You may also change your
answer to this question to include the total number of jobs you are currently working.
PROGRAMMER BOX E1a.1
IF EF3 = 1 AND E1 = 1 (CURRENTLY WORKING AT PRELOADED JOB AND ANOTHER JOB), GO
TO E5;
IF EF3 = 1 AND E1 = 0, D, R (CURRENTLY WORKING AT PRELOADED JOB AND NO OTHER
JOB), GO TO E4;
IF EF3 = 2 – 4 AND E1 = 1 (CURRENTLY WORKING AT NEW JOB), GO TO E5;
ELSE, CONTINUE TO E2.
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EF3 = 2 – 4 AND E1 = 0, D, R (NOT CURRENTLY WORKING)
E2.
Have you been looking for work during the past four weeks?
YES ................................................................................................ 1
NO .................................................................................................. 0
GO TO E4
DON’T KNOW ................................................................................ d
GO TO E4
REFUSED ...................................................................................... r
GO TO E4
E2 = 1 (LOOKING FOR WORK)
IF D1 = 1, FILL Response option a (Contact YouthBuild staff)
E3.
I’m going to read you a list of things that some people do to look for work. Please tell me
whether or not you did any of these things during the last four weeks.
CODE ONE PER ROW
YES
NO
DK
REF
(IF D1 = 1)
a. Contact YouthBuild staff?
1
0
d
r
b. Contact your state’s One Stop office, workforce
development office, or unemployment office?
1
0
d
r
c. Ask friends or relatives?
1
0
d
r
d. Look through job advertisements in a newspaper or on
the internet?
1
0
d
r
e. Send out resumes?
1
0
d
r
f.
1
0
d
r
g. Contact any employers in person, by mail, or by phone?
1
0
d
r
h. Did you do something else? (SPECIFY)
1
0
d
r
Fill out applications?
_______________________________ (STRING 255)
SPECIFY TEXT: Please tell me what else you did to look for work…
PROGRAMMER BOX E3.1.
AFTER E3, GO TO E4.
Prepared by Mathematica Policy Research
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E1 = 0, D, R (NOT CURRENTLY WORKING)
In addition to [PL JOB NAME], have IF EF3 = 1 – 2; ELSE Have
other IF EF3 = 1 – 2
This includes jobs you are no longer working at. IF EF3 = 1 – 2
E4.
[In addition to [PL JOB NAME], have / Have] you worked at any [other] jobs for pay since
[REF DATE]?
[This includes jobs you are no longer working at.]
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER BOX E4.1.
IF EF3 = 1 – 2 AND E4 = 1, CONTINUE TO E5;
IF EF3 = 1 – 2 AND E4 = 0, D, R, SKIP TO BOX E8.2;
IF EF3 = 3 – 4 AND E4 = 1, CONTINUE TO E5;
IF EF3 = 3 – 4 AND E4 = 0, D, R, SKIP TO E20.
Prepared by Mathematica Policy Research
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E1 = 1 OR E4 = 1
E5.
(EF3 = 2 – 4 AND E1 = 1 AND E1a = 1, D, R)
Where are you currently working? Please tell me the name of the company or employer.
(EF3 = 2 – 4 AND E1 = 1 AND E1a GT 1)
At which of your jobs do you work the most hours? Please tell me the name of the
company or employer.
(EF3 = 1 AND E1 = 1)
In addition to [12M JOB NAME], what is the name of the second company or employer
where you currently work?
(EF3 = 1 AND E4 = 1)
Where else have you worked most recently since [REF DATE]]? Please tell me the name of
the company or employer.
(EF3 = 2 – 4 AND E4 = 1)
Where have you worked most recently since [REF DATE]?] Please tell me the name of the
company or employer.
PROBE: We ask this because we have a few questions to ask about your current or most
recent job, such as the date you started and how many hours you usually work a week,
and it helps to have the name of your employers to refer to.
___________________________________________________ (STRING 255)
JOB NAME FOR SLOT #2
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
PROGRAMMER SKIP BOX E5a.1
IF E5 = (D, R), CONTINUE TO E5b;
ELSE (TEXT ENTERED AT E5), RECORD TEXT AS JOB NAME AT SLOT #2 AND
SKIP TO BOX E5b.2
Prepared by Mathematica Policy Research
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E5 = D, R
your current job IF (EF3 = 2 – 4 AND E1 = 1 AND E1a = 1, D, R)
the job where you work the most hours IF (EF3 = 2 – 4 AND E1 = 1 AND E1a GT 1)
this job IF EF3 = 1
your most recent job since [REF DATE] IF EF3 = 2 – 4 AND E4 = 1
E5b.
We will ask you a few questions about [your current job / the job where you work the most
hours / this job / your most recent job since [REF DATE]]. Can you give me a word or name
that I can use to help refer to this job in the upcoming questions?
___________________________________________________ (STRING 255)
JOB NAME FOR SLOT #2
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
PROGRAMMER SKIP BOX E5b.1
IF E5b = D, R (NO NAME GIVEN) AND EF3 = 3 – 4, SKIP TO E20;
IF E5b = D, R (NO NAME GIVEN) AND EF3 = 1 – 2, GO TO BOX E8.2 AND COMPLETE
LOOP FOR SLOT #1;
ELSE (TEXT ENTERED), RECORD AS JOB NAME FOR SLOT #2 AND CONTINUE TO
BOX E5b.2.
PROGRAMMER LOOP BOX E5b.2
BEGIN LOOP TO COLLECT JOB NAMES FOR SLOTS #3 – #6.
ASK E6 – E8; LOOP ENDS IF E6 = 0, M OR AFTER SLOT #6.
PROGRAMMER LOOP BOX E5b.3
IF (EF3 = 1 AND E1a GE 3) OR (EF3 = 2 – 4 AND E1a GE 2), THEN SET E6_3 = 1 AND SKIP TO
E7_3; ELSE CONTINUE TO E6_3.
IF (EF3 = 1 AND E1a GE 4) OR (EF3 = 2 – 4 AND E1a GE 3), THEN SET E6_4 = 1 AND SKIP TO
E7_4; ELSE CONTINUE TO E6_4.
IF (EF3 = 1 AND E1a GE 5) OR (EF3 = 2 – 4 AND E1a GE 4), THEN SET E6_5 = 1 AND SKIP TO
E7_5; ELSE CONTINUE TO E6_5.
IF (EF3 = 1 AND E1a GE 6) OR (EF3 = 2 – 4 AND E1a GE 5), THEN SET E6_6 = 1 AND SKIP TO
E7_6; ELSE CONTINUE TO E6_6.
Prepared by Mathematica Policy Research
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E5 OR E5b HAS A RECORDED JOB (TEXT ENTERED)
E6.
Have you worked at another job for pay since [REF DATE]? This includes any selfemployment, current jobs and jobs you no longer work at.
YES ................................................................................................ 1
NO .................................................................................................. 0
END LOOP; GO TO BOX E8.2
DON’T KNOW ................................................................................ d
END LOOP; GO TO BOX E8.2
REFUSED ...................................................................................... r
END LOOP; GO TO BOX E8.2
E6 = 1
E7_3: second / where you currently work IF EF3 = 2 – 4 AND E1a GE 2; third / where you
currently work IF EF3 = 1 AND E1a GE 3; ELSE NO ADDITIONAL FILL
E7_4: third / where you currently work IF EF3 = 2 – 4 AND E1a GE 3; fourth / where you currently
work IF EF3 = 1 AND E1a GE 4; ELSE NO ADDITIONAL FILL
E7_5: fourth / where you currently work IF EF3 = 2 – 4 AND E1a GE 4; fifth / where you currently
work IF EF3 = 1 AND E1a GE 5; ELSE NO ADDITIONAL FILL
E7_6: fifth / where you currently work IF EF3 = 2 – 4 AND E1a GE 5; sixth / where you currently
work IF EF3 = 1 AND E1a GE 6; ELSE NO ADDITIONAL FILL
E7.
What is the name of the [second / third / fourth / fifth] company or employer [where you
currently work]?
___________________________________________________ (STRING 255)
JOBS NAMES FOR SLOTS #3 - #6
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
PROGRAMMER SKIP BOX E7.1
IF E7 = D, R (NO NAME GIVEN), CONTINUE;
ELSE (TEXT ENTERED AT E7), RECORD TEXT AS JOB AND SKIP TO BOX E8.1
E7 = D, R
E8.
We will ask you a few questions about this job. Can you give me a word or name that I can
use to help refer to this job in the upcoming questions?
___________________________________________________ (STRING 255)
JOBS NAMES FOR SLOTS #3 - #6
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
PROGRAMMER BOX E8.1
IF E8 = D, R (NO NAME GIVEN), END LOOP AND GO TO BOX E8.2;
ELSE, RETURN TO E6 TO ASK ABOUT ANOTHER JOB.
END LOOP AFTER SLOT #6.
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PROGRAMMER BOX E8.2
BEGIN JOB LOOP E9 TO E19;
AFTER SLOT #1, RETURN HERE AND REPEAT FOR SLOTS #2 - # 6.
JOBS 2 – 6 ONLY
JOB NAME FOR SLOT #2 FROM E5 OR E5b; SLOTS #3 TO #6 FROM E7 OR E8
E9.
When did you start working at [JOB NAME]?
PROBE: I just need a month and year. Your best estimate is fine.
PROGRAMMER:
|
COLLECT DATE WITH SEPARATE FIELDS
| |/| | | | |
(1-12)
(2009 - 2017)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
HARD CHECK: IF E9_Month = 0 OR GT 12
HARD CHECK: IF E9 DATE GT CURRENT DATE; INTERVIEWER: The date you provided is in the
future. Please correct the date.
HARD CHECK: IF E9 YEAR GT CURRENT YEAR (IF MONTH = DK OR R, CHECK YEAR);
INTERVIEWER: The date you provided is in the future. Please correct the date.
SOFT CHECK: IF E9 IS BEFORE 2012; I just want to be sure I recorded your answer correctly.
You said you started working at this job in [FILL JOB YEAR]. Is that correct?
SOFT CHECK: IF E9 = D or R; Your response to this question is important. Please provide a
response.
Prepared by Mathematica Policy Research
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SLOT #1 IF EF3 = 1 (STILL WORKING), SET E10_1 = 2 AND CONTINUE; IF EF3 = 2 (NO LONGER AT
PRELOADED JOB), ASK E10_1.
SLOT #2: IF (EF3 = 2 – 4 AND E1a GE 1) OR (EF3 = 1 AND E1a GE 2), THEN SET E10_2 = 2 AND
CONTINUE; ELSE ASK E10_2
SLOT #3: IF (EF3 = 2 – 4 AND E1a GE 2) OR (EF3 = 1 AND E1a GE 3), THEN SET E10_3 = 2 AND
CONTINUE; ELSE ASK E10_3
SLOT #4: IF (EF3 = 2 – 4 AND E1a GE 3) OR (EF3 = 1 AND E1a GE 4), THEN SET E10_4 = 2 AND
CONTINUE; ELSE ASK E10_4
SLOT #5: IF (EF3 = 2 – 4 AND E1a GE 4) OR (EF3 = 1 AND E1a GE 5), THEN SET E10_5 = 2 AND
CONTINUE; ELSE ASK E10_5
SLOT #6: IF (EF3 = 2 – 4 AND E1a GE 5) OR (EF3 = 1 AND E1a GE 6), THEN SET E10_6 = 2 AND
CONTINUE; ELSE ASK E10_6
JOB NAME FOR SLOT #1 FROM PRELOAD; SLOT #2 FROM E5 OR E5B; SLOTS #3 TO #6 FROM E7
OR E8
E10.
When did you stop working at [JOB NAME]?
ENTER DATE ON NEXT SCREEN ............................................................................ 1
STILL WORKING AT THIS JOB ................................................................................. 2
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
E10_month & E10_year
When did you stop working at [JOB NAME]?
PROBE: I just need a month and year. Your best estimate is fine.
PROGRAMMER:
|
|
(1-12)
|/|
COLLECT DATE WITH SEPARATE FIELDS
|
|
|
|
(2011- 2017)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
HARD CHECK: IF E10_Month = 0 OR GT 12
HARD CHECK: IF E10 DATE GT CURRENT DATE; INTERVIEWER: The date you provided is in the
future. Please correct the date.
HARD CHECK: IF E10 YEAR GT CURRENT YEAR (IF MONTH = DK OR R, CHECK YEAR);
INTERVIEWER: The date you provided is in the future. Please correct the date.
SOFT CHECK: IF E10 DATE IS BEFORE REFERENCE DATE; INTERVIEWER: THIS DATE IS
BEFORE THE REFERENCE DATE. I just want to be sure I recorded your answer correctly. You
said you stopped working at this job in [FILL JOB YEAR]. Is that correct?
SOFT CHECK: IF E10 DATE IS BEFORE E9 (START DATE); INTERVIEWER: THIS DATE IS
BEFORE THE START DATE. I just want to be sure I recorded your answer correctly. It looks like
the date you stopped working at this job in [E10 MONTH AND YEAR] is before your start date of
[FILL E9 MONTH AND YEAR].
SOFT CHECK: IF E10 = D or R; Your response to this question is important. Please provide a
response.
Prepared by Mathematica Policy Research
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PROGRAMMER SKIP BOX E10.1
IF SLOT #2 AND EF3 = 2 – 4, CONTINUE TO E11;
ELSE, SKIP TO E13a.
SLOT #2 ONLY IF EF3 = 2 – 4
Are you IF E10_2 = 2; ELSE Were you
JOB NAME FOR SLOT #2 FROM E5 OR E5B; SLOTS #3 TO #6 FROM E7 OR E8
E11.
[Are you / Were you] self-employed at [JOB NAME]?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
SLOT #2 ONLY IF EF3 = 2 – 4
Is your IF E10_2 = 2; ELSE Was your
JOB NAME FOR SLOT #2 FROM E5 OR E5B; SLOTS #3 TO #6 FROM E7 OR E8
E12.
[Is your / Was your] job at [JOB NAME] through a temporary employment agency?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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SLOT #1 IF EF3 = 1 – 2; SLOTS #2 – 6
do IF E10 = 2; ELSE did
JOB NAME FOR SLOT #1 FROM PRELOAD; SLOT #2 FROM E5 OR E5B; SLOTS #3 TO #6 FROM
E7 OR E8
E13a.
How many hours per week, including regular overtime hours [do / did] you usually work at
[JOB NAME]?
ENTER NUMBER ON NEXT SCREEN ......................................... 1
E13.
THE NUMBER VARIES ................................................................. 2
GO TO E13b
DON’T KNOW ................................................................................ d
GO TO E13b
REFUSED ...................................................................................... r
GO TO E13b
How many hours per week, including regular overtime hours [do / did] you usually work at
[JOB NAME]?
| | | HOURS PER WEEK
(RANGE 0-99)
DON’T KNOW ................................................................................ d
GO TO E13b
REFUSED ...................................................................................... r
GO TO E13b
SOFT CHECK: IF E13 = 0 OR E13 GT 80; I just want to be sure I recorded your answer correctly.
You said you worked [FILL E13] hours per week, is that correct?
PROGRAMMER SKIP BOX E13a.1
IF ((E13a = 2, D, R) OR (E13 = D, R), CONTINUE TO E13b;
IF E13a = 1 AND E13 GE 0, SKIP TO E14.
Prepared by Mathematica Policy Research
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(E13a = 2, D, R) OR (E13 = D, R)
work IF E10 = 2; ELSE worked
JOB NAME FOR SLOT #1 FROM PRELOAD; SLOT #2 FROM E5 OR E5B; SLOTS #3 TO #6 FROM
E7 OR E8
E13b. Which best describes how many hours per week you [work / worked] at [JOB NAME]? Is it…
PROBE:
Your best estimate is fine.
CODE ONE ONLY
Less than 10 hours per week, .................................................................................. 1
Between 10 and 14 hours per week, ....................................................................... 2
Between 15 and 19 hours per week, ....................................................................... 3
Between 20 and 24 hours per week, ....................................................................... 4
Between 25 and 29 hours per week, ....................................................................... 5
Between 30 and 34 hours per week, ....................................................................... 6
Between 35 and 39 hours per week, or ................................................................... 7
40 or more hours per week? .................................................................................... 8
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
SLOT #1 IF EF3 = 1 – 2; SLOTS #2 – 6
do IF E10 = 2; ELSE did
JOB NAME FOR SLOT #1 FROM PRELOAD; SLOT #2 FROM E5 OR E5B; SLOTS #3 TO #6 FROM
E7 OR E8
E14.
How many days per week [do / did] you work at [JOB NAME]?
INTERVIEWER:
|
IF LESS THAN ONE DAY PER WEEK, CODE ONE (1).
| DAYS PER WEEK
(RANGE 1-7)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
HARD CHECK: IF E14 = 0 OR E14 GT 7; INTERVIEWER: THE RESPONSE SHOULD BE BETWEEN
1 AND 7. IF LESS THAN ONE DAY, CODE ONE (1).
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SLOT #2 ONLY IF EF3 = 2 – 4
you IF E11 = 1 (SELF-EMPLOYED); ELSE they
E15.
What kind of company is [JOB NAME]? What do [they / you] make, do, or sell?
___________________________________________________ (STRING 255)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
SLOT #1 IF EF3 = 1 OR IF (EF3 = 2 AND E1 = 0, D, R AND E4 = 0, D, R) (NO OTHER JOBS SINCE
REF DATE);
SLOT #2 IF EF3 = 2 – 4
do / are IF E10 = 2; ELSE did / were;
E16.
Please briefly describe what you [do / did] at [JOB NAME]? What [are / were] your most
important duties?
___________________________________________________ (STRING 255)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
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SLOT #2 ONLY IF EF3 = 2 – 4
DISPLAY OPTION 1 ONLY IF D1 = 1 (RECEIVED YB SERVICES)
JOB NAME FOR SLOT #2 FROM E5 OR E5B; SLOTS #3 TO #6 FROM E7 OR E8
E17.
How did you find your job at [JOB NAME]?
(ITEMS 1 – 5) Were you referred or helped by…
(ITEMS 6 – 7) Did you search for this job by looking at…
(ITEMS 8 – 10) Did you hear about it from…
CODE ONE PER ROW
YES
NO
DK
REF
(IF D1 = 1)
a. YouthBuild?
1
0
d
r
b. A state employment agency or state job service?
1
0
d
r
c. A private employment agency?
1
0
d
r
d. Friends, relatives, or colleagues?
1
0
d
r
e. A union?
1
0
d
r
f.
1
0
d
r
g. The internet?
1
0
d
r
h. A former employer?
1
0
d
r
i.
School?
1
0
d
r
j.
A job fair?
1
0
d
r
1
0
d
r
Want ads, newspaper ads, or the local paper?
k. Did you find this job some other way?
_______________________________ (STRING 255)
SPECIFY TEXT: Please tell me what else you did to find this job…
Prepared by Mathematica Policy Research
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ALL JOBS
are / at IF E10 = 2; ELSE were / when you left
E18_amt.
How much [are / were] you making [at / when you left] [JOB NAME]? Please include
tips, commissions, and regular overtime.
INTERVIEWER: IF R HAS NOT BEEN PAID YET, LEAVE THIS FIELD BLANK AND CODE 10
ON THE NEXT SCREEN.
|
| | | | | |.|
(RANGE 01-999,999)
|
| AMOUNT
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
E18_unit.
INTERVIEWER: SELECT A UNIT.
PROGRAMMER:
DO NOT ALLOW DK OR REFUSED BUTTON HERE.
CODE ONE ONLY
PER HOUR ........................................................................................................... 1
PER WEEK ........................................................................................................... 2
ONCE EVERY TWO WEEKS ............................................................................... 3
TWICE A MONTH ................................................................................................. 4
PER MONTH OR MONTHLY ............................................................................... 5
PER YEAR ............................................................................................................ 6
PER DAY .............................................................................................................. 7
PER JOB ............................................................................................................... 8
SOME OTHER PAY PERIOD ............................................................................... 9
HAS NOT YET BEEN PAID .................................................................................. 10
HARD CHECK: IF E18_amt = EMPTY AND E18_unit 1 - 8; INTERVIEWER: E18_unit CAN ONLY BE 9
OR 10 SINCE YOU DID NOT ENTER AN AMOUNT. PLEASE CORRECT.
HARD CHECK: IF E18_amt = 1 – 999,999 AND E18_unit = 10; INTERVIEWER: E18_amt IS NOT
BLANK; YOU CANNOT CODE 10 HERE. PLEASE CORRECT.
SOFT CHECK: IF E18_amt GT 50,000 (REGARDLESS OF UNIT); I just want to be sure I recorded
your answer correctly. Is it correct that you [make / made] [FILL AMT] [FILL UNIT]?
PROGRAMMER SKIP BOX E18.1.
IF (E18_AMT = D, R) OR (E18_AMT GT 0 AND E18_UNIT = 7 – 9), CONTINUE TO E18b;
IF (E18_AMT GT 0 AND E18_UNIT = 1 – 7), SKIP TO E18c;
IF E18_AMT = 0, SKIP TO E19;
IF E18_UNIT = 10, SKIP TO E19.
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(E18_AMT = D, R) OR (E18_AMT GT 0 AND E18_UNIT = 7 – 9)
E18b. Which of the following ranges best describes your annual pay at [JOB NAME]?
CODE ONE ONLY
Less than $5,000, ...................................................................................................... 1
$5,000 or more, but less than $10,000, ................................................................... 2
$10,000 or more, but less than $20,000, ................................................................. 3
$20,000 or more, but less than $30,000, ................................................................. 4
$30,000 or more, but less than $40,000, ................................................................. 5
$40,000 or more, but less than $50,000, or ............................................................. 6
$50,000 or more?....................................................................................................... 7
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
IF (E18_AMT GT 0 AND E18_UNIT = 1 – 7) OR E18b = 1 – 7
E18c.
Is that amount before or after taxes?
BEFORE TAXES ......................................................................................................... 1
AFTER TAXES............................................................................................................ 2
NOT TAXED ................................................................................................................ 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
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SLOT #1 IF EF3 = 1 OR IF (EF3 = 2 AND E1 = 0, D, R AND E4 = 0, D, R) (NO OTHER JOBS SINCE
REF DATE);
SLOT #2 IF EF3 = 2 – 4
Are IF E10 = 2; ELSE Were
E19.
[Are / Were] any of the following benefits available to you at [JOB NAME]?
CODE ONE PER ROW
YES
NO
DK
REF
a. Health insurance?
1
0
d
r
b. Paid vacation?
1
0
d
r
c. Paid holiday?
1
0
d
r
d. Paid sick leave?
1
0
d
r
e. Retirement or pension benefits?
1
0
d
r
1
0
d
r
f.
Dental benefits, including any offered at a
cost to you?
PROGRAMMER LOOP BOX E19.1
RETURN TO E9 FOR NEXT JOB.
IF NO OTHER JOB OR END OF LOOP, CONTINUE TO E20.
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ALL
FILL STATE WELFARE NAME
E20.
The next questions are about income support you or someone in your household may
have received. If you aren’t sure about a particular item, just let me know. In the past 12
months, did you or anyone in your household receive…
[DISPLAY ITEM]
YES
NO
DK
REF
a. TANF or welfare?
1
0
2
r
b. Unemployment insurance?
1
0
2
r
c. SNAP or Food Stamps?
1
0
2
r
d. WIC or the Special Supplemental Food
Program for Women, Infants, and Children?
1
0
2
r
e. SSI or Social Security Retirement, Disability,
or Survivor’s benefits?
1
0
2
r
f.
Payments for providing foster care?
1
0
2
r
g.
Assistance with utilities such as gas,
electricity, or water?
1
0
2
r
h. Child support?
1
0
2
r
i.
Money from family or friends?
1
0
2
r
j.
Any other type of income support
1
0
2
r
_______________________________ (STRING 255)
SPECIFY TEXT: Please tell me the other type of income support…
PROGRAMMER BOX E20.1.
IF ANY E20a-i = 1, CONTINUE TO E21;
IF E20j = 1 AND E20j_specify HAS A RESPONSE, CONTINUE TO E21;
IF NO ITEMS = 1, SKIP TO SECTION F;
IF ONLY E20j = 1 AND E20j_specify = D OR R, SKIP TO SECTION F.
Prepared by Mathematica Policy Research
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AT LEAST ONE AT E20a-i = 1 OR (E20j = 1 AND E20j_specify HAS A RESPONSE)
FILL RESPONSE OPTIONS (A-I) FROM E20
FILL RESPONSE J FROM E20j_specify;
IF E20j_specify IS EMPTY, DO NOT INCLUDE RESPONSE OPTION FROM E20J.
E21.
For each type of income support you mentioned, please tell me who in your household
received the income support.
Did you, someone else, or both you and someone else receive….
[DISPLAY ITEM]
CODE ONE PER ROW
YOU
SOMEONE
ELSE
BOTH
DK
REF
a. TANF or welfare?
1
2
3
d
r
b. Unemployment insurance?
1
2
3
d
r
c. SNAP or Food Stamps?
1
2
3
d
r
d. WIC or the Special Supplemental
Food Program for Women, Infants,
and Children?
1
2
3
d
r
e. SSI or Social Security Retirement,
Disability, or Survivor’s benefits?
1
2
3
d
r
f.
1
2
3
d
r
g. Assistance with utilities such as gas,
electricity, or water?
1
2
3
d
r
h. Child support?
1
2
3
d
r
i.
Money from family or friends?
1
2
3
d
r
j.
[FILL FROM E20j]
1
2
3
d
r
Payments for providing foster care?
Prepared by Mathematica Policy Research
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F. CRIMINAL JUSTICE INVOLVEMENT AND DELINQUENCY
ALL
F0.
These next questions are about experiences you may have had with the police or courts.
All of your answers will be kept private to the fullest extent of the law.
ENTER 1 TO CONTINUE ..................................................................................... 1
ALL
F1.
Since [REF DATE], have you been arrested or taken into custody for a crime or illegal
offense? Please include probation or parole violations, but do not include minor motor
vehicle violations.
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
GO TO F4
DON’T KNOW ....................................................................................................... d
GO TO F4
REFUSED ............................................................................................................. r
GO TO F4
F1 = 1 (ARRESTED)
F2.
Since [REF DATE], how many times have you been arrested or taken into custody for a
crime or illegal offense?
|
| | ARRESTS
(RANGE 0-99)
DON’T KNOW....................................................................................................... d
REFUSED............................................................................................................. r
SOFT CHECK: IF F2 = 15-99; I just want to be sure I recorded your answer correctly. You said
that you have been arrested or taken into custody for a crime or illegal offense [FILL F2] times.
Is this correct?
SOFT CHECK: IF F1 = 1 AND F2 = 0; You mentioned in the previous question that you had been
arrested. You just answered you were arrested 0 times. Would you like to back and change your
answer about being arrested or change the number of times you have been arrested?
PROGRAMMER BOX F2.1
IF F1 = 1 AND F2 GT 0, CONTINUE TO F3;
IF F1 = 1 AND F2 = D, R, CONTINUE TO F3;
IF F1 = 1 AND F2 = 0 (AFTER SOFT CHECK), SKIP TO F4.
Prepared by Mathematica Policy Research
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F1 = 1 (ARRESTED) AND (F2 GT 0 OR F2 = D, R)
F3.
Since [REF DATE], have you been charged with any of the following offenses?
PROBE:
All of your answers will be kept private to the fullest extent of the law.
CODE ONE PER ROW
YES
NO
DK
REF
a. A drug offense, such as possessing, selling, or
manufacturing drugs?
1
0
d
r
b. Driving under the influence or driving while intoxicated?
1
0
d
r
c.
1
0
d
r
d. A property offense, such as shoplifting, burglary,
larceny, theft, auto theft, bad checks, fraud, forgery,
arson, vandalism, or possession of stolen goods?
1
0
d
r
e. A violent offense, such as physical or sexual assault,
rape, robbery, manslaughter, attempted murder, or
murder?
1
0
d
r
f.
1
0
d
r
Failure to pay child support?
Some other offense not listed?
_______________________________ (STRING 200)
SPECIFY TEXT: Please tell me the other offense you were charged with…
ALL
F4.
Since [REF DATE] have you been convicted or found delinquent of or pled guilty to a
crime or illegal offense? Please do not include minor motor vehicle violations.
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
GO TO G1
DON’T KNOW ....................................................................................................... d
GO TO G1
REFUSED ............................................................................................................. r
GO TO G1
Prepared by Mathematica Policy Research
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F4 = 1 (CONVICTED)
F5.
Since [REF DATE] how many times have you been convicted or found delinquent of or
pled guilty to a crime or illegal offense?
| | | CONVICTIONS
(RANGE 0-99)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
SOFT CHECK: IF F5 = 15 - 99; I just want to be sure I recorded your answer correctly. You said
that you have been convicted of or pled guilty to a crime or illegal offense [FILL F5] times. Is
this correct?
SOFT CHECK: IF F4 = 1 AND F5 = 0; You mentioned in the previous question that you had been
convicted of or pled guilty to a crime. You just answered that you were convicted of or pled
guilty to a crime 0 times. Would you like to go back and change your answer about being
arrested or change the number of times you have been convicted of or pled guilty to a crime?
PROGRAMMER BOX F5.1
IF F4 = 1 AND F5 GT 0, CONTINUE TO F6;
IF F4 = 1 AND F5 = D, R, CONTINUE TO F6;
IF F4 = 1 AND F5 = 0 (AFTER SOFT CHECK), SKIP TO G1.
Prepared by Mathematica Policy Research
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F4 = 1 AND (F5 GT 0 OR F5 = D, R)
F6.
Since [REF DATE], have you been convicted or found delinquent of or pled guilty to any of the
following offenses?
PROBE:
All of your answers will be kept private to the fullest extent of the law.
CODE ONE PER ROW
YES
NO
DK
REF
a. A drug offense, such as possessing, selling, or
manufacturing drugs?
1
0
d
r
b. Driving under the influence or driving while intoxicated?
1
0
d
r
c. Failure to pay child support?
1
0
d
r
d. A property offense, such as shoplifting, burglary,
larceny, theft, auto theft, bad checks, fraud, forgery,
arson, vandalism, or possession of stolen goods?
1
0
d
r
e. A violent offense, such as physical or sexual assault,
rape, robbery, manslaughter, attempted murder, or
murder?
1
0
d
r
f.
1
0
d
r
Some other offense not listed? (SPECIFY)
_______________________________ (STRING 200)
SPECIFY TEXT: Please tell me the other offense for which you were convicted or plead guilty…
F4 = 1 AND (F5 GT 0 OR F5 = D, R)
The next questions are about any sentences you may have received since [REF DATE].
F7.
Since [REF DATE], have you been sentenced to spend time in a group home, reform
school, juvenile or adult prison, jail, or other correctional facility? Please include
instances when you did not actually serve the time.
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
GO TO F10
DON’T KNOW ....................................................................................................... d
GO TO F10
REFUSED ............................................................................................................. r
GO TO F10
Prepared by Mathematica Policy Research
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F7 = 1 (SENTENCED TO TIME)
F8.
Since [REF DATE], how many separate times were you sentenced to spend time in a group
home, reform school, juvenile or adult prison, jail, or other correctional facility?
| | | NUMBER OF TIMES SENTENCED
(RANGE 0-99)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
SOFT CHECK: IF F8 = 0, 15 - 99; I just want to be sure I recorded your answer correctly. You
said that you have been sentenced [FILL F8] times. Is this correct?
F7 = 1 (SENTENCED TO TIME)
F9_amt.
Since [REF DATE], how much time in total have you spent in a group home, reform
school, juvenile or adult prison, jail, or other correctional facility? You may answer in
days, weeks, months or years.
INTERVIEWER:
IF NO TIME SPENT, LEAVE THIS FIELD BLANK AND CODE 5 ON THE
NEXT SCREEN.
ENTER AMOUNT.
| | | TIME SPENT
(RANGE 01-99)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
F9_unit.
INTERVIEWER:
PROGRAMMER:
ENTER UNIT.
DO NOT ALLOW DK OR REFUSED BUTTON.
CODE ONE ONLY
DAYS..................................................................................................................... 1
WEEKS ................................................................................................................. 2
MONTHS ............................................................................................................... 3
YEARS .................................................................................................................. 4
NO TIME SPENT .................................................................................................. 5
HARD CHECK: IF F9_amt = EMPTY AND F9_unit 1 - 4; INTERVIEWER: F9_unit CAN ONLY BE 5
SINCE YOU DID NOT ENTER AN AMOUNT. PLEASE CORRECT.
HARD CHECK: IF F9_amt = 1 – 99 = EMPTY AND F9_unit = 5; INTERVIEWER: F9_amt IS NOT
BLANK; YOU CANNOT CODE 5 HERE. PLEASE CORRECT.
Prepared by Mathematica Policy Research
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F4 = 1 (CONVICTED) AND (F5 GT 0 OR F5 = D, R)
F10.
The next set of questions is about other sentences you may have received. Since [REF
DATE], have you been sentenced to any of the following?
CODE ONE PER ROW
YES
NO
DK
REF
a. Fines?
1
0
d
r
b. Loss of driver’s license?
1
0
d
r
c. Mandated community service?
1
0
d
r
d. Probation?
1
0
d
r
e. Parole?
1
0
d
r
f.
1
0
d
r
Some other sentence
_______________________________ (STRING 200)
SPECIFY TEXT: Please tell me the other sentence you received…
PROGRAMMER SKIP BOX F10.1
IF F10d OR F10e = 1 (PROBATION OR PAROLE), CONTINUE.
ELSE SKIP TO SECTION G.
Prepared by Mathematica Policy Research
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F10d OR F10e = 1 (ON PROBATION OR PAROLE)
F11_amt.
How long were you put on probation or parole? You may answer in days, weeks, months
or years.
ENTER AMOUNT
| | | TIME SPENT
(RANGE 01-99)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
INSERT UNIVERSEF10d OR F10e = 1 (ON PROBATION OR PAROLE)
F11_unit.
INTERVIEWER:
PROGRAMMER:
ENTER UNIT.
DO NOT ALLOW DK OR REFUSED BUTTON.
CODE ONE ONLY
DAYS..................................................................................................................... 1
WEEKS ................................................................................................................. 2
MONTHS ............................................................................................................... 3
YEARS .................................................................................................................. 4
F10d OR F10e = 1 (ON PROBATION OR PAROLE)
F12.
Are you still on probation or parole?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
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G. SOCIAL AND EMOTIONAL DEVELOPMENT
ALL
G0.
The next questions ask about how you feel about yourself.
Enter 1 to continue
ALL
G1.
Please let me know if you strongly agree, agree, disagree, or strongly disagree.
[DISPLAY ITEM]
Do you strongly agree, agree, disagree or strongly disagree?
CODE ONE PER ROW
STRONGLY
AGREE
AGREE
DISAGREE
STRONGLY
DISAGREE
DK
REF
a. I feel that I’m a person of worth, at
least on an equal plane with others
1
2
3
4
d
r
b. I feel that I have a number of good
qualities
1
2
3
4
d
r
c. All in all, I am inclined to feel that I
am a failure
1
2
3
4
d
r
d. I am able to do things as well as
most other people
1
2
3
4
d
r
e. I feel I do not have much to be
proud of
1
2
3
4
d
r
I take a positive attitude towards
myself
1
2
3
4
d
r
g. On the whole, I am satisfied with
myself
1
2
3
4
d
r
h. I wish I could have more respect
for myself
1
2
3
4
d
r
i.
I certainly feel useless at times
1
2
3
4
d
r
j.
At times I think I am no good at all
1
2
3
4
d
r
f.
Prepared by Mathematica Policy Research
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ALL
G2.
The next questions are about how you feel about things that happen to you.
Please let me know if you strongly agree, agree, disagree, or strongly disagree.
[DISPLAY ITEM]
Do you strongly agree, agree, disagree or strongly disagree?
CODE ONE PER ROW
STRONGLY
AGREE
AGREE
DISAGREE
STRONGLY
DISAGREE
DK
REF
a. I have little control over the things
that happen to me
1
2
3
4
d
r
b. There is really no way I can solve
some of the problems I have
1
2
3
4
d
r
c. Sometimes I feel like I am being
pushed around in life
1
2
3
4
d
r
d. What happens to me in the future
mostly depends on me
1
2
3
4
d
r
e. I can do just about anything I
really set my mind to
1
2
3
4
d
r
1
2
3
4
d
r
f.
If I am in trouble, I can usually
think of a solution
ALL
G3.
The next question is about people in general.
Generally speaking, would you say: (1) most people can be trusted, or (2) that you can’t be
too careful in life?
CODE ONE ONLY
MOST PEOPLE CAN BE TRUSTED .......................................................................... 1
CAN’T BE TOO CAREFUL ......................................................................................... 2
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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ALL
G4.
Now I’m going to read you some statements about your current relationships with family
and friends. Please let me know if you strongly agree, agree, disagree, or strongly
disagree.
[DISPLAY ITEM]
Do you strongly agree, agree, disagree or strongly disagree?
Strongly
Agree
Agree
Disagree
Strongly
Disagree
DK
REF
a. There are people I know who will
help me if I really need it
1
2
3
4
d
r
b. There is no one I feel comfortable
talking about problems with
1
2
3
4
d
r
c. I am with a group of people who
think the same way I do about
things
1
2
3
4
d
r
d. If something went wrong, no one
would help me
1
2
3
4
d
r
e. I have a trustworthy person to turn
to if I have problems
1
2
3
4
d
r
1
2
3
4
d
r
f.
There is no one who likes to do the
things I do
Prepared by Mathematica Policy Research
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H. IDENTITY DEVELOPMENT
ALL
H0.
The next questions are about how you make decisions and solve problems.
Enter 1 to continue
ALL
H1.
Please tell me how strongly you agree or disagree with each of the following statements.
[DISPLAY ITEM]
Do you strongly agree, agree, disagree or strongly disagree?
CODE ONE PER ROW
STRONGLY
AGREE
AGREE
DISAGREE
STRONGLY
DISAGREE
DK
REF
a. Difficult problems make you very
upset
1
2
3
4
d
r
b. When making decisions, you
usually go with your “gut
feeling” without thinking too
much about the consequences of
each alternative
1
2
3
4
d
r
c. When you have a problem to
solve, one of the first things you
do is get as many facts about the
problem as possible
1
2
3
4
d
r
d. When you are attempting to find
a solution to a problem, you
usually try to think of as many
different ways to approach the
problem as possible
1
2
3
4
d
r
e. When making decisions, you
generally use a systematic
method for judging and
comparing alternatives
1
2
3
4
d
r
f. After carrying out a solution to a
problem, you usually try to
analyze what went right and what
went wrong
1
2
3
4
d
r
Prepared by Mathematica Policy Research
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ALL
H2.
This next question is about what you do when you need to make a decision or solve a
problem.
Would you rather get $80 tomorrow, or get $100 three months from now?
CODE ONE ONLY
$80 TOMORROW ....................................................................................................... 1
$100 THREE MONTHS FROM NOW ......................................................................... 2
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
H3.
In the past month, have you paid any money you owed, such as credit card debt or loans?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
DOES NOT APPLY ..................................................................................................... 98
ALL
H4.
Next, I am going to ask you some questions about volunteer or community service work.
Since [REF DATE], have you ever performed volunteer or community service work, not
including court ordered service?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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IF H4 = 1
H5.
Since [REF DATE], about how often have you volunteered? You can tell me the number of
hours per week, month, or year.
PROBE: Your best estimate is fine.
PROGRAMMER:
NUMBER RANGE IS 00 – 150
PROGRAMMER:
DO NOT ALLOW DK OR REFUSED BUTTONS ON UNIT SCREENS
(FOR AMOUNT SCREEN ONLY)
INTERVIEWER:
CODE NUMBER OF HOURS HERE AND UNIT ON THE NEXT SCREEN
(FOR UNIT SCREEN ONLY)
INTERVIEWER:
SELECT A UNIT
| | | NUMBER OF HOURS
(RANGE 00-150)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
H5a_unit. INTERVIEWER:
PROGRAMMER:
SELECT A UNIT.
DO NOT ALLOW DK OR REFUSED BUTTON HERE.
CODE ONE ONLY
PER WEEK ................................................................................................................. 1
PER MONTH ............................................................................................................... 2
PER YEAR .................................................................................................................. 3
ALL
H6.
Are you registered to vote in the U.S.?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
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ALL
DISPLAY OPTION a ONLY IF H6 NE 0
H7.
Since [REF DATE] have you…
CODE ONE PER ROW
YES
NO
DK
REF
a. Voted in one or more elections?
1
0
d
r
b. Gotten involved in a national, state, or local political
effort or electoral campaign?
1
0
d
r
ALL
H8.
In the past month, have you served in a leadership role in your workplace, religious group,
community, or local school?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
H9.
These next questions ask about things you might do in your community.
In the past month, how often have you done the following activities? Would you say, not
at all, a few times a month, a few times a week, or every day?
[DISPLAY ITEM]
Would you say, not at all, a few times a month, a few times a week, or every day?
CODE ONE PER ROW
NOT AT
ALL
A FEW
TIMES A
MONTH
A FEW
TIMES A
WEEK
EVERY
DAY
DK
REF
a. Helped members of the
community
1
2
3
4
d
r
b. Attended community
meetings to help improve the
conditions within my
community
1
2
3
4
d
r
c. Served as a positive role
model for kids in my
neighborhood
1
2
3
4
d
r
Prepared by Mathematica Policy Research
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IF A7 GT 0 (HAS CHILDREN) AND OMBFLAG=1
IF A7 NE 0 , FILL: [Now thinking of your school-aged children:]
IF A7 = 1, FILL: child’s
IF A7 GT 1, FILL: children’s
IF A7=1, FILL: his or her
IF A7 GT 1, FILL: their
H10.
[Now, thinking of your school-aged children:]
In the past month, how often have you talked to someone about [your child’s/
children’s] needs at [his or her/their] school? Would you say…
CODE ONE ONLY
Not at all, .................................................................................................................... 1
A few times a month, ................................................................................................ 2
A few times a week, or .............................................................................................. 3
Every day ................................................................................................................... 4
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
NO SCHOOL-AGED CHILDREN ................................................................................ 98
ALL
H11.
The next questions are about things you do in a typical day. First, how many hours do you
usually sleep? Would you say…
CODE ONE ONLY
less than three hours, ............................................................................................... 1
3 to 5 hours, ............................................................................................................... 2
6 to 8 hours, ............................................................................................................... 3
9 to 11 hours, or ........................................................................................................ 4
more than 11 hours?................................................................................................. 5
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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ALL
H12.
Thinking about a typical day, how many hours do you usually spend…
[DISPLAY ITEM]
Would you say none or almost none, one, two or three, four or five, or six or more?
CODE ONE PER ROW
NONE OR
ALMOST
NONE
ONE
TWO OR
THREE
FOUR OR
FIVE
SIX OR
MORE
DK
REF
a. Watching TV or listening to
music?
1
2
3
4
5
d
r
b. Hanging out?
1
2
3
4
5
d
r
c. Playing video or computer
games or using the internet?
1
2
3
4
5
d
r
d. Reading or studying?
1
2
3
4
5
d
r
e. In school or training?
1
2
3
4
5
d
r
f.
1
2
3
4
5
d
r
1
2
3
4
5
d
r
Taking care of a child?
g. Taking care of a family
member, not including a
child?
ALL
H13.
Taking everything all together, how would you say things are these days? Would you say
that you are very happy, pretty happy or not too happy?
CODE ONE ONLY
VERY HAPPY ............................................................................................................. 1
PRETTY HAPPY ......................................................................................................... 2
NOT TOO HAPPY....................................................................................................... 3
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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I. HEALTH AND WELL-BEING
ALL
I0.
Now, I would like to ask you some questions about your general health.
ENTER 1 TO CONTINUE ........................................................................................... 1
ALL
I1.
In general, would you say your health is…
CODE ONE ONLY
excellent, .................................................................................................................... 1
very good, .................................................................................................................. 2
good,........................................................................................................................... 3
fair, or ......................................................................................................................... 4
poor? .......................................................................................................................... 5
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
or women’s health IF GENDER = FEMALE
I2.
Since [REF DATE], have you had…
CODE ONE PER ROW
YES
NO
DK
REF
a. An annual checkup including general health [or women’s
health]?
1
0
d
r
b. A dental exam?
1
0
d
r
c. A flu shot?
1
0
d
r
ALL
I3.
What age do you think you will live to?
| | | | AGE
(RANGE 000-999)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
SOFT CHECK: IF I3 GT 100 OR LT 20; I just want to be sure I recorded your answer correctly.
You said [FILL I3] years. Is this correct?
Prepared by Mathematica Policy Research
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ALL
I4.
Over the last 2 weeks, how often have you been bothered by any of the following
problems?
[DISPLAY ITEM]
Would you say that the problem happened not at all, several days, more than half the days,
or nearly every day?
CODE ONE PER ROW
NOT AT
ALL
SEVERAL
DAYS
MORE
THAN
HALF
THE
DAYS
a. Little interest or pleasure in doing
things?
1
2
3
4
d
r
b. Feeling down, depressed, or
hopeless?
1
2
3
4
d
r
c. Trouble falling or staying asleep,
or sleeping too much?
1
2
3
4
d
r
d. Feeling tired or having little
energy?
1
2
3
4
d
r
e. Poor appetite or overeating?
1
2
3
4
d
r
f. Feeling bad about yourself – or that
you are a failure and have let
yourself or your family down?
1
2
3
4
d
r
g. Trouble concentrating on things,
such as reading the newspaper or
watching television?
1
2
3
4
d
r
h. Moving or speaking so slowly that
other people could have noticed.
Or the opposite – being so fidgety
or restless that you have been
moving around a lot more than
usual?
1
2
3
4
d
r
i. Thoughts that you would be better
off dead, or of hurting yourself in
some way?
1
2
3
4
d
r
Prepared by Mathematica Policy Research
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NEARLY
EVERY
DAY
DK
REF
9-30-15
(I4a – i) = 2-4 (ANYTHING CHECKED AT I4)
I5.
How difficult have these problems made it for you to do your work, take care of things at
home, or get along with other people? Would you say…
CODE ONE ONLY
Not difficult at all, ................................................................................................ 1
Somewhat difficult, ............................................................................................. 2
Very difficult, or ................................................................................................... 3
Extremely difficult? ............................................................................................. 4
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
ALL
I6.
The next few questions are about gang activity in your neighborhood. Remember, all of
your responses will be kept private to the fullest extent of the law.
Have you ever belonged to a gang?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
even if you aren’t in a gang IF I6 = 0, D, R
I7.
In the past 12 months, have you been involved in gang fights [even if you aren’t in a
gang]?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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9-30-15
ALL
I8.
The next few questions are about drug and alcohol use. Remember, all of your responses
will be kept private to the fullest extent of the law.
In a typical week, how many times do you have five or more drinks in a row? A “drink” is a
glass of wine, a bottle of beer, a shot glass of liquor, or a mixed drink. Would you say…
CODE ONE ONLY
Never, ......................................................................................................................... 1
Less than once, ......................................................................................................... 2
Once, .......................................................................................................................... 3
Twice, ......................................................................................................................... 4
Three to five times, or ............................................................................................... 5
Every day or almost every day? .............................................................................. 6
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
I9.
Since [REF DATE], have you used or tried any of the following drugs?
CODE ONE PER ROW
YES
NO
DK
REF
a. Marijuana?
1
0
d
r
b. Any kind of cocaine, including powder, freebase, or
crack cocaine?
1
0
d
r
c. Inhalants, such as glue or solvents?
1
0
d
r
d. Pills without a doctor’s prescription?
1
0
d
r
e. Any other type of illegal drug, such as
methamphetamine, LSD, PCP, ecstasy, mushrooms,
speed, ice, or heroin?
1
0
d
r
PROGRAMMER SKIP BOX I9.1
IF I8 = 2 – 5 OR ANY I9a-e = 1, CONTINUE.
ELSE SKIP TO SECTION J.
Prepared by Mathematica Policy Research
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9-30-15
IF I8 = 2 – 6 OR ANY I9A – E = 1
drinking IF I8 = 2 – 5 AND ALL I9a-e = 0, d, r;
drug use IF I8 = 1, d, r AND ANY I9a-e = 1;
drinking or drug use IF I8 = 2 – 5 AND ANY I9a-e = 1
I10.
Since [REF DATE], how often has your drinking or drug use interfered with your
responsibilities either at work or school, or something else? Would you say…
CODE ONE ONLY
Never .......................................................................................................................... 1
1 time, or .................................................................................................................... 2
More than 1 time? ..................................................................................................... 3
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
IF I8 = 2 – 6 OR ANY I9A – E = 1
drinking alcohol IF I8 = 2 – 5 AND ALL I9a-e = 0, d, r;
doing drugs IF I8 = 1, d, r AND ANY I9a-e = 1;
drinking alcohol or doing drugs IF I8 = 2 – 5 AND ANY I9a-e = 1
I11.
During the past 30 days, how many times did you drive a car or other vehicle when you
had been drinking alcohol or doing drugs? Was it…
CODE ONE ONLY
0 times, ....................................................................................................................... 1
1 time, ......................................................................................................................... 2
2 to 3 times, ............................................................................................................... 3
4 to 5 times, or ........................................................................................................... 4
6 or more times? ....................................................................................................... 5
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
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9-30-15
J. ADDRESS AND CONTACT INFORMATION UPDATE
ALL
IF NOT FIELD CALL IN, fill: We will be sending your payment in the next two weeks and need to
make sure we have your correct address.
J0.
The next questions will be about how to contact you. [We will be sending your payment in
the next two weeks and need to make sure we have your correct address.]
ENTER 1 TO CONTINUE ..................................................................................... 1
ALL
J1.
What is your street address?
INTERVIEWER:
IF RESPONDENT GIVES PO BOX, LET HIM/HER KNOW WE WILL
COLLECT A MAILING ADDRESS LATER. TRY TO COLLECT A PHYSICAL
ADDRESS HERE.
___________________________________________________
STREET 1
___________________________________________________
STREET 2
___________________________________________________
STREET 3
___________________________________________________
CITY
___________________________________________________
STATE
___________________________________________________
ZIP
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
J1a.
Is your mailing address the same as your street address?
YES ............................................................................................................................. 1
GO TO J2
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
GO TO J2
REFUSED ................................................................................................................... r
GO TO J2
Prepared by Mathematica Policy Research
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9-30-15
J1a = 0
J1b.
What is your mailing address?
___________________________________________________
STREET 1
___________________________________________________
STREET 2
___________________________________________________
STREET 3
___________________________________________________
CITY
___________________________________________________
STATE
___________________________________________________
ZIP
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
J2.
What is your cell phone number?
ENTER NUMBER ....................................................................................................... 1
DOESN’T HAVE/OFFER CELL PHONE .................................................................... 2
GO TO J4
DON’T KNOW ............................................................................................................. d
GO TO J4
REFUSED ................................................................................................................... r
GO TO J4
J2 = 1
J2_phone.
PHONE NUMBER:
|
|
|
|-|
|
|
|-|
|
|
|
|
DON’T KNOW ....................................................................................................... d
GO TO J4
REFUSED ............................................................................................................. r
GO TO J4
HARD CHECK: IF J2_phone IS NOT 10 NUM DIGITS; The phone number should be 10 digits.
Please provide the 10-digit phone number.
THE PHONE NUMBER SHOULD BE 10 NUMERIC DIGITS, NO SPACES, DASHES,
PARENTHESES OR OTHER PUNCTUATION. THE FIELD SHOULD ALSO NOT BE EMPTY.
SOFT CHECK: USE STANDARD PHONE NUMBER CHECKS.
PROGRAMMER BOX J2.1
IF COMPLETE CELL PHONE ENTERED, CONTINUE TO J3a;
IF D OR R, SKIP TO J4.
Prepared by Mathematica Policy Research
91
9-30-15
J2_phone HAS COMPLETE PHONE NUMBER ENTERED
J3a.
May we send you text messages? Message and data rates may apply.
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
J4.
What is your home phone number?
ENTER NUMBER ....................................................................................................... 1
DOESN’T HAVE/OFFER HOME PHONE................................................................... 2
GO TO J6
DON’T KNOW ............................................................................................................. d
GO TO J6
REFUSED ................................................................................................................... r
GO TO J6
J4 = 1
J4_phone.
PHONE NUMBER:
|
|
|
|-|
|
|
|-|
|
|
|
|
DON’T KNOW ....................................................................................................... d
GO TO J6
REFUSED ............................................................................................................. r
GO TO J6
HARD CHECK: IF J4_phone IS NOT 10 NUM DIGITS; The phone number should be 10 digits.
Please provide the 10-digit phone number.
THE PHONE NUMBER SHOULD BE 10 NUMERIC DIGITS, NO SPACES, DASHES,
PARENTHESES OR OTHER PUNCTUATION. THE FIELD SHOULD ALSO NOT BE EMPTY.
SOFT CHECK: USE STANDARD PHONE NUMBER CHECKS.
PROGRAMMER BOX J4.1
IF COMPLETE PHONE ENTERED, CONTINUE TO J4_cell;
IF D OR R, SKIP TO J6.
J4_phone HAS COMPLETE PHONE NUMBER ENTERED
J4_cell.
Is this this number, [FILL J4_phone], for a cell phone?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
92
9-30-15
J4_phone HAS COMPLETE PHONE NUMBER ENTERED
J5.
Whose name is that number listed under?
___________________________________________________
NAME
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
PROGRAMMER BOX J5.1
IF J4_cell = 1, CONTINUE TO J5a;
ELSE, SKIP TO J6.
Prepared by Mathematica Policy Research
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9-30-15
J4_cell = 1
J5b.
May we send you text messages at this number ([FILL J4_phone])? Message and data
rates may apply.
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
J6.
Is there another phone number where you can be reached?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
GO TO J8a
DON’T KNOW ............................................................................................................. d
GO TO J8a
REFUSED ................................................................................................................... r
GO TO J8a
J6 = 1
J6_phone.
PHONE NUMBER:
|
|
|
|-|
|
|
|-|
|
|
|
|
DON’T KNOW ............................................................................................................. d
GO TO J8a
REFUSED ................................................................................................................... r
GO TO J8a
HARD CHECK: IF J6_phone IS NOT 10 NUM DIGITS; The phone number should be 10 digits.
Please provide the 10-digit phone number.
THE PHONE NUMBER SHOULD BE 10 NUMERIC DIGITS, NO SPACES, DASHES,
PARENTHESES OR OTHER PUNCTUATION. THE FIELD SHOULD ALSO NOT BE EMPTY.
SOFT CHECK: USE STANDARD PHONE NUMBER CHECKS.
PROGRAMMER BOX J6.1
IF COMPLETE PHONE ENTERED, CONTINUE TO J6_cell;
ELSE, SKIP TO J8a.
Prepared by Mathematica Policy Research
94
9-30-15
J6_phone HAS COMPLETE PHONE NUMBER ENTERED
J6_cell.
Is this number, [FILL J6_phone], for a cell phone?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
J6_phone HAS COMPLETE PHONE NUMBER ENTERED
J7.
Whose name is that number listed under?
___________________________________________________
NAME
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
PROGRAMMER BOX J7.1
IF J6_cell = 1, CONTINUE TO J7a;
ELSE, SKIP TO J8a.
J6_cell = 1
J7b.
May we send you text messages at this number ([FILL J6_phone])? Message and data
rates may apply.
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
ALL
J8a.
Are you planning on moving in the next 12 months?
YES ............................................................................................................................. 1
NO ............................................................................................................................... 0
GO TO J9
DON’T KNOW ............................................................................................................. d
GO TO J9
REFUSED ................................................................................................................... r
GO TO J9
Prepared by Mathematica Policy Research
95
9-30-15
J8a = 1
J8b.
Where will you be moving to?
INTERVIEWER:
PROBE TO COLLECT CITY AND STATE IF RESPONDENT DOES NOT
KNOW EXACT ADDRESS.
___________________________________________________
STREET 1
___________________________________________________
STREET 2
___________________________________________________
STREET 3
___________________________________________________
CITY
___________________________________________________
STATE
___________________________________________________
ZIP
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER: THIS DOES NOT HAVE TO BE A COMPLETE ADDRESS
ALL
J9.
What is the best E-mail address to reach you at?
ENTER E-MAIL ADDRESS ........................................................... 1
DOESN’T HAVE/OFFER E-MAIL ADDRESS ................................ 2
GO TO BOX J10.1
DON’T KNOW ................................................................................ d
GO TO BOX J10.1
REFUSED ...................................................................................... r
GO TO BOX J10.1
Prepared by Mathematica Policy Research
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9-30-15
J9 = 1
J9_email.
E-MAIL ADDRESS:
___________________________________________________ (STRING 50)
DON’T KNOW ................................................................................ d
GO TO BOX J10.1
REFUSED ...................................................................................... r
GO TO BOX J10.1
SOFT CHECK: IF E-MAIL DOES NOT HAVE A “@” OR “.”; PLEASE ENTER A VALID E-MAIL
ADDRESS. THE E-MAIL SHOULD INCLUDE AN “@” SIGN AND A PERIOD.
PROGRAMMER BOX J9.1
IF A VALID E-MAIL IS ENTERED, CONTINUE TO J10;
ELSE, SKIP TO BOX J10.1.
J9 IS HAS VALID E-MAIL ENTERED
J10.
What is another e-mail address you have?
ENTER E-MAIL ADDRESS ........................................................... 1
DOESN’T HAVE/OFFER E-MAIL ADDRESS ................................ 2
GO TO BOX J10.1
DON’T KNOW ................................................................................ d
GO TO BOX J10.1
REFUSED ...................................................................................... r
GO TO BOX J10.1
J10 = 1
J10_email.
E-MAIL ADDRESS:
___________________________________________________ (STRING 50)
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
SOFT CHECK: IF E-MAIL DOES NOT HAVE A “@” OR “.”; PLEASE ENTER A VALID E-MAIL
ADDRESS. THE E-MAIL SHOULD INCLUDE AN “@” SIGN AND A PERIOD.
Prepared by Mathematica Policy Research
97
9-30-15
FACEBOOK = 1
J11.
Do you have a Facebook account?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
BOX J11a.1
GO TO
DON’T KNOW ....................................................................................................... d
BOX J11a.1
GO TO
REFUSED ............................................................................................................. r
BOX J11a.1
GO TO
J11 = 1
J11a.
What name do you use on Facebook?
___________________________________________________ (STRING 50)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER BOX J11a.1
IF MYSPACE = 1, CONTINUE TO J12;
IF MYSPACE = 0, SKIP TO BOX J12a.1.
MYSPACE = 1
J12.
Do you have a MySpace account?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
BOX J12a.1
GO TO
DON’T KNOW ....................................................................................................... d
BOX J12a.1
GO TO
REFUSED ............................................................................................................. r
BOX J12a.1
GO TO
J12 = 1
J12a.
What name do you use on MySpace?
___________________________________________________ (STRING 50)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
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9-30-15
PROGRAMMER BOX J12a.1
IF TWITTER = 1, CONTINUE TO J13;
IF TWITTER = 0, SKIP TO J14.
TWITTER = 1
J13.
Do you have a Twitter account?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
GO TO J14
DON’T KNOW ....................................................................................................... d
GO TO J14
REFUSED ............................................................................................................. r
GO TO J14
J13 = 1
J13a.
What user name or handle do you use on Twitter?
___________________________________________________ (STRING 50)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
ALL
J14.
Do you have a social networking account other than Facebook, MySpace or Twitter?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
GO TO J15
DON’T KNOW ....................................................................................................... d
GO TO J15
REFUSED ............................................................................................................. r
GO TO J15
J14 = 1
J14a.
What other social networking provider do you use?
___________________________________________________ (STRING 100)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
Prepared by Mathematica Policy Research
99
9-30-15
J14 = 1
J14b.
What name do you use on this social networking account?
___________________________________________________ (STRING 100)
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER LOOP BOX J15.
BEGIN LOOP
ASK J15 TO J18 THREE TIMES.
LOOP ENDS EARLY WHEN J15 = D, R.
ALL
J15.
FIRST PERSON:
As part of the study, we will contact you again in a year and a half. In case you move, we
would like the name, address, and telephone number of up to three relatives or close
friends who would know where you are. We will only contact them if we have trouble
getting in touch with you directly.
What is the name of the first person who will know where you are?
SECOND AND THIRD PERSON:
What is the name of another relative or close friend who will know how to contact you a
year and a half from now?
___________________________________________________ (STRING 20)
FIRST NAME
___________________________________________________ (STRING 20)
MIDDLE INITIAL/NAME
___________________________________________________ (STRING 30)
LAST NAME
DON’T KNOW ....................................................................................................... d
GO TO J19
REFUSED ............................................................................................................. r
GO TO J19
Prepared by Mathematica Policy Research
100
9-30-15
J15 = ANSWERED
J16.
What is [FILL FIRST NAME]’s relationship to you?
MOTHER ............................................................................................................... 1
FATHER ................................................................................................................ 2
SISTER OR BROTHER ........................................................................................ 3
FRIEND ................................................................................................................. 4
GRANDPARENT ................................................................................................... 5
AUNT OR UNCLE ................................................................................................. 6
OTHER .................................................................................................................. 7
SPOUSE OR PARTNER....................................................................................... 8
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
J15 = ANSWERED
J17.
What is [FILL FIRST NAME]’s telephone number?
ENTER NUMBER ................................................................................................. 1
DOESN’T HAVE/OFFER HOME PHONE............................................................. 2
GO TO J18
DON’T KNOW ....................................................................................................... d
GO TO J18
REFUSED ............................................................................................................. r
GO TO J18
J17 = 1
J17_phone.
PHONE NUMBER:
|
|
|
|-|
|
|
|-|
|
|
|
|
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
HARD CHECK: IF J17_phone IS NOT 10 NUM DIGITS; The phone number should be 10 digits.
Please provide the 10-digit phone number.
THE PHONE NUMBER SHOULD BE 10 NUMERIC DIGITS, NO SPACES, DASHES,
PARENTHESES OR OTHER PUNCTUATION. THE FIELD SHOULD ALSO NOT BE EMPTY.
SOFT CHECK: USE STANDARD PHONE NUMBER CHECKS.
Prepared by Mathematica Policy Research
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9-30-15
J15 = ANSWERED
J18.
What is [FILL FIRST NAME]’s address?
INTERVIEWER:
PROBE TO COLLECT CITY AND STATE IF RESPONDENT DOES NOT
KNOW EXACT ADDRESS.
___________________________________________________
STREET 1
___________________________________________________
STREET 2
___________________________________________________
STREET 3
___________________________________________________
CITY
___________________________________________________
STATE
___________________________________________________
ZIP
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
PROGRAMMER: THIS DOES NOT HAVE TO BE A COMPLETE ADDRESS
PROGRAMMER LOOP BOX J18.1.
RETURN TO J15 AND ASK FOR ANOTHER CONTACT.
END LOOP IF THIS IS THE THIRD LOOP.
Prepared by Mathematica Policy Research
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9-30-15
ALL
J19.
The last questions are about the best ways to reach you for future surveys. Did you
receive any of the following announcements or notifications about this survey?
YES
NO
DK
REF
a. A letter in the mail?
1
0
d
r
b. An e-mail?
1
0
d
r
c. A text message?
1
0
d
r
d. A Facebook message?
1
0
d
r
e. A Facebook post?
1
0
d
r
f.
1
0
d
r
1
0
d
r
NOT IN THIS VERSION
g. Some other notification? (SPECIFY)
____________________________
(STRING 200)
SPECIFY TEXT: How else were you notified about this survey?
ALL
J20.
How would you like to be contacted in the future about upcoming surveys?
YES
NO
DK
REF
a. A letter in the mail?
1
0
d
r
b. An e-mail?
1
0
d
r
c. A text message?
1
0
d
r
d. Your cell phone?
1
0
d
r
e. Your home phone?
1
0
d
r
f.
1
0
d
r
1
0
d
r
A Facebook message?
g. Some other way? (SPECIFY)
____________________________
(STRING 200)
SPECIFY TEXT: Please tell me how you would like to be contacted…
Prepared by Mathematica Policy Research
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ALL
J21.
Have you ever visited the YouthBuild Research Project Facebook page? The page is
www.facebook.com/YouthBuildResearchProject.
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW ....................................................................................................... d
REFUSED ............................................................................................................. r
ALL
IF NOT FIELD CALL IN, fill: You will be receiving a gift card within the next few weeks to thank you
for completing the survey!
IF FIELD CALL IN, fill: Those are all the questions we have for you. To thank you for completing
the survey, your field interviewer will give you a $25 gift card.
IF FIELD CALL IN, fill: Please hand the phone back to the field interviewer so we can complete the
interview.
IF FIELD CALL IN, fill interviewer probe: INTERVIEWER: Please let the field interviewer know that the
respondent completed the interview and that he or she can distribute the $25 gift card incentive.
END.
[You will be receiving a gift card within the next few weeks to thank you for completing the
survey!] [Those are all the questions we have for you. To thank you for completing the
survey, your field interviewer will give you a $25 gift card.]
To stay informed about the study, please like us on Facebook by visiting our Page:
www.facebook.com/youthbuildresearchproject
You can also become Facebook friends with our study representative, Pat Williams. Find
her on Facebook by searching for “p.williams.2012”.
Thank you for your participation in the YouthBuild Research Project! [Please hand the
phone back to the field interviewer so we can complete the interview.]
INTERVIEWER:
Please let the field interviewer know that the respondent completed the
interview and that he or she can distribute the $25 gift card incentive.
Persons are not required to respond to this collection of information unless this survey displays a currently valid OMB control
number (OMB 1203-0503, expires 06/30/2018). Responding to this questionnaire, which seeks to help the U.S. Department of
Labor understand how YouthBuild programs are serving disadvantaged youth, is voluntary. Public reporting burden for this
collection of information is estimated to average 35 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate to Eileen Pederson, U.S. Department of Labor, Employment and Training
Administration, Office of Policy Development and Evaluation, Room N-5641, 200 Constitution Avenue, NW, Washington, DC
20210.
Prepared by Mathematica Policy Research
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| File Type | application/pdf |
| File Title | YouthBuild 48-month Follow Up Survey |
| Subject | CATI |
| Author | MATHEMATICA |
| File Modified | 2015-10-01 |
| File Created | 2015-09-30 |