Download:
pdf |
pdfAPPENDIX A3:
YOUTHBUILD 48-MONTH FOLLOW-UP
SURVEY
WEB VERSION
PROPOSED CHANGES
OMB No.: 1203-0503
Expiration Date: 06/30/2018
YouthBuild
48 Month Follow Up Survey
Web 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.
Prepared by Mathematica Policy Research
9-30-15
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 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).
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 at 12
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)
3 IF Comp_status = 1 AND W1_D3 = 3,
OR
3 IF Comp_status = 2 AND W2_D3 = 3,
OR
Prepared by Mathematica Policy Research
9-30-15
Preloads
Values Definitions / Format
Source
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,
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
[plJOB 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
Prepared by Mathematica Policy Research
9-30-15
CONTENTS
Section
Page
IN.
INTRODUCTION/SCREENER ....................................................................................1
A.
HOUSEHOLD INFORMATION ...................................................................................5
B.
EDUCATIONAL ATTAINMENT .................................................................................11
C.
SERVICE RECEIPT..................................................................................................16
D.
YOUTHBUILD PROGRAM EXPERIENCES .............................................................25
E.
EMPLOYMENT AND EARNINGS .............................................................................36
F.
CRIMINAL JUSTICE INVOLVEMENT AND DELINQUENCY .................................... 57
G.
SOCIAL AND EMOTIONAL DEVELOPMENT...........................................................64
H.
IDENTITY DEVELOPMENT......................................................................................66
I.
HEALTH AND WELL-BEING ....................................................................................71
J.
ADDRESS AND CONTACT INFORMATION UPDATE ............................................. 76
Prepared by Mathematica Policy Research
i
9-30-15
All
$40 IF PayExperiment = 1 AND (Today – SampleLoadDate LE 30 days); ELSE $25
INTRODUCTION
The YouthBuild Evaluation is a study paid for by the U.S. Department of Labor (DOL) and the
Corporation for National and Community Service (CNCS). The goal of the study is to learn how
YouthBuild helps youth and young adults get a General Educational Development (GED)
certificate or high school diploma, gain employment skills and find work or prepare for postsecondary 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 a short survey. The survey 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.
The survey should take around 35 minutes to complete. To thank you, we will send you a card
worth [FILL $25 OR $40]. The card can be used anywhere that a credit or debit card can be used.
If you have any questions, please contact us by phone at 1-844-498-1469 or by e-mail at
[email protected].
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
1
9-30-15
IN. INTRODUCTION/IDENTITY VERIFICATION
ALL
V1.
First, we just need to confirm some of your information.
Is this the correct spelling of your name?
[FILL FIRST] [FILL MIDDLE] [FILL LAST]
Yes ........................................................................................................................ 1
GO TO V2
No, my name is misspelled or has changed......................................................... 2
GO TO V1a
HARD CHECK: IF V1 = NO RESPONSE; Please provide an answer to this question and continue.
V1 = 2
V1a.
Please correct the spelling of your name below.
PROGRAMMER:
FILL FIELDS WITH PRELOADED NAME DATA
First name
(STRING 20)
Middle name
(STRING 20)
Last name
(STRING 20)
HARD CHECK: IF V1a_FirstName = NO RESPONSE; Please provide the correct spelling of your
first name.
HARD CHECK: IF V1a_LastName = NO RESPONSE; Please provide the correct spelling of your
last name.
Prepared by Mathematica Policy Research
2
9-30-15
ALL
IF V1 = 1, FILL: FIRST NAME FROM PRE-LOAD
IF V1 = 2, FILL: FIRST NAME FROM V1A
V2.
Are you usually called [FIRST NAME] or do you go by another name?
I go by [FIRST NAME] .......................................................................................... 1
GO TO V3
I go by another name............................................................................................ 2
NO RESPONSE .......................................................................................................... M
GO TO V3
V2 = 2
V2a.
What other name do you go by?
Name
(STRING 20)
NO RESPONSE .......................................................................................................... M
ALL
V3.
What is your date of birth?
PROGRAMMER:
Month
▼
Day
INSERT DROPDOWNS WITH FOLLOWING RANGES
Year
▼
▼
(1-12) (1-31) (1980 - 2000)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF V3 = NO RESPONSE; Please provide an answer to this question and continue.
To continue to the next question without providing a response, click the continue button.
PROGRAMMER VERIFICATION BOX V3.1
SET DOB_VERIFY:
IF V3 DOB MATCHES PRELOADED DOB, SET DOB_VERIFY = 1 AND SKIP TO BOX V4.2;
IF V3 = M, OR V3 DOB DOES NOT MATCH PRELOADED DOB, OR PRELOADED DOB = M,
SET DOB_VERIFY = 0 AND CONTINUE TO V4.
Prepared by Mathematica Policy Research
3
9-30-15
DOB_VERIFY = 0 (DOB DOES NOT MATCH OR IS MISSING)
V4.
What are the last 4-digits of your Social Security Number?
(RANGE 0000-9999)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF V1 = NO RESPONSE; Please provide an answer to this question and continue.
To continue to the next question without providing a response, click the continue button.
PROGRAMMER VERIFICATION BOX V4.1
SET SSN_VERIFY:
IF V4 SSN MATCHES PRELOADED SSN, SET SSN_VERIFY = 1;
IF V4 = M, OR V4 SSN DOES NOT MATCH PRELOADED SSN, OR PRELOADED SSN = M,
SET SSN_VERIFY = 0;
ALL RESPONSES CONTINUE TO BOX V4.2.
PROGRAMMER VERIFICATION BOX V4.2
IF DOB_VERIFY = 1 OR SSN_VERIFY = 1, GO TO SECTION A;
IF DOB_VERIFY = 0 AND SSN_VERIFY = 0, CONTINUE TO V5;
Prepared by Mathematica Policy Research
4
9-30-15
(NAME_VERIFY = 1 AND (DOB_VERIFY = 0 AND SSN_VERIFY = 0)) OR NAME_VERIFY = 0
V5.
There may be a problem with some of our records. A representative from Mathematica will
give you a call to verify our information.
PROGRAMMER:
DISPLAY THE FOLLOWING QUESTIONS ON THE SAME SCREEN.
What is the best number to reach you?
.
□ Check here if you don’t have a phone number ................................................... 1
Which of the following is the best time to reach you?
PROGRAMMER:
▼
DROPDOWN OPTIONS INCLUDE: Anytime, Weekday mornings,
Weekday afternoons, Weekday evenings, Weekend mornings, Weekend
afternoons, Weekend evenings
What is your email address?
□ Check here if you don’t have an email ................................................................ 1
SOFT CHECK: IF V5_phone = NO RESPONSE; Please provide a phone number so we can help
you complete the survey. If you don’t have a phone number, please check the box.
PROGRAMMER VERIFICATION BOX V5.1
SEND CASE TO SUPERVISOR REVIEW.
SEND ALERT WITH THE INFORMATION COLLECTED AT V5.
Prepared by Mathematica Policy Research
5
9-30-15
A. HOUSEHOLD INFORMATION
ALL
A1.
The first questions are about your housing situation.
Where do you live now? If you stay in more than one place, where do you stay most often?
Select 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 ........................................................................ 8
GO TO A3
Some other arrangement (SPECIFY) ................................................................... 9
Specify
(STRING 200)
NO RESPONSE ................................................................................................... M
SPECIFY TEXT: Please specify 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
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
6
9-30-15
ALL
A3.
What is your marital status?
Select one only
Married .................................................................................................................. 1
Divorced................................................................................................................ 2
Separated ............................................................................................................. 3
Widowed ............................................................................................................... 4
Never married ....................................................................................................... 5
NO RESPONSE ................................................................................................... M
PROGRAMMER SKIP BOX A3.1
IF A1 = 1 – 6, 9, 10, M (LIVING IN HOUSE, OTHER, OR EMPTY) CONTINUE;
ELSE, SKIP TO A6.
A1 = 1 – 6, 9, 10, M
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
NO RESPONSE ................................................................................................... M
A1 = 1, 2, 3, 9, M
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 CURRENTLY LIVING WITH YOU
(RANGE 0-99)
NO RESPONSE ................................................................................................... M
HARD CHECK: IF A5 = 0; Your response to this question should be at least one (1). Please
update your answer below.
SOFT CHECK: IF A4 = 1 AND A5 < 2; In the previous question you mentioned you live with your
spouse or partner. Your answer to this question should include yourself and your spouse or
partner. Please indicate below how many people currently live with you.
To continue to the next question without changing your response, click the continue button.
Prepared by Mathematica Policy Research
7
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
NO RESPONSE ................................................................................................... M
GO TO SECTION B
A6a = 1
A7.
How many children do you have? Please do not include a current pregnancy.
CHILDREN
(RANGE 00-99)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF A7 =15 – 99; You said that you have [FILL A7] children. Please check that this
is correct and either keep your answer or change your answer below.
To keep your answer without making changes, click the continue button.
SOFT CHECK: IF A7 = 0; You mentioned in a previous question that you have children. You just
mentioned that you have 0 children. Click here to go back and change your answer about
having children. You may also change your answer below.
To keep your answer without making changes, click the continue button.
PROGRAMMER SKIP BOX A7.1
IF A7 = 0 OR M (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.
A7 = 1
A8a.
Does this child live with you?
Yes ........................................................................................................................ 1
GO TO A9
No ......................................................................................................................... 0
GO TO A9
NO RESPONSE ................................................................................................... M
GO TO A9
SOFT CHECK: IF A8a = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
Prepared by Mathematica Policy Research
8
9-30-15
A7 GT 1
A8b.
How many of your children live with you?
CHILDREN LIVING WITH YOU
(RANGE 0-99)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF A8b = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
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. Click here to go back and change your answer about the number of children
you have. You may also change your answer below.
To continue to the next question without making changes, click the continue button.
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
NO RESPONSE ................................................................................................... M
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 = M, 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 = M, GO TO A11.
Prepared by Mathematica Policy Research
9
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
NO RESPONSE ................................................................................................... M
GO TO A11
IF A10a = 1
IF A7 = 1 AND A8a = 0, FILL: child
IF A7 GT 1 AND (A7 – A8B GT 1), FILL: children
IF A7 GT1 AND (A7 – A8B = 1), FILL; child
A10.
Thinking just about the [child / children] who [does / do] not live with you, please indicate
which of the following activities you have done in the past week.
Select all that apply
Read with your [child/children].............................................................................. 1
Played with your [child/children], not including sports .......................................... 2
Did arts and crafts with your [child/children] ......................................................... 3
Played sports with your [child/children] ................................................................ 4
Talked with or listened to your [child/children]...................................................... 5
Attended your [child/children]’s events ................................................................. 6
Helped your [child/children] with homework ......................................................... 7
Picked up or dropped your [child/children] off ...................................................... 8
Done some other activities with your [child/children]............................................ 9
NO RESPONSE .......................................................................................................... M
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
NO RESPONSE ................................................................................................... M
GO TO SECTION B
A11 = 1
A12.
Did you make this payment last month?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
10
9-30-15
B. EDUCATIONAL ATTAINMENT
PL_DROPOUT = 1 (DATA NOT PREVIOUSLY COLLECTED)
B1.
The next questions ask about your experiences in school and your future education plans.
Did you drop out of high school before graduating?
Yes ........................................................................................................................ 1
GO TO B2
No ......................................................................................................................... 0
GO TO B3
NO RESPONSE ................................................................................................... M
GO TO B3
B1 = 1
B2.
What was the highest grade that you finished in high school before you dropped out?
Select one only
8th grade or less ................................................................................................... 1
9th grade/freshman in high school ....................................................................... 2
10th grade/sophomore in high school .................................................................. 3
11th grade/junior in high school ........................................................................... 4
NO RESPONSE ................................................................................................... M
PL_diploma = 0 (DATA NOT PREVIOUSLY COLLECTED)
The next questions ask about your experiences in school and your future education plans. IF
PL_droupout = 0.
B3.
[The next questions ask about your experiences in school and your future education
plans.]
Do you have a high school diploma, a GED, HiSET or TASC, a Certificate of Completion, or
do you have none of these?
Select 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
NO RESPONSE ................................................................................................... M
GO TO B5a
SOFT CHECK: IF B3 = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
Prepared by Mathematica Policy Research
11
9-30-15
IF B3 = 1 – 3 OR (PL_DIPLOMA = 1 – 3 AND PL_DIPDATE = 1)
The next questions ask about your experiences in school and your future education plans. IF
PL_droupout = 0 AND PL_diploma = 1, 2, 3
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
[The next questions ask about your experiences in school and your future education plans.]
B4.
In what month and year did you obtain your [GED, HiSET or TASC/high school
diploma/Certificate of Completion]?
PROGRAMMER:
Month
INSERT DROPDOWN FOR MONTH (SPELL OUT MONTHS) AND YEAR
Year
▼
(1-12) (2000 - 2017)
NO RESPONSE ................................................................................................... M
HARD CHECK: IF B4_Month = 0 OR GT 12
HARD CHECK: IF B4 DATE GT CURRENT DATE (B4_Month = EMPTY, CHECK THE YEAR); The
date you provided is in the future. Please correct the date below.
HARD CHECK: IF B4 YEAR GT CURRENT YEAR (If B4_Month = EMPTY, check Year); The date you
provided is in the future. Please correct the date below.
SOFT CHECK: IF B4 DATE IS BEFORE [REF DATE]; You said you obtained your [GED, HiSET or
TASC / high school diploma / Certification of Completion] in [FILL B4 MONTH AND YEAR].
Please check that this is correct and either keep your answer or change your answer below.
To keep your answer without making changes, click the continue button.
ALL
The next questions ask about your experiences in school and your future education plans. IF
PL_droupout = 0 AND PL_diploma = 1, 2, 3 AND PL_dipdate = 0.
[The next questions ask about your experiences in school and your future education plans.]
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
NO RESPONSE ................................................................................................... M
GO TO B7
Prepared by Mathematica Policy Research
12
9-30-15
B5a = 1
B5b.
Where were you enrolled in or attending those classes?
Select all that apply
Regular high school .............................................................................................. 1
Charter school ...................................................................................................... 2
Special high school for persons with disabilities .................................................. 3
GED, HiSET or TASC preparation class or Certificate of Completion
program ................................................................................................................ 4
Vocational, technical, business or trade school ................................................... 5
2-year college or community college .................................................................... 6
4-year college or university................................................................................... 7
Somewhere else ................................................................................................... 8
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF B5b = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
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
NO RESPONSE ................................................................................................... M
GO TO BOX B6.1
Prepared by Mathematica Policy Research
13
9-30-15
B5c = 1
B6.
Which degrees have you completed?
Select all that apply
Vocational, technical, business or trade school ................................................... 1
2-year college or community college .................................................................... 2
4-year college or university................................................................................... 3
Graduate school ................................................................................................... 4
Other degree (SPECIFY) ...................................................................................... 5
Specify
(STRING 200)
NO RESPONSE ................................................................................................... M
SPECIFY TEXT: Please specify 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, M
B7.
How likely is it that you will attend college?
Select one only
Very likely ............................................................................................................. 1
Somewhat likely .................................................................................................... 2
Somewhat unlikely ................................................................................................ 3
Very unlikely ......................................................................................................... 4
NO RESPONSE ................................................................................................... M
SKIP BOX B7.1
ALL RESPONSES SKIP TO SECTION C.
Prepared by Mathematica Policy Research
14
9-30-15
B5b_6 OR B5b_7 = 1
B8.
How likely is it that you will graduate from college?
Select one only
Very likely ............................................................................................................. 1
Somewhat likely .................................................................................................... 2
Somewhat unlikely ................................................................................................ 3
Very unlikely ......................................................................................................... 4
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
15
9-30-15
C. SERVICE RECEIPT
ALL
C1.
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.
Since [REF DATE], have you participated in any of the following education related
services?
YES
1
a. GED, HiSET or TASC preparation
NO
0
b.
Academic tutoring not including GED, HiSET or TASC preparation
1
0
c.
Courses to prepare for a high school diploma
1
0
d. Standardized achievement test preparation for state or local tests
1
0
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
f.
1
0
1
0
Getting help finding financial aid
g. Another education related service
(STRING 255)
SPECIFY TEXT: Please specify the other education related service you participated in:
SOFT CHECK: IF ANY ROWS ARE EMPTY; You may have missed a question or two on this
page. Please review your answers below and provide the missing responses.
To continue to the next question, click the “next” button below.
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
16
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 EMPTY, 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.
Since [REF DATE], about how long have you spent…
(Your best estimate is fine.)
PROGRAMMER:
INSERT DROPDOWN
PROGRAMMER:
RANGE IS 00 – 999
Number
Hours, Days,
Weeks or
Months
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 standardized achievement test preparation for 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]
PROGRAMMER:
▼
USE THESE DROPDOWN OPTIONS:
Hours .................................................................................................................... 1
Days ...................................................................................................................... 2
Weeks ................................................................................................................... 3
Months .................................................................................................................. 4
SOFT CHECK: IF C2a-g NUM = M OR C2a-g UNIT = M; You may have missed a question or two
on this page. Please review your answers below and provide the missing responses.
To continue to the next question, click the "next" button below.
Prepared by Mathematica Policy Research
17
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 tests preparation; C1e = 1, FILL:
College preparation activities; C1f = 1, FILL: Getting help finding financial aid
C1g = 1, FILL: FROM C1g_specify; IF C1g_specify IS EMPTY, 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 received the following education related [service / services]:
•
[FILL FIRST SELECTED ITEM]
•
[FILL SECOND SELECTED ITEM]
•
[CONTINUE FILLING]
Where did you receive [this service most often/most of these services]?
Select one only
Community based organization ............................................................................ 1
School ................................................................................................................... 2
Former or current employer .................................................................................. 3
[[YB BROGRAM] or another/A] YouthBuild program ........................................... 4
Somewhere else ................................................................................................... 5
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
18
9-30-15
ALL
C4.
Since [REF DATE], have you received any help enrolling or participating in any of the
following education related services?
YES
NO
a. A high school diploma program
1
0
b. English as a Second Language (ESL) training
1
0
c.
1
0
1
0
Courses for college credit
d. Another type of education activity or academic service
(STRING 255)
SPECIFY TEXT: Please specify the other education related service you participated in:
SOFT CHECK: IF ANY ROWS ARE EMPTY; You may have missed a question or two on this
page. Please review your answers below and provide the missing responses.
To continue to the next question, click the “next” button below.
ALL
C5.
Since [REF DATE], have you participated in any of the following training or job related
services?
YES
NO
a. A job skills training program
1
0
b. Construction training or another on-the-job training
1
0
c.
1
0
d. A job certification program
1
0
e. Job search assistance, including help filling out an application, writing a
resume, or going for an interview
1
0
1
0
1
0
f.
Career counseling
Help applying to a vocational training program, including help with an
application or interview
g. Another training or job related service
(STRING 255)
SPECIFY TEXT: Please specify the other training or job related service you participated in:
SOFT CHECK: IF ANY ROWS ARE EMPTY; You may have missed a question or two on this
page. Please review your answers below and provide the missing responses.
To continue to the next question, click the “next” button below.
PROGRAMMER BOX C5.1.
IF NO C5 ITEMS = 1, SKIP TO BOX C8;
IF ANY C5a-g = 1, CONTINUE TO C6.
Prepared by Mathematica Policy Research
19
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.
Since [REF DATE], about bout how long have you spent…
(Your best estimate is fine.)
PROGRAMMER:
INSERT DROPDOWN
PROGRAMMER:
RANGE IS 00 – 999
Number
Hours, Days,
Weeks or
Months
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 C5g_specify / In the other training or job related
service you mentioned]
PROGRAMMER:
▼
▼
USE THESE DROPDOWN OPTIONS:
Hours .................................................................................................................... 1
Days ...................................................................................................................... 2
Weeks ................................................................................................................... 3
Months .................................................................................................................. 4
SOFT CHECK: IF C6a-g NUM = M OR C6a-g UNIT = M; You may have missed a question or two
on this page. Please review your answers below and provide the missing responses.
To continue to the next question, click the "next" button below.
Prepared by Mathematica Policy Research
20
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 EMPTY, 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 received the following training or job related [service / services]:
•
[FILL FIRST SELECTED ITEM]
•
[FILL SECOND SELECTED ITEM]
•
[CONTINUE FILLING]
Where did you receive [this service most often/most of these services]?
Select one only
Community based organization ............................................................................ 1
School ................................................................................................................... 2
Former or current employer .................................................................................. 3
[[YB PROGRAM] or another/A] YouthBuild program ........................................... 4
Somewhere else ................................................................................................... 5
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
21
9-30-15
ALL
C8.
Since [REF DATE], have you participated in any of the following personal development
services?
YES
NO
a. Getting help or advice from a mentor
1
0
b. Life skills training such as parenting skills classes, learning how to balance a
checkbook, etc.
1
0
c.
1
0
d. Leadership development training
1
0
e. Health services
1
0
f.
1
0
1
0
Communication or public-speaking training
Mental health services
g. Working with a case manager
SOFT CHECK: IF ANY ROWS ARE EMPTY; You may have missed a question or two on this
page. Please review your answers below and provide the missing responses.
To continue to the next question, click the “next” button below.
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
22
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.
Since [REF DATE], about how long have you spent…
(Your best estimate is fine.)
PROGRAMMER:
INSERT DROPDOWN
PROGRAMMER:
RANGE IS 00 – 999
Number
Hours, Days,
Weeks or
Months
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
PROGRAMMER:
▼
USE THESE DROPDOWN OPTIONS:
Hours .................................................................................................................... 1
Days ...................................................................................................................... 2
Weeks ................................................................................................................... 3
Months .................................................................................................................. 4
SOFT CHECK: IF C9a-g NUM = M OR C9a-g UNIT = M; You may have missed a question or two
on this page. Please review your answers below and provide the missing responses.
To continue to the next question, click the "next" button below.
Prepared by Mathematica Policy Research
23
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]?
Select one only
Community based organization ............................................................................ 1
School ................................................................................................................... 2
Former or current employer .................................................................................. 3
[[YB Program] or another/A] YouthBuild program ................................................ 4
Somewhere else ................................................................................................... 5
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
24
9-30-15
D. YOUTHBUILD (YB) PROGRAM EXPERIENCES
ALL
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
The next questions are about your experiences with YouthBuild.
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
NO RESPONSE ................................................................................................... M
GO TO BOX D1b.1
SOFT CHECK: IF D1 = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
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
The next questions are about your experiences YouthBuild]. IF C3, C7, OR C10 = 4
[The next questions are about your experiences with YouthBuild.]
D1a.
Did you receive [YouthBuild services / these services] from [YB PROGRAM]?
Yes ........................................................................................................................ 1
GO TO BOX D1b.1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
25
9-30-15
D1a = 0, M
D1b.
What is the name, city and state of the YouthBuild program where you received services?
YouthBuild Program Name
(STRING 200)
City
(STRING 200)
State/Territory
Select▼ (INSERT DROPDOWN)
NO RESPONSE ................................................................................................... M
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 = M, 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 OR M, 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 = M, 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 = M, AND RAOutcome = 1 (TREATMENT), SKIP TO D3;
IF PL_YBstatus = 0 AND D1 = M, AND RAOutcome = 2 (CONTROL), SKIP TO SECTION E
Prepared by Mathematica Policy Research
26
9-30-15
(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
GO TO D3
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
PROGRAMMER SKIP BOX D1c.1
IF D1c = 1, SET D3 = 2 (GRADUATED) AND GO TO D4; ELSE, GO TO D2.
D1c = 0 OR M
D2.
Why did you not participate in YouthBuild?
Select all that apply
You had no transportation .................................................................................... 1
You were incarcerated .......................................................................................... 2
It was at a bad time of the day.............................................................................. 3
You got a job......................................................................................................... 4
You moved............................................................................................................ 5
You were expecting a child or had child care problems ....................................... 6
You had health problems or an injury ................................................................... 7
A family member became ill ................................................................................. 8
You had pressure from your family ...................................................................... 9
You did not like the program................................................................................. 10
You did not like or get along with the program staff ............................................. 11
You did not like or get along with other participants ............................................. 12
You were expelled or asked to leave ................................................................... 13
The program closed .............................................................................................. 14
Some other reason (SPECIFY) ............................................................................ 15
Specify
(STRING 255)
SPECIFY TEXT: Please specify the reason why you did not participate:
Prepared by Mathematica Policy Research
27
9-30-15
D1c = 0 OR M
D2a.
In what month and year did you stop going to YouthBuild?
Your best estimate is fine.
PROGRAMMER:
▼
INSERT DROPDOWN FOR MONTH (SPELL OUT MONTHS)
20
MONTH
YEAR
(1-12) (2011 - 2017)
NO RESPONSE ................................................................................................... M
HARD CHECK: IF D2a_Month = 0 OR GT 12
HARD CHECK: IF D2a DATE GT CURRENT DATE (If D2a_Month = EMPTY, check Year); The date
you provided is in the future. Please correct the date below.
HARD CHECK: IF D2a YEAR GT CURRENT YEAR (If D2a_Month = EMPTY, check Year); The date
you provided is in the future. Please correct the date below.
SOFT CHECK: IF D2a DATE IS BEFORE [REF DATE]; You said you stopped going to YouthBuild
in [FILL D2a MONTH AND YEAR]. Please check that this is correct and either keep your answer
or change your answer below.
To keep your answer without making changes, click the continue button.
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
28
9-30-15
(PL_YBstatus = 1 AND D1 = 1 OR M) OR (PL_YBstatus = 3 AND D1 = 1) OR (PL_YBstatus = 0 AND
D1 = 1) OR (PL_YBstatus = 0 AND (D1 = M) 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]?
Select 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 ................................................................................................................ 2
No longer enrolled in [YB PROGRAM / YouthBuild] and did not
graduate or complete the program ....................................................................... 3
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF D3 = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
PROGRAMMER SKIP BOX D3.1
IF D3 = 1, M, SKIP TO D6;
IF D3 = 2 – 3, CONTINUE TO D4.
Prepared by Mathematica Policy Research
29
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]?
Your best estimate is fine.
PROGRAMMER:
▼
INSERT DROPDOWN FOR MONTH (SPELL OUT MONTHS)
20
MONTH
YEAR
(1-12) (2011 - 2017)
NO RESPONSE ................................................................................................... M
HARD CHECK: IF D4_Month = 0 OR GT 12
HARD CHECK: IF D4 DATE GT CURRENT DATE; The date you provided is in the future. Please
correct the date below.
HARD CHECK: IF D4 YEAR GT CURRENT YEAR (If D4_Month = EMPTY, check Year); The date
you provided is in the future. Please correct the date below.
SOFT CHECK: IF D4 DATE IS BEFORE REF DATE; You said you [graduated or completed /
stopped going to] the program in [FILL D4 YEAR]. Please check that this is correct and either
keep your answer or change your answer below.
To keep your answer without making changes, click the continue button.
SOFT CHECK: IF D4 MONTH = M OR D4 YEAR = M; Your response to this question is important.
Please provide a response and continue.
To continue to the next question without providing a response, click the continue button.
PROGRAMMER SKIP BOX D4.1
IF D3 = 2 SKIP TO D6;
IF D3 = 3, CONTINUE TO D5.
Prepared by Mathematica Policy Research
30
9-30-15
IF D3 = 3
D5.
Why did you stop going to [YB PROGRAM /YouthBuild]?
Select all that apply
You had no transportation .................................................................................... 1
You were incarcerated .......................................................................................... 2
It was at a bad time of the day.............................................................................. 3
You got a job......................................................................................................... 4
You moved............................................................................................................ 5
You were expecting a child or had child care problems ....................................... 6
You had health problems or an injury ................................................................... 7
A family member became ill ................................................................................. 8
You had pressure from your family ...................................................................... 9
You did not like the program................................................................................. 10
You did not like or get along with the program staff ............................................. 11
You did not like or get along with other participants ............................................. 12
You were expelled or asked to leave ................................................................... 13
The program closed .............................................................................................. 14
Some other reason ............................................................................................... 15
Specify
(STRING 255)
NO RESPONSE ................................................................................................... M
SPECIFY TEXT: Please specify the other reason you stopped going:
PROGRAMMER SKIP BOX D5.1
ALL RESPONSES TO D5 CONTINUE TO D6.
Prepared by Mathematica Policy Research
31
9-30-15
(PL_YBSTATUS = 1 AND D1 = 1 OR M) OR (PL_YBSTATUS = 3 AND D1 = 1) OR (PL_YBSTATUS =
0 AND D1 = 1) OR (PL_YBSTATUS = 0 AND (D1 = M) AND TREATMENT) OR IF D1C = 1 (D3 WAS
ASKED OR HAS A VALUE)
have you gone to IF D3 = 1, M;
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.
MONTHS
(RANGE 00-99)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF D6 = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
(PL_YBSTATUS = 1 AND D1 = 1 OR M) OR (PL_YBSTATUS = 3 AND D1 = 1) OR (PL_YBSTATUS =
0 AND D1 = 1) OR (PL_YBSTATUS = 0 AND (D1 = M) AND TREATMENT) OR IF D1C = 1 (D3 WAS
ASKED OR HAS A VALUE)
Do IF D3 = 1, M;
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
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
32
9-30-15
(PL_YBSTATUS = 1 AND D1 = 1 OR M) OR (PL_YBSTATUS = 3 AND D1 = 1) OR (PL_YBSTATUS =
0 AND D1 = 1) OR (PL_YBSTATUS = 0 AND (D1 = M) AND TREATMENT) OR IF D1C = 1 (D3 WAS
ASKED OR HAS A VALUE) OR (PL_YBstatus = 2 AND D1 = 1)
D8.
How would you rate the quality of [YB PROGRAM / YouthBuild] with regards to its:
Select one per row
VERY
GOOD
GOOD
OKAY
POOR
DOES NOT
APPLY TO ME
a. Caring staff
1
2
3
4
5
b. Safe and positive environment
1
2
3
4
5
c.
1
2
3
4
5
Community service
(PL_YBSTATUS = 1 AND D1 = 1 OR M) OR (PL_YBSTATUS = 3 AND D1 = 1) OR (PL_YBSTATUS =
0 AND D1 = 1) OR (PL_YBSTATUS = 0 AND (D1 = M) AND TREATMENT) OR IF D1C = 1 (D3 WAS
ASKED OR HAS A VALUE) OR (PL_YBstatus = 2 AND D1 = 1)
D9.
How would you rate the quality of [YB PROGRAM / YouthBuild] with regards to the
following?
Select one per row
VERY
GOOD
GOOD
OKAY
POOR
a. Construction or other job
training
1
2
3
4
b. Counseling
1
2
3
4
c.
1
2
3
d. Classroom instruction
1
2
3
e. Helping you find a job
1
2
f.
1
2
1
2
Leadership training
Helping you get into college
g. Your overall YouthBuild
experience
Prepared by Mathematica Policy Research
33
DOES NOT
APPLY TO ME
5
5
4
5
4
5
3
4
5
3
4
5
3
4
5
9-30-15
(PL_YBSTATUS = 1 AND D1 = 1 OR M) OR (PL_YBSTATUS = 3 AND D1 = 1) OR (PL_YBSTATUS =
0 AND D1 = 1) OR (PL_YBSTATUS = 0 AND (D1 = M) AND TREATMENT) OR IF D1C = 1 (D3 WAS
ASKED OR HAS A VALUE) 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 the
following?
Select one per row
VERY GOOD
GOOD
OKAY
POOR
(IF D3 = 2)
a. Their attempts to keep in contact
with you after completing [YB
PROGRAM]
1
2
3
4
b. Understanding your needs
1
2
3
4
c.
1
2
3
4
d. Helping you learn, either
academically, vocationally or
personally
1
2
3
4
(IF D3 = 2 OR 3)
e. Help after leaving [YB PROGRAM /
YouthBuild]
1
2
3
4
Helping you solve problems
Prepared by Mathematica Policy Research
34
9-30-15
(PL_YBSTATUS = 1 AND D1 = 1 OR M) OR (PL_YBSTATUS = 3 AND D1 = 1) OR (PL_YBSTATUS =
0 AND D1 = 1) OR (PL_YBSTATUS = 0 AND (D1 = M) AND TREATMENT) OR IF D1C = 1 (D3 WAS
ASKED OR HAS A VALUE) OR (PL_YBSTATUS = 2 AND D1 = 1)
D11.
Do you have at least one person on the [YB PROGRAM / YouthBuild] staff who really cares
about you and to whom you can go to talk about personal things?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
PROGRAMMER SKIP BOX D11.1
IF D3 = 2 OR 3 (GRADUATED OR STOPPED) OR PL_YBstatus = 2 OR
(PL_YBstatus = 1 AND D1 = 0) OR (PL_YBstatus = 0 AND D1 = 0 AND TREATMENT) OR
(PL_YBstatus = 3 AND D1 = 0), CONTINUE TO D12;
ELSE, SKIP TO SECTION E.
D3 = 2 OR 3 (GRADUATED OR STOPPED) OR PL_YBSTATUS = 2 OR (PL_YBstatus = 1 AND D1 =
0) OR (PL_YBstatus = 0 AND D1 = 0 AND TREATMENT) 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]?
CODE ONE ONLY
More than once a month........................................................................................... 1
About once a month ................................................................................................. 2
A few times per year ................................................................................................. 3
About once per year ................................................................................................. 4
Not at all ..................................................................................................................... 5
DON’T KNOW ............................................................................................................. d
REFUSED ................................................................................................................... r
Prepared by Mathematica Policy Research
35
9-30-15
E. EMPLOYMENT AND EARNINGS
ALL
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 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.
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
NO RESPONSE ................................................................................................... M
GO TO BOX EF3
EF1 = 1
EF2.
Are you still working at [PL JOB NAME]?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
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.
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 OR M (NOT STILL WORKING AT PRELOADED JOB), SET EF3 = 2;
IF EF1 = 0 OR M (INCORRECT PRELOAD DATA), SET EF3 = 3;
ELSE (PL_job = 0) SET EF3 = 4.
Prepared by Mathematica Policy Research
36
9-30-15
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 .................................................................................................................. 1
Quit ....................................................................................................................... 2
Fired ...................................................................................................................... 3
Some other reason (SPECIFY) ............................................................................ 99
Specify
(STRING 255)
NO RESPONSE ................................................................................................... M
SPECIFY TEXT: Please specify the other reason you stopped working at that job.
ALL
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. IF PL_job = 0
In addition to [PL JOB NAME], are IF EF3 = 1; ELSE Are
another IF EF3 = 1; ELSE a
E1.
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.
[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
NO RESPONSE ................................................................................................... M
GO TO BOX E1a.1
SOFT CHECK: IF E1 = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
Prepared by Mathematica Policy Research
37
9-30-15
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?
NUMBER OF CURRENT JOBS
(RANGE 0-9)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF E1a = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without providing a response, click the continue button.
SOFT CHECK: IF E1a = 4 – 9; You reported that you currently have [FILL E1a] paid jobs. Please
check that this is correct and either keep your answer or change your answer below.
To keep your answer without making changes, click the continue button.
HARD CHECK: IF E1a = 0; You mentioned in a previous question that you are currently working.
You just mentioned that you have 0 jobs. Click here to go back and change your answer about
currently working. You may also change your answer below.
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. Click here to go back and change
your answer about currently working at [PL JOB NAME]. You may also change your answer
below 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, M (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.
EF3 = 2 – 4 AND E1 = 0 OR M (NOT CURRENTLY WORKING)
E2.
Have you been looking for work during the past four weeks?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
GO TO E4
NO RESPONSE ................................................................................................... M
GO TO E4
Prepared by Mathematica Policy Research
38
9-30-15
E2 = 1 (LOOKING FOR WORK)
IF D1 = 1, FILL Response option a (Contact YouthBuild staff)
E3.
Below is a list of things that some people do to look for work. Please indicate whether or
not you did any of these things during the last four weeks.
Select one per row
Yes
No
(IF D1 = 1)
a. Contact YouthBuild staff
1
0
b. Contact your state’s One Stop office, workforce development
office, or unemployment office
1
0
c.
1
0
d. Look through job advertisements in a newspaper or on the
internet
1
0
e. Send out resumes
1
0
f.
1
0
g. Contact any employers in person, by mail, or by phone
1
0
h. Something else (SPECIFY)
1
0
Ask friends or relatives
Fill out applications
(STRING 255)
SPECIFY TEXT: Please specify what other things you did to look for work in the last four weeks:
PROGRAMMER BOX E3.1.
AFTER E3, GO TO E4.
Prepared by Mathematica Policy Research
39
9-30-15
E1 = 0 OR M (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
GO TO E20
NO RESPONSE ................................................................................................... M
GO TO E20
SOFT CHECK: IF E4 = M; Your response to this question is important. Please provide a
response and continue.
To continue to the next question without making changes, click the continue button.
PROGRAMMER BOX E4.1.
IF EF3 = 1 – 2 AND E4 = 1, CONTINUE TO E5;
IF EF3 = 1 – 2 AND E4 = 0 OR M, SKIP TO BOX E8.2;
IF EF3 = 3 – 4 AND E4 = 1, CONTINUE TO E5;
IF EF3 = 3 – 4 AND E4 = 0 OR M, SKIP TO E20.
Prepared by Mathematica Policy Research
40
9-30-15
E1 = 1 OR E4 = 1
If you work the same number of hours at more than one job, please pick one of your jobs to
enter below. IF (EF3 = 2 – 4 AND E1 = 1 AND E1a GT 1)
E5.
(EF3 = 2 – 4 AND E1 = 1 AND E1a = 1, M)
Where are you currently working? Please enter 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 enter 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 enter the name of
the company or employer.
(EF3 = 2 – 4 AND E4 = 1)
Where have you worked most recently since [REF DATE]] Please enter the name of the
company or employer.
Only enter the name of one job below. [If you work the same number of hours at more than one
job, please pick one of your jobs to enter below]. We will ask you about other jobs later.
Name of company/employer
(JOB NAME FOR SLOT #2)
(STRING 255)
NO RESPONSE ................................................................................................... M
E5a.
Check here if you don’t know the name of the employer....................................... 1
HARD CHECK: IF E5 HAS TEXT AND E5a = 1; You have entered the name of a
company/employer and checked the box below. Please clear the text or uncheck the box.
PROGRAMMER SKIP BOX E5a.1
IF E5 = M, 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
41
9-30-15
E5 = M
your current job IF (EF3 = 2 – 4 AND E1 = 1 AND E1a = 1, M);
the job where you work the most hours / If you work the same number of hours at more than
one job, please pick one of your jobs to enter below. 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]]. Please enter a word or name
that can be used to help you refer to this job in the upcoming questions.
Only enter the name of one job below. [If you work the same number of hours at more than one
job, please pick one of your jobs to enter below]. We will ask you about other jobs later.
(JOB NAME FOR SLOT #2)
(STRING 255)
NO RESPONSE ................................................................................................... M
PROGRAMMER SKIP BOX E5b.1
IF E5b = M (NO NAME GIVEN) AND EF3 = 3 – 4, SKIP TO E20;
IF E5B = M (NO NAME GIVEN) AND EF3 = 1 - 2, GO TO BOX E8.2 AND COMPLETE
LOOP FOR SLOT #1;
ELSE (TEXT ENTERED), RECORD TEXT 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
42
9-30-15
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
NO RESPONSE ...................................................................... M 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]?
Only enter the name of one job below. We will ask you about other jobs later.
Name of company/employer
(JOB NAME FOR SLOTS #3 - #6)
(STRING 255)
NO RESPONSE .................................................................... M
E7a.
Check here if you don’t know the name of the employer........ 1
HARD CHECK: IF E7 HAS TEXT AND E7a = 1; You have entered the name of a
company/employer and checked the box below. Please clear the text or uncheck the box.
PROGRAMMER SKIP BOX E7.1
IF E7 = M AND E7a = 1 (DOESN’T KNOW NAME), CONTINUE ;
IF E7 = M AND E7a = M (FIELD AND BOX EMPTY), CONTINUE;
ELSE (TEXT ENTERED AT E7), RECORD TEXT AS JOB AND SKIP TO BOX E8.1
Prepared by Mathematica Policy Research
43
9-30-15
(E7 = M AND E7a = 1) OR (E7 = M AND E7a = M)
E8.
We will ask you a few questions about this job. Please enter a word or name that can be
used to help you refer to this job in the upcoming questions.
(JOB NAME FOR SLOTS #3 - #6)
(STRING 255)
NO RESPONSE ................................................................................................... M
PROGRAMMER BOX E8.1
IF E8 = M (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.
PROGRAMMER BOX E8.2
BEGIN JOB LOOP E9 TO E19
AFTER SLOT #1, RETURN HERE AND REPEAT FOR SLOTS #2 - # 6.
Prepared by Mathematica Policy Research
44
9-30-15
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]?
Your best estimate is fine.
PROGRAMMER:
▼
INSERT DROPDOWN FOR MONTH (SPELL OUT MONTHS)
20
MONTH
YEAR
(1-12) (2011 - 2017)
NO RESPONSE ................................................................................................... M
HARD CHECK: IF E9_Month = 0 OR GT 12
HARD CHECK: IF E9 DATE GT CURRENT DATE; The date you provided is in the future. Please
correct the date below.
HARD CHECK: IF E9 YEAR GT CURRENT YEAR (If E9_Month = EMPTY, check Year); The date you
provided is in the future. Please correct the date below.
SOFT CHECK: IF E9 YEAR IS BEFORE 2012; You said you started working at this job in [FILL
JOB YEAR]. Please check that this is correct and either keep your answer or change your
answer below.
To keep your answer without making changes, click the continue button.
SOFT CHECK: IF E9 MONTH = M OR E9 YEAR = M; Your response to this question is important.
Please provide a month and year to continue. Your best estimate is fine.
To keep your answer without making changes, click the continue button.
Prepared by Mathematica Policy Research
45
9-30-15
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]? Check the box below if you are still working
at this job.
Your best estimate is fine.
Check the box below if you are still working at this job.
PROGRAMMER:
▼
INSERT DROPDOWN FOR MONTH (SPELL OUT MONTHS)
20
MONTH
YEAR
(1-12) (2011 - 2017)
NO RESPONSE ................................................................................................... M
E10a. Check here if you are still working at this job ........................................................ 1
HARD CHECK: IF E10_Month = 0 OR GT 12
HARD CHECK: IF E10 DATE GT CURRENT DATE; The date you provided is in the future. Please
correct the date below.
HARD CHECK: IF E10 YEAR GT CURRENT YEAR (If E10_Month = EMPTY, check Year); The date
you provided is in the future. Please correct the date below.
SOFT CHECK: IF E10 = M AND E10a = M (NOT CHECKED); Your response to this question is
important. Please provide a response and continue. If you are still working at this job, check
the box below.
To continue to the next question without providing a response, click the continue button.
SOFT CHECK: IF E10 MONTH GT 0 AND E10 YEAR = M; Please provide a year. Your best
estimate is fine.
To keep your answer without making changes, click the continue button.
SOFT CHECK: IF E10 MONTH = M AND E10 YEAR GT 0; Please provide a month. Your best
estimate is fine.
To keep your answer without making changes, click the continue button.
SOFT CHECK: IF E10 DATE IS BEFORE REFERENCE DATE; INTERVIEWER: You said you
stopped working at this job in [FILL E10 DATE]. Please check that this is correct and either
keep your answer or change your answer below.
To keep your answer without making changes, click the continue button.
Prepared by Mathematica Policy Research
46
9-30-15
SOFT CHECK: IF E10 DATE IS BEFORE E9 (START DATE); The date you stopped working at this
job in [E10 MONTH AND YEAR] is before your start date of [FILL E9 MONTH AND YEAR]. Please
check that this is correct and either keep your answer or change your answer below.
To keep your answer without making changes, click the continue button.
HARD CHECK: IF E10 HAS DATE AND E10a = 1; You provided the date you stopped working at
this job and checked the box indicating you are still working at this job. Please confirm the date
and uncheck the box to continue.
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
NO RESPONSE ................................................................................................... M
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
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
47
9-30-15
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
E13.
How many hours per week, including regular overtime hours [do / did] you usually work at
[JOB NAME]?
Your best estimate is fine.
Hours per week
(RANGE 0-999)
NO RESPONSE ................................................................................................... M
E13a. Check here if the number of hours varies .............................................................. 1
SOFT CHECK: IF E13 = M AND E13a = M; Your response to this question is important. Please
provide a response and continue.
To continue to the next question without providing a response, click the continue button.
SOFT CHECK: IF E13 = 0 OR E13 GT 80; You said you worked [FILL E13] hours per week, is that
correct? Please check that this is correct and either keep your answer or change your answer
to continue.
To keep your answer without making changes, click the continue button.
PROGRAMMER SKIP BOX E13a.1
IF (E13 = 0, M) AND (E13a = 1, M), CONTINUE TO E13b;
IF E13a GT 0 AND (E13a = 1, M), SKIP TO E14;
Prepared by Mathematica Policy Research
48
9-30-15
(E13 = 0, M) AND (E13a = 1, M)
IF E10 = 2; ELSE worked / that
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]?
Select 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 ..................................................................... 7
40 or more hours per week ................................................................................... 8
NO RESPONSE ................................................................................................... M
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]?
If you [work / worked] less than one day per week, please enter one (1).
Days per week
(RANGE 1-7)
NO RESPONSE ................................................................................................... M
HARD CHECK: IF E14 = 0 OR E14 GT 7; Please provide a response between 1 and 7 to continue.
Prepared by Mathematica Policy Research
49
9-30-15
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)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF E15 = M; Your response to this question is important. Please briefly describe
what [they / you] make, do, or sell.
To continue to the next question without providing a response, click the continue button.
SLOT #1 IF EF3 = 1 OR IF (EF3 = 2 AND E1 = 0 OR M AND E4 = 0, M) (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)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF E16 = M; Your response to this question is important. Please briefly describe
your duties.
To continue to the next question without providing a response, click the continue button.
Prepared by Mathematica Policy Research
50
9-30-15
SLOT #2 ONLY IF EF3 = 2 – 4
DISPLAY OPTION 1 ONLY IF C3, C7, OR C10 = 4 OR (D1 = 1)
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]?
Select all that apply
You were referred or helped by:
YouthBuild ............................................................................................................ 1
State employment agency or state job service..................................................... 2
Private employment agency ................................................................................. 3
Friends, relatives, or colleagues ........................................................................... 4
A union.................................................................................................................. 5
You searched for this job by looking at:
Want ads, newspaper ads, or the local paper ...................................................... 6
The Internet .......................................................................................................... 7
You heard about it from:
A former employer ................................................................................................ 8
School ................................................................................................................... 9
A job fair................................................................................................................ 10
You found this job some other way (SPECIFY) ................................................... 99
Specify
(STRING 255)
NO RESPONSE ................................................................................................... M
SPECIFY TEXT: Please specify what else you did to find this job:
Prepared by Mathematica Policy Research
51
9-30-15
ALL JOBS
are / at IF E10 = 2; ELSE were / when you left
E18.
How much [are / were] you making [at / when you left] [JOB NAME]? Please include tips,
commissions, and regular overtime.
Amount
Pay Period
Please Select▼
(RANGE 0-999,999)
AMOUNT NO RESPONSE................................................................................... M
UNIT NO RESPONSE .......................................................................................... M
E18a.
Check here if you have not yet been paid. ...................................................... 1
PROGRAMMER:
USE THESE OPTIONS
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
SOFT CHECK: IF AMOUNT = 0; If you have not been paid yet, check the box below.
To continue to the next question without making changes, click the continue button.
SOFT CHECK: IF AMOUNT = M AND UNIT = 1 – 8; Please provide the amount you [are / were]
paid.
To continue to the next question without making changes, click the continue button.
SOFT CHECK: IF AMOUNT = 1 – 999,999 AND UNIT = M; Please choose a pay period.
To continue to the next question without making changes, click the continue button.
HARD CHECK: IF (AMOUNT GT 0 OR UNIT = 1 – 9) AND E18a = 1; You provided a number or pay
period and checked the box indicating you have not yet been paid. Please uncheck the box to
continue.
Prepared by Mathematica Policy Research
52
9-30-15
PROGRAMMER SKIP BOX E18a.1.
IF E18_AMOUNT = M OR E18_UNIT = M OR (E18_AMOUNT GT 0 AND E18_UNIT = 7 –
9), CONTINUE TO E18b;
IF (E18_AMOUNT GT 0 AND E18_UNIT = 1 – 7), SKIP TO E18c;
IF E18a = 1 OR E18_AMOUNT = 0, SKIP TO E19.
IF E18_AMOUNT = M OR E18_UNIT = M OR (E18_AMOUNT GT 0 AND E18_UNIT = 7 – 9)
E18b. Which of the following ranges best describes your annual pay at [JOB NAME]?
Your best estimate is fine.
Select 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 ............................................................... 6
$50,000 or more ................................................................................................... 7
NO RESPONSE ................................................................................................... M
IF (E18_AMOUNT 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 ............................................................................................................ 3
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
53
9-30-15
SLOT #1 IF EF3 = 1 OR IF (EF3 = 2 AND E1 = 0 OR M AND E4 = 0 OR M) (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]?
Select one per row
Yes
No
a. Health insurance
1
0
b. Paid vacation
1
0
c.
1
0
d. Paid sick leave
1
0
e. Retirement or pension benefits
1
0
f.
1
0
Paid holiday
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.
Prepared by Mathematica Policy Research
54
9-30-15
ALL
FILL STATE WELFARE NAME
E20.
The next questions are about income support you or someone in your household may
have received. Please indicate if you or anyone in your household received any of the
following in the past 12 months.
Select one per row
Yes
No
I don’t
know
a. TANF or welfare
1
0
2
b. Unemployment insurance
1
0
2
c.
1
0
2
d. WIC or the Special Supplemental Food Program
for Women, Infants, and Children
1
0
2
e. SSI or Social Security Retirement, Disability, or
Survivor’s benefits
1
0
2
f.
1
0
2
g. Assistance with utilities such as gas, electricity, or
water
1
0
2
h. Child support
1
0
2
i.
Money from family or friends
1
0
2
j.
Any other type of income support (SPECIFY)
1
0
SNAP or Food Stamps
Payments for providing foster care
(STRING 255)
SPECIFY TEXT: Please specify the other type of income support you or someone in your household
received in the past 12 months:
PROGRAMMER BOX E20.1.
IF ANY E20a-I = 1, CONTINUE TO E21;
IF E20j = 1 AND E20j_SPECIFY NE M (HAS A RESPONSE), CONTINUE TO E21;
IF NO ITEMS = 1, SKIP TO SECTION F;
IF ONLY E20j = 1 AND E20j_SPECIFY = M, SKIP TO SECTION F.
Prepared by Mathematica Policy Research
55
9-30-15
AT LEAST ONE AT E20a-i = 1 OR (E20j = 1 AND E20j_SPECIFY NE M)
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 indicate whether you, someone
else, or both you and someone else in your household received the income support.
Select one per row
You
Someone
else
Both you and
someone else
a. TANF or welfare
1
2
3
b. Unemployment insurance
1
2
3
c.
1
2
3
d. WIC or the Special Supplemental Food
Program for Women, Infants, and Children
1
2
3
e. SSI or Social Security Retirement, Disability,
or Survivor’s benefits
1
2
3
f.
1
2
3
g. Assistance with utilities such as gas,
electricity, or water
1
2
3
h. Child support
1
2
3
i.
Money from family or friends
1
2
3
j.
[FILL FROM E20j]
1
2
3
SNAP or Food Stamps
Payments for providing foster care
Prepared by Mathematica Policy Research
56
9-30-15
F. CRIMINAL JUSTICE INVOLVEMENT AND DELINQUENCY
ALL
F1.
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.
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
NO RESPONSE ................................................................................................... M
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?
NUMBER OF ARRESTS
(RANGE 0-99)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF F2 = 15-99; You said that you have been arrested or taken into custody for a
crime or illegal offense [FILL F2] times. Please check that this is correct and either keep your
answer or change your answer below.
To keep your answer without making changes, click the continue button.
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. Click here to go back and change your
answer about being arrested. You may also change your answer below.
To continue to the next question without making changes, click the continue button.
PROGRAMMER BOX F2.1
IF F1 = 1 AND F2 GT 0, CONTINUE TO F3;
IF F1 = 1 AND F2 = M, CONTINUE TO F3;
IF F1 = 1 AND F2 = 0 (AFTER SOFT CHECK), SKIP TO F4.
Prepared by Mathematica Policy Research
57
9-30-15
F1 = 1 (ARRESTED) AND (F2 GT 0 OR F2 = M)
F3.
Since [REF DATE], have you been charged with any of the offenses listed below?
Select one per row
Yes
No
a. A drug offense, such as possessing, selling, or
manufacturing drugs
1
0
b. Driving under the influence or driving while intoxicated
1
0
c.
1
0
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
e. A violent offense, such as physical or sexual assault, rape,
robbery, manslaughter, attempted murder, or murder
1
0
f.
1
0
Failure to pay child support
Some other offense not listed
(STRING 255)
SPECIFY TEXT: Please specify 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
GO TO F5
No ......................................................................................................................... 0
SKIP TO G1
NO RESPONSE ................................................................................................... M
SKIP TO G1
Prepared by Mathematica Policy Research
58
9-30-15
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?
Times
(RANGE 0-99)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF F5 = 15 - 99; You said that you have been convicted of or pled guilty to a crime
or illegal offense [FILL F5] times. Please check that this is correct and either keep your answer
or change your answer below.
To keep your answer without making changes, click the continue button.
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 you were convicted of or pled guilty to
a crime 0 times. Click here to go back and change your answer about being convicted of or
having pled guilty to a crime. You may also change your answer below.
To continue to the next question without making changes, click the continue button.
PROGRAMMER BOX F5.1
IF F4 = 1 AND F5 GT 0, CONTINUE TO F6;
IF F4 = 1 AND F5 = M, CONTINUE TO F6;
IF F4 = 1 AND F5 = 0 (AFTER SOFT CHECK), SKIP TO G1.
F4 = 1 AND (F5 GT 0 OR F5 = M)
F6.
Since [REF DATE], have you been convicted or found delinquent of or pled guilty to any of the
offenses listed below?
Select one per row
Yes
No
a. A drug offense, such as possessing, selling, or
manufacturing drugs
1
0
b. Driving under the influence or driving while intoxicated
1
0
c.
1
0
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
e. A violent offense, such as physical or sexual assault,
rape, robbery, manslaughter, attempted murder, or
murder
1
0
f.
1
0
Failure to pay child support
Some other offense not listed
(STRING 255)
SPECIFY TEXT: Please specify the other offense for which you were convicted or pled guilty:
Prepared by Mathematica Policy Research
59
9-30-15
F4 = 1 AND (F5 GT 0 OR F5 = M)
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
NO RESPONSE ................................................................................................... M
GO TO F10
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)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF F8 = 0, 15 - 99; You said that you have been sentenced [FILL F8] times. Please
check that this is correct and either keep your answer or change your answer below.
To keep your answer without making changes, click the continue button.
Prepared by Mathematica Policy Research
60
9-30-15
F7 = 1 (SENTENCED TO TIME)
F9.
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.
Amount
Unit
Please Select▼
(RANGE 0-99)
PROGRAMMER:
USE THESE UNIT OPTIONS
Days ...................................................................................................................... 1
Weeks ................................................................................................................... 2
Months .................................................................................................................. 3
Years .................................................................................................................... 4
AMOUNT NO RESPONSE ............................................................................ M
UNIT NO RESPONSE ................................................................................... M
F9a.
Check here if you were sentenced, but did not spend time in a group
home, reform school, juvenile or adult prison, jail, or other correctional
facility ............................................................................................................. 1
SOFT CHECK: IF AMOUNT = 0; Please provide an amount greater than 0 or check the box below
To continue to the next question without making changes, click the continue button.
SOFT CHECK: IF AMOUNT = M AND UNIT = 1 – 4; Please provide an amount and continue.
To continue to the next question without making changes, click the continue button.
SOFT CHECK: IF AMOUNT = 1 – 99 AND UNIT = M; Please select days, weeks, months or years.
To continue to the next question without making changes, click the continue button.
SOFT CHECK: IF AMOUNT GE 0 AND F9a = 1; You provided the amount of time you spent and
checked the box indicating did not spend any time. Please confirm the amount of time you
spent and uncheck the box to continue.
To continue to the next question without making changes, click the continue button.
Prepared by Mathematica Policy Research
61
9-30-15
F4 = 1 (CONVICTED) AND (F5 GT 0 OR F5 = M)
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:
Select one per row
Yes
No
a. Fines
1
0
b. Loss of driver’s license
1
0
c.
1
0
d. Probation
1
0
e. Parole
1
0
f.
1
0
Mandated community service
Some other sentence
(STRING 255)
SPECIFY TEXT: Please specify 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
62
9-30-15
F10d OR F10e = 1 (ON PROBATION OR PAROLE)
F11.
How long were you put on probation or parole? You may answer in days, weeks, months
or years.
Amount
Unit
Please Select▼
(RANGE 0-99)
PROGRAMMER:
USE THESE UNIT OPTIONS
Days ...................................................................................................................... 1
Weeks ................................................................................................................... 2
Months .................................................................................................................. 3
Years .................................................................................................................... 4
AMOUNT NO RESPONSE ............................................................................ M
UNIT NO RESPONSE ................................................................................... M
SOFT CHECK: IF AMOUNT = 0; Please provide an amount greater than 0.
To continue to the next question without making changes, click the continue button.
SOFT CHECK: IF AMOUNT = M AND UNIT = 1 – 4; Please provide an amount and continue.
To continue to the next question without making changes, click the continue button.
SOFT CHECK: IF AMOUNT = 1 – 99 AND UNIT = M; Please select days, weeks, months or years.
To continue to the next question without making changes, click the continue button.
F10d OR F10e = 1 (ON PROBATION OR PAROLE)
F12.
Are you still on probation or parole?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
63
9-30-15
G. SOCIAL AND EMOTIONAL DEVELOPMENT
ALL
G1.
The next questions ask about how you feel about yourself. Below is a list of statements
dealing with your general feelings about yourself. Please indicate if you strongly agree,
agree, disagree, or strongly disagree.
Select one per row
Strongly
Agree
Agree
Disagree
Strongly
Disagree
a. I feel that I’m a person of worth, at least on
an equal plane with others
1
2
3
4
b. I feel that I have a number of good qualities
1
2
3
4
All in all, I am inclined to feel that I am a
failure
1
2
3
4
d. I am able to do things as well as most other
people
1
2
3
4
e. I feel I do not have much to be proud of
1
2
3
4
f.
I take a positive attitude towards myself
1
2
3
4
g. On the whole, I am satisfied with myself
1
2
3
4
h. I wish I could have more respect for myself
1
2
3
4
i.
I certainly feel useless at times
1
2
3
4
j.
At times I think I am no good at all
1
2
3
4
c.
ALL IF OMBFLAG=1
G2.
The next questions are about how you feel about things that happen to you. Please
indicate if you strongly agree, agree, disagree, or strongly disagree.
Select one per row
Strongly
Agree
Agree
Disagree
Strongly
Disagree
a. I have little control over the things that
happen to me
1
2
3
4
b. There is really no way I can solve some
problems I have
1
2
3
4
1
2
3
4
d. What happens to me in the future depends
on me
1
2
3
4
e. I can do just about anything I really set my
mind to
1
2
3
4
f.
1
2
3
4
c.
Sometimes I feel like I am being pushed
around in life
If I am in trouble, I usually think of a solution
Prepared by Mathematica Policy Research
64
9-30-15
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?
Select one only
Most people can be trusted .................................................................................. 1
Can’t be too careful .............................................................................................. 2
NO RESPONSE ................................................................................................... M
ALL
G4.
Do you agree or disagree with the following statements about your current relationships
with family and friends?
Select one per row
Strongly
Agree
Agree
Disagree
Strongly
Disagree
a. There are people I know who will help me if I
really need it
1
2
3
4
b. There is no one I feel comfortable talking
about problems with
1
2
3
4
1
2
3
4
d. If something went wrong, no one would help
me
1
2
3
4
e. I have a trustworthy person to turn to if I have
problems
1
2
3
4
1
2
3
4
c.
f.
I am with a group of people who think the
same way I do about things
There is no one who likes to do the things I
do
Prepared by Mathematica Policy Research
65
9-30-15
H. IDENTITY DEVELOPMENT
ALL
H1.
The next questions are about how you make decisions and solve problems.
Please read the following statements and rate how strongly you agree or disagree with
each one.
Select one per row
Strongly
Agree
Agree
Disagree
Strongly
Disagree
a. Difficult problems make you very upset
1
2
3
4
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
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. 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
e. When making decisions, you generally use
a systematic method for judging and
comparing alternatives
1
2
3
4
1
2
3
4
c.
f.
After carrying out a solution to a problem,
you usually try to analyze what went right
and what went wrong
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?
Select one only
$80 tomorrow ........................................................................................................ 1
$100 three months from now ................................................................................ 2
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
66
9-30-15
ALL IF OMBFLAG=1
H3.
In the past month, have you paid any money you owed, such as credit card debt or loans?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
Does not apply, I do not have any debt ................................................................ 98
NO RESPONSE ................................................................................................... M
ALL
H4.
The next questions 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
NO RESPONSE ................................................................................................... M
IF H4 = 1
H5a.
Since [REF DATE], about how often have you volunteered? You can answer with the
number of hours per week, month, or year.
PROGRAMMER:
INSERT DROPDOWN
PROGRAMMER:
RANGE IS 00 – 150
Number of hours Per Week, Month, or Year
Please Select▼
PROGRAMMER:
USE THESE UNIT OPTIONS
Per Week .............................................................................................................. 1
Per Month ............................................................................................................. 2
Per Year................................................................................................................ 3
AMOUNT NO RESPONSE................................................................................... M
UNIT NO RESPONSE .......................................................................................... M
Prepared by Mathematica Policy Research
67
9-30-15
ALL
H6.
Are you registered to vote in the U.S.?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
ALL
DISPLAY OPTION a ONLY IF H6 NE 0
H7.
Since [REF DATE] have you:
Select one per row
Yes
No
a. Voted in one or more elections?
1
0
b. Gotten involved in a national, state, or local political
effort or electoral campaign?
1
0
ALL IF OMBFLAG=1
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
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
68
9-30-15
ALL IF OMBFLAG=1
H9.
The next questions ask about things you might do in your community. In the past month,
how often have you done the following activities?
Select one per row
Not at all
A few
times a
month
A few
times a
week
Every day
a. Helped members of the community
1
2
3
4
b. Attended community meetings to help
improve the conditions within my
community
1
2
3
4
1
2
3
4
c.
Served as a positive role model for kids in
my neighborhood
IF A7 GT 0 (HAS CHILDREN0 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 [her or her/their] school?
Select one only
Not at all................................................................................................................ 1
A few times a month ............................................................................................. 2
A few times a week ............................................................................................... 3
Every day .............................................................................................................. 4
Not applicable, none of my children are enrolled in school .................................. NA
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
69
9-30-15
ALL
H11
The next questions are about things you do in a typical day. First, how many hours do you
usually sleep?
Select one only
Less than three hours ........................................................................................... 1
3 to 5 hours ........................................................................................................... 2
6 to 8 hours ........................................................................................................... 3
9 to 11 hours ......................................................................................................... 4
More than 11 hours .............................................................................................. 5
NO RESPONSE ................................................................................................... M
ALL
H12.
Thinking about a typical day, how many hours do you usually spend:
Select one per row
None or
Almost
None
One
Two or
Three
Four or
Five
Six or
More
a. Watching TV or listening to music
1
2
3
4
5
b. Hanging out
1
2
3
4
5
1
2
3
4
5
d. Reading or studying
1
2
3
4
5
e. In school or training
1
2
3
4
5
f.
1
2
3
4
5
1
2
3
4
5
c.
Playing video or computer games
or using the internet
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?
Select one only
Very happy............................................................................................................ 1
Pretty happy.......................................................................................................... 2
Not too happy ....................................................................................................... 3
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
70
9-30-15
I. HEALTH AND WELL-BEING
ALL
I1.
The next questions are about your general health.
In general, would you say your health is:
Select one only
Excellent ............................................................................................................... 1
Very good ............................................................................................................. 2
Good ..................................................................................................................... 3
Fair ........................................................................................................................ 4
Poor ...................................................................................................................... 5
NO RESPONSE ................................................................................................... M
ALL
or women’s health IF GENDER = FEMALE
I2.
Since [REF DATE], have you had…
Select one per row
Yes
No
a. An annual checkup including general health [or women’s
health]
1
0
b. A dental exam
1
0
c.
1
0
A flu shot
ALL
I3.
What age do you think you will live to?
YEARS OLD
(RANGE 0-999)
NO RESPONSE ................................................................................................... M
SOFT CHECK: IF I3 GT 100 OR LT 20; You said you think you will live to [FILL I3] years old.
Please check that this is correct and either keep your answer or change your answer below.
To continue to the next question without providing a response, click the continue button.
Prepared by Mathematica Policy Research
71
9-30-15
ALL
I4.
Over the last 2 weeks, how often have you been bothered by any of the following
problems?
Select one per row
Not at all
Several
days
More than
half the
days
Nearly
every day
a. Little interest or pleasure in doing things
1
2
3
4
b. Feeling down, depressed, or hopeless
1
2
3
4
1
2
3
4
d. Feeling tired or having little energy
1
2
3
4
e. Poor appetite or overeating
1
2
3
4
Feeling bad about yourself – or that you
are a failure and have let yourself or your
family down
1
2
3
4
g. Trouble concentrating on things, such as
reading the newspaper or watching
television
1
2
3
4
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
1
2
3
4
c.
f.
i.
Trouble falling or staying asleep, or
sleeping too much
Thoughts that you would be better off
dead, or of hurting yourself in some way
ANY 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?
Select one only
Not difficult at all ................................................................................................... 1
Somewhat difficult ................................................................................................ 2
Very difficult .......................................................................................................... 3
Extremely difficult ................................................................................................. 4
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
72
9-30-15
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
NO RESPONSE ................................................................................................... M
ALL
FILL IF I6 = 0, M: even if you aren’t in a gang
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
NO RESPONSE ................................................................................................... M
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.)
Select one only
Never .................................................................................................................... 1
Less than once ..................................................................................................... 2
Once ..................................................................................................................... 3
Twice .................................................................................................................... 4
Three to five times ................................................................................................ 5
Every day or almost every day ............................................................................. 6
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
73
9-30-15
ALL
I9.
Since [REF DATE], have you used or tried any of the following drugs?
Select one per row
Yes
No
a. Marijuana
1
0
b. Any kind of cocaine – including powder, freebase, or crack
cocaine
1
0
c.
Inhalants, such as glue or solvents
1
0
d. Pills without a doctor’s prescription
1
0
e. Any other type of illegal drug, such as methamphetamine, LSD,
PCP, ecstasy, mushrooms, speed, ice, or heroin
1
0
PROGRAMMER SKIP BOX I9.1
IF I8 = 2 – 6 OR ANY I9a-e = 1, CONTINUE.
ELSE SKIP TO SECTION J.
IF I8 = 2 – 6 OR ANY I9a – e = 1
drinking IF I8 = 2 – 6 AND ALL I9a-e = 0, M;
drug use IF I8 = 1, M 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 / drug use / drinking or drug use]
interfered with your responsibilities either at work or school, or something else?
Select one only
Never .................................................................................................................... 1
1 time .................................................................................................................... 2
More than 1 time ................................................................................................... 3
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
74
9-30-15
IF I8 = 2 – 6 OR ANY I9a – e = 1
drinking alcohol IF I8 = 2 – 6 AND ALL I9a-e = 0, M;
doing drugs IF I8 = 1, M 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 / doing drugs / drinking alcohol or doing drugs]?
Select one only
0 times .................................................................................................................. 1
1 time .................................................................................................................... 2
2 to 3 times ........................................................................................................... 3
4 to 5 times ........................................................................................................... 4
6 or more times ..................................................................................................... 5
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
75
9-30-15
J. ADDRESS AND CONTACT INFORMATION UPDATE
ALL
J1.
The next questions are 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.
What is your street address?
Please only enter your street address here. We will ask for your PO BOX or mailing address later.
Street Address 1
(STRING 200)
Street Address 2 or Apt
(STRING 200)
City
(STRING 200)
State/Territory
Select▼ (INSERT DROPDOWN)
Zip
(STRING 10)
SOFT CHECK: IF STREET ADDRESS 1 IS MISSING; Please enter your street address so we can
send your payment. To continue to the next question without providing a response, click the
continue button.
SOFT CHECK: IF CITY IS MISSING; Please enter your city. To continue to the next question
without providing a response, click the continue button.
ALL
J1a.
Is your mailing address the same as your street address?
Yes ........................................................................................................................ 1
SKIP TO J2
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
76
SKIP TO J2
9-30-15
J1a = 0
J1b.
What is your mailing address?
Address 1 or PO BOX
(STRING 200)
Address 2 or Apt
(STRING 200)
City
(STRING 200)
State/Territory
Select▼ (INSERT DROPDOWN)
Zip
(STRING 10)
SOFT CHECK: IF MAILING ADDRESS 1 IS MISSING; Please enter your mailing address so we
can send your payment. To continue to the next question without providing a response, click
the continue button.
SOFT CHECK: IF CITY IS MISSING; Please enter your city. To continue to the next question
without providing a response, click the continue button.
ALL
J2.
What is your cell phone number?
NO RESPONSE ................................................................................................... M
J2a.
Check here if you don’t have a cell phone ......................................................... 1
HARD CHECK: IF J2 HAS DATA ENTERED, BUT IS NOT 10 NUM DIGITS; The phone number
should be 10 digits. Please correct the number below.
PROGRAMMER BOX J2a.1
IF COMPLETE CELL PHONE ENTERED (REGARDLESS OF J2a CHECK BOX),
CONTINUE TO J3;
IF J2 = M, SKIP TO J4.
Prepared by Mathematica Policy Research
77
9-30-15
J2 HAS COMPLETE PHONE NUMBER ENTERED
J3a.
May we send you text messages? Message and data rates may apply.
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
ALL
J4.
What is your home phone number?
NO RESPONSE ................................................................................................... M
J4a.
Check here if you don’t have a home phone ..................................................... 1
HARD CHECK: IF J4 HAS DATA ENTERED, BUT IS NOT 10 NUM DIGITS; The phone number
should be 10 digits. Please correct the number below.
PROGRAMMER BOX J4a.1
IF COMPLETE HOME PHONE ENTERED (REGARDLESS OF J4a CHECK BOX),
CONTINUE TO J4_CELL;
IF J4 = M, SKIP TO J6.
J4_phone HAS COMPLETE PHONE NUMBER ENTERED
J4_cell.
Is this number, [FILL J4_phone], for a cell phone?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
78
9-30-15
J4 HAS COMPLETE PHONE NUMBER ENTERED
J5.
Whose name is that number listed under?
First name
(STRING 20)
Middle name
(STRING 20)
Last name
(STRING 20)
NO RESPONSE ................................................................................................... M
J5a.
Check here if you don’t know............................................................................. 1
PROGRAMMER BOX J5.1
IF J4_cell = 1, CONTINUE TO J5a;
ELSE, SKIP TO J6.
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
NO RESPONSE ................................................................................................... M
Prepared by Mathematica Policy Research
79
9-30-15
ALL
J6.
What is another phone number where you can be reached?
NO RESPONSE ................................................................................................... M
Check here if you don’t have another phone number ....................................... 1
J6a.
HARD CHECK: IF J6 HAS DATA ENTERED, BUT IS NOT 10 NUM DIGITS; The phone number
should be 10 digits. Please correct the number below.
PROGRAMMER BOX J6a.1
IF COMPLETE HOME PHONE ENTERED (REGARDLESS OF J6a CHECK BOX),
CONTINUE TO J7;
IF J6 = M, SKIP TO J8.
J6_phone HAS COMPLETE PHONE NUMBER ENTERED
J6_cell.
Is this number, [FILL J6_phone], for a cell phone?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
NO RESPONSE ................................................................................................... M
J6 HAS COMPLETE PHONE NUMBER ENTERED
J7.
Whose name is that number listed under?
First name
(STRING 20)
Middle name
(STRING 20)
Last name
(STRING 20)
NO RESPONSE ................................................................................................... M
J7a.
□ Check here if you don’t know .............................................................................. 1
PROGRAMMER BOX J7.1
IF J6_cell = 1, CONTINUE TO J7a;
ELSE, SKIP TO J8a.
Prepared by Mathematica Policy Research
80
9-30-15
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
NO RESPONSE ................................................................................................... M
ALL
J8a.
Are you planning on moving in the next 12 months?
Yes ........................................................................................................................ 1
No ......................................................................................................................... 0
GO TO J9
NO RESPONSE ................................................................................................... M
GO TO J9
J8a = 1
J8b.
Where will you be moving to?
Please complete as much as you know at this time even if it is just the city and state.
Street Address 1
(STRING 200)
Street Address 2
(STRING 200)
City
(STRING 200)
State/Territory
Select▼ (INSERT DROPDOWN)
Zip
(STRING 10)
NO RESPONSE ................................................................................................... M
PROGRAMMER: THIS DOES NOT HAVE TO BE A COMPLETE ADDRESS
Prepared by Mathematica Policy Research
81
9-30-15
ALL
J9.
What is the best E-mail address to reach you at?
E-Mail
(STRING 50)
NO RESPONSE ................................................................................................... M
J9a.
Check here if you don’t have an e-mail address ............................................ 1
HARD 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 J9a.1
IF A VALID E-MAIL IS ENTERED (REGARDLESS OF J9a CHECKBOX),
CONTINUE TO J10; ELSE, SKIP TO BOX J10a.1.
J9 IS HAS VALID E-MAIL ENTERED
J10.
If you have another Email address, what is it?
E-Mail
(STRING 50)
NO RESPONSE ................................................................................................... M
J10a.
Check here if you don’t have another e-mail address .................................... 1
HARD 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
82
9-30-15
SURVEY SUBMITTED
Acknowledgment of receipt page.
You will receive a gift card within the next few weeks to thank you for completing the
survey!
To stay informed about the study, please like us on Facebook by visiting our page. You
can also become a friend of our study representative, Pat Williams, at:
http://www.facebook.com/p.williams.2012.
Thank you again for your participation in the YouthBuild Research Project!
PROGRAMMER:
THE LINK FOR “PAGE” IS www.facebook.com/YouthBuildResearchProject
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
83
9-30-15
| File Type | application/pdf |
| File Title | YouthBuild 48-Month Follow Up Survey |
| Subject | WEB |
| Author | MATHEMATICA |
| File Modified | 2015-10-01 |
| File Created | 2015-09-30 |