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Attachment A: Screening Testing Instruments and Protocols ………………………………………………. 2
Attachment B: Comparison to NCVS ……………………………………………………………………………………. 68
Attachment C: Preliminary Crime Incident Report Items for Cognitive Testing ....................... 73
Attachment D: NCVS‐1 (Non‐Screening Items) for Cognitive Testing …………………………………… 97
Attachment E: Recruitment Materials …………………………………………………………………………………. 101
Attachment F: Cues Examples Questionnaire ……………………………………………………………………… 107
Attachment G: Consent Form ……………………………………………………………………………………………… 111
NCVS Redesign: Cognitive Testing
ATTACHMENT A – SCREENER TESTING
INSTRUMENTS AND PROTOCOLS
Instrument Version 1 (page A2)
o Interviewer‐administered, Interleafed, Long Cues
Instrument Version 2 (page A18)
o Interviewer‐administered, Interleafed, Short Cues
Instrument Version 3 (page A32)
o Interviewer‐administered, Not Interleafed, Long Cues
Instrument Version 4 (page A44)
o Interviewer‐administered, Not Interleafed, Short Cues
Incident Data Sheet for Versions 3, 4 (page A52)
Screener Cognitive Interview Protocol (page A53)
Attachment A: Screener Testing Instruments and Protocols
A1
Instrument Version 1
Mode
Interleaf
Cue Length
Interviewer
Yes
Long
INTRO1. The questions will ask about things that happened to you in the past 12 months. First,
can you think of anything that happened that was important to you in (ANCHOR
MONTH/YEAR), such as a birthday, a vacation, a new job, or anything else, even a big story in
the news?
_______________________________________________________________________
_______________________________________________________________________
In this study, it is important to only report events that happened in the past 12 months. As you
think about what happened to you, please think carefully about whether it happened before or
after (ANCHOR DATE), and only report things that happened after this date.
INTRO2. This survey will cover the following types of things: theft; break‐ins; deliberate
damage to your property; physical attacks against you, personally; unwanted sexual contact;
being followed or stalked; being cheated out of something; and having your identity stolen.
For each topic, I’m going to ask several questions. We find that this helps remind people of
things they might not think of. I’m going to ask you to say yes or no after each question.
1. First I’ll ask about different things that might have been stolen from you. This may have
happened to you while you were at home, at work or school, or somewhere else. In the past 12
months…
Yes
No
a) Was something belonging to you stolen, such as things that you
carry, like a cell phone, money, a wallet, purse, or briefcase?
b) How about things that you wear, like clothing, jewelry, or shoes?
Yes
No
c) How about things in your home, like a TV, laptop, tools, or guns?
Yes
No
d) Still thinking about anything that was stolen in the past 12 months,
Yes
No
was anything stolen out of one of your vehicles, such as a package
or groceries?
e) Was anything stolen from your porch, lawn, garage, or other part
Yes
No
of your property, such as a bicycle, garden hose or lawn furniture?
(ASKED OF HOUSEHOLD RESPONDENT ONLY)
f) Was anything stolen belonging to the children who live here?
Yes
No
(ASKED OF HOUSEHOLD RESPONDENT ONLY)
g) Were any other things that belong to you stolen in the past 12
Yes
No
months?
Attachment A: Screener Testing Instruments and Protocols
A2
1h. In the past 12 months, did anyone TRY to steal anything belonging to you?
1
Yes
2
No
IF YES TO ANY IN #1a‐h, CONTINUE. ELSE GO TO #2.
1_1. How many times was something (IF #1=YES: stolen/IF #1a=YES: attempted to be
stolen) in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
1_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 1_2, COMPLETE 1_3.
1_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
A.
Did anyone break in, or try to break in, to your home or property as part of this
incident?
1
Yes
2
No
B.
Was there any damage to your property as part of this incident?
1
Yes
2
No
C.
Were you or was someone else from your household there when this happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO #2
3
Yes, both me and someone else – CONTINUE
4
No – GO TO #2
Attachment A: Screener Testing Instruments and Protocols
A3
D.
Were you physically attacked, or threatened with an attack, during this incident?
1
Yes ‐ CONTINUE
2
No – GO TO #2
E.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A4
2. The next few questions ask about break‐ins.
(IF A BREAK‐IN WAS REPORTED AS PART OF OTHER INCIDENTS, READ: You’ve already told me
about (a time/some times) when someone broke in or tried to break in to your home or
property. Other than what you have already mentioned,)
In the past 12 months… (ASKED OF HOUSEHOLD RESPONDENT ONLY)
a) Has anyone broken in or TRIED to break into your home by forcing a
Yes
No
door or window, pushing past someone, jimmying a lock, cutting a
screen, or coming through an open door or window?
b) Has anyone broken in or TRIED to break into your garage, shed, or
Yes
No
storage room?
c) Has anyone broken in or TRIED to break into a hotel or motel room or
Yes
No
vacation home where you were staying?
(IF YES TO ANY IN #2A‐C, CONTINUE. ELSE TO GO #3)
2_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
2_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 2_2, COMPLETE 2_3.
2_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
A.
Was there any damage to your property as part of this incident?
1
Yes
2
No
B.
Were any items or belongings stolen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A5
C.
Were you or was someone else from your household there when this incident
happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO #3
3
Yes, both me and someone else – CONTINUE
4
No – GO TO #3
D.
Were you physically attacked or threatened with an attack during this incident?
1
Yes ‐ CONTINUE
2
No – GO TO #3
E.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A6
3a. The next few questions ask about vehicles. What was the TOTAL number of cars, vans,
trucks, motorcycles, or other motor vehicles owned by you or any other member of this
household during the last 12 months? Include those you no longer own. (ASKED OF
HOUSEHOLD RESPONDENT ONLY)
______________
3b. In the past 12 months… (ASKED OF HOUSEHOLD RESPONDENT ONLY)
a) Was a vehicle you owned at the time stolen or used without
Yes
No
permission?
b) Did anyone steal any vehicle parts such as a tire, car stereo, GPS,
Yes
No
hubcap, or battery?
c) Did anyone steal any gas from a vehicle you own?
Yes
No
d) Did anyone TRY to steal a vehicle or vehicle parts?
Yes
No
(IF YES TO ANY IN #3A‐D, CONTINUE. ELSE SKIP TO #4)
3_1. How many times did this happen to you (or someone else in this household) in the past
12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
3_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 3_2, COMPLETE 3_3.
3_3. For the next questions, only focus on the incident when a vehicle was stolen in (MONTH
/YEAR).
A.
Was there any damage to your vehicle as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A7
B.
Other than the (vehicle theft/theft of vehicle parts), were any items or
belongings stolen from the vehicle, such as a cell phone, money, or any other items that
were in the vehicle?
1
Yes
2
No
C.
Were you or was someone else from your household there when this incident
happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO 3B
3
Yes, both me and someone else – CONTINUE
4
No – GO TO 3B
D.
Were you physically attacked or threatened with an attack during this incident?
1
Yes ‐ CONTINUE
2
No – GO TO 3B
E.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
No
2
Attachment A: Screener Testing Instruments and Protocols
A8
4. Now I'd like to ask about any acts of vandalism that may have been committed against you
and the other people living with you. Vandalism is when someone deliberately damages or
destroys something belonging to you. It does not include things that were done by accident.
Examples of vandalism are breaking windows, slashing tires, and painting graffiti on walls.
In the past 12 months, has anyone vandalized your home, car, or something else belonging to
you or someone else living here?
1
Yes ‐ CONTINUE
2
No – GO TO #5
4_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
4_2. In what month and year did (this/these events) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 4_2, COMPLETE 4_3.
4_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
A.
Were any items or belongings stolen as part of the incident?
1
Yes
2
No
B.
Were you or was someone else from your household there when this happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO #5
3
Yes, both me and someone else – CONTINUE
4
No – GO TO #5
C.
Were you physically attacked or threatened with an attack during this incident?
1
Yes ‐ CONTINUE
2
No – GO TO #5
Attachment A: Screener Testing Instruments and Protocols
A9
D.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
5. The next few questions ask about any physical attacks against you personally. These may
have happened at your home or while you were at work, at school, or away from home.
(IF ANY ATTACK WAS REPORTED AS PART OF OTHER INCIDENTS, READ: You’ve already told me
about (a time/some times) when you were recently attacked or someone threatened to attack
you. Other than what you’ve already mentioned,)
In the past 12 months…
a) Has anyone attacked or tried to attack you with a weapon, for
Yes
No
instance, a gun or knife?
b) Has anyone attacked or tried to attack you with something else
Yes
No
that was used as a weapon, like a baseball bat, scissors, or a stick?
c) Has anyone attacked or tried to attack you by throwing
Yes
No
something at you, such as a rock or bottle?
d) Has anyone attacked or tried to attack you by slapping, grabbing,
Yes
No
kicking, punching, or choking you?
e) Has anyone attacked, tried to attack, or used force against you in
Yes
No
any other way in the past 12 months? Please mention it even if
you are not certain it was a crime.
(IF YES TO ANY IN #5A‐E, GO TO 5_1. ELSE CONTINUE)
5f. (Other than incidents already mentioned,) In the past 12 months, did anyone THREATEN to
attack you, but not actually do it?
Yes ‐ CONTINUE
No – SKIP TO 5h
5g. (IF YES TO 5f) How were you threatened? Was it face‐to‐face, by phone or text, or online?
1
Face‐to‐face
2
By phone or text
3
Online
4
Some other way (e.g., by mail, to a third party)
Attachment A: Screener Testing Instruments and Protocols
A10
(IF FACE‐TO‐FACE IN 5G, SKIP TO 5_1. ELSE CONTINUE)
5h. People sometimes don’t think of attacks by someone they know, like a current or former
spouse or partner, someone at work, a friend, or a family member. (Other than incidents
already mentioned,) Has anyone YOU KNOW used any kind of physical force against you in the
past 12 months? Examples are if someone you know choked you, slapped you, hit you with
something other than a fist, attacked you with a weapon, or otherwise physically hurt you.
1
Yes ‐ CONTINUE
2
No – GO TO #6
5_1. How many times were you attacked or threatened in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
5_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 5_2, COMPLETE 5_3.
5_3. For the next question, focus only on the incident that happened in (MONTH/YEAR).
A.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A11
6. Now I’d like to ask about any sexual contact in the past 12 months that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen. I want to remind you that the
information you provide is confidential.
Sexual contact includes someone touching your private parts, unwanted kissing, or penetrating
your (IF FEMALE: vagina or)/(ALL: anus) with a penis, mouth, tongue, fingers, or object. This
could have been done by someone you know well, someone you casually know, or a stranger.
(IF ANY SEXUAL CONTACT WAS REPORTED ALREADY, READ: You’ve already told me about (a
time/some times) when someone had, or tried to have, sexual contact with you that you DID
NOT CONSENT TO and that you DID NOT WANT to happen. Other than what you’ve already
mentioned,)
In the past 12 months…
a) Did anyone forcibly touch or grab your private parts – or TRY to
Yes
No
do this?
b) Did anyone force you to have sexual contact by holding you down
Yes
No
with his or her body weight, pinning your arms, hitting or kicking
you, or using some other type of force – or TRIED to do this?
c) Did anyone threaten to hurt you or someone close to you if you
Yes
No
did not have sexual contact?
d) Did anyone have sexual contact with you – or try to have sexual
Yes
No
contact with you – while you were passed out, unconscious,
blacked out, asleep, or unable to consent because you were
drunk or high?
(IF YES TO ANY IN 6A‐D, CONTINUE. ELSE GO TO #7)
6_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
6_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
Attachment A: Screener Testing Instruments and Protocols
A12
7. Now, I would like to ask you about other types of unwanted contacts or behaviors. When
answering, please think about anyone who may have done these things, including a current or
former spouse or partner, other people you may know, or strangers. However, please DO NOT
include bill collectors, solicitors, or sales people.
In the past 12 months…
a. Has anyone followed you around and watched you?
Yes
No
b. Has anyone sneaked into your home, car, or any other place and
Yes
No
did unwanted things to let you know they had been there?
c. Has anyone waited for you at your home, work, school, or any
Yes
No
other place when you didn’t want them to?
d. Still thinking about unwanted contacts and behaviors, in the past
Yes
No
12 months, has anyone showed up, rode or drove by places where
you were when they had no business being there?
e. Has anyone left or sent you unwanted items, cards, letters,
Yes
No
presents, flowers, or any other unwanted items?
f. Has anyone harassed or repeatedly asked your friends or family for
Yes
No
information about you or your whereabouts?
The next questions are about unwanted contacts or behaviors using various technologies, such
as your phone, the Internet, or social media apps. Again, please DO NOT include contacts from
bill collectors, solicitors, or sales people. In the past 12 months…
Yes
No
g. Has anyone made unwanted phone calls to you, left voice
messages, sent text messages, or used the phone excessively to
contact you?
h. Has anyone spied on you or monitored your activities using
Yes
No
technologies such as a listening device, camera, or computer or cell
phone monitoring software?
i. Has anyone tracked your whereabouts with an electronic tracking
Yes
No
device or application, such as GPS or an application on your cell
phone?
j. Still thinking about unwanted contacts and behaviors, in the past 12
Yes
No
months has anyone posted or threatened to post inappropriate,
unwanted, or personal information about you on the Internet? This
includes private photographs, videos, or spreading rumors.
k. Has anyone sent unwanted e‐mails or messages using the Internet,
Yes
No
for example, using social media apps or websites like Instagram,
Twitter, or Facebook?
l. Has anyone monitored your activities using social media apps like
Yes
No
Instagram, Twitter, or Facebook?
(IF YES TO ANY IN 7A‐L, CONTINUE. ELSE GO TO #8)
Attachment A: Screener Testing Instruments and Protocols
A13
7n. Has anyone done (this/any of these things) to you more than once in the past 12 months?
1 Yes ‐ CONTINUE
2 No – GO TO #8
7o. Did any of these unwanted contacts or behaviors make you fear for your safety or the
safety of someone close to you?
1 Yes
2 No
7p. Did any of these unwanted contacts or behaviors cause you substantial emotional distress?
1 Yes
2 No
7q. IF ANY INCIDENTS REPORTED EARLIER: Were any of these unwanted contacts or behaviors
done by the same person(s) who carried out any of the other incidents you’ve mentioned
today?
1
2
Yes
No
Attachment A: Screener Testing Instruments and Protocols
A14
8. The next items are about whether anyone got you to give them money by lying about a
product or service, or by deliberately hiding information about it from you. In the past 12
months...
a. Did you pay for something or a service that you never got, or that
Yes
No
was fake or worthless?
b. Were you told you won something, such as a prize or lottery, but
Yes
No
you had to pay money in order to collect it, or you never got it or it
was fake or worthless?
c. Were you told you would get a high return on an investment you
Yes
No
made, but it was fake or worth far less than you were led to expect?
d. Did you pay someone to help you improve your credit or finances,
Yes
No
but then not receive what you were promised?
e. Did you donate money to an organization you thought was a
Yes
No
charity, but which turned out to be fake?
f. Did you put money into a business opportunity, but it was fake or
Yes
No
you earned much less than you were led to expect?
g. Did you send money to help someone who told you they urgently
Yes
No
needed money, but it turned out their story wasn’t true?
h. Did you send money to someone who pretended to need help
Yes
No
moving money from another country, but they just kept your money?
i. Were there any other times in the past 12 months when someone
Yes
No
got you to give them money by lying about a product or service, or by
deliberately hiding information from you?
j. Thinking about all the situations I just asked you about, did anyone
Yes
No
TRY anything (else) like this on you in the past 12 months, but you did
not send them any money?
(IF YES TO ONLY ONE IN #8A‐J, CONTINUE. IF YES TO MORE THAN ONE IN #8A‐J, GO TO #8B.
ELSE GO TO #9)
8a. In the past 12 months, did this happen to you once or more than once?
1
Once – GO TO #9
2
More than once– CONTINUE
8b. Were these all done by the same people or company, or were these done by different
people or different companies?
1
Same
2
Different
Attachment A: Screener Testing Instruments and Protocols
A15
9. Now I’d like to ask you about any times someone used your personal information without
your permission for their own benefit. In the past 12 months…
Yes
No
Does not
a) Did someone, without your permission, use or try to use
your existing checking or savings account, including any debit
apply
or ATM cards?
b) Did someone use or try to use one or more of your existing
Yes
No
Does not
credit cards without your permission? Please do not include
apply
debit cards.
c) Did someone misuse or try to misuse another type of
Yes
No
existing account, such as your telephone, utilities, an online
payment account like Paypal, insurance policies, or
something else?
d) Still thinking about the past 12 months, did someone,
Yes
No
without your permission, use or try to use your personal
information to open any NEW accounts, such as wireless
telephone accounts, credit card accounts, loans, bank
accounts, online payment accounts, or something else?
e) Did someone use or try to use your personal information
Yes
No
for some other fraudulent purpose, such as getting medical
care, a job, or government benefits; renting an apartment or
house; giving your information to the police when they were
charged with a crime or traffic violation, or something else?
(IF YES TO ONLY ONE IN #9A‐E, CONTINUE. IF YES TO MORE THAN ONE IN #9A‐E, GO TO #9B.
ELSE GO TO INTRO BEFORE #10)
9a.
In the past 12 months, did this happen to you once, or more than once?
1
Once – GO TO #9C
2
More than once – CONTINUE
9b. Were these all done by the same person, or were these done by different people?
1
Same
2
Different
9c. IF ANY INCIDENTS REPORTED EARLIER: (Was this/Were any of these) done by the same
person(s) who carried out any of the other incidents you’ve mentioned today?
1
2
Yes
No
Attachment A: Screener Testing Instruments and Protocols
A16
INTRO BEFORE #10: Before we move on, I’d like to review the different incidents that you’ve
reported to me.
GO BACK THROUGH RESPONSES TO QUESTIONS 1‐9 AND REVIEW WHAT HAPPENED IN EACH.
Example:
A break‐in in May 2015 in which some belongings were stolen, and you were attacked.
Another break‐in in December 2015, in which there was some vandalism.
A theft in October 2015
A theft in January 2015 when you were attacked.
10. I want to make sure we’ve captured everything that has happened to you. At the beginning
of this survey, you recalled that {RESPONSE TO INTRO1} occurred around (ANCHOR DATE). Is
there anything (else) that you might think of as a crime that happened to you in the past 12
months that you haven’t mentioned? It could be something you called the police about, or
something you didn’t consider reporting to the police.
1
Yes – CONTINUE
2
No – GO TO END
10a. What happened?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Thank you. Now I’d like to ask you some questions about the questions you just answered.
(INTERVIEWER – GO TO PROTOCOL TO ASK COGNITIVE PROBES)
Attachment A: Screener Testing Instruments and Protocols
A17
Instrument Version 2
Mode
Interleaf
Cue Length
Interviewer
Yes
Short
INTRO1. The questions will ask about things that happened to you in the past 12 months. First,
can you think of anything that happened that was important to you in (ANCHOR
MONTH/YEAR), such as a birthday, a vacation, a new job, or anything else, even a big story in
the news?
_______________________________________________________________________
_______________________________________________________________________
In this study, it is important to only report events that happened in the past 12 months. As you
think about what happened to you, please think carefully about whether it happened before or
after (ANCHOR DATE), and only report things that happened after this date.
INTRO2. This survey will cover the following types of things: theft; break‐ins; deliberate
damage to your property; physical attacks against you, personally; unwanted sexual contact;
being stalked; being cheated out of something; and having your identity stolen.
1. First I’ll ask about different things that might have been stolen from you. In the past 12
months, was something belonging to you or your children under 12 stolen? This might include
things like money, jewelry, clothing, cell phones, TVs or other electronics, or any other items
belonging to you.
1
2
Yes
No
1a. Did anyone attempt to steal anything belonging to you?
1
Yes
2
No
IF YES TO EITHER #1 OR #1a, CONTINUE. ELSE GO TO #2.
1_1. How many times was something (IF #1=YES: stolen/IF #1a=YES: attempted to be
stolen) in the past 12 months?
1
Once
Attachment A: Screener Testing Instruments and Protocols
A18
2
Twice
3
Three times
4
Four or more times
1_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 1_2, COMPLETE 1_3.
1_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
A.
Did anyone break in, or try to break in, to your home or property as part of this
incident?
1
Yes
2
No
B.
Was there any damage to your property as part of this incident?
1
Yes
2
No
C.
Were you or was someone else from your household there when this happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO #2
3
Yes, both me and someone else – CONTINUE
4
No – GO TO #2
D.
Were you physically attacked, or threatened with an attack, during this incident?
1
Yes ‐ CONTINUE
2
No – GO TO #2
E.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A19
2. The next few questions ask about break‐ins. (IF A BREAK‐IN WAS REPORTED AS PART OF
OTHER INCIDENTS, READ: You’ve already told me about (a time/some times) when someone
broke in or tried to break in to your home or property. Other than what you have already
mentioned,)
In the past 12 months, did anyone break in or try to break into your home, your garage or shed,
or a hotel or motel room or vacation home where you or someone else in this household were
staying by forcing a door or window, pushing past someone, jimmying a lock, cutting a screen,
or entering through an open door or window?
1
Yes ‐ CONTINUE
2
No – GO TO #3
2_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
2_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 2_2, COMPLETE 2_3.
2_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
A.
Was there any damage to your property as part of this incident?
1
Yes
2
No
B.
Were any items or belongings stolen as part of this incident?
1
Yes
2
No
C.
Were you or was someone else from your household there when this incident
happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO #3
3
Yes, both me and someone else – CONTINUE
Attachment A: Screener Testing Instruments and Protocols
A20
D.
4
No – GO TO #3
Were you physically attacked or threatened with an attack during this incident?
1
Yes ‐ CONTINUE
2
No – GO TO #3
E.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A21
3A. The next few questions ask about vehicles. In the past 12 months, did you or anyone else in
this household have a car, van, truck, motorcycle, or other motor vehicle stolen or used without
permission?
1
Yes ‐ CONTINUE
2
No – GO TO 3B
3A_1. How many times did this happen to you (or someone else in this household) in
the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
3A_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 3A_2, COMPLETE 3A_3.
3A_3. For the next questions, only focus on the incident when a vehicle was stolen in (MONTH
/YEAR).
A.
Was there any damage to your vehicle as part of this incident?
1
Yes
2
No
B.
Other than the vehicle theft itself, were any items or belongings stolen from the
vehicle, such as a cell phone, money, or any other items that were in the vehicle?
1
Yes
2
No
C.
Were you or was someone else from your household there when this incident
happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO 3B
3
Yes, both me and someone else – CONTINUE
Attachment A: Screener Testing Instruments and Protocols
A22
D.
4
No – GO TO 3B
Were you physically attacked or threatened with an attack during this incident?
1
2
Yes ‐ CONTINUE
No – GO TO 3B
E.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
IF YES IN 3A: Next are questions about other types of vehicle theft that may have happened in
the past 12 months, NOT including what you’ve already shared.
3B. In the past 12 months, were any vehicle parts stolen from a car, van, truck, motorcycle, or
other motor vehicle belonging to you or someone else in this household, such as a tire, hubcap,
car stereo, GPS device, battery or engine parts, gasoline, or any other vehicle parts?
1
Yes ‐ CONTINUE
2
No – GO TO #4
3B_1. How many times did this happen to you or someone else in this household in the
past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
3B_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 3B_2, COMPLETE 3B_3.
3B_3. For the next questions, focus only on the incident in which vehicle parts were stolen in
(MONTH/YEAR).
Attachment A: Screener Testing Instruments and Protocols
A23
A.
Besides the theft of vehicle parts, was there any other damage to your vehicle as
part of this incident?
1
Yes
2
No
B.
Other than the vehicle parts, were any items or belongings stolen from the
vehicle, such as a cell phone, money, or any other items that were in the vehicle?
1
Yes
2
No
C.
Were you or was someone else from your household there when this happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO #4
3
Yes, both me and someone else – CONTINUE
4
No – GO TO #4
D.
Were you physically attacked or threatened with an attack during this incident?
1
Yes ‐ CONTINUE
2
No – GO TO #4
E.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A24
4. Now I’d like to ask about any acts of vandalism that may have been committed against you
and the other people living with you. Vandalism is when someone damages or destroys
something belonging to you on purpose. Examples are breaking windows, slashing tires, or
painting graffiti on walls. In the past 12 months, has anyone vandalized your home, car, or
something else belonging to you or someone else living here?
1
Yes ‐ CONTINUE
2
No – GO TO #5
4_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
4_2. In what month and year did (this/these events) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 4_2, COMPLETE 4_3.
4_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
A.
Were any items or belongings stolen as part of the incident?
1
Yes
2
No
B.
Were you or was someone else from your household there when this happened?
1
Yes, me – CONTINUE
2
Yes, someone else – GO TO #5
3
Yes, both me and someone else – CONTINUE
4
No – GO TO #5
C.
Were you physically attacked or threatened with an attack during this incident?
1
Yes ‐ CONTINUE
2
No – GO TO #5
D.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A25
5. The next few questions ask about any physical attacks against you personally. (IF ANY
ATTACK WAS REPORTED AS PART OF OTHER INCIDENTS, READ: You’ve already told me about (a
time/some times) when you were recently attacked or someone threatened to attack you.
Other than what you’ve already mentioned,)
In the past 12 months, has anyone attacked or threatened to attack you in any way? This might
include things like attacking you with a weapon, attacking you with something else used as a
weapon, throwing something at you, grabbing, punching or choking you, or any other type of
attack or threat or use of force against you.
1
Yes ‐ CONTINUE
2
No – GO TO #6a
5_1. (IF ATTACK HAS ALREADY BEEN REPORTED: Other than the attack(s) or threat(s)
you already mentioned,) How many times were you attacked or threatened in the past
12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
5_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
FOR EACH INCIDENT IN 5_2, COMPLETE 5_3.
5_3. For the next question, focus only on the incident that happened in (MONTH/YEAR).
A.
Did anyone have, or try to have, sexual contact with you that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen as part of this incident?
1
Yes
2
No
Attachment A: Screener Testing Instruments and Protocols
A26
6a. Now I’d like to ask about any sexual contact in the past 12 months that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen. I want to remind you that the
information you provide is confidential.
(IF ANY SEXUAL CONTACT WAS REPORTED ALREADY, READ: You’ve already told me about (a
time/some times) when someone had, or tried to have, sexual contact with you that you DID
NOT CONSENT TO and that you DID NOT WANT to happen. Other than what you’ve already
mentioned,)
In the past 12 months, has anyone had, or tried to have sexual contact with you by touching or
penetrating your private parts that you DID NOT CONSENT TO and that YOU DID NOT WANT to
happen? For example, by holding or pinning you, hitting or kicking you, or using some other
type of force; OR by threatening to hurt you or someone close to you? This could have been
done by someone you know well, someone you casually know, or a stranger.
1
Yes
2
No
6b. In the past 12 months, has anyone had, or tried to have sexual contact with you – while you
were passed out, unconscious, blacked out, asleep, or unable to consent because you were
drunk or high?? This could have been done by someone you know well, someone you casually
know, or a stranger.
1
Yes
2
No
IF YES TO EITHER 6A OR 6B, CONTINUE. OTHERWISE, GO TO #7.
6_1. How many times did unwanted sexual contact happen to you in the past 12
months?
1
Once
2
Twice
3
Three times
4
Four or more times
6_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
Attachment A: Screener Testing Instruments and Protocols
A27
Now, I would like to ask you about other types of unwanted contacts or behaviors.
7. In the past 12 months, has anyone, male or female stalked you, for example, by following you
or spying on you, showing up at your home or your work place, repeatedly calling or texting
you, tracking your whereabouts on a GPS, or posting false information about you online?
1
Yes ‐ CONTINUE
2
No – GO TO #8
7a. Has anyone done (this/any of these things) to you more than once in the past 12 months?
1 Yes ‐ CONTINUE
2 No – GO TO #8
7b. Did any of these unwanted contacts or behaviors make you fear for your safety or the
safety of someone close to you?
1 Yes
2 No
7c. Did any of these unwanted contacts or behaviors cause you substantial emotional distress?
1 Yes
2 No
7d. IF ANY INCIDENTS REPORTED EARLIER: Were any of these unwanted contacts or behaviors
done by the same person(s) who carried out any of the other incidents you’ve mentioned
today?
1
2
Yes
No
Attachment A: Screener Testing Instruments and Protocols
A28
8. In the past 12 months, Has anyone convinced you to buy a product or a service, make an
investment, or seek a job opportunity by lying about, misrepresenting, or hiding information??
Include anything that might have happened longer ago, but you just realized in the past 12
months that it happened.
1
Yes – CONTINUE
2
No – GO TO #9
8a. In the past 12 months, did this happen to you once or more than once?
1
Once – GO TO #9
2
More than once– CONTINUE
8b. Were these all done by the same people or company, or were these done by different
people or different companies?
1
Same
2
Different
Attachment A: Screener Testing Instruments and Protocols
A29
9. In the past 12 months, has anyone used your financial accounts without your permission, or
used your personal information to open a new account, or stolen your personal information for
their own benefit? Include anything that might have happened longer ago, but you just realized
in the past 12 months that it happened.
1
Yes
2
No
9aa. Thinking about all the situations I just asked you about, did anyone TRY to do anything like
this in the past 12 months but did not succeed?
1
Yes
2
No
IF YES TO #9 OR #9aa, CONTINUE. ELSE GO TO INTRO BEFORE #10.
9a.
How many different times did this happen to you?
1
Once – GO TO #9C
2
More than once – CONTINUE
9b. Were these all done by the same person, or were these done by different people?
1
Same
2
Different
9c. IF ANY INCIDENTS REPORTED EARLIER: (Was this/Were any of these) done by the same
person(s) who carried out any of the other incidents you’ve mentioned today?
1
2
Yes
No
Attachment A: Screener Testing Instruments and Protocols
A30
Before we move on, I’d like to review the different incidents that you’ve reported to me.
GO BACK THROUGH RESPONSES TO QUESTIONS 1a‐9 AND REVIEW WHAT HAPPENED IN EACH.
Example:
A break‐in in May 2015 in which some belongings were stolen, and you were attacked.
Another break‐in in December 2015, in which there was some vandalism.
A theft in October 2015
A theft in January 2015 when you were attacked.
10. I want to make sure we’ve captured everything that has happened to you. At the beginning
of this survey, you recalled that {RESPONSE TO INTRO1} occurred around [ANCHOR DATE]. To
make sure we haven’t missed anything, is there anything (else) that you might think of as a
crime that happened to you in the past 12 months that you haven’t mentioned? It could be
something you called the police about, or something you didn’t consider reporting to the
police.
1
Yes – CONTINUE
2
No – GO TO END
10a. What happened?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Thank you. Now I’d like to ask you some questions about the questions you just answered.
(INTERVIEWER – GO TO PROTOCOL TO ASK COGNITIVE PROBES)
Attachment A: Screener Testing Instruments and Protocols
A31
Instrument Version 3
Mode
Interleaf
Cue Length
Interviewer
No
Long
INTRO1. The questions will ask about things that happened to you in the past 12 months. First,
can you think of anything that happened that was important to you in (ANCHOR
MONTH/YEAR), such as a birthday, a vacation, a new job, or anything else, even a big story in
the news?
_______________________________________________________________________
_______________________________________________________________________
In this study, it is important to only report events that happened in the past 12 months. As you
think about what happened to you, please think carefully about whether it happened before or
after (ANCHOR DATE), and only report things that happened after this date.
INTRO2. This survey will cover the following types of things: theft; break‐ins; deliberate
damage to your property; physical attacks against you, personally; unwanted sexual contact;
being followed or stalked; being cheated out of something; and having your identity stolen.
1. First I’ll ask about different things that might have been stolen from you. This may have
happened to you while you were at home, at work or school, or somewhere else. In the past 12
months…
a) Was something belonging to you stolen, such as things that you
Yes
No
carry, like a cell phone, money, a wallet, purse, or briefcase?
b) How about things that you wear, like clothing, jewelry, or shoes?
Yes
No
c) How about things in your home, like a TV, laptop, tools, or guns?
Yes
No
d) Still thinking about anything that was stolen in the past 12 months,
Yes
No
was anything stolen out of one of your vehicles, such as a package
or groceries?
e) Was anything stolen from your porch, lawn, garage, or other part
Yes
No
of your property, such as a bicycle, garden hose or lawn furniture?
(ASKED OF HOUSEHOLD RESPONDENT ONLY)
f) Was anything stolen belonging to the children who live here?
Yes
No
(ASKED OF HOUSEHOLD RESPONDENT ONLY)
g) Were any other things that belong to you stolen in the past 12
Yes
No
months?
Attachment A: Screener Testing Instruments and Protocols
A32
1h. In the past 12 months, did anyone TRY to steal anything belonging to you?
1
Yes ‐ CONTINUE
2
No – GO TO #2
IF YES TO ANY IN #1a‐h, CONTINUE. ELSE GO TO #2.
1_1. How many times was something (IF #1=YES: stolen/IF #1a=YES: attempted to be
stolen) in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
1_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO RECORD
DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
2. The next few questions ask about break‐ins. In the past 12 months… (ASKED OF HOUSEHOLD
RESPONDENT ONLY)
Yes
No
a) Has anyone broken in or TRIED to break into your home by forcing a
door or window, pushing past someone, jimmying a lock, cutting a
screen, or coming through an open door or window?
b) Has anyone broken in or TRIED to break into your garage, shed, or
Yes
No
storage room?
c) Has anyone broken in or TRIED to break into a hotel or motel room or
Yes
No
vacation home where you were staying?
(IF YES TO ANY IN #2A‐C, CONTINUE. ELSE TO GO #3)
2_1.
How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
Attachment A: Screener Testing Instruments and Protocols
A33
2_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO
RECORD DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
3a. The next few questions ask about vehicles. What was the TOTAL number of cars, vans,
trucks, motorcycles, or other motor vehicles owned by you or any other member of this
household during the last 12 months? Include those you no longer own. (ASKED OF
HOUSEHOLD RESPONDENT ONLY)
______________
3b. In the past 12 months… (ASKED OF HOUSEHOLD RESPONDENT ONLY)
a) Was a vehicle you owned at the time stolen or used without
Yes
No
permission?
b) Did anyone steal any vehicle parts such as a tire, car stereo, GPS,
Yes
No
hubcap, or battery?
c) Did anyone steal any gas from a vehicle you own?
Yes
No
d) Did anyone TRY to steal a vehicle or vehicle parts?
Yes
No
(IF YES TO ANY IN #3A‐D, CONTINUE. ELSE SKIP TO #4)
3_1. How many times did this happen to you (or someone else in this household) in
the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
3_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO
RECORD DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
Attachment A: Screener Testing Instruments and Protocols
A34
4. Now I'd like to ask about any acts of vandalism that may have been committed against you
and the other people living with you. Vandalism is when someone deliberately damages or
destroys something belonging to you. It does not include things that were done by accident.
Examples of vandalism are breaking windows, slashing tires, and painting graffiti on walls.
In the past 12 months, has anyone vandalized your home, car, or something else belonging to
you or someone else living here?
1
Yes ‐ CONTINUE
2
No – GO TO #5
4_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
4_2. In what month and year did (this/these events) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO
RECORD DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
5. The next few questions ask about any physical attacks against you personally. These may
have happened at your home or while you were at work, at school, or away from home.
In the past 12 months…
a) Has anyone attacked or tried to attack you with a weapon, for
Yes
No
instance, a gun or knife?
b) Has anyone attacked or tried to attack you with something else
Yes
No
that was used as a weapon, like a baseball bat, scissors, or a stick?
c) Has anyone attacked or tried to attack you by throwing
Yes
No
something at you, such as a rock or bottle?
d) Has anyone attacked or tried to attack you by slapping, grabbing,
Yes
No
kicking, punching, or choking you?
e) Has anyone attacked, tried to attack, or used force against you in
Yes
No
any other way in the past 12 months? Please mention it even if
you are not certain it was a crime.
(IF YES TO ANY IN #5A‐E, GO TO #5_1. ELSE CONTINUE)
Attachment A: Screener Testing Instruments and Protocols
A35
5f. (Other than incidents already mentioned,) In the past 12 months, did anyone THREATEN to
attack you, but not actually do it?
Yes ‐ CONTINUE
No – GO TO 5h
5g. (IF YES TO 5f) How were you threatened? Was it face‐to‐face, by phone or text, or online?
1
Face‐to‐face
2
By phone or text
3
Online
4
Some other way (e.g., by mail, to a third party)
(IF CODE 1 IN 5G, GO TO 5_1. ELSE CONTINUE)
5h. People sometimes don’t think of attacks by someone they know, like a current or former
spouse or partner, someone at work, a friend, or a family member. (Other than incidents
already mentioned,) Has anyone YOU KNOW used any kind of physical force against you in the
past 12 months? Examples are if someone you know choked you, slapped you, hit you with
something other than a fist, attacked you with a weapon, or otherwise physically hurt you.
1
Yes ‐ CONTINUE
2
No – GO TO #6
5_1. How many times were you attacked or threatened in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
5_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO RECORD
DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
Attachment A: Screener Testing Instruments and Protocols
A36
6. Now I’d like to ask about any sexual contact in the past 12 months that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen. I want to remind you that the
information you provide is confidential.
Sexual contact includes someone touching your private parts, unwanted kissing, or penetrating
your (IF FEMALE: vagina or)/(ALL: anus) with a penis, mouth, tongue, fingers, or object. This
could have been done by someone you know well, someone you casually know, or a stranger.
In the past 12 months…
Yes
No
a) Did anyone forcibly touch or grab your private parts – or TRY to
do this?
b) Did anyone force you to have sexual contact by holding you down
Yes
No
with his or her body weight, pinning your arms, hitting or kicking
you, or using some other type of force – or TRIED to do this?
c) Did anyone threaten to hurt you or someone close to you if you
Yes
No
did not have sexual contact?
d) Did anyone have sexual contact with you – or try to have sexual
Yes
No
contact with you – while you were passed out, unconscious,
blacked out, asleep, or unable to consent because you were
drunk or high?
(IF YES TO ANY IN 6A‐D, CONTINUE. ELSE GO TO #7)
6_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
6_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO RECORD
DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
Attachment A: Screener Testing Instruments and Protocols
A37
7. Now, I would like to ask you about other types of unwanted contacts or behaviors. When
answering, please think about anyone who may have done these things, including a current or
former spouse or partner, other people you may know, or strangers. However, please DO NOT
include bill collectors, solicitors, or sales people.
In the past 12 months…
a. Has anyone followed you around and watched you?
Yes
No
b. Has anyone sneaked into your home, car, or any other place and
Yes
No
did unwanted things to let you know they had been there?
c. Has anyone waited for you at your home, work, school, or any
Yes
No
other place when you didn’t want them to?
d. Still thinking about unwanted contacts and behaviors, has anyone
Yes
No
showed up, rode or drove by places where you were when they had
no business being there?
e. Has anyone left or sent you unwanted items, cards, letters,
Yes
No
presents, flowers, or any other unwanted items?
f. Has anyone harassed or repeatedly asked your friends or family for
Yes
No
information about you or your whereabouts?
The next questions are about unwanted contacts or behaviors using various technologies, such
as your phone, the Internet, or social media apps. Again, please DO NOT include contacts from
bill collectors, solicitors, or sales people. In the past 12 months…
Yes
No
g. Has anyone made unwanted phone calls to you, left voice
messages, sent text messages, or used the phone excessively to
contact you?
h. Has anyone spied on you or monitored your activities using
Yes
No
technologies such as a listening device, camera, or computer or cell
phone monitoring software?
i. Has anyone tracked your whereabouts with an electronic tracking
Yes
No
device or application, such as GPS or an application on your cell
phone?
j. Still thinking about unwanted contacts and behaviors, in the past 12
Yes
No
months has anyone posted or threatened to post inappropriate,
unwanted, or personal information about you on the Internet? This
includes private photographs, videos, or spreading rumors.
k. Has anyone sent unwanted e‐mails or messages using the Internet,
Yes
No
for example, using social media apps or websites like Instagram,
Twitter, or Facebook?
l. Has anyone monitored your activities using social media apps like
Yes
No
Instagram, Twitter, or Facebook?
(IF YES TO ANY IN #7A‐L, CONTINUE AND MARK INCIDENT DATA SHEET. ELSE GO TO #8)
Attachment A: Screener Testing Instruments and Protocols
A38
7n. Has anyone done (this/any of these things) to you more than once in the past 12 months?
1 Yes ‐ CONTINUE
2 No – GO TO #8
7o. Did any of these unwanted contacts or behaviors make you fear for your safety or the
safety of someone close to you?
1 Yes
2 No
7p. Did any of these unwanted contacts or behaviors cause you substantial emotional distress?
1 Yes
2 No
7q. IF ANY INCIDENTS REPORTED EARLIER: Were any of these unwanted contacts or behaviors
done by the same person(s) who carried out any of the other incidents you’ve mentioned
today?
1
Yes
2
No
8. The next items are about whether anyone got you to give them money by lying about a
product or service, or by deliberately hiding information about it from you. In the past 12
months...
a. Did you pay for something or a service that you never got, or that
Yes
No
was fake or worthless?
b. Were you told you won something, such as a prize or lottery, but
Yes
No
you had to pay money in order to collect it, or you never got it or it
was fake or worthless?
c. Were you told you would get a high return on an investment you
Yes
No
made, but it was fake or worth far less than you were led to expect?
d. Did you pay someone to help you improve your credit or finances,
Yes
No
but then not receive what you were promised?
e. Did you donate money to an organization you thought was a
Yes
No
charity, but which turned out to be fake?
f. Did you put money into a business opportunity, but it was fake or
Yes
No
you earned much less than you were led to expect?
g. Did you send money to help someone who told you they urgently
Yes
No
needed money, but it turned out their story wasn’t true?
h. Did you send money to someone who pretended to need help
Yes
No
moving money from another country, but they just kept your money?
i. Were there any other times in the past 12 months when someone
Yes
No
got you to give them money by lying about a product or service, or by
deliberately hiding information from you?
j. Thinking about all the situations I just asked you about, did anyone
Yes
No
Attachment A: Screener Testing Instruments and Protocols
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TRY anything (else) like this on you in the past 12 months, but you did
not send them any money?
(IF YES TO ANY IN #8A‐J, CONTINUE AND MARK INCIDENT DATA SHEET. ELSE GO TO #9)
8a. In the past 12 months, did this happen to you once or more than once?
1
Once – GO TO #9
2
More than once– CONTINUE
8b. Were these all done by the same people or company, or were these done by different
people or different companies?
1
Same
2
Different
9. Now I’d like to ask you about any times someone used your personal information without
your permission for their own benefit. In the past 12 months…
a) Did someone, without your permission, use or try to use
Yes
No
Does not
your existing checking or savings account, including any debit
apply
or ATM cards?
b) Did someone use or try to use one or more of your existing
Yes
No
Does not
credit cards without your permission? Please do not include
apply
debit cards.
c) Did someone misuse or try to misuse another type of
Yes
No
existing account, such as your telephone, utilities, an online
payment account like Paypal, insurance policies, or
something else?
d) Still thinking about the past 12 months, did someone,
Yes
No
without your permission, use or try to use your personal
information to open any NEW accounts, such as wireless
telephone accounts, credit card accounts, loans, bank
accounts, online payment accounts, or something else?
e) Did someone use or try to use your personal information
Yes
No
for some other fraudulent purpose, such as getting medical
care, a job, or government benefits; renting an apartment or
house; giving your information to the police when they were
charged with a crime or traffic violation, or something else?
(IF YES TO ANY IN #9A‐E, CONTINUE AND MARK INCIDENT DATA SHEET. ELSE GO TO INTRO
BEFORE #10)
Attachment A: Screener Testing Instruments and Protocols
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9a. In the past 12 months, did this happen to you once or more than once?
1
Once – GO TO #9C
2
More than once– CONTINUE
9b. Were these all done by the same person, or were these done by different people?
1
Same
2
Different
9c. IF ANY INCIDENTS REPORTED EARLIER: (Was this/Were any of these) done by the same
person(s) who carried out any of the other incidents you’ve mentioned today?
1
2
Yes
No
Attachment A: Screener Testing Instruments and Protocols
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INTRO BEFORE #10. Before we move on, I’d like to review the different incidents that you’ve
reported to me.
REVIEW INCIDENT DATA SHEET WITH RESPONDENT
IF ANY COLUMN HAS MULTIPLE INCIDENTS WITHIN IT, ASK:
10a. In (MONTH/YEAR), you reported (READ ITEMS FROM DATA SHEET). Were these part of the
same incident, or were they separate incidents?
1
Same incident (CIRCLE INCIDENTS ON DATA SHEET THAT BELONG TOGETHER)
2
Separate incident
10b. I want to make sure we’ve captured everything that has happened to you. At the
beginning of this survey, you recalled that {RESPONSE TO INTRO1} occurred around (ANCHOR
DATE). Is there anything (else) that you might think of as a crime that happened to you in the
past 12 months that you haven’t mentioned? It could be something you called the police about,
or something you didn’t consider reporting to the police.
1
Yes – CONTINUE
2
No – GO TO END
10c. What happened?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Thank you. Now I’d like to ask you some questions about the questions you just answered.
(INTERVIEWER – GO TO PROTOCOL TO ASK COGNITIVE PROBES)
Attachment A: Screener Testing Instruments and Protocols
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Attachment A: Screener Testing Instruments and Protocols
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Instrument Version 4
Mode
Interleaf
Cue Length
Interviewer
No
Short
INTRO1. The questions will ask about things that happened to you in the past 12 months. First,
can you think of anything that happened that was important to you in (ANCHOR
MONTH/YEAR), such as a birthday, a vacation, a new job, or anything else, even a big story in
the news?
_______________________________________________________________________
_______________________________________________________________________
In this study, it is important to only report events that happened in the past 12 months. As you
think about what happened to you, please think carefully about whether it happened before or
after (ANCHOR DATE), and only report things that happened after this date.
INTRO2. This survey will cover the following types of things: theft; break‐ins; deliberate
damage to your property; physical attacks against you, personally; unwanted sexual contact;
being followed or stalked; being cheated out of something; and having your identity stolen.
1. . First I’ll ask about different things that might have been stolen from you. In the past 12
months, was something belonging to you or your children under 12 stolen? This might include
things like money, jewelry, clothing, cell phones, TVs or other electronics, or any other items
belonging to you.
1
2
Yes
No
1a. Did anyone attempt to steal anything belonging to you?
1
Yes
2
No
IF YES TO EITHER #1 OR #1A, CONTINUE. ELSE GO TO #2.
1_1. How many times was something (IF #1=YES: stolen/IF #1a=YES: attempted to be
stolen) in the past 12 months?
1
Once
2
Twice
3
Three times
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4
Four or more times
1_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO RECORD
DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
2. The next few questions ask about break‐ins. In the past 12 months, did anyone break in or try
to break into your home, your garage or shed, or a hotel or motel room or vacation home
where you or someone else in this household were staying by forcing a door or window,
pushing past someone, jimmying a lock, cutting a screen, or entering through an open door or
window?
1
Yes ‐ CONTINUE
2
No – GO TO #3
2_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
2_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO
RECORD DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
Attachment A: Screener Testing Instruments and Protocols
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3A. The next few questions ask about vehicles. In the past 12 months, did you or anyone else in
this household have a car, van, truck, motorcycle, or other motor vehicle stolen or used without
permission?
1
Yes ‐ CONTINUE
2
No – GO TO 3B
3A_1. How many times did this happen to you (or someone else in this household) in
the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
3A_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO
RECORD DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
IF YES IN 3A: Next are questions about other types of vehicle theft that may have happened in
the past 12 months, NOT including what you’ve already shared.
3B. In the past 12 months, were any vehicle parts stolen from a car, van, truck, motorcycle, or
other motor vehicle belonging to you or someone else in this household, such as a tire, hubcap,
car stereo, GPS device, battery or engine parts, gasoline, or any other vehicle parts?
1
Yes ‐ CONTINUE
2
No – GO TO #4
3B_1. How many times did this happen to you or someone else in this household in the
past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
Attachment A: Screener Testing Instruments and Protocols
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3B_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO
RECORD DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
IF ANY INCIDENTS REPORTED SO FAR: Now I’d like to see if anything else has happened to you
in the past 12 months.
4. Now I’d like to ask about any acts of vandalism that may have been committed against you
and the other people living with you. Vandalism is when someone damages or destroys
something belonging to you on purpose. Examples are breaking windows, slashing tires, or
painting graffiti on walls. In the past 12 months, has anyone vandalized your home, car, or
something else belonging to you or someone else living here?
1
Yes ‐ CONTINUE
2
No – GO TO #5
4_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
4_2. In what month and year did (this/these events) happen? (IF UNABLE TO PROVIDE
EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO
RECORD DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
5. The next few questions ask about any physical attacks against you personally. In the past 12
months, has anyone attacked or threatened to attack you in any way? This might include things
like attacking you with a weapon, attacking you with something else used as a weapon,
throwing something at you, grabbing, punching or choking you, or any other type of attack or
threat or use of force against you.
1
2
Yes ‐ CONTINUE
No – GO TO #6a
Attachment A: Screener Testing Instruments and Protocols
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5_1. How many times were you attacked or threatened in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
5_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO RECORD
DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
6a. Now I’d like to ask about any sexual contact in the past 12 months that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen. I want to remind you that the
information you provide is confidential.
In the past 12 months, has anyone had, or tried to have sexual contact with you by touching or
penetrating your private parts that you DID NOT CONSENT TO and that YOU DID NOT WANT to
happen? For example, by holding or pinning you, hitting or kicking you, or using some other
type of force; OR by threatening to hurt you or someone close to you? This could have been
done by someone you know well, someone you casually know, or a stranger.
1
Yes
2
No
6b. In the past 12 months, has anyone had, or tried to have sexual contact with you – while you
were passed out, unconscious, blacked out, asleep, or unable to consent because you were
drunk or high? This could have been done by someone you know well, someone you casually
know, or a stranger.
1
Yes
2
No
IF YES TO EITHER 6A OR 6B, CONTINUE. OTHERWISE, GO TO #7.
6_1. How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
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6_2. In what month and year did (this/these) happen? (IF UNABLE TO PROVIDE EXACT
MONTH, RECORD VERBATIM RESPONSE, SUCH AS “SPRING”) (INTERVIEWER TO RECORD
DATES IN INCIDENT DATA SHEET)
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident
Now, I would like to ask you about other types of unwanted contacts or behaviors.
7. In the past 12 months, has anyone, male or female stalked you, for example, by following you
or spying on you, showing up at your home or your work place, repeatedly calling or texting
you, tracking your whereabouts on a GPS, or posting false information about you online?
1
Yes ‐ CONTINUE
2
No – GO TO #8
7a. Has anyone done (this/any of these things) to you more than once in the past 12 months?
1 Yes – CONTINUE (INTERVIEWER TO MARK INCIDENT DATA SHEET)
2 No – GO TO #8
7b. Did any of these unwanted contacts or behaviors make you fear for your safety or the
safety of someone close to you?
1 Yes
2 No
7c. Did any of these unwanted contacts or behaviors cause you substantial emotional distress?
1
Yes
2
No
7d. IF ANY INCIDENTS REPORTED EARLIER: Were any of these unwanted contacts or behaviors
done by the same person(s) who carried out any of the other incidents you’ve mentioned
today?
1
Yes
2
No
8. In the past 12 months, Has anyone convinced you to buy a product or a service, make an
investment, or seek a job opportunity by lying about, misrepresenting, or hiding information?
Include anything that might have happened longer ago, but you just realized in the past 12
months that it happened.
Attachment A: Screener Testing Instruments and Protocols
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1
Yes – CONTINUE (INTERVIEWER TO MARK INCIDENT DATA SHEET)
2
No – GO TO #9
8a. In the past 12 months, did this happen to you once or more than once?
1
Once – GO TO #9
More than once– CONTINUE
2
8b. Were these all done by the same people or company, or were these done by different
people or different companies?
1
Same
2
Different
9. In the past 12 months, has anyone used your financial accounts without your permission, or
used your personal information to open a new account, or stolen your personal information for
their own benefit? Include anything that might have happened longer ago, but you just realized
in the past 12 months that it happened.
1
Yes
2
No
9aa. Thinking about all the situations I just asked you about, did anyone TRY to do anything like
this in the past 12 months but did not succeed?
1
Yes
2
No
IF YES TO #9 OR #9aa, CONTINUE (AND MARK INCIDENT DATA SHEET). ELSE GO TO INTRO
BEFORE #10.
9a.
How many different times did this happen to you?
1
Once – GO TO #9C
2
More than once – CONTINUE
9b. Were these all done by the same person, or were these done by different people?
1
Same
2
Different
9c. IF ANY INCIDENTS REPORTED EARLIER: (Was this/Were any of these) done by the same
person(s) who carried out any of the other incidents you’ve mentioned today?
1
2
Yes
No
Attachment A: Screener Testing Instruments and Protocols
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Before we move on, I’d like to review the different incidents that you’ve reported to me.
REVIEW INCIDENT DATA SHEET WITH RESPONDENT
IF ANY COLUMN HAS MULTIPLE INCIDENTS WITHIN IT, ASK:
10a. In (MONTH/YEAR), you reported (READ ITEMS FROM DATA SHEET). Were these part of the
same incident, or were they separate incidents?
1
Same incident (CIRCLE INCIDENTS ON DATA SHEET THAT BELONG TOGETHER)
2
Separate incident
10b. I want to make sure we’ve captured everything that has happened to you. At the
beginning of this survey, you recalled that {RESPONSE TO INTRO1} occurred around (ANCHOR
DATE). Is there anything (else) that you might think of as a crime that happened to you in the
past 12 months that you haven’t mentioned? It could be something you called the police about,
or something you didn’t consider reporting to the police.
1
Yes – CONTINUE
2
No – GO TO END
10c. What happened?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Thank you. Now I’d like to ask you some questions about the questions you just answered.
(INTERVIEWER – GO TO PROTOCOL TO ASK COGNITIVE PROBES)
Attachment A: Screener Testing Instruments and Protocols
A51
Incident Data Sheet
Respondent ID _________
Version # ________
Interviewer Initials __________
Before
May Jun
Aug Sep Oct Nov Dec Jan Feb Mar Apr Don't May‐
Jul
2015 2015 2015 2015 2015 2015 2015 2015 2016 2016 2016 2016 know
15
1. Theft
2. Break‐in
3. Vehicle Theft
4. Vandalism
5. Attack or threat of
attack
6. Unwanted sexual
contact
7. Stalking
8. Fraud
9. Identity theft
Attachment A: Screener Testing Instruments and Protocols
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NCVS‐R: SCREENER COGNITIVE INTERVIEW
PROTOCOL
COGNITIVE INTERVIEW PROTOCOL – INTERVIEWER ADMINISTERED
Date:_______________ Time_____ ID #:_____Interviewer Initials:_______________
1. Introduction
Thank you for taking the time to help us out today. The session will take approximately
1 hour. I’ll give you a little background about what we’ll be doing today.
Westat is working on this project for the Bureau of Justice Statistics. We are interested
in how people classify different experiences that may happen to them to help us test
questions that may be used on the National Crime Victimization Survey. The NCVS is
administered every year nationwide and collects information on victimization. Westat is
looking at ways these questions can be improved.
Today, I’ll ask you a series of questions being considered for the NCVS. I’d like you to
pretend that I am interviewing you in your home. After you answer all of the questions,
we will talk about the answers you gave.
At this stage we are still developing the questionnaire and trying to figure out how to
make it as easy as possible for people to understand and answer correctly.
So at any time you should feel free to let me know if:
•
•
•
•
there are words you don’t understand, or
the question doesn’t make sense to you, or
you could interpret it more than one way, or
if the answer you are looking for is not provided.
After I have asked you the questions, we’ll go back through them so you can help me
understand how well the questions are working. In particular, we are trying to find out
how people like you go about answering these questions. So, basically, the more you
can tell us, the more we will understand about the questions.
This is a research project and your participation is voluntary. You can skip any question
and you can stop at any point. We would very much appreciate your permission to
audio record this conversation. The audio recording will be used for note-taking
purposes only and may be viewed by the project or the BJS staff. It will be destroyed
Attachment A: Screener Testing Instruments and Protocols
A53
when the project is over. When we are finished, we will give you 40 dollars in gratitude
for your assistance. We are interested in everything you have to say and we encourage
you to speak openly about the questions and your answers.
2. Consent Process
HAND THE CONSENT FORM TO PARTICIPANT, ANSWER ANY QUESTIONS, AND
OBTAIN CONSENT BEFORE CONTINUING. This form contains all of the things I just
told you about your rights in this interview. Please read it over and sign both copies if
you are willing to take part in the study.
Do you have any questions before we get started?
[START RECORDER AND GET ORAL PERMISSION TO RECORD.] It is [DATE AND
TIME], do I have your permission to audio record this conversation? ~~~~ Thank you.
Do you have any questions before we get started?
ADMINISTER QUESTIONNAIRE.
Follow-up Probes
DURING THE SESSION – STATE THE QUESTION NUMBER SO ANY OBSERVERS
AND THE RECORDING KNOW AT ALL TIMES WHICH QUESTION IS BEING ASKED.
IF RESPONDENT ASKS A QUESTION OR HAS A PROBLEM WITH A QUESTION AS
YOU ARE ASKING IT, PROBE IMMEDIATELY TO UNDERSTAND THE NATURE OF
THE PROBLEM, AND THEN INFORM R THAT YOU WILL FOLLOW UP MORE ON
THIS AFTER YOU HAVE FINISHED ASKING ALL OF THE QUESTIONS.
EXAMPLE PROBES
You seemed to have taken a long time to answer that question. Can you tell
me what you were thinking about?
What part of the question doesn’t make sense to you? Tell me more.
GENERAL PROBES TO ASK AFTER COMPLETING THE QUESTIONNAIRE:
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A54
A.1
What were your overall reactions to the series of questions I just asked you?
A.2 I am interested in both what worked well and what didn’t work well with the
questions.
o What did you like about the questions?
o What didn’t you like about the questions?
A.3
What time period were you thinking about as you answered the questions?
(IF NOT 12 MONTHS) Tell me more about why you were thinking
about that time period.
How easy or difficult was it to remember what happened to you in the
past 12 months?
At the beginning, you were asked to think about what might have been
going on in your life 12 months ago. Did this help you to think about
things that happened to you over the past 12 months? Explain.
o Did this help you to make sure you were excluding things that
might have happened before that date? Explain.
At the end, I reminded you of the events that you had mentioned at the
beginning of the interview. What did you think of being reminded about
that as a way to help you figure out if you had forgotten anything else
that might have happened to you in the past year?
A.4 How well did the questions capture the different types of crimes people might
have experienced in the last 12 months?
A.5
IF RESPONDENT SAID YES TO ANY OF THEM: How well did they
capture what happened to you in the last 12 months? What makes you
say that?
What did you think about the overall flow of the questionnaire?
(VERSIONS 1 AND 2) What did you think about being asked some
follow-up questions each time you reported an incident?
o We are trying to figure out if respondents would prefer to be
asked a few questions about each incident as soon as you
report it, or if it makes more sense to ask all the main questions
first, and then later ask for details about each one. Which way
makes it easier for you to remember what happened to you?
(Explain)
Attachment A: Screener Testing Instruments and Protocols
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o What did you think about the follow-up questions you were
asked about each incident? Were there other key questions you
thought we’d be asking you?
(VERSIONS 3 AND 4) We are trying to figure out if respondents would
prefer to be asked a few questions about each incident as soon as you
report it, or if it makes more sense to ask all the main questions first,
and then later ask for details about each one. Which way makes it
easier for you to remember what happened to you?
Introduction
B.1 Now let’s go back through the questions I asked. At the beginning, I read an
introduction to you that said “The next set of questions will ask you about different
things that might have happened to you in the past 12 months, such as having items
stolen; break-ins; someone destroying your property; physical attacks; unwanted sexual
contact; other unwanted contacts or behaviors; being lied to about a product or service;
and someone using your personal information without your permission.”
We are trying to figure out if it’s helpful to provide an overview of the types of
incidents that we’ll be asking about. What are your thoughts about this
introduction?
How well did these categories fit with what happened to you?
Were any of the categories confusing or unfamiliar to you?
Any other feedback on this introduction before we move on?
Attachment A: Screener Testing Instruments and Protocols
A56
THEFT
First I asked you if something belonging to you or your children was stolen.
(VERSIONS 1 AND 3) I read you a series of questions about different types of
things that could be stolen, such as things that you carry, things that you wear,
things in your home, things stolen out of a vehicle or off your property, and things
that belong to children. What did you think about this list?
(VERSIONS 2 AND 4) Do you recall any of the examples I gave you for this
question?
o Did you think this was a complete list, or did you think they were just
some examples of the types of things that might be stolen? (RE-READ
LIST IF NECESSARY)
What kinds of places were you thinking about things being stolen from when you
answered this question?
o Were you thinking about things that might have been stolen from your
work? Your vehicle? The areas outside of your home? Other places?
I also asked you if anyone attempted to steal anything from you. What do you
think I meant by that?
(IF YES) You said yes to (this question/one of these questions). Can you tell me
briefly about what happened to you?
o How easy or difficult was it to remember the month and year when this
happened?
o (IF VERSIONS 1 AND 2 AND YES TO ANY INTERLEAF ITEMS) I
asked you several follow up questions to find out what else might have
happened as part of this incident. Tell me more about your answers.
(IF NO) You said no to (this question/all of these questions). What types of
situations were you thinking about as you answered this question? (REPEAT
QUESTION IF NECESSARY)
BREAK-INS
Next, I asked you about any break ins or attempted break-ins.
Do you remember what kinds of places I mentioned where break-ins might
occur?
(IF YES) You said yes to this question. Can you tell me briefly about what
happened to you?
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o How easy or difficult was it to remember the month and year when this
happened?
o (IF VERSIONS 1 AND 2 AND YES TO ANY INTERLEAF ITEMS) I
asked you several follow up questions to find out what else might have
happened as part of this incident. Tell me more about your answers.
(IF NO) You said no to this question. What types of situations do you think this
question was asking about?
VEHICLE THEFT
(VERSIONS 1 AND 3)
Next, I asked you about vehicle theft, including a vehicle being stolen, vehicle parts
being stolen, gas being stolen, or attempted vehicle or vehicle part theft.
(IF YES TO ANY) You said yes to (ITEM). Can you tell me briefly about what
happened to you?
o How easy or difficult was it to remember the month and year when this
happened?
o (IF VERSION 1 AND YES TO ANY INTERLEAF ITEMS) I asked you
several follow up questions to find out what else might have happened
as part of this incident. Tell me more about your answers.
(IF NO TO ALL) You said no to this question. What types of situations were you
thinking about as you answered this question? (REPEAT ITEMS IF
NECESSARY)
(VERSIONS 2 AND 4)
Next, I asked you about vehicle theft.
(IF YES) You said yes to this question. Can you tell me briefly about what
happened to you?
o How easy or difficult was it to remember the month and year when this
happened?
o (IF VERSION 1 AND YES TO ANY INTERLEAF ITEMS) I asked you
several follow up questions to find out what else might have happened
as part of this incident. Tell me more about your answers.
(IF NO) You said no to this question. What types of situations were you thinking
about as you answered this question? (REPEAT QUESTION IF NECESSARY)
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In question 3B, I asked you if any vehicle parts were stolen, and then I read you a list of
different types of vehicle parts.
Do you remember what types of vehicle parts I mentioned?
Did you think this was a complete list, or did you think they were just some
examples of the types of vehicle parts that might be stolen? (RE-READ LIST IF
NECESSARY)
(IF YES) You said yes to this question. Can you tell me briefly about what
happened to you?
o How easy or difficult was it to remember the month and year when this
happened?
o (IF VERSION 2 AND YES TO ANY INTERLEAF ITEMS) I asked you
several follow up questions to find out what else might have happened
as part of this incident. Tell me more about your answers.
(IF NO) You said no to this question. What types of situations were you thinking
about as you answered this question? (REPEAT QUESTION IF NECESSARY)
VANDALISM
Next I asked you about vandalism, and read you a definition that said “Vandalism is
when someone damages or destroys something belonging to you on purpose.”
Do you remember what examples of vandalism I gave you?
What do you think about this definition? Was there anything unclear about it?
What do you think is meant by “on purpose”? What kinds of situations would this
include? Not include?
(IF YES) You said yes to this question. Can you tell me briefly about what
happened to you?
o How easy or difficult was it to remember the month and year when this
happened?
o (IF VERSIONS 1 OR 2 AND YES TO ANY INTERLEAF ITEMS) I asked
you several follow up questions to find out what else might have happened
as part of this incident. Tell me more about your answers.
(IF NO) You said no to this question. What types of situations were you thinking
about as you answered this question? (REPEAT QUESTION IF NECESSARY)
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ATTACKS
(VERSIONS 1 AND 3) The next questions asked if anyone attacked you or threatened
to attack you, and I asked you about various ways you might have been attacked.
(VERSIONS 2 AND 4) Next I asked you if anyone attacked you or threatened to attack
you, and then I read you a list of ways you might have been attacked.
Do you recall any of the different ways I mentioned that people could be
attacked?
What comes to mind when you hear “attacking you with a weapon”?
What comes to mind when you hear “attacking you with something else used as
a weapon”? What are some examples of other things that could be used as
weapons?
How about “throwing something at you”? What do you think this is asking about?
How about “slapping, grabbing, punching or choking you”? Do you think of these
as attacks?
(VERSIONS 1 AND 3) And when I asked if anyone had attacked, tried to attack
or used force against you in any other way”, what did you think of?
(VERSIONS 2 AND 4) And when it said “any other type of attack or threat or use
of force against you,” what do you think of?
What is meant by a “threat”?
o How is that different from an “attempted” attack? Were you thinking
about times that someone might have tried to attack you?
o When you answered this question were you trying to remember times
that you were actually attacked, or were you also thinking about times
when you were threatened?
What types of places were you thinking about when you heard this question?
Was it just at home, or were you also thinking about work, school, or places away
from home?
(IF YES) You said yes to this question. Can you tell me briefly about what
happened to you?
o How easy or difficult was it to remember the month and year when this
happened?
o (IF YES TO ANY INTERLEAF ITEMS) I asked you a follow up question
to find out what else might have happened as part of this incident. Tell
me more about your answers.
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(VERSIONS 1 AND 3)
Then I asked you to think about any attacks by someone you know, like a current or
former spouse or partner, someone at work, a friend, or a family member. Had you
already been thinking about these types of people in the previous questions, or did this
make you think of any other types of situations that happened to you?
Sexual Contact
Next I asked you about sexual contact that you did not consent to and did not want to
happen.
Do you recall what types of situations this question was asking about?
(IF YES TO ANY) You said yes (to ITEM). Can you tell me briefly about what
happened to you?
o How easy or difficult was it to remember the month and year when this
happened?
o (IF NEEDED) Were you physically attacked during this incident? Say
more about that.
(IF VERSIONS 1 AND 3 AND NO TO ALL ITEMS) I asked you about someone
forcibly touching or grabbing your private parts, or trying to do this. Can you tell
me what types of situations this might include?
o Then I asked you about someone forcing you to have sexual contact
by holding you down with his or her body weight, pinning your arms,
hitting or kicking you, or using some other type of force, or trying to do
this. Can you tell me what types of situations this might include?
o Then I asked you about someone threatening to hurt you or someone
close to you if you did not have sexual contact. Can you tell me what
types of situations this might include?
o And finally, I asked about someone having, or trying to have, sexual
contact with you while you were passed out, unconscious, blacked out,
asleep, or unable to consent because you were drunk or high. Again,
can you tell me what types of situations this might include?
(IF VERSIONS 2 AND 4 AND ANSWER IS NO) You said no to this item. What
types of situations were you thinking about as you answered this question?
(REPEAT QUESTION IF NECESSARY)
(VERSIONS 2 AND 4) Question 6b asked you about whether you had, or tried to
have sexual contact with you – while you were passed out, unconscious, blacked
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A61
out, asleep, or unable to consent because you were drunk or high. What types of
situations do you think that includes?
o (IF YES) You said yes. Can you tell me briefly about what happened to
you?
(ASK ALL) I asked you about someone touching your private parts. What do you
think is meant by “private parts”?
STALKING
VERSIONS 1 AND 3
Next I asked you about other types of unwanted contacts or behaviors, like someone
following you or watching you, sneaking into your home, sending you unwanted items,
or harassing your friends or family about your whereabouts.
(IF YES TO ANY) You said yes to (ITEMS). Can you tell me briefly about what
happened to you?
(IF NO TO ALL) What do you think this series of questions was asking about?
o (LISTEN IF R REFERS TO THIS AS “STALKING”. IF NOT ASK Do you
think of these types of behaviors as stalking? Explain.
Then I asked you about different types of unwanted contacts using technology like the
phone, the Internet, or social media apps.
(IF YES TO ANY) You said yes to (ITEMS). Can you tell me briefly about what
happened to you?
(IF NO TO ALL) What do you think this series of questions was asking about?
o (LISTEN IF R REFERS TO THIS AS “STALKING”. IF NOT ASK Do you
think of these types of behaviors as stalking? Explain.
(IF YES TO ANY) Later I asked you if any of these things happened to you more than
once in the past 12 months. What does that mean if something only happened once vs.
more than once?
I also asked if this unwanted contact made you fear for your safety or the safety
of someone known to you. What do you think I meant by that?
Then I asked if this caused you substantial emotional distress. What do you think
I meant by that?
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VERSIONS 2 AND 4
Next I asked you about anyone stalking you, and then I read you a list of ways you
might have been stalked.
Do you recall any of the different ways I mentioned that people could be stalked?
In your own words, what do you think of as stalking? What are some examples?
What comes to mind when you hear “following or spying on you”? In what types
of situations might you think of this as stalking?
Another example was “showing up at your home or workplace” – in what types of
situations might you think of this as stalking?
How about “repeatedly calling or texting you?” – in what types of situations might
you think of this as stalking?
Suppose a bill collector was calling you repeatedly. Would you call that stalking?
Why/why not?
Another example was “tracking your whereabouts on GPS” - in what types of
situations might you think of this as stalking?
How about “posting false information about you online” - in what types of
situations might you think of this as stalking?
(IF YES) You said yes to this question. Can you tell me briefly about what
happened to you?
o Later I asked you if any of these things happened to you more than
once in the past 12 months. What does that mean if something only
happened once vs. more than once?
o I also asked if this unwanted contact made you fear for your safety or
the safety of someone known to you. What do you think I meant by
that?
o Then I asked if this caused you substantial emotional distress. What do
you think I meant by that?
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FRAUD
(VERSIONS 1 AND 3)
Next I asked you about whether anyone got you to give them money by lying about a
product or service, or by deliberately hiding information about it from you.
(IF YES TO AT LEAST ONE) You said yes to (ITEMS). Can you tell me briefly
about what happened to you?
o How long ago did it actually happen?
o How did you realize that it had happened to you?
(IF NO TO ALL) You said no to all of the items in this set. What types of
situations were you thinking about as you answered this question? (REPEAT
ITEMS IF NECESSARY)
(ALL) I asked you whether any TRIED anything like this on you but you did not
send them any money. What types of situations would this include?
Are there any other ways that you might have been cheated out of money or
something valuable that weren’t covered in this question?
In item c, I asked you if you were told you would get a high return on an
investment you made, but it was fake or worth far less than you were led to
expect. What kind of situation do you think this was asking about?
o Have you ever had an investment where you lost most of your money?
Did you consider this to be a fraud?
(IF YES TO ANY) Later I asked you if any of these things happened to you
more than once in the past 12 months. What does that mean if something
only happened once vs. more than once?
(VERSIONS 2 AND 4)
Next I asked about whether anyone convinced you to buy a product or a service, make
an investment, or seek a job opportunity by lying about, misrepresenting, or hiding
information.
What types of situations do you think this was asking about?
What comes to mind when you think about someone convincing you to pay them
money by lying about something? Do you think of this as fraud?
What comes to mind when you think about someone convincing you to pay them
money by misrepresenting something? Do you think of this as fraud?
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What about someone convincing you to pay them money by hiding information
about something? Do you think of this as fraud?
(IF YES) You said yes to this question. Can you tell me briefly about what
happened to you?
o How long ago did it actually happen?
o How did you realize that it had happened to you?
o I asked you if any of these things happened to you more than once in
the past 12 months. What does that mean if something only happened
once vs. more than once?
o
(IF #8B WAS ANSWERED) How did you decide on your answer of
whether this had been done by the same people or company or by
different people or different companies?
(ASK ALL) Are there any other ways that you have been a victim of fraud that
weren’t covered in this question?
IDENTITY THEFT
(VERSIONS 1 AND 3)
Finally, I asked you if anyone used or tried to use your personal information without your
permission for their own benefit.
(IF YES TO AT LEAST ONE) You said yes to (ITEMS). Can you tell me briefly
about what happened to you?
o How long ago did it actually happen?
o How did you realize that it had happened to you?
o How did you decide whether to answer if it had happened once or
more than once?
(IF NO TO ALL) You said no to all of the items in this set. What types of
situations were you thinking about as you answered this question? (REPEAT
ITEMS IF NECESSARY)
(VERSIONS 2 AND 4)
Finally, I asked you if anyone had used your financial accounts without your permission,
used your personal information to open a new account, or stole your personal
information for their own benefit.
What types of situations do you think this question is asking about?
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What do you think is meant by “stole your personal information for their own
benefit”?
(IF YES) You said yes to this question. Can you tell me briefly about what
happened to you?
o How long ago did it actually happen?
o How did you realize that it had happened to you?
o How did you decide whether to answer if it had happened once or
more than once?
o (IF #9B WAS ANSWERED) How did you decide on your answer of
whether this had been done by the same person or by different
people?
I also asked if anyone TRIED to use your personal information for their own
benefit. Under what circumstances would someone say yes to this item?
Review
Finally, at the end, I went through and summarized all of the incidents that you had told
me about. (REVIEW LIST IF NECESSARY)
How accurate was I in summarizing what had happened to you?
o What did we miss, if anything?
o Were any of the incidents we reviewed at the end actually part of the
same incident?
o If we were going to ask you detailed follow-up questions about each
incident you reported, like about the location of the incident, whether any
weapons were used, and how you responded to the incident, would you
be able to keep the different incidents clear in your mind?
Closing and Incentive
Those are all the questions I have for you. Is there anything we haven't discussed that
you would like to mention?
DISCUSS ANY RESPONDENT COMMENTS.
Thank you for your time.
Attachment A: Screener Testing Instruments and Protocols
A66
Current NCVS
I'm going to read some examples that will give you an idea of the kinds of crimes this study
covers.
As I go through them, tell me if any of these happened to you in the last 6 months, that is
since __________ ______, 20 ____.
Was something belonging to YOU stolen, such as ‐
Read each category.
(a) Things that you carry, like luggage, a wallet, purse, briefcase book ‐
(b) Clothing, jewelry, or cellphone ‐
(c) Bicycle or sports equipment ‐
(d) Things in your home ‐ like a TV, stereo, or tools ‐
(e) Things outside your home such as a garden hose or lawn furniture ‐ (Asked of Household
Respondent only)
(f) Things belonging to children in the household ‐ (Asked of Household Respondent only)
(g) Things from a vehicle, such as a package, groceries, camera, or CDs ‐
OR
(h) Did anyone ATTEMPT to steal anything belonging to you?
Long Cues
First I’ll ask about different things that might have been stolen from you. This may have happened
to you while you were at home, at work or school, or somewhere else. In the past 12 months…
a) Was something belonging to you stolen, such as things that you carry, like a cell phone, money, a
wallet, purse, or briefcase?
b) How about things that you wear, like clothing, jewelry, or shoes?
c) How about things in your home, like a TV, laptop, tools, or guns?
d) Still thinking about anything that was stolen in the past 12 months, was anything stolen out of
one of your vehicles, such as a package or groceries?
e) Was anything stolen from your porch, lawn, garage, or other part of your property, such as a
bicycle, garden hose or lawn furniture? (ASKED OF HOUSEHOLD RESPONDENT ONLY)
f) Was anything stolen belonging to the children who live here? (ASKED OF HOUSEHOLD
RESPONDENT ONLY)
g) Were any other things that belong to you stolen in the past 12 months?
1h. In the past 12 months, did anyone TRY to steal anything belonging to you?
Short Cues
Break‐in
(Other than any incidents already mentioned,) has anyone ‐
(a) Broken in or ATTEMPTED to break into your home by forcing a door or window, pushing
past someone, jimmying a lock, cutting a screen, or entering through an open door or
window?
(b) Has anyone illegally gotten in or tried to get into a garage, shed, or storage room? OR
(c) Illegally gotten in or tried to get into a hotel or motel room or vacation home where you
were staying?
The next few questions ask about break‐ins. In the past 12 months… (ASKED OF HOUSEHOLD
RESPONDENT ONLY)
a) Has anyone broken in or TRIED to break into your home by forcing a door or window, pushing
past someone, jimmying a lock, cutting a screen, or coming through an open door or window?
b) Has anyone broken in or TRIED to break into your garage, shed, or storage room?
c) Has anyone broken in or TRIED to break into a hotel or motel room or vacation home where you
were staying?
The next few questions ask about break‐ins.
Since (ANCHOR DATE), did anyone break in or try to break
into your home, your garage or shed, or a hotel or motel
room or vacation home where you or someone else in this
household were staying by forcing a door or window,
pushing past someone, jimmying a lock, cutting a screen,
or entering through an open door or window?
Vehicle Theft
During the last 6 months, (other than any incidents already mentioned,) (was the
vehicle/were any of the vehicles) ‐ Read each category.
(a) Stolen or used without permission?
(b) Did anyone steal any parts such as a tire, car stereo, hubcap, or battery?
(c) Did anyone steal any gas from (it/them)? OR
(d) Did anyone ATTEMPT to steal any vehicle or parts attached to (it/them)?
In the past 12 months… (ASKED OF HOUSEHOLD RESPONDENT ONLY)
a) Was a vehicle you owned at the time stolen or used without permission?
b) Did anyone steal any vehicle parts such as a tire, car stereo, GPS, hubcap, or battery?
c) Did anyone steal any gas from a vehicle you own?
d) Did anyone TRY to steal a vehicle or vehicle parts?
The next few questions ask about vehicles. Since (ANCHOR
DATE), did you or anyone else in this household have a
car, van, truck, motorcycle, or other motor vehicle stolen
or used without permission?
Theft
First I’ll ask about different things that might have
been stolen from you. Since (ANCHOR DATE), was
something belonging to you or your children under
12 stolen? This might include things like money,
jewelry, clothing, cell phones, TVs or other
electronics, or any other items belonging to you.
Did anyone attempt to steal anything belonging to
you?
Since (ANCHOR DATE), were any vehicle parts stolen from
a car, van, truck, motorcycle, or other motor vehicle
belonging to you or someone else in this household, such
as a tire, hubcap, car stereo, GPS device, battery or engine
parts, gasoline, or any other vehicle parts?
Attachment B Comparison to NCVS
Vandalism
Current NCVS
(FROM 2009 NCVS Vandalism Supplement) Now I'd like to ask about ALL acts of vandalism
that may have been committed during the last 6 months against YOUR household.
Vandalism is the deliberate, intentional damage to or destruction of household property.
Examples are breaking windows, slashing tires, and painting graffiti on walls.
Long Cues
Now I'd like to ask about any acts of vandalism that may have been committed against you and the
other people living with you. Vandalism is when someone damages or destroys something
belonging to you on purpose. Examples are breaking windows, slashing tires, and painting graffiti
on walls.
Since __________ ______, 20 ____, has anyone intentionally damaged or destroyed
property owned by you or someone else in your household?
In the past 12 months, has anyone vandalized your home, car, or something else belonging to you
or someone else living here?
Short Cues
Now I’d like to ask about any acts of vandalism that may
have been committed against you and the other people
living with you. Vandalism is when someone damages or
destroys something belonging to you on purpose.
Examples are breaking windows, slashing tires, or painting
graffiti on walls. Since (ANCHOR DATE), has anyone
vandalized your home, car, or something else belonging to
you or someone else living here?
(EXCLUDE any damage done in conjunction with incidents already mentioned. )
Assault
IPV
(Other than any incidents already mentioned,) has anyone attacked or threatened you in
any of these ways ‐
(Exclude telephone threats) ‐
(a) With any weapon, for instance, a gun or knife ‐
(b) With anything like a baseball bat, frying pan, scissors, or stick ‐
(c) By something thrown, such as a rock or bottle ‐
(d) Include any grabbing, punching, or choking,
(e) Any rape, attempted rape or other type of sexual attack ‐
(f) Any face to face threats ‐
OR
(g) Any attack or threat or use of force by anyone at all? Please mention it even if you are
not certain it was a crime.
The next few questions ask about any physical attacks against you personally. These may have
happened at your home or while you were at work, at school, or away from home. In the past 12
months,
a) Has anyone attacked or tried to attack you with a weapon, for instance, a gun or knife?
b) Has anyone attacked or tried to attack you with something else that was used as a weapon, like a
baseball bat, scissors, or a stick?
c) Has anyone attacked or tried to attack you by throwing something at you, such as a rock or
bottle?
d) Has anyone attacked or tried to attack you by slapping, grabbing, kicking, punching, or choking
you?
e) Has anyone attacked, tried to attack, or used force against you in any other way in the past 12
months? Please mention it even if you are not certain it was a crime.
f) (Other than incidents already mentioned,) In the past 12 months, did anyone THREATEN to attack
you, but not actually do it?
People often don't think of incidents committed by someone they know. (Other than any
incidents already mentioned,) did you have something stolen from you OR were you
attacked or threatened by ‐ (Exclude telephone threats) Read each category.
(a) Someone at work or school ‐
(b) A neighbor or friend ‐
(c) A relative or family member ‐
(d) Any other person you've met or known?
People sometimes don’t think of attacks by someone they know, like a current or former spouse or
partner, someone at work, a friend, or a family member. (Other than incidents already mentioned,)
Has anyone YOU KNOW used any kind of physical force against you in the past 12 months?
Examples are if someone you know choked you, slapped you, hit you with something other than a
fist, attacked you with a weapon, or otherwise physically hurt you.
Attachment B Comparison to NCVS
The next few questions ask about any physical attacks
against you personally.
Since (ANCHOR DATE), has anyone attacked or threatened
to attack you in any way? This might include things like
attacking you with a weapon, attacking you with
something else used as a weapon, throwing something at
you, grabbing, punching or choking you, or any other type
of attack or threat or use of force against you.
Sexual Assault
Current NCVS
(Other than any incidents already mentioned,) has anyone attacked or threatened you in
any of these ways ‐
(Exclude telephone threats) ‐
(e) Any rape, attempted rape or other type of sexual attack ‐
Incidents involving forced or unwanted sexual acts are often difficult to talk about. (Other
than any incidents already mentioned,) have you been forced or coerced to engage in
unwanted sexual activity by ‐ Read each category.
(a) Someone you didn't know ‐
(b) A casual acquaintance ‐ OR
(c) Someone you know well?
Stalking
(FROM 2016 NCVS STALKING SUPPLEMENT) Now, I would like to ask you some questions
about times when you may have experienced unwanted contacts or behaviors. I want to
remind you that the information you provide is confidential. When answering, please think
about anyone who may have done these things, including current or former spouses or
partners, other people you may know, or strangers. However, please DO NOT include bill
collectors, solicitors, or other sales people.
SQ1. In the past 12 months, have you experienced any unwanted contacts or behaviors?
By that I mean has anyone –
a. Followed you around and watched you?
b. [Has anyone] Sneaked into your home, car, or any place else and did unwanted things to
let you know they had been there?
c. [Has anyone] Waited for you at your home, work, school, or any place else when you
didn’t want them to?
Still thinking about unwanted contacts and behaviors, in the past 12 months, has anyone…
d. Showed up, rode or drove by places where you were when they had no business being
there?
e. [Has anyone] Left or sent unwanted items, cards, letters, presents, flowers, or any other
unwanted items?
f. [Has anyone] Harassed or repeatedly asked your friends or family for information about
you or your whereabouts?
Long Cues
Now I’d like to ask about any sexual contact in the past 12 months that you DID NOT CONSENT TO
and that YOU DID NOT WANT to happen. I want to remind you that the information you provide is
confidential.
Sexual contact includes someone touching your private parts, unwanted kissing, or penetrating
your (IF FEMALE: vagina or)/(ALL: anus) with a penis, mouth, tongue, fingers, or object. This could
have been done by someone you know well, someone you casually know, or a stranger.
In the past 12 months…
a) Did anyone forcibly touch or grab your private parts – or TRY to do this?
b) Did anyone force you to have sexual contact by holding you down with his or her body weight,
pinning your arms, hitting or kicking you, or using some other type of force – or TRIED to do this?
c) Did anyone threaten to hurt you or someone close to you if you did not have sexual contact?
d) Did anyone have sexual contact with you – or try to have sexual contact with you – while you
were passed out, unconscious, blacked out, asleep, or unable to consent because you were drunk
or high?
Now, I would like to ask you about other types of unwanted contacts or behaviors. When
answering, please think about anyone who may have done these things, including a current or
former spouse or partner, other people you may know, or strangers. However, please DO NOT
include bill collectors, solicitors, or sales people.
In the past 12 months…
a. Has anyone followed you around and watched you?
b. Has anyone sneaked into your home, car, or any other place and did unwanted things to let you
know they had been there?
c. Has anyone waited for you at your home, work, school, or any other place when you didn’t want
them to?
d. Still thinking about unwanted contacts and behaviors, in the past 12 months, has anyone showed
up, rode or drove by places where you were when they had no business being there?
e. Has anyone left or sent you unwanted items, cards, letters, presents, flowers, or any other
unwanted items?
f. Has anyone harassed or repeatedly asked your friends or family for information about you or
your whereabouts?
Attachment B Comparison to NCVS
Short Cues
Now I’d like to ask about any sexual contact in the past 12
months that you DID NOT CONSENT TO and that YOU DID
NOT WANT to happen. I want to remind you that the
information you provide is confidential.
Since (ANCHOR DATE), has anyone had, or tried to have
sexual contact with you by touching or penetrating your
private parts that you DID NOT CONSENT TO and that YOU
DID NOT WANT to happen? For example, by holding or
pinning you, hitting or kicking you, or using some other
type of force; OR by threatening to hurt you or someone
close to you? This could have been done by someone you
know well, someone you casually know, or a stranger.
Since (ANCHOR DATE), has anyone had, or tried to have
sexual contact with you – while you were passed out,
unconscious, blacked out, asleep, or unable to consent
because you were drunk or high?? This could have been
done by someone you know well, someone you casually
know, or a stranger.
Now, I would like to ask you about other types of
unwanted contacts or behaviors.
Since (ANCHOR DATE), has anyone, male or female stalked
you, for example, by following you or spying on you,
showing up at your home or your work place, repeatedly
calling or texting you, tracking your whereabouts on a
GPS, or posting false information about you online?
Current NCVS
(FROM 2016 NCVS STALKING SUPPLEMENT) Now I want to ask about unwanted contacts or
behaviors using various technologies, such as your phone, the Internet, or social media
apps. Again, please DO NOT include bill collectors, solicitors, or other sales people. In the
past 12 months, has anyone…
g. Made unwanted phone calls to you, left voice messages, sent text messages, or used the
phone excessively to contact you?
h. [Has anyone] Spied on you or monitored your activities using technologies such as a
listening device, camera, or computer or cell phone monitoring software?
Still thinking about unwanted contacts and behaviors, in the past 12 months, has anyone…
i. Tracked your whereabouts with an electronic tracking device or application, such as GPS
or an application on your cell phone?
j. [Has anyone] Posted or threatened to post inappropriate, unwanted, or personal
information about you on the Internet, this includes private photographs, videos, or
spreading rumors?
k. [Has anyone] Sent unwanted e‐mails or messages using
the Internet, for example, using social media apps or websites like Instagram, Twitter, or
Facebook?
l. [Has anyone] Monitored your activities using social
media apps like Instagram, Twitter, or Facebook?
Fraud
Long Cues
Short Cues
The next questions are about unwanted contacts or behaviors using various technologies, such as
your phone, the Internet, or social media apps. Again, please DO NOT include contacts from bill
collectors, solicitors, or sales people. In the past 12 months…
g. Has anyone made unwanted phone calls to you, left voice messages, sent text messages, or used
the phone excessively to contact you?
h. Has anyone spied on you or monitored your activities using technologies such as a listening
device, camera, or computer or cell phone monitoring software?
i. Has anyone tracked your whereabouts with an electronic tracking device or application, such as
GPS or an application on your cell phone?
j. Still thinking about unwanted contacts and behaviors, in the past 12 months has anyone posted
or threatened to post inappropriate, unwanted, or personal information about you on the
Internet? This includes private photographs, videos, or spreading rumors.
k. Has anyone sent unwanted e‐mails or messages using the Internet, for example, using social
media apps or websites like Instagram, Twitter, or Facebook?
l. Has anyone monitored your activities using social media apps like Instagram, Twitter, or
Facebook?
The next items are about whether anyone got you to give them money by lying about a product or
service, or by deliberately hiding information about it from you. In the past 12 months...
a. Did you pay for something or a service that you never got, or that was fake or worthless?
b. Were you told you won something, such as a prize or lottery, but you had to pay money in order
to collect it, or you never got it or it was fake or worthless?
c. Were you told you would get a high return on an investment you made, but it was fake or worth
far less than you were led to expect?
d. Did you pay someone to help you improve your credit or finances, but then not receive what you
were promised?
e. Did you donate money to an organization you thought was a charity, but which turned out to be
fake?
f. Did you put money into a business opportunity, but it was fake or you earned much less than you
were led to expect?
g. Did you send money to help someone who told you they urgently needed money, but it turned
out their story wasn’t true?
h. Did you send money to someone who pretended to need help moving money from another
country, but they just kept your money?
i. Were there any other times in the past 12 months when someone got you to give them money by
lying about a product or service, or by deliberately hiding information from you?
j. Thinking about all the situations I just asked you about, did anyone TRY anything (else) like this on
you in the past 12 months, but you did not send them any money?
Attachment B Comparison to NCVS
Since (ANCHOR DATE), Has anyone convinced you to buy a
product or a service, make an investment, or seek a job
opportunity by lying about, misrepresenting, or hiding
information?? Include anything that might have
happened longer ago, but you just realized in the past 12
months that it happened.
Identity Theft
Current NCVS
(FROM NCVS 2012 IDENTITY THEFT SUPPLEMENT)
1a. During the past 12 months, since ______, 20__ has someone, without your permission,
used or attempted to use your existing checking or savings account, including any debit or
ATM cards?
Long Cues
Now I’d like to ask you about any times someone used your personal information without your
permission for their own benefit. In the past 12 months…
a) Did someone, without your permission, use or try to use your existing checking or savings
account, including any debit or ATM cards?
b) Did someone use or try to use one or more of your existing credit cards without your
2a. Since ______, 20__ has someone used or attempted to use one or more of your existing permission? Please do not include debit cards.
credit cards without your permission? Please do not include debit cards.
c) Did someone misuse or try to misuse another type of existing account, such as your telephone,
utilities, an online payment account like Paypal, insurance policies, or something else?
3. Since ___, 20__ has someone misused or attempted to misuse another type of existing
d) Still thinking about the past 12 months, did someone, without your permission, use or try to use
your personal information to open any NEW accounts, such as wireless telephone accounts, credit
account such as your telephone, utilities, online payment account like Paypal, insurance
card accounts, loans, bank accounts, online payment accounts, or something else?
policies, or something else?
e) Did someone use or try to use your personal information for some other fraudulent purpose,
4. Since ________, 20___, has someone, without your permission, used or attempted to use such as getting medical care, a job, or government benefits; renting an apartment or house; giving
your personal information to open any NEW accounts such as wireless telephone accounts, your information to the police when they were charged with a crime or traffic violation, or
credit card accounts, loans, bank accounts, online payment accounts, or something else?
something else?
Short Cues
Since (ANCHOR DATE), has anyone used your financial
accounts without your permission, or used your personal
information to open a new account, or stolen your
personal information for their own benefit? Include
anything that might have happened longer ago, but you
just realized in the past 12 months that it happened.
Thinking about all the situations I just asked you about,
did anyone TRY to do anything like this in the past 12
months but did not succeed?
5. Since________ 20__, has someone used or attempted to use your personal information
for some other fraudulent purpose, such as getting medical care, a job, or government
benefits; renting an apartment or house; giving your information to the police when they
were charged with a crime or traffic violation, or something else?
I want to make sure we’ve captured everything that has happened to you. At the beginning of this
survey, you recalled that {RESPONSE TO INTRO1} occurred around (ANCHOR DATE). Is there
anything (else) that you might think of as a crime that happened to you in the past 12 months that
During the last 6 months, (other than any incidents already mentioned,) did anything which you haven’t mentioned? It could be something you called the police about, or something you didn’t
consider reporting to the police.
you thought was a crime happen to YOU, but you did NOT report to the police?
Catch All
During the last 6 months, (other than any incidents already mentioned,) did you call the
police to report something that happened to YOU which you thought was a crime?
Additional Items
(Other than any incidents already mentioned,) since __________ ______, 20 ____, were you
attacked or threatened OR did you have something stolen from you ‐ Read each category.
(a) At home including the porch or yard ‐
(b) At or near a friend's, relative's, or neighbor's home ‐
(c) At work or school ‐
d) In places such as a storage shed or laundry room, a shopping mall, restaurant, bank, or
airport ‐
(e) While riding in any vehicle ‐
(f) On the street or in a parking lot ‐
(g) At such places as a party, theater, gym, picnic area, bowling lanes, or while fishing or
hunting ‐ OR
(h) Did anyone ATTEMPT to attack or ATTEMPT to steal anything belonging to you from any
of these places?
Attachment B Comparison to NCVS
I want to make sure we’ve captured everything that has
happened to you. At the beginning of this survey, you
recalled that {RESPONSE TO INTRO1} occurred around
(ANCHOR DATE). To make sure we haven’t missed
anything, is there anything (else) that you might think of
as a crime that happened to you in the past 12 months
that you haven’t mentioned? It could be something you
called the police about, or something you didn’t consider
reporting to the police.
NCVS Redesign: Cognitive Testing
ATTACHMENT C – PRELIMINARY CRIME INCIDENT
REPORT ITEMS FOR COGNITIVE TESTING
Location Items (page C2)
Presence Items (page C6)
Victim Offender Relationship Items (page C7)
Police Efficacy (page C11)
Victim Services (page C21)
Informal Help‐seeking (page C24)
Location Items
[IF INTERLEAFING VERSION AND ANY ITEMS INDICATE A BREAK‐IN – THEN GO TO 10a1.
OTHERWISE CONTINUE]
10a.
Did this incident happen in, or was there an attempt to get into YOUR home, garage,
another building on your property, or any place you paid to stay overnight?
Yes
No
→ CONTINUE
→ SKIP to 10b
10a1. Which of these best describes where this incident happened?
Inside your home, an attached garage, or enclosed porch,
including any attempts to enter any of these
Inside a detached building on your property, such as a
detached garage or storage shed, including any attempts
to enter these.
Inside a vacation or second home that your own
Inside a hotel or motel room
Inside a home you rented for a vacation from a rental agency
or website listing service (for example AIRBNB, Flipkey,
or Roomorama)
None of these
→ CONTINUE
10b. Did this incident happen immediately near, but NOT inside YOUR home or place where you
paid to stay overnight? For example, somewhere on your property or on the street
immediately outside of your home.
Yes
→ CONTINUE
No
→ SKIP to 10c
Attachment C: Preliminary Crime Incident Report Items for Testing
C2
10b1. Which of these best describes where this incident happened? (Immediately near, but
NOT inside your home or place where you were staying overnight.)
Your own yard, sidewalk, driveway, carport, unenclosed
porch – but NOT apartment yards, fields or playgrounds
An apartment hall, storage area, laundry room – but NOT
apartment parking lot/garage
On the street immediately adjacent to your home or place
you were staying overnight
A parking lot or parking garage
→ SKIP to 10e1
None of these
→ CONTINUE
10c.
[Did this incident happen] Inside or immediately near a friend’s/relative’s/neighbor’s home?
Yes
No
→ CONTINUE
→ SKIP to 10d
10c1
Which of these best describes where this incident happened? (Inside or immediately
near a friend’s/relative’s/neighbor’s home.)
At or inside (friend’s/relative’s/neighbor’s) home or other
building on THEIR property
In the yard, or on the driveway, or carport but NOT in
apartment yards
In an apartment hall, storage area, laundry room – but NOT
in apartment parking lot/garage
On the street immediately adjacent to THEIR home
A parking lot or parking garage
None of these
→ SKIP to 10e1
→ CONTINUE
10d.
[Did this incident happen] Inside a business or public building, but not a school or public
transportation? For example, at a restaurant or bar, gas station, gym, store, or office.
Yes
No
→ CONTINUE
→ SKIP to 10e
Attachment C: Preliminary Crime Incident Report Items for Testing
C3
10d1
Which of these best describes where this incident happened? (Inside a business or
public building, but not a school or public transportation)
Inside a restaurant, bar, or nightclub
Inside a bank
Inside a gym
Inside a laundromat
Inside a gas station
Inside another commercial building, such as a store
Inside an office
Inside a factory or warehouse
None of these
→ CONTINUE
10e.
[Did this incident happen] In a parking lot or parking garage that was NOT a part of a school
property?
Yes
No
→ CONTINUE
→ SKIP to 10f
10e1
Which of these best describes where this incident happened? (Inside a parking lot or
parking garage)
A commercial parking lot or parking garage – for example
at a store or a mall
A NON‐commercial parking lot or parking garage – for
example at an airport
An apartment/townhouse parking lot or parking garage
None of these
→ CONTINUE
10f.
[Did this incident happen] On a school property, inside a school, or on a school bus?
Yes
No
→ CONTINUE
→ SKIP to 10g
10f1
Which of these best describes where this incident happened? (On a school property,
inside a school, or on a school bus)
Inside a school building
On school property such as parking area, play area, etc
On a school bus
None of these
→ CONTINUE
Attachment C: Preliminary Crime Incident Report Items for Testing
C4
10g.
[Did this incident happen] On the street, in an open area, an apartment yard, or on public
transportation?
Yes
No
→ CONTINUE
→ SKIP to 10i
10g1
Which of these best describes where this incident happened? (On the street, in an open
area, or on public transportation)
At an apartment yard, a park, field, or playground
On the street, but not immediately adjacent to your own or a
friend’s/relatives/neighbors’ home
On public transportation, such as bus, train, subway, or
airplane including stations or terminals (airports)
None of these
→ CONTINUE
10i.
Please tell me where the incident happened?
Other specify: |_______________________________________________________|
Attachment C: Preliminary Crime Incident Report Items for Testing
C5
Presence Items
20a.
Were you or any member of this household aware of this incident as it was
happening?
Yes
No
→ CONTINUE
20b. Which household members were aware of this incident as it was happening?
→ CONTINUE
Respondent only
Respondent and other household members
→ CONTINUE
Only other household member(s), not respondent
21.
Did you personally see an offender?
Yes
No
Attachment C: Preliminary Crime Incident Report Items for Testing
C6
Preliminary Victim Offender Relationship Items
Questions determining the victim‐offender relationship for incidents with one offender
Q62. Was the offender someone you knew or a stranger you had never seen before?
[1]
Knew or had seen before ‐ SKIP to 64
[2]
Stranger
[3]
Don't know
Q63. Would you be able to recognize the offender if you saw him/her?
[1]
Yes ‐ SKIP to 65a
[2]
Not sure (possibly or probably) ‐ SKIP to 65a
[3]
No ‐ SKIP to 67
Q64. How well did you know the offender ‐ by sight only, casual acquaintance, or well known?
[1]
Sight only ‐ ASK 65a
[2]
Casual acquaintance ‐ SKIP to 66a
[3]
Well known ‐ SKIP to 66a
Q65a. Would you have been able to tell the police how they might find the offender, for
instance, where he/she lived, worked, went to school, or spent time?
[1]
Yes ‐ SKIP to 67
[2]
No ‐ Skip to71a
[3]
Other ‐ Specify ‐ Ask 65b
Q65b. Please specify.
Specify ‐ SKIP to 67
Attachment C: Preliminary Crime Incident Report Items for Testing
C7
66a. How well did you know the offender? For example, was the offender a friend, cousin,
etc.?
RELATIVE
[1]
Spouse at time of incident ‐ SKIP to 67
[2]
Ex‐spouse at time of incident ‐ SKIP to 67
[3]
Parent or step‐parent ‐ SKIP to 67
[4]
Own child or step‐child ‐ SKIP to 67
[5]
Brother/sister ‐ SKIP to 67
[6]
Other relative ‐ Specify ‐ ASK 66b
NONRELATIVE
[7]
Boyfriend or girlfriend, ex‐boyfriend or ex‐girlfriend ‐ SKIP to 67
[8]
Friend or ex‐friend ‐ SKIP to 67
[9]
Roommate, boarder ‐ SKIP to 67
[10] Schoolmate ‐ SKIP to 67
[11] Neighbor ‐ SKIP to 67
[12] Customer/client ‐ SKIP to 67
[14] Patient ‐ SKIP to 67
[15] Supervisor (current or former) ‐ SKIP to 67
[16] Employee (current or former) ‐ SKIP to 67
[17] Co‐worker (current or former) ‐ SKIP to 67
[18] Teacher/school staff ‐ SKIP to 67
[19] Other nonrelative ‐ Specify ‐ ASK 66c
66b. Please specify the other relative
Specify ‐ SKIP to 67
66c. Please specify the other nonrelative.
Specify
Attachment C: Preliminary Crime Incident Report Items for Testing
C8
Questions determining the victim‐offender relationship for incidents with more than one
offender.
74. How many offenders were there?
__________ Number of offenders
75. Were any of the offenders known to you, or were they strangers you had never seen
before?
[1]
All known ‐ SKIP to 77a
[2]
Some known ‐ SKIP to 77a
[3]
All strangers ‐ ASK 76
[4]
Don't know ‐ ASK 76
76. Would you be able to recognize any of them if you saw them?
[1]
Yes ‐ SKIP to 78a
[2]
Not sure (possibly or probably) ‐ SKIP to 78a
[3]
No ‐ SKIP to 80a
77a. How well did you know the offender(s) ‐ by sight only, casual acquaintance, or well known?
Did you know the offenders by sight only, were they casual acquaintances, or did you know
them well?
Enter all that apply.
[1]
Sight only
[2]
Casual acquaintance
[3]
Well known
77b. [CHECK ITEM H]
Is "casual acquaintance" or "well known" marked in 77a?
[1]
Yes ‐ SKIP to 79a
[2]
No ‐ ASK 78a
78a. Would you have been able to tell the police how they might find any of them, for instance,
where they lived, worked, went to school, or spent time?
[1]
Yes ‐ SKIP to 80a
[2]
No ‐ SKIP to 80a
[3]
Other ‐ Specify ‐ ASK 78b
78b. Please specify.
Specify ‐ SKIP to 80a
Attachment C: Preliminary Crime Incident Report Items for Testing
C9
Exhibit 3. (Continued).
79a. How did you know them? For example, were they friends, cousins, etc.?
Enter all that apply.
RELATIVE
[1]
Spouse at time of incident ‐ SKIP to 80a
[2]
Ex‐spouse at time of incident ‐ SKIP to 80a
[3]
Parent or step‐parent ‐ SKIP to 80a
[4]
Own child or step‐child ‐ SKIP to 80a
[5]
Brother/sister ‐ SKIP to 80a
[6]
Other relative ‐ Specify ‐ ASK 84b
NONRELATIVE
[7]
Boyfriend or girlfriend, ex‐boyfriend or ex‐girlfriend ‐ SKIP to 80a
[8]
Friend or ex‐friend ‐ SKIP to 80a
[9]
Roommate, boarder ‐ SKIP to 80a
[10] Schoolmate ‐ SKIP to 80a
[11] Neighbor ‐ SKIP to 80a
[12] Customer/client ‐ SKIP to 85a
[14] Patient ‐ SKIP to 80a
[15] Supervisor (current or former) ‐ SKIP to 80a
[16] Employee (current or former) ‐ SKIP to 80a
[17] Co‐worker (current or former) ‐ SKIP to 80a
[18] Teacher/school staff ‐ SKIP to 80a
[13] Other nonrelative ‐ Specify ‐ ASK 79c
79b. Please specify the other relative.
Specify ‐ SKIP to 80a
79c.Please specify the other nonrelative.
Specify
Attachment C: Preliminary Crime Incident Report Items for Testing
C10
Police Efficacy
115. Were the police informed or did they find out about this incident in any way?
1 Yes
2 No (Go to 117a)
3 Don’t Know (go to 129)
116a Who informed the police? If more than one person, choose lowest‐numbered applicable
response.
1
Respondent (Go to 116c)
2
Other household member (Go to 116c)
3
School employee or School Resource Officer (Go to 116c)
4
Other official (e.g., security guard, building manager, etc..) (Go to 116c)
5
Some other person
Go to 123a
6
Police were at scene
Go to 123a
7
Offender was police officer Go to 123a
8
Some other way ‐ specify
116b. Specify______________________
116c. How were the police first notified?
1 By telephone (Go to 116e)
2 Approached officer or police car (Go to 116f)
3 Went to police station (Go to 116f)
4 Reported using the Internet (Go to 119a)
5 Don’t know –someone else notified the police (Go to 119a)
6 Some other way – specify
116d. Specify _________ Then go to 119a
116e. Were the police notified by a 911 call, through another police number, or through a
general city number or city hotline number ?
1
911/emergency number
2
Another police phone number
3
General city number/hotline
4
Don’t know
Attachment C: Preliminary Crime Incident Report Items for Testing
C11
116f. Would you describe this as an emergency contact with police, or was it a non‐emergency
or a routine contact with police?
1
Emergency contact
2
Non‐emergency contact
3
Don’t know
116g. Was the crime still underway when the police were contacted, or was it over?
1
Still underway (Go to 119a)
2
Crime was over
3
Don’t Know
116h. What was the gap in time between when the crime was over and the police were
contacted? Was it within 5 minutes, within 10 minutes, an hour, a day or longer?
1
Within 5 minutes
2
Within 10 minutes
3
Within an hour
4
Within a day
5
Longer than a day
6
Don’t know how long
Go to 119a
117a. What was the reason it was not reported to the police? [Mark all that apply.]
Dealt with another way
1 Reported to another official (guard, apt manager, school official, etc.)
2
I took care of it myself or informally
2a Third party already dealing with it
Not Important enough to respondent
3
I recovered my property
3a It was not serious enough
4
Child Offender(s), ‘kid’s stuff’
5
Not clear it was a crime or that harm was intended
6
No insurance, loss less than deductible, etc..
Police couldn’t do anything
7
Didn’t find out until too late
8
Could not recover or identify property
9
Could not find or identify offender
Police wouldn’t help
10 Police wouldn’t think it was important enough, wouldn’t want to be bothered or get
involved
Attachment C: Preliminary Crime Incident Report Items for Testing
C12
10a Police would not be sympathetic
10b Didn’t think Police would believe me
11 Police would be inefficient, ineffective (they’d arrive late or not at all, wouldn’t do a
good job, etc.)
Afraid of Police
11a Afraid or distrust the police
11b Police would not keep it confidential
12 Police would harass/insult respondent, cause respondent trouble
13 Offender was police officer
Consequences for the Victim
13b Didn’t want to make more trouble for myself
13c Might lose job if reported
13d Did not want humiliation
16 Afraid of reprisal by offender or others
13e Private or personal matter
Other Reason
14 Did not want to get offender in trouble with the law
15 Was advised not to report to police
17 Did not want to or could not take time – too inconvenient
17a Did not want to go to court18. Other Specify – Ask 117b
19 Respondent not present or doesn’t know why it wasn’t reported
117b. Specify______________________
117c. Check item P. Is more than one reason marked in 117a?
1
Yes
2
No – Go to 130
118 Which of these would you say was the most important reason why the incident was not
reported to the police?
Go to 130
Attachment C: Preliminary Crime Incident Report Items for Testing
C13
119a. Besides the fact that it was a crime, did YOU have any other reason for reporting this
incident to the police?
To get help with this incident
1
Stop or prevent THIS incident from happening
2
Needed help after the incident due to injury
To recover loss
3
To recover property
4
To collect insurance
To get offender
5
To prevent further crimes against respondent/respondent’s household by this
offender
6
To stop this offender from committing other crimes against anyone
7
To punish offender
8
Catch or find offender – other reason or no reason given
To let police know
9
To improve police surveillance of respondent’s home, area, etc.…
10 Duty to let police know about crime
Other
11 Other reasons – specify (Go to 119b)
12 No other reason (Go to 121)
If any reason given besides 11, 12 given, go to 119c
119b. Specify
119c Check Item Q. Is more than one reason marked in 119a?
1
Yes
2
No (Go to 121)
120. Which of these would you say was the most important reason why the incident was
reported to the police?
Attachment C: Preliminary Crime Incident Report Items for Testing
C14
121. Did the police come when they found out about the incident, did they just take a report
over the phone, or did they deal with it just using the mail or the Internet?
1
Police came (go to 122a)
2
Took report over the phone (go to 121b)
3
Dealt with it using the mail (go to 121c)
4
Dealt with it using the Internet (go to 121c)
5
Took phone report with follow‐up through the mail or internet (go to 121b)
121b. How satisfied were you with the manner with which the phone report was taken? Would
you say you were ….
1
Extremely satisfied
2 Very satisfied
3 Moderately satisfied
4 Slightly satisfied or
5 Not at all satisfied?
121c. Should the police have come when they were contacted, or was the incident handled
appropriately?
1
Police should have come
2
It was handled appropriately
3
Don’t Know
GO TO 124
Q122a. How satisfied were you with the time it took the police to come after they were
contacted? Would you say you were ….
1 Extremely satisfied
2 Very satisfied
3 Moderately satisfied
4 Slightly satisfied or
5 Not at all satisfied?
Q122b. Had the police told you in advance how long it would take them to get there?
1 Yes
2 No
Attachment C: Preliminary Crime Incident Report Items for Testing
C15
123a. What did they do while they were (there/here) to try to solve the crime? (Mark all that
apply)
1
Took report
2
Searched/looked around
3
Took evidence (fingerprints, inventory, etc.…)
4
Questioned witnesses or suspects
5
Made arrest
6
Recovered property
7
Other, Specify (Go to 123b)
8
Don’t Know (Go to 123c)
123b. Specify__________ Then ask 123c
123c. What did they do while they were (there/here) to provide help or assistance? (Mark all
that apply)
1
Calmed people down; restored order
2
Resolved the conflict between the parties
3
Gave advice about insurance
4
Gave (other) advice about how to handle the damage or loss
5
Gave advice about services or organizations that could help
6
Contacted emergency medical services
7
Other, Specify (Go to 123d)
8
Don’t Know (Go to 124)
123d. Specify__________ Then ask 124
124. Did you (or anyone in your household) have any later contact with the police about the
incident?
1
Yes (Go to 125a)
2
No (Go to 127c)
3
Don’t know (Go to 127c)
125a Did the police get in touch with you or did you get in touch with them?
1
Police contacted respondent or other HHLD member (Go to 126)
2
Respondent (or other HHLD member) contacted the police (Go to 126)
3
Both (Go to 126)
4
Don’t Know (Go to 126)
5
Other – specify (Go to 125b)
Attachment C: Preliminary Crime Incident Report Items for Testing
C16
126. Was that in person, by phone, through the mail, or over the Internet?
1
In person
2
By telephone
3
Through the mail
4
Over the Internet
5
Any combination of reasons
127a What did the police do in following up this incident? (mark all that apply)
1
Took report (Go to 127c)
2
Questioned witnesses or suspects (Go to 127c)
3
Did or promised surveillance/investigation (Go to 127c)
4
Recovered property (Go to 127c)
5
Made arrest (Go to 127c)
6
Gave advice about services or organizations that could help
7
Stayed in touch with household respondent (Go to 127c)
8
Other – Specify
9
Nothing (to respondent’s knowledge) (Go to 127c)
10 Don’t Know (Go to 127c)
127b. Specify
Now we have a few questions about how you feel the police handled this incident.
127c How respectfully would you say that you were treated by the police? Were you treated...
1 Extremely respectfully,
2 Very respectfully,
3 Moderately respectfully,
4 Slightly respectfully, or
5 Not at all respectfully?
127d When you talked to the police, how polite were they? Would you say they were...
1 Extremely polite,
2 Very polite,
3 Moderately polite,
4 Slightly polite, or
5 Not at all polite?
If Response 4 or 5 for either 127c or 127d, then ask 127e. Otherwise go to 127f.
Attachment C: Preliminary Crime Incident Report Items for Testing
C17
127e Why did you feel that the police were disrespectful or impolite?
MARK ALL THAT APPLY
Specify _____________________
127f How satisfied were you that the police did everything they could do to address the reason
you contacted them? Would you say you were …
1
Extremely satisfied
2
Very satisfied
3
Moderately satisfied
4
Slightly satisfied
5
Not at all satisfied
127g (Voice) How interested were the police in hearing the details about this incident? Were
they...
1 Extremely interested,
2 Very interested,
3 Moderately interested,
4 Slightly interested, or
5 Not at all interested?
127h (Voice) How satisfied were you with the amount of time that you were given to tell your
story? Would you say you were …
1 Extremely satisfied
2 Very satisfied
3 Moderately satisfied
4 Slightly satisfied
5 Not at all satisfied
127i (Respect) When you talked to the police, how polite were they? Would you say they
were...
1 Extremely polite,
2 Very polite,
3 Moderately polite,
4 Slightly polite, or
5 Not at all polite?
Attachment C: Preliminary Crime Incident Report Items for Testing
C18
127j (Respect) How respectfully would you say that you were treated by the police? Were you
treated...
1 Extremely respectfully,
2 Very respectfully,
3 Moderately respectfully,
4 Slightly respectfully, or
5 Not at all respectfully?
127k (Trust) How satisfied were you that the police did everything they could do to address
the reason you contacted them? Would you say you were …
1 Extremely satisfied
2 Very satisfied
3 Moderately satisfied
4 Slightly satisfied
5 Not at all satisfied
127l (Trust) How much understanding and support do you think the police involved showed to
you? Would you say they offered you …
1 A great deal,
2 A lot,
3 A moderate amount,
4 A little, or
5 None at all?
127m. (Satisfaction) Overall, how professional would you say that the police were? Would you
say that they were ...
1 Extremely professional,
2 Very professional,
3 Moderately professional,
4 Slightly professional, or
5 Not at all professional?
127n. (Satisfaction) Taking the whole experience into account, how satisfied are you with the
way you were treated during this contact by the police? Were you ..
1 Extremely satisfied
2 Very satisfied
3 Moderately satisfied
4 Slightly satisfied
5 Not at all satisfied
Attachment C: Preliminary Crime Incident Report Items for Testing
C19
128. Did you (or someone in your household) sign a complaint against the offender(s) to the
police department or the authorities?
1
Yes
2
No
129. As far as you know, was anyone arrested or were charges brought against anyone in
connection with this incident?
1
Yes
2
No
Attachment C: Preliminary Crime Incident Report Items for Testing
C20
Victim Services
Q130.
Q131.
Q132.
Q133.
Did you seek any help or advice concerning this incident from any office or agency –
other than police – that assists victims of crime?
Yes
No
Don’t know
Did you file a claim to receive victim compensation?
Yes
[if Q130=yes or Q131=yes, ask Q132]
No
[If Q130=no and Q131=no, skip to Q136]
Don’t know
[If Q130=don’t know and Q131=don’t know, skip to next
section]
Did you receive any services, assistance, or compensation from this or these offices
or agencies?
Yes
[ask Q133]
No
[skip to Q135]
Don’t know
[skip to next section]
What type of services did you receive?
Crisis hotline counseling?
Counseling or therapy?
Legal or court services?
Assistance getting a restraining, protection, or no‐contact order?
Federal or state victim compensation?
Short term or emergency financial assistance?
Shelter or safehouse services?
Safety planning?
Risk or threat assessment?
Medical advocacy?
Any other services? – specify __________________
Attachment C: Preliminary Crime Incident Report Items for Testing
● Yes
● Yes
● Yes
● Yes
● Yes
● Yes
● Yes
● Yes
● Yes
● Yes
● Yes
● No
● No
● No
● No
● No
● No
● No
● No
● No
● No
● No
C21
Q134.
Were there other services that you sought but did not receive?
Yes (ask Q135)
No (skip to next section)
Q135. Why did you not receive the services or compensation that you sought? Was it
because…
Services were not available in your local area?
● Yes ● No
You did not have a means of transportation to and from the service provider?
● Yes ● No
You did not have childcare to go to get services?
● Yes ● No
The service provider could not accommodate you (e.g. no beds available in shelter)?
● Yes ● No
You were unable to take time off of work or school to get services?
● Yes ● No
There were language barriers?
● Yes ● No
You were not eligible for services?
● Yes ● No
[If YES to Q131] The claim has not been processed yet?
● Yes ● No
Some other reason?
● Yes ● No – (specify) ________________
[Skip to next section after Q135 – victims who sought services, will not receive Q136]
Q136.
Why didn’t you seek victim assistance or services? Was it because…?
Services were not available in your local area?
● Yes ● No
You did not know of services that were available?
● Yes ● No
You did not have a means of transportation to and from the service provider?
● Yes ● No
You did not have childcare to go to seek services?
● Yes ● No
Attachment C: Preliminary Crime Incident Report Items for Testing
C22
You were unable to take time off of work or school to seek services?
● Yes ● No
There were language barriers?
● Yes ● No
You did not think you were eligible for services?
● Yes ● No
You did not need services?
● Yes ● No
Some other reason?
● Yes ● No – (specify) ________________
Attachment C: Preliminary Crime Incident Report Items for Testing
C23
Informal Help-Seeking
Other than the police, did you tell anyone about this incident?
o Yes
o No (Skip to next section)
o Don’t know (skip to next section)
Which of the following people did you tell about the incident?
o Parents
o Children
o Other family member
o Friend
o Neighbor
o Teacher or school administrator (if R=student)
o Supervisor (if R > 16)
o Coworker or classmate
o Community or religious leader
o Medical professional
o Other – specify__________________________________
Attachment C: Preliminary Crime Incident Report Items for Testing
C24
NCVS Redesign: Cognitive Testing
ATTACHMENT D – NCVS‐1 (NON‐SCREENING
ITEMS) FOR COGNITIVE TESTING
Police Ask‐All Items (page D2)
Police Ask-All Items
PQ1. The next questions refer to "local police." They would be the police officers or sheriff's
deputies who work in this immediate area and would come if you called for help from
your home.
Have you had contact with your local police in any of the following ways? Please exclude
contact with guards or other security personnel who are not part of the local police.
MARK ALL THAT APPLY1
a. You reported a crime, disturbance or suspicious activity
b. You reported a non‐crime emergency such as a traffic accident or medical
emergency
c. You sought help from the local police for something else
d. You participated in a community meeting, block watch or other anti‐crime activity
when the local police were present
e. You have been stopped by the local police while driving or riding in a motor vehicle
f. You have been stopped by the local police for any other reason
g. Have you had any other contact with the local police that we have not covered
IF ANY POSITIVE RESPONSE a‐g AND SKIP TO PQ2. ELSE GO TO PQ3
PQ2. When was your most recent contact with local police? Was it….
a. within the past 6 months;
b. 6 months to one year ago; or
c. more than a year ago
1
There was also discussion of asking yes-no for each police contact a-g.
Attachment D: NCVS‐1 (Non‐Screener) Items for Cognitive Testing
D2
PQ3. We would like to know your views of your local police. (IF BOX PQa NOT CHECKED: even
though you may never have had direct contact with them,)
Please draw on everything you know about them and give us your best judgments when
you respond to these questions.
These questions would have the response scale:
Very bad
Somewhat Bad
Neither good nor bad
Somewhat Good
Very Good
VOL: DK
VOL: NO ANSWER
a.
(SUMMATIVE) Taking everything into account, how would you rate the job the local
police are doing?
b.
(VOICE) How would you rate the local police on taking the time to listen to what people
have to say before making decisions?
c.
(VOICE) How would you rate the local police on listening to what citizens have to say to
them?
d.
(NEUTRALITY‐FACTUALLY DRIVEN) How would you rate the local police on fully
gathering the facts before making their decisions about what to do in an incident?
e.
(NEUTRALITY‐FACTUALLY DRIVEN) How would you rate the police on getting the facts
about a situation before deciding how to act?
f.
(NEUTRALITY‐EXPLAINING DECISIONS) How would you rate the local police on taking the
time to explain to the people involved why they are taking particular actions?
g.
(NEUTRALITY‐FREE FROM BIAS) How would you rate the local police on treating people
fairly, regardless of who they are?
h.
(RESPECT) How would you rate the local police on treating people politely?
i.
(RESPECT) How would you rate the local police on treating people respectfully,
regardless of who they are?
j.
(TRUST) How would you rate the local police to make decisions that are right for people
in this area?
Attachment D: NCVS‐1 (Non‐Screener) Items for Cognitive Testing
D3
k.
l.
(TRUST) How would you rate police in the law in ways that protect the rights of all of the
people?
(TRUST) How would you rate the local police on trying to find the best solutions for
individual situations?
These questions would have the response scale:
very ineffective
somewhat ineffective
neither ineffective or effective
somewhat effective
very effective
m. How effective are the local police at preventing crime?
n.
How effective are the local police in catching the people who commit crime in this area?
o.
How effective are the local police at addressing the issues that really concern people in
this community?
Attachment D: NCVS‐1 (Non‐Screener) Items for Cognitive Testing
D4
NCVS Redesign: Cognitive Testing
ATTACHMENT E – RECRUITMENT MATERIALS
Craigslist Ad (page E2)
Recruitment Screener (page E3)
ID #_________________
One-hour research interview (receive $40)
Westat is looking for adults 18 years and older to give their opinions about some survey
questions in a national household crime survey. We are looking for individuals who have been a
victim of a crime or an attempted crime within the past 12 months. The in-person interview will
take about an hour and will be held at Westat in Rockville, MD. Participants will receive $40
cash at the end of the interview.
In the interview, participants will be asked to give their reactions to some survey questions. All
information you provide will be treated as confidential. No information about you will be shared
with others, and you will not be put on a marketing/mailing list.
If you are interested in participating and have been the victim of a crime or an attempted crime,
please call 1-855-414-9253, say you are calling about the national household crime survey, and
provide your name, phone number, and a good time to reach you.
Someone from Westat will contact you and ask some questions to determine if you are eligible.
Please understand that we may not be able to interview everyone who contacts us.
WESTAT
EOE
Attachment E: Recruitment Materials
E2
ID #_________________
NCVS-R NCVS-1(Screener)
Recruiting Screener
Hello, this is [NAME] from [Focus Groups of Cleveland/Westat].
INCOMING: Thanks for calling us about participating in one of our studies. I just need to
get a little bit of background information to start.
OUTGOING: I’m calling about a study we’re helping the U.S. Department of Justice with.
Let me first tell you a little about it. The Department of Justice is testing some questions
for a crime survey and wants to be sure that their questions make sense to different
types of people. So we are trying to find people who are interested in helping us by
giving their reactions to the questions. If you are interested and eligible, we will invite
you to an in-person interview, which will take about an hour. At the end of the in-person
interview you will receive $40 cash to help pay for your expenses in getting here. To
make sure you are eligible for the study, I need to ask you a few questions. This will only
take about 2 minutes. Is this a good time? IF NO, ASK FOR A BETTER TIME TO CALL
BACK.
1. How old are you? (RECRUIT A MIX)
________
REF
DK
IF UNDER 18, REF OR DK, INELIGIBLE. THANK AND END
2. When was the last time you participated in a research focus group or interview?
LESS THAN 12 MONTHS AGO
12 MONTHS AGO OR MORE
NEVER
REF
DK
IF LESS THAN 12 MONTHS AGO, REF OR DK, INELIGIBLE. THANK AND END.
IF INELIGIBLE: Thank you for taking the time to answer these questions. You’re not
eligible to participate in the study at this time.
Attachment E: Recruitment Materials
E3
ID #_________________
3. RECORD GENDER. (RECRUIT A MIX)
IF NECESSARY, ASK: What is your gender?
FEMALE
MALE
OTHER
DK
REF
5. During the last 12 months, did any of the following happen to you? (RECRUIT A MIX)
YES
NO
a. Someone stole your vehicle or parts from your vehicle
1
2
b. Someone stole something else or tried to steal something
1
2
c. Someone attacked you or tried to attack you
1
2
d. Someone broke into your home or tried to break into your
1
2
e. Someone destroyed or vandalized your property
1
2
f.
1
2
g. Someone stole your identity
1
2
h. Did any other type of crime happen to you over the past 12
1
2
from you or your property
home
Someone cheated you or tried to cheat you out of money or
something valuable
months? (If yes, specify)
_______________________________________________
_______________________________________________
Attachment E: Recruitment Materials
E4
ID #_________________
(IF NONE TO ANY IN #5, COUNT AS A NON-VICTIM. RECRUIT NO MORE THAN 2 NONVICTIMS IN CLEVELAND, NO MORE THAN 6 NON-VICTIMS IN ROCKVILLE)
6. What is the highest grade or level of education you have completed? (RECRUIT A MIX)
LESS THAN HIGH SCHOOL
HIGH SCHOOL DIPLOMA/GED
SOME COLLEGE (INCLUDES ASSOCIATE’S)
COLLEGE GRADUATE (BA, BS)
GRADUATE/PROFESSIONAL DEGREE (MA, MS, MD, JD, PhD, etc.)
REF
DK
7. Are you of Hispanic, Latino, or Spanish origin? (RECRUIT A MIX)
YES
NO
REF
DK
8.
What is your race? Please select one or more. (RECRUIT A MIX)
White
Black or African American
Asian
Native Hawaiian or other Pacific Islander
American Indian or Alaska Native
END: RECORD RESPONDENT NAME AND CONTACT INFORMATION ON CONTACT
INFORMATION SHEET.
Attachment E: Recruitment Materials
E5
ID #_________________
Contact Information
It appears you are eligible for our study. We’d like to schedule an interview to take place at
{LOCATION}. Let me read you the days and times I have available, and you can tell me what
would be best for you. This will take about 1 hour of your time and we will pay you $40 cash.
May I please have your full name and address? (We need your address so that we can send
you directions. It will include a map that shows you exactly where the room is).
Name ______________________________________________________________________
Address ____________________________________________________________________
Phone Number _______________________________________________________________
Email Address________________________________________________________________
We’d like to audio record the interview. This allows us to carefully review the discussion
and draw the proper conclusions. Will that be alright with you?
Yes
No
DO NOT SCHEDULE
Date: __________________________
Time: __________________________
I will send the directions out to you shortly. If you have to cancel your interview, please call
back so that we can schedule someone in your place, OK? You can reach me at: [Recruiter’s
Phone Number].
Attachment E: Recruitment Materials
E6
NCVS Redesign: Cognitive Testing
ATTACHMENT F – Cues Examples Questionnaire
•
Cues Examples Questionnaire (page F2)
Attachment F: Cues Examples Questionnaire
F1
Cues Examples Questionnaire
To be administered to n=300 from GfK Panel
The next questions ask you to give examples of things that might happen to different people.
Your answers don’t have to be based on your own experiences. Just report the things that
come to mind.
1) Thinking about things that might be stolen, please list three examples of things that
might be stolen from someone.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
2) Still thinking about things that might be stolen, please list three examples of things that
might be stolen from a home.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
3) Thinking about someone trying to break into a home, please list three ways they might
try to break in.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
4) Still thinking about a break-in, please list three other types of structures on someone’s
property that might be broken into.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
Attachment F: Cues Examples Questionnaire
F2
5) Please list three types of vehicle parts might be stolen from a vehicle.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
6) Other than vehicle parts, please list three things that might be stolen from a vehicle.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
7) Vandalism is when someone deliberately damages or destroys something belonging to
you. It does not include things that were done by accident. Please give three examples
of vandalism.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
8) Thinking about ways someone could be physically attacked, please list three things,
other than guns or knives, that might be used as a weapon to attack someone.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
9) If someone were to attack a person by throwing something at them, what might they
throw at them? Please list three examples.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
Attachment F: Cues Examples Questionnaire
F3
10) If someone were to physically attack a person without using a weapon or throwing
something at them, how might they attack the person? Please list three examples.
a. ________________________________________________
b. ________________________________________________
c. ________________________________________________
11) Fraud is when a person or company gets someone to give them money by lying about a
product or service or by deliberately hiding information about it. Please list three ways a
person could be the victim of a fraud. Make the boxes longer for this one to invite more
detailed descriptions.
a. ____________________________________________________________________
b. ____________________________________________________________________
c. ____________________________________________________________________
12) Identity theft is when someone uses someone else’s personal information without
permission for financial gain. Please list examples of identity theft. Make the box longer
for this one to invite more detailed descriptions.
a. ____________________________________________________________________
b. ____________________________________________________________________
c. ____________________________________________________________________
[If respondent is age 18 year or older, ask 13; otherwise skip to end]
13) Which of these things has ever happened to you? (MARK YES OR NO FOR EACH)
a.
b.
c.
d.
e.
f.
g.
h.
i.
Theft
Break-in
Theft of a vehicle part
Theft of something from a vehicle
Physical attack with a weapon or something used for a weapon
Physical attack by having something thrown at you
Some other type of physical attack
Fraud
Identity theft
Panel to supply age, race, gender, and education for each respondent.
Attachment F: Cues Examples Questionnaire
F4
NCVS Redesign: Cognitive Testing
ATTACHMENT G – CONSENT FORM
Consent to Participate in an Interview
Purpose: We are inviting you to participate in a research activity. The research involves answering
survey questions about crimes you may, or may not have experienced. You will then be asked how
you came up with your answers or how you understood the questions. The feedback will help us
develop recommendations for improving the survey questions.
Sponsorship: Westat is conducting this project on behalf of, and funded by, the Bureau of Justice
Statistics (BJS).
What is involved: We will be asking you to answer a series of questions about different types of
crimes, and then will ask you for feedback about those questions. Your participation in this research
project is voluntary, and you have the right to stop at any time or to refuse to answer any question.
The session will take approximately 60 minutes.
Confidentiality: We would like to record the interview. Sometimes it is helpful to review a
portion of a recording as we make recommendations for improving the survey. If the recording is
reviewed later, it will only be by a few Westat staff and possibly the client (BJS).
You will never be identified by name. The things you say may be put in a written summary of this
discussion, but there will be no way to identify who said what, and your name will not be used
anywhere.
Risks: The only cost to you is the time and effort to review and answer questions. You may skip
any question that you do not want to answer, both in the questions we present to you and in the
discussion afterwards. The information you provide will be treated as confidential to the full extent
allowed by law. The recordings will be destroyed within 3 months of the end of the study.
Benefits: There are no direct benefits to you for participating in this study. However, you will be
helping with an important research project.
Questions: If you have questions about your rights and welfare as a research participant, please call
the Westat Human Subjects Protections office at 1-888-920-7631. Please leave a message with your
full name, the name of the research study that you are calling about (The N.C.V.S Redesign), and a
phone number beginning with the area code. Someone will return your call as soon as possible.
You will be paid $40 cash after completing the session.
If you agree to participate, please sign below.
I have read and understand the statements above. I consent to participate in this session.
Participant’s signature
Date
__________
| File Type | application/pdf |
| Author | trumanj |
| File Modified | 2016-06-22 |
| File Created | 2016-04-26 |