Maricopa County - Evaluation Follow Up

2015 Census Test

2015 EFU short v3

Maricopa County - Evaluation Follow Up

OMB: 0607-0981

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19


Questionnaire Content Document for the Enumerator Instrument

for the 2015 Evaluation Followup



Question name

ATTEMPT TYPE

Question wording for in person housing unit respondent


Describe this contact attempt for <address>.

Response options

  • Personal visit

  • Outbound call attempt

  • Inbound call received

  • Message received

  • Not Attempted/Quit before dialing



Question name

RESP LOCATION

Question wording for in person housing unit respondent


Are you attempting to contact <partial address> or a proxy?



Response options

  • Attempting address

  • Attempting proxy



Question name

DATE OF CONTACT

Question wording for in person housing unit respondent


Enter the month and day of the contact attempt.


Response options

Capture date. Possibly use wheels for each component or whatever method is consistent with other screens. Default to the current date.



Question name

TIME OF CONTACT

Question wording for in person housing unit respondent


Enter the time when you made the contact attempt.

Response options

Capture time. Possibly use wheels for each component or whatever method is consistent with other screens. Include an AM/PM choice.



Question name

RESULT OF MESSAGE

Question wording for in person housing unit respondent


Result of voice or text message received:

Response options

  • Requests appointment; specifies date and time

  • All other





Question name

NUMBER CALLED

Question wording for in person housing unit respondent


N/A


Response options

Allow the enumerator to select from the case phones or add a phone number not on the list. If new phone is added then have a label field for the enumerator to identify if the Phone number is for the Household or the Proxy.



Question name

DIAL OUTCOME

Question wording for in person housing unit respondent


N/A

Response options

  • Someone Answers

  • Ring no answer

  • Answering machine/service – Message left

  • Answering machine/service – No message left

  • New number from recording

  • Normal busy/circuits busy

  • Fast or WATTS/FTS busy

  • Fax machine reached, no message sent

  • Number could not be completed as dialed

  • No signal or funny signal

  • Number not in service

  • Number changed, no new number given

  • Bad connection

  • Temporarily not in service

  • TDD or TYY reached

  • Number not dialed/Number misdialed

  • Other noncontact


If Other noncontact selected, display a write-in field with the label Specify.





Question name

VERIFY DIALED NUMBER

Question wording for in person housing unit respondent


Hello. My name is (your name) and I am from the U.S. Census Bureau. Have I reached <insert phone number selected from NUMBER CALLED>?

Response options

  • Yes

  • No



Question name

INTRO PHONE

Question wording for in person housing unit respondent

IF OUTBOUND CALL DISPLAY: I am calling about a very important survey.


IF INBOUND CALL DISPLAY: Thank you for returning my call. My name is <fill enumerator name> from the U.S. Census Bureau. I contacted your household concerning a very important survey.


Both: Are you the lady or gentleman of the house?


May I speak with someone at least 15 years old who lives here and knows about the people in the household? Would that be you?

Response options

  • Yes, Continue someone is available

  • No, Eligible person is not home now or not available now

  • No, Other outcome or problem interviewing household



Question name

ADDRESS VERIFY

Question wording for in person housing unit respondent


I’m calling to complete a Census questionnaire for <partial address>. This survey is authorized by Title 13 of the United States Code and your response is required by law. Our approval number from the Office of Management and Budget is XXXX-XXXX. All of the information you provide will remain confidential. The interview will take about 15 minutes. Is this: <fill CENSUSADDRESS>?

Response options

  • Yes

  • No



Question name

KNOW ADDRESS

Question wording for in person housing unit respondent


Do you know where <FULLCENSUSADDRESS> is?

Response options

  • Yes

  • No


If “Yes” then display a 125 character text box with the label Specify.



Question name

PHONE INBOUND

Question wording for in person housing unit respondent


In case we get disconnected, what phone number are you calling from?

Response options

Phone Number (separate by a hyphen with auto-tabbing)

  • Area code: 3-digit text box

  • Number: 3-digit text box

  • Exchange: 4-digit text box


Radio button:

  • Continue with interview



Question name

INTRO EFU

Question wording for in person housing unit respondent

Hello, I’m (your name) from the U.S. Census Bureau. Here is my identification. As part of the census, we are contacting households to make sure we counted everyone correctly. Here is a letter explaining our interview and information we will refer to later.



(Hand respondent letter.)


Is this <partial address>?


May I speak with someone at least 15 years old who lives here and knows about the people in the household? Would that be you?

Response options

  • Yes

  • No, not correct address

  • No contact with anyone

  • No, Eligible person is not home now or not available now



Screen name

INTRO PROXY EFU

Question wording for in person housing unit respondent

In person:

Hello, I’m (your name) from the U.S. Census Bureau. Here is my identification. As part of the census, we are contacting households to make sure we counted everyone correctly. Here is a letter explaining our interview and information we will refer to later.

(Hand respondent letter.)

May I ask you some questions about <partial address>?


Response options

  • Yes

  • No, address does not exist

  • No contact with proxy



Question name

INTRO PARTIAL

Question wording for in person housing unit respondent

Hello, I’m (your name) from the U.S. Census Bureau. (Show ID). May I speak to <RESP NAME>?

Response options

  • <RESP NAME> available

  • Contact made - <RESP NAME> unavailable

  • <RESP NAME> doesn’t exist/Respondent doesn’t know <RESP NAME>

  • No contact with anyone



Question name

PARTIAL REVIEW

Question wording for in person housing unit respondent

We previously completed some of the Census questionnaire for <PARTIAL CENSUS ADDRESS>. So far you have told me about:

<List each person on the roster>.



We will now resume where we left off.

Response options

(Radio button)

  • Resume



Question name

ADDRESS

Question wording for in person housing unit respondent

On <CENSUSDAY>, were you living or staying at <partial address>?

Response options

  • Yes

  • No


Screen name

RESP NAME

Question wording for in person housing unit respondent


What is your name?

Response options

Name:

  • First Name: 20-character text box

  • Middle Name: 20-character text box

  • Last Name: 20-character text box

  • Nickname: 20-character text box

  • Maiden Name: 20-character text box



Screen name

RESP PHONE

Question wording for in person housing unit respondent


What is the best phone number to reach you?

Response options

Allow the enumerator to select from all phones number with PHONEASSOC=HH or the ability to add a phone number with the label “Phone Number” if the option “Other” is selected.



Screen name

ANYONE

Question wording for in person housing unit respondent

Did anyone live at this address on <CENSUSDAY>?

Response options

  • Yes

  • No



Question name

OCCUPANCY

Question wording for in person housing unit respondent

On <CENSUSDAY>, was this unit vacant or occupied by a different household?

Response options

  • Vacant

  • Occupied by a different household

  • Not a housing unit





Question name

SPECIFIC UNIT STATUS

Question wording for in person housing unit respondent


Unit status on <CENSUSDAY>

Response options

  • Vacant – regular

  • Vacant – usual home elsewhere

  • Demolished/burned out

  • Cannot locate

  • Nonresidential

  • Empty mobile home/trailer site

  • Uninhabitable (open to elements, condemned, under construction)

  • Duplicate



Question name

VACANT DESCRIPTION EFU

Question wording for in person housing unit respondent


Now look at the calendar. Which category best describes this vacant unit as of <CENSUSDAY>?

Response options

  • For rent

  • Rented, not occupied

  • For sale

  • Sold, not occupied

  • For seasonal, recreational, or occasional use

  • For migrant workers

  • Other



Question name

A6

Question wording for in person housing unit respondent


Was <partial address> vacant or not occupied at anytime during 2015?

Response options

  • Yes, <partial address> was vacant or not occupied in 2015

  • No, someone always lived at <partial address> in 2015







Question name

A7

Question wording for in person housing unit respondent


Please look at the calendar. When was <partial address> vacant or not occupied in 2015?


Response options

  • We need a From: and a To: response. Prefill the year with 2015.

  • For user selectable elements, the default text before an answer is selected is left blank.


Month user selectable element containing only the name of the month (i.e., January, February, etc.) in chronological order (starts with December and goes to January).


User selectable elements containing:

  • 01-31 as the default if no month is selected

  • 01-30 if month = April, June, September, or November

  • 01-31 if month = January, March, May, July, August, October, December

  • 01-28 if month = February and year is 1900 or not divisible by 4

  • 01-29 if month = February and year is divisible by 4 and not 1900


Year drop down box: Starts with 2015 and ends with 2015



Screen name

WHO

Question wording for in person housing unit respondent


Do you know who lived at <partial address> on <CENSUS DAY>?

Response options

  • Yes

  • No



Screen name

OTHERS

Question wording for in person housing unit respondent


On <CENSUS DAY>, was there anyone else living or staying at <partial address>?

Response options

  • Yes

  • No





Screen name

PEOPLE EFU

Question wording for in person housing unit respondent

Besides you, what are the names of the other people who were living or staying here on <CENSUSDAY>? Enter a name on each screen until you have listed everybody everyone who was living or staying there.

Response options

Text boxes:

  • First Name: 20-character text box

  • Middle Name: 20-character text box

  • Last Name: 20-character text box

  • Nickname: 20-character text box

  • Maiden Name: 20-character text box


If one person is added then prompt resident for another name. with this question:

"Were there any other people living or staying <here/there> on <CENSUS DAY>?


If a second person is added then prompt resident for another name. with this question:

Any other person?


Enter a name on each screen until response to “Any other person?” is “No”





Screen name

B4

Question wording for in person housing unit respondent

Was there anyone who had another place to live but stayed <here/there> often aroud April 1, 2015?



So far you have told me about the following people:

<List of names>

Response options


  • Yes

  • No


If “Yes”, prompt respondent for a name.

Text boxes:

  • First Name: 20-character text box

  • Middle Name: 20-character text box

  • Last Name: 20-character text box

  • Nickname: 20-character text box

  • Maiden name: 20-character text box


Then ask “Any more people?” If yes, prompt respondent for another name.

Ask for another name until the response to “Any more people?” is “No”



Screen name

B5

Question wording for in person housing unit respondent

Around April 1, 2015, was there anyone who was staying <here/there> until they found a place to live?



So far you have told me about the following people:

<List of names>

Response options

  • Yes

  • No


If “Yes”, prompt respondent for a name.

Text boxes:

  • First Name: 20-character text box

  • Middle Name: 20-character text box

  • Last Name: 20-character text box

  • Nickname: 20-character text box

  • Maiden name: 20-character text box


Then ask “Any more people?” If yes, prompt respondent for another name.

Ask for another name until the response to “Any more people?” is “No”



Screen name

B6

Question wording for in person housing unit respondent

Were there any babies, foster children, or other children who stayed here around April 1, 2015 that you did not mention yet?



So far you have told me about the following people:

<List of names>

Response options

  • Yes

  • No


If “Yes”, prompt respondent for a name.

Text boxes:

  • First Name: 20-character text box

  • Middle Name: 20-character text box

  • Last Name: 20-character text box

  • Nickname: 20-character text box

  • Maiden name: 20-character text box


Then ask “Any more people?” If yes, prompt respondent for another name.

Ask for another name until the response to “Any more people?” is “No”



Screen name

B7

Question wording for in person housing unit respondent

Have I missed any relatives or unrelated people who lived or stayed <here/there> around April 1, 2015?



So far you have told me about the following people:

<List of names>

Response options

  • Yes

  • No


If “Yes”, prompt respondent for a name.

Text boxes:

  • First Name: 20-character text box

  • Middle Name: 20-character text box

  • Last Name: 20-character text box

  • Nickname: 20-character text box

  • Maiden name: 20-character text box


Then ask “Any more people?” If yes, prompt respondent for another name.

Ask for another name until the response to “Any more people?” is “No”





Screen name

E1

Question wording for in person housing unit respondent

Was there anyone else living or staying at <partial address> during January, February, or March 2015 who is no longer living <here/there>?



So far you have told me about the following people:

<List of names>

Response options

  • Yes

  • No


If “Yes”, prompt respondent for a name.

Text boxes:

  • First Name: 20-character text box

  • Middle Name: 20-character text box

  • Last Name: 20-character text box

  • Nickname: 20-character text box

  • Maiden name: 20-character text box


Then ask “Any more people?” If yes, prompt respondent for another name.

Ask for another name until the response to “Any more people?” is “No”





Screen name

ROSTER_REVIEW

Question wording for in person housing unit respondent

Based on what you’ve told me so far, the names I have listed are:

<names>



Is this list correct?

You will not be able to change this list later.

Response options

Yes

No



Screen name

ROSTER_EDIT

Question wording for in person housing unit respondent

What type of correction needs to be made? You can change spelling, add additional people, or remove someone from the list.

Response options

(Check boxes)

Change spelling

Add additional people

Remove someone



Screen name

ROSTER_REVIEW2

Question wording for in person housing unit respondent

Based on what you’ve told me so far, the names I have listed are:



<names>



Is this updated list correct?

You will not be able to change this list later.

Response options

Yes

No



Question name

SEX

Question wording for in person housing unit respondent

Are you male or female?

Response options

  • Male

  • Female



Question name

DATE OF BIRTH

Question wording for in person housing unit respondent


What is <your/ roster name’s> date of birth?


Response options

  • For user selectable elements, the default text before an answer is selected is left blank.


Month user selectable element containing only the name of the month (i.e., January, February, etc.) in chronological order (starts with December and goes to January).


User selectable elements containing:

  • 01-31 as the default if no month is selected

  • 01-30 if month = April, June, September, or November

  • 01-31 if month = January, March, May, July, August, October, December

  • 01-28 if month = February and year is 1900 or not divisible by 4

  • 01-29 if month = February and year is divisible by 4 and not 1900


Year drop down box: Starts with 2015 and goes to 1889.

Question name

AGE

Question wording for in person housing unit respondent

What was <your/roster name’s> age on <CENSUSDAY>? If you don’t know the exact age, please estimate.


Make sure the respondent gives the age in completed years as of <CENSUSDAY>. Do not round up. Do not enter age in months. For babies less than 1 year old enter 0 as the age.


Response options

Write-in Box: [3] [this screen should only allow numeric entries.]


Label above the write-in box that reads “Age on <CENSUSDAY>”



Question name

CONFIRM AGE

Question wording for in person housing unit respondent

For the Census, we need to record age as of <CENSUSDAY>. So, just to confirm <you were/ ROSTER NAME was> <AGE/less than one year old> on <CENSUSDAY>?

Response options

  • Yes

  • No







Question name

CHANGE AGE


Question wording for in person housing unit respondent

What was <your/ROSTERNAME’s> age on <CENSUSDAY>? If you don’t know the exact age, please estimate.


Enter CORRECT age.


Make sure the respondent gives the CORRECT age in completed years as of <CENSUSDAY>. Do not round up. Do not enter age in months. For babies less than 1 year old enter 0 as the age.


Response options

Write-in Box: [3]


Label above the write-in box that reads “Age on <CENSUSDAY>”






Question name

CHANGE DATE OF BIRTH

Question wording for in person housing unit respondent

Since <your/ROSTERNAME’s> age as of <CENSUSDAY> was <CHANGE AGE>, can you help me correct <your/ROSTERNAME’s> date of birth?


I have <DOB – Convert to Month Day, Year>. What should it be?


Enter CORRECT date of birth.

Response options

Example:

[ Month] [Day] [ Year]


Month user selectable element containing only the name of the month (i.e., January, February, etc.) in chronological order.


Day drop down box containing:

  • 01-31 as the default if no month is selected

  • 01-30 if month = April, June, September, or November

  • 01-31 if month = January, March, May, July, August, October, December

  • 01-28 if month = February and year is 1900 or not divisible by 4

  • 01-29 if month = February and year is divisible by 4 and not 1900


Year user selectable element: Starts with 2015 and goes to 1889.



Question name

BABY FLAG

Question wording for in person housing unit respondent

For the Census, we need to record age as of <CENSUSDAY>. So, just to confirm, <ROSTER NAME> was born after <CENSUSDAY>?

Response options

  • Yes

  • No



Question name

C4

Question wording for in person housing unit respondent


Please look at the calendar on the back of the letter. During 2015, when did <you/<name>> live or stay at <partial address>?

Response options

  • We need a From: and a To: response. Prefill the year with 2015.

  • For user selectable elements, the default text before an answer is selected is left blank.


Month user selectable element containing only the name of the month (i.e., January, February, etc.) in chronological order (starts with December and goes to January).


User selectable elements containing:

  • 01-31 as the default if no month is selected

  • 01-30 if month = April, June, September, or November

  • 01-31 if month = January, March, May, July, August, October, December

  • 01-28 if month = February and year is 1900 or not divisible by 4

  • 01-29 if month = February and year is divisible by 4 and not 1900


Year drop down box: Starts with 2015 and ends with 2015



Question name

C5

Question wording for in person housing unit respondent


(Ask or Verify) During 2015, did <you/<name>> live at <partial address> all year, move, or go back and forth between addresses?

Response options

  • All year

  • Go back and forth

  • Move – was the move:

  • Before 4/1

  • On 4/1

  • After 4/1



Question name

C6

Question wording for in person housing unit respondent


(Ask or Verify) During 2015, did <you/<name>> stay at <partial address>?

Response options

  • Most of the time?

  • Half of the time?

  • Less than half of the time?

  • Short stays?

  • Daytime only, didn’t spend nights?

  • Certain days of the week?:

  • Sunday

  • Monday

  • Tuesday

  • Wednesday

  • Thursday

  • Friday

  • Saturday



Question name

C7

Question wording for in person housing unit respondent


(Ask or Verify) <Were you/Was <name>> staying at <partial address> on Wednesday, April 1st?

Response options

  • Yes

  • No



Screen name

RELATIVES

Question wording for in person housing unit respondent

Some people live or stay in more than one place and we would like to make sure everyone is only counted once.

Around <CENSUS DAY>, did you <,NAME2, NAME3, or NAME4, ETC.> sometimes live or stay somewhere else with a parent, grandparent, or other person?

Response options

  • Yes

  • No


Who? Check all that apply.

Check boxes – where the roster names are the response options

  • <roster name 1>

  • <roster name 2-n (if applicable)>



Screen name

COLLEGE HOUSING

Question wording for in person housing unit respondent

Around <CENSUSDAY>, were you <, NAME2, NAME3, or NAME4, etc.> living or staying somewhere else while attending college?

Response options

  • Yes

  • No


Who? Check all that apply.

Check boxes – where the roster names are the response options

  • <roster name 1>

  • <roster name 2-n (if applicable)>





Screen name

JOB

Question wording for in person housing unit respondent

Around <CENSUSDAY>, were you <, name2, name3, or name4 etc> sometimes living or staying somewhere else to be closer to a job (including military assignments)?

Response options

  • Yes

  • No


Who? Check all that apply.

Check boxes – where the roster names are the response options

  • <roster name 1>

  • <roster name 2-n (if applicable)>



Screen name

NURSING/GROUP HOME

Question wording for in person housing unit respondent

Around <CENSUSDAY>, did you <name2, name3, or name4 etc> sometimes stay in a place like a nursing home or a group home?

Response options

  • Yes

  • No


Who? Check all that apply.

Check boxes – where the roster names are the response options

  • <roster name 1>

  • <roster name 2-n (if applicable)>



Screen name

JAIL/PRISON

Question wording for in person housing unit respondent

Around <CENSUSDAY>, were you, < name2, name3, or name4 etc> staying in a jail or prison?

Response options

  • Yes

  • No


[Note: If “Yes, display the following]


Who? Check all that apply.

  • <roster name 1>

  • <roster name 2-n (if applicable)>



Screen name

SEASONAL

Question wording for in person housing unit respondent

Do you <, name2, name3, or name4, etc > sometimes live or stay at another home, like a seasonal or second residence? < Read if necessary> Do not include situations you have already told me about related to stays with parents, grandparents, or other persons, college housing, jobs, military service, or staying at nursing homes, prisons, or jails.

Response options

  • Yes

  • No

[Note: If “Yes”, display the following]


Who? Check all that apply.

Check boxes – where the roster names are the response options

  • <roster name 1>

  • <roster name 2-n (if applicable)>




Screen name

ANOTHER REASON

Question wording for in person housing unit respondent

Around <CENSUSDAY>, did you <name2, name3, name4, etc> sometimes live somewhere elsefor any reason other than those just mentioned? < Read if necessary> Do not include situations you have already told me about related to, stays with parents, grandparents, or other persons, college housing, jobs, military service, seasonal or second residences, or staying at nursing homes, prisons, or jails.

Response options

  • Yes

  • No


[Note: If “Yes, display the following]


Who? Check all that apply.

Check boxes – where the roster names are the response options

  • <roster name 1>

  • <roster name 2-n (if applicable)>



Screen name

FULLSTAY (D2)

Question wording for in person housing unit respondent


Please provide the full address <flag_location1> where <name> sometimes lived or stayed around April 1st <flag_location2>. Fill in as much information as the respondent can provide.

Response options

Address Type:

  • City Style

  • P.O. Box

  • Rural Route


If City Style is selected, then display:

House Number: 20-character text box

Street Name: 100-Character text box

Apt/Unit #: 52-character text box

City: 20-character text box

State: drop down menu with alphabetical states and District of Columbia

Zip: 5-character text box


If P.O. Box is selected:

P.O. Box #: 10-character text box

City: 20-character text box

State: drop down menu with alphabetical states and District of Columbia

Zip: 5-character text box


Please provide a physical address such as:

  • An address you would give to a shipping company if you wanted a package delivered to your home, or

  • An address you would provide if you were requesting emergency services such as a 911 call, or

  • A location description such as “The apartment over the Post Office on County Road 5” or “The blue house on the northeast corner of Main Street and First Avenue”.


Location Description: 250-character text box


If Rural Route is selected:

Rural Route Descriptor: drop down menu with the following options

  • RR

  • HC

  • SR

  • PSC

  • RTE

Rural Route #: 10-character text box

Box ID: 10-character text box

City: 20-character text box

State: drop down menu with alphabetical states and District of Columbia

Zip: 5-character text box


Please provide a physical address such as:

  • An address you would give to a shipping company if you wanted a package delivered to your home, or

  • An address you would provide if you were requesting emergency services such as a 911 call, or

  • A location description such as “The apartment over the Post Office on County Road 5” or “The blue house on the northeast corner of Main Street and First Avenue”.


Location Description: 250-character text box


  • If this is a 1-person household use “you” in the question stem instead of <person>.

  • Use the location flags (flag_location1 and flag_location2) from the Table below. Only one flag will be used for each person.



Location Flags

Response Option

flag_location1

flag_location2

flag_location3

  1. Seasonal

of the seasonal or second residence

N/A

seasonal or second residence

  1. Relatives

N/A

for the relatives address

Relatives address

  1. College housing

of the college housing

N/A

college housing address

  1. Job

N/A

for the job

job address

  1. Nursing home

of the nursing home

N/A

nursing home

  1. Prison or jail

of the prison or jail

N/A

prison or jail

  1. Another reason

N/A

for another reason

other place

Note: Due to the wording of the question stem in FULL STAY, different flags are needed for some of the location types so we create two flags for this screen (flag_location1 and flag_location2).







Question name

D3

Question wording for in person housing unit respondent


Is that place a house or apartment or another type of place like those show on List B on the back of the letter?

Response options

  • House/apartment/mobile home/condo/townhouse

  • College dorm/residence hall/sorority/fraternity house

  • Military barracks

  • Nursing home

  • Skilled nursing unit in assisted living

  • Independent/assisted living

  • Correctional facility

  • Group home

  • Other


If Other place is selected, display a write-in field with the label Specify.



Question name

D4

Question wording for in person housing unit respondent


Please look at the calendar on the back of the letter. During 2015, when did <you/<name>> live or stay at <newly collected ADDRESS>?

Response options

  • We need a From: and a To: response. Prefill the year with 2015.

  • For user selectable elements, the default text before an answer is selected is left blank.


Month user selectable element containing only the name of the month (i.e., January, February, etc.) in chronological order (starts with December and goes to January).


User selectable elements containing:

  • 01-31 as the default if no month is selected

  • 01-30 if month = April, June, September, or November

  • 01-31 if month = January, March, May, July, August, October, December

  • 01-28 if month = February and year is 1900 or not divisible by 4

  • 01-29 if month = February and year is divisible by 4 and not 1900


Year drop down box: Starts with 2015 and ends with 2015





Question name

D5

Question wording for in person housing unit respondent


(Ask or Verify) During 2015, did <you/<name>> live at that address all year, move, or go back and forth between addresses?

Response options

  • All year

  • Go back and forth

  • Move – was the move:

  • Before 4/1

  • On 4/1

  • After 4/1



Question name

D6

Question wording for in person housing unit respondent


(Ask or Verify) During 2015, did <you/<name>> stay at that address?

Response options

  • Most of the time?

  • Half of the time?

  • Less than half of the time?

  • Short stays?

  • Daytime only, didn’t spend nights?

  • Certain days of the week?:

  • Sunday

  • Monday

  • Tuesday

  • Wednesday

  • Thursday

  • Friday

  • Saturday



Question name

D7

Question wording for in person housing unit respondent


(Ask or Verify) Where <were you/was <name>> staying on Wednesday, April 1st?

Response options

  • <partial address>

  • <newly collected ADDRESS>

  • Some other place



Question name

ADDRESS CHECK

Question wording for in person housing unit respondent


How are you familiar with <FULLCENSUSADDRESS>?

Response options

  • Respondent used to live at address

  • Respondent knows someone who lives at address

  • Address needs a slight correction

  • Use this address for billing and shipping purposes

  • Not familiar



Question name

NO COMPLETE

Question wording for in person housing unit respondent


Thank you for your time. Why are you exiting this interview?

Response options

  • Eligible respondent not available

  • Inconvenient time – Need to set an appointment

  • Inconvenient time – No appointment made

  • Language Barrier

  • Hearing Barrier

  • Refusal by Respondent

  • Other


If other selected, display 200-character text box



Question name

APPOINTMENT TYPE

Question wording for in person housing unit respondent


Would you like me to call on the phone or come back in person?

Response options

  • Telephone appointment

  • In person appointment



Question name

WHO TO CALL

Question wording for in person housing unit respondent

Whom should I ask for when I call back?

Response options

Allow enumerator to select from a dropdown of roster entries or to add a new name (within a 42-character text box)



Question name

APPOINTMENT PHONE

Question wording for in person housing unit respondent


What is the best number for me to call back on?

Response options

Allow the enumerator to select from the case phones or add a phone number not on the list with the label “Phone Number”. If new phone is added then have a label field for the enumerator to identify if the Phone number is for the Household or the Proxy.



Question name

APPOINTMENT DATE

Question wording for in person housing unit respondent


What is the best date and time <fill>?

Response options

Capture date (month and day) using a calendar.



Question name

APPOINTMENT TIME

Question wording for in person housing unit respondent


What is the best date and time <fill>?


Display date selected from APPOINTMENT DATE and any appointments scheduled for that day



Question name

Language Barrier phone

Question wording for in person housing unit respondent


Please give me your phone number and someone may contact you?

Response options

(numeric keypad should be available to enter a phone number)


Phone Number (separate by a hyphen with auto-tabbing)

  • Area Code: 3-digit text box

  • Prefix: 3-digit text box

  • Suffix: 4-digit text box



Question name

Language Barrier

Question wording for in person housing unit respondent


In which language was the interview attempted?

Response options

(drop down box of languages with other option without text box)



Question name

Language BARRIER RESP

Question wording for in person housing unit respondent


What language does the respondent speak?

Response options

(drop down box of languages with other option without text box)



Question name

Refusal Reason

Question wording for in person housing unit respondent


What reasons were given for the refusal, if known?


Response options

  • Respondent too busy / doesn’t have time

  • Not interested / Does not want to be bothered

  • Survey is a waste of taxpayer money

  • Done enough other surveys

  • Claims they already completed questionnaire

  • Questions legitimacy of questionnaire

  • Privacy concerns

  • Scheduling difficulties

  • Survey is voluntary / Claims does not have to do questionnaire

  • Does not understand the questionnaire / Asks questions about the questionnaire

  • Anti-government concerns

  • Hang-up / Slammed door

  • Hostile Resp / dangerous situation / threatened enumerator

  • Breaks appointment (puts off enumerator indefinitely)

  • Other


If “other” selected, display a 200-character text box.



Question name

PERSONAL NON-CONTACT

Question wording for in person housing unit respondent


Select the best category to describe the personal visit.


Response options

  • No one home

  • No one home – appointment broken

  • No one home – Notice of Visit removed from last contact attempt

  • No one home appears vacant

  • Household does not answer door – evidence that someone is home

  • Unable to reach / locked gate / physical access denied

  • Not a housing unit/Away for duration of operation

  • Other


If “Other” is selected, display a 100-character text box with the label Specify.



Question name

PROXY NAME

Question wording for in person housing unit respondent


My final questions are about you, in case I or someone else from the Census Bureau needs to contact you again for additional information.


Ask or confirm.

What is your name?


Response options

Name:

  • First Name: 20-character text box

  • Middle Name: 20-character text box

  • Last Name: 20-character text box



Question name

PROXY PHONE

Question wording for in person housing unit respondent


N/A

Response options

If ATTEMPT TYPE=Outbound call attempt and RESP_TYPE=proxy:

  • Yes

  • No

If no, then the following question should be displayed as well as the text boxes to collect the phone number:

Ask or confirm. What is the best phone number to reach you?


If ATTEMPT TYPE=Inbound call received and RESP_TYPE=proxy:


Phone Number (separate by a hyphen with auto-tabbing)

  • Area Code: 3-digit text box

  • Prefix: 3-digit text box

  • Suffix: 4-digit text box



Question name

LOCATION OF PROXY

Question wording for in person housing unit respondent


N/A

Response options

Address Type:

  • City Style

  • Rural Route


If City Style is selected, then display:


[ ] <house number + street name + (unit designation) + city + state + zip>

{get this data from input files. Unit designation is not necessary but if it’s filled on input, then it should be used here. If the enumerator checks this box, then these address parts should be filled in the proxy address fields (PROXY_*) and PROXY_ADDRTYPE = CITY STYLE.}


House Number: 20-character text box

Street Name: 100-character text box

Apt/Unit #: 52-character text box

City: 20-character text box

State: drop down menu with alphabetical states and District of Columbia

Zip: 5-character numeric text box


Please provide a physical address such as:

  • An address you would give to a shipping company if you wanted a package delivered to your home, or

  • An address you would provide if you were requesting emergency services such as a 911 call, or

  • A location description such as “The apartment over the Post Office on County Road 5” or “The blue house on the northeast corner of Main Street and First Avenue”.


Location Description: 250-character text box


If Rural Route is selected:

Rural Route Descriptor: drop down menu with the following options

  • RR

  • HC

  • SR

  • PSC

  • RTE

Rural Route #: 10-character text box

Box ID: 10-character text box

City: 20-character text box

State: drop down menu with alphabetical states and District of Columbia

Zip: 5-character numeric text box


Please provide a physical address such as:

  • An address you would give to a shipping company if you wanted a package delivered to your home, or

  • An address you would provide if you were requesting emergency services such as a 911 call, or

  • A location description such as “The apartment over the Post Office on County Road 5” or “The brick house with the screened porch on the northeast corner of Main Street and First Avenue”.


Location Description: 250-character text box



Question name

TYPE OF PROXY

Question wording for in person housing unit respondent


N/A

Response options

  • Neighbor

  • Landlord or Property Manager (Owner, Rental Office Manager, etc.)

  • Real Estate Agent/Office

  • Relative of Household Member

  • Caregiver or Health Provider

  • In mover (moved in after <CENSUSDAY>)

  • Government Office or Worker (Tax Assessor, Letter Carrier, etc.)

  • Utility Worker (Meter Reader, Telephone Repair, Cable/Satellite, etc.)

  • Enumerator Personal Knowledge

  • Other


If Other, display a 125-character text box with the label Specify.



Question name

GOOD BYE

Question wording for in person housing unit respondent


That completes the interview. Thank you for your time and cooperation.



Question name

TRANSLATOR

Question wording for in person housing unit respondent


Was there a translator present?


Response options

  • Yes

  • No



Question name

ID TRANSLATOR

Question wording for in person housing unit respondent


Who was the translator?

Response options

  • <Insert all household members>

  • Another Enumerator

  • Neighbor

  • Local community member

  • Other


If “other” selected, display a 100-character text box with the label Specify.



Question name

LANGUAGE

Question wording for in person housing unit respondent

If TRANSLATOR= no:

What language was the interview conducted in?


If TRANSLATOR= yes:

What language was the interview translated from?

Response options

(drop down box of languages with other option with text box)


If “other” selected, display 35-character text box with the label Specify.



Question name

UNABLE TO INTERVIEW

Question wording for in person housing unit respondent

Select the best category to describe why an interview cannot be conducted at the census address for the length of the operation.


Response options

  • Demolished/burned out

  • Cannot locate

  • Nonresidential

  • Empty mobile home/trailer site

  • Uninhabitable (open to elements, condemned, under construction)

  • Address does not exist

  • Household away for duration of operation





Question name

STRATEGIES

Question wording for in person housing unit respondent

Did you leave a Notice of Visit?

Respondent’s User ID for this case is <CASE ID (formatted as XXXX-XXXX-XXXX)>.

Response options

  • Yes

  • No







Question name

UNSUCCESSFUL PROXY

Question wording for in person housing unit respondent


N/A

Response options

  • Neighbor

  • Landlord or Property Manager (Owner, Rental Office Manager, etc.)

  • Real Estate Agent/Office

  • Relative of Household Member

  • Caregiver or Health Provider

  • In mover (moved in after <CENSUS DAY>)

  • Government Office or Worker (Tax Assessor, Letter Carrier, etc.)

  • Utility Worker (Meter Reader, Telephone Repair, Cable/Satellite, etc.)

  • Other


If “other” is selected, display a 125-character text box with the label Specify.



Question name

CASE NOTES

Question wording for in person housing unit respondent


Enter any notes about the case in the text box.

Response options







File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKelly A Govern
File Modified0000-00-00
File Created2021-01-24

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