CIR Cognitive Testing Attachments

Attachments
Attachment A1_CIR Round 1…………………………………………………………………………………………………………..2
Attachment A2_CIR Round 2…………………………………………………………………………………………………………..57
Attachment A3_Youth screener testing_long cues………………………………………………………………………..118
Attachment A3A_Youth screener testing_long cues_protocol……………………………………………………….131
Attachment B1_Letter to VSO………………………………………………………………………………………………………..145
Attachment B2_Recruitment for Victims………………………………………………………………………………………..148
Attachment C1_Craigslist Ad…………………………………………………………………………………………………………..150
Attachment C2_Recruitment Screener…………………………………………………………………………………………..152
Attachment D_Consent Assent Resources……………………………………………………………………………………..160
Attachment E_Data entry sheet……………………………………………………………………………………………………..165

Attachment A1_CIR Round 1

NCVS-R: CIR COGNITIVE INTERVIEW PROTOCOL
Round 1
Date: Time__ ID #:__Interviewer Initials:
1. Introduction
Thank you for taking the time to help us out today. The session will take approximately
an hour and a half. 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, which is part of the
U.S. Department of Justice. 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 people’s experiences with crime and victimization. (YOUTH:
Anyone age 12 or older is eligible to be selected for this national survey.) 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. Every now and then, I will stop you and
we will talk about the answers you gave.
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 listened to by the project or the BJS staff. It will be destroyed
when the project is over. When we are finished, we will give you (ADULTS: 60/YOUTH:
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
ADULTS: 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.
YOUTH: HAND THE ASSENT FORM TO PARTICIPANT, ANSWER ANY QUESTIONS,
AND OBTAIN ASSENT BEFORE CONTINUING. This form contains all of the things I

just told you about your rights in this interview. Please read it over and if you are willing
to take part in the study, I will sign both copies.
[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?
Spontaneous Probing Strategy
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 OR AS THEY ARE ANSWERING IT, IMMEDIATELY PROBE TO
UNDERSTAND THE NATURE OF THE PROBLEM.
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.
• Tell me more about what you thought that question was asking?
• How did you decide on your answer?

NCVS-R CIR Testing Round 1

Page 2

SCREENER
INTRO1. The next questions will ask about things that may have happened to you in the past 12
months--that is since [MONTH x] of 2016. In this study, it is important to report only events
that happened since that month. Can you think of anything that was happening in your own life
at that time, such as a birthday, a vacation, changing jobs, or anything like that?
_________________________
As I ask you about different kinds of experiences, please think carefully about when things
happened, and only tell me about things that happened during or after [MONTH X 2016].
INTRO2. This survey will cover the following types of things: having items stolen; break-ins;
someone destroying your property; physical attacks; and unwanted sexual contact.
VEHICLE THEFT (ADULTS ONLY)
First I’ll ask about vehicles.
1. At any point in the past 12 months, have you or anyone else in the household owned a car,
van, truck, motorcycle, or other motor vehicle?
Yes - GO TO 1A
No - GO TO 3
1A. How many motor vehicles have you or someone in your household owned over the past 12
months? Please include any you no longer own.
_____________ motor vehicles
1B. In the past 12 months, did anyone steal or try to steal (this vehicle/one of these vehicles)?
1
2

Yes - CONTINUE
No – GO TO 2

1_1.

How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times

NCVS-R CIR Testing Round 1

Page 3

1_2.
•
•
•

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET [Attachment E] FOR EACH INCIDENT
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. MARK APPROPRIATE BOXES ON INCIDENT DATA
SHEET FOR THAT INCIDENT.
1_3. For the next questions, only focus on the incident when someone stole or tried to steal a
vehicle in (MONTH /YEAR).
Most recent
A. Were any items or
belongings stolen from the
vehicle, such as a cell
phone, money, or any
other items that were in
the vehicle?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. (IF CODE 1 IN B) 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?

NCVS-R CIR Testing Round 1

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

Page 4

2. Next I will ask about theft of vehicle parts, which might include a tire, hubcap, GPS or audio
system, battery, airbag, catalytic converter, gasoline, or any other vehicle parts. (Other than
what you’ve already told me,) In the past 12 months, did anyone steal or try to steal any
vehicle parts from (this vehicle/one of these vehicles)?
1
2

Yes – GO TO 2_1
No – GO TO 3

2_1.

How many times did this happen in the past 12 months?
1
2
3
4

2_2.
•
•
•

Once
Twice
Three times
Four or more times

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
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. MARK APPROPRIATE BOXES ON INCIDENT DATA
SHEET FOR THAT INCIDENT.

NCVS-R CIR Testing Round 1

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2_3. For the next questions, focus only on the incident in which someone stole or tried to steal
vehicle parts in (MONTH/YEAR).
Most recent
A. Other than the vehicle
parts, was anything else
stolen from the vehicle,
such as a cell phone,
money, or any other items
that were in the vehicle?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. (IF CODE 1 IN B) 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?

NCVS-R CIR Testing Round 1

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

Page 6

THEFT (ADULTS AND YOUTH)
3. Next I’ll ask about anything [ADULTS: else] that might have been stolen like money, jewelry,
clothing, cell phones, TVs or other electronics, or anything else that belongs to you. In the past
12 months, was something that belongs to you stolen?
1
2

Yes
No

3b. (IF Q3=YES: Other than what you have already told me,) Did anyone try to steal anything
that belongs to you in the past 12 months, but not actually steal it?
1
2

Yes
No

CONCURRENT PROBES FOR YOUTH ONLY:
What kinds of things get stolen from kids these days? (IF NECESSARY: If you had to
guess, what would you say are the top 3 things that get stolen from kids?)
Where do things get stolen from kids these days?
I also asked you if anyone tried to steal anything from you. What do you think I meant
by that?
IF YES TO #3 OR #3b, CONTINUE. ELSE GO TO #4.
3_1. How many times did someone steal or try to steal something 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”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident

NCVS-R CIR Testing Round 1

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FOR EACH INCIDENT IN 3_2, COMPLETE 3_3. ASK QUESTIONS A-D FOR EACH INCIDENT BEFORE
MOVING TO THE NEXT COLUMN. MARK APPROPRIATE BOXES ON INCIDENT DATA SHEET FOR
THAT INCIDENT.
3_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
Most recent
A. Did anyone break in, or
try to break in, to your
home or another building
on your property as part of
this incident?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. (IF CODE 1 IN B) 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?

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

CONCURRENT PROBES FOR YOUTH ONLY:
IF Q3_3C WAS ASKED
I just asked you about sexual contact that you DID NOT CONSENT TO and that YOU
DID NOT WANT to happen. What do you think this question was asking about?
What do you think is meant when the question said “Did not consent and did not want it
to happen”?

NCVS-R CIR Testing Round 1

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BREAK-IN (ADULTS ONLY)
4. The next few questions ask about break-ins, which might have happened by someone
forcing a door or window, pushing past someone, jimmying a lock, cutting a screen, or entering
through an open door or window. (Other than what you have already told me,)
In the past 12 months, did anyone break in or try to break into your home, garage or shed?
1
2

Yes
No

4b. In the past 12 months, did anyone break in or try to break into a hotel or motel room or
vacation home where you or someone else in your household was staying?
1
2

Yes - CONTINUE
No – GO TO #5

IF YES TO #4 OR #4b, CONTINUE. ELSE GO TO #5.
4_1. (IF BREAK-IN HAS ALREADY BEEN MENTIONED: Other than the break-in(s) that
you told me about earlier in this interview,) How many times did someone break in or
try to break in during 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) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
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. MARK APPROPRIATE BOXES ON INCIDENT DATA
SHEET FOR THAT INCIDENT.

NCVS-R CIR Testing Round 1

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4_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
Most recent
A. Was anything stolen as
part of this incident?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. 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?

NCVS-R CIR Testing Round 1

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

Page 10

VANDALISM (ADULTS ONLY)
5. Vandalism is when someone deliberately damages or destroys something belonging to you.
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 that belongs to you or
someone else living here?
1
2

Yes - CONTINUE
No – GO TO #6

5_1.

How many times did this happen 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 events) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT

•
•

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. MARK APPROPRIATE BOXES ON INCIDENT DATA
SHEET FOR THAT INCIDENT.

NCVS-R CIR Testing Round 1

Page 11

5_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
Most recent
A. Was anything stolen as
part of the incident?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. 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?

NCVS-R CIR Testing Round 1

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

Page 12

ATTACKS (ADULTS AND YOUTH)
6. The next few questions ask about any physical attacks against you personally. This might
include things like someone attacking you with a weapon or something used as a weapon,
someone throwing something at you, someone grabbing, slapping, punching or choking you, or
any other type of attack or use of force against you. (Besides what you’ve already told me,) In
the past 12 months, has anyone attacked or threatened to attack you?
1
Yes – GO TO 6_1
2
No – GO TO 7
CONCURRENT PROBES FOR YOUTH ONLY:
When you hear the word “attack”, what do you think of?
What are some different ways that people your age are attacked by others?
This question also used the phrase “use of force against you”. What do you think that
means?
What do you think is meant by a “threatened attack”?
6_1. (IF ATTACK HAS ALREADY BEEN REPORTED: Other than the attack(s) or threat(s)
you told me about earlier in this interview,) How many times were you attacked or
threatened in the past 12 months?
1
2
3
4
6_2.
•
•
•

Once
Twice
Three times
Four or more times

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident

NCVS-R CIR Testing Round 1

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FOR EACH INCIDENT IN 6_2, COMPLETE 6_3. RECORD INFO ON INCIDENT DATA SHEET.
6_3. For the next question, focus only on the incident that happened in (MONTH/YEAR).
Most recent
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

Next most
recent

1 Yes
2 No

Next most
recent

1 Yes
2 No

Next most
recent

1 Yes
2 No

UNWANTED SEXUAL CONTACT (ADULTS AND YOUTH)
The next question is sensitive and I want to remind you that the information you provide is
confidential. The question asks about sexual contact that you DID NOT CONSENT TO and that
YOU DID NOT WANT to happen. This could have been done by someone you know well,
someone you casually know, or a stranger.
Please include someone having sexual contact or trying to have sexual contact with you by
holding or pinning you, hitting or kicking you, or using some other type of force or threat of
force.
7a. (Besides what you’ve already told me,) In the past 12 months, has anyone had, or tried to
have sexual contact with you by touching or penetrating your (ADULTS: sexual body
parts/YOUTH: private parts) that you DID NOT CONSENT TO and that YOU DID NOT WANT to
happen?
1
Yes
2
No
7c. 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
2

Yes
No

NCVS-R CIR Testing Round 1

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CONCURRENT PROBES FOR YOUTH ONLY:
I asked about sexual contact in the past 12 months that you DID NOT CONSENT TO
and that YOU DID NOT WANT to happen.
First of all, what do you think the phrase “sexual contact that you DID NOT CONSENT
TO” means?
What do you think is meant by “sexual contact that YOU DID NOT WANT TO
HAPPEN”?
I also reminded you before I read these questions that the information you provide is
confidential. What do you think I meant by that? Why do you think I said that before I
read the question?
Then I asked you whether 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. What types of situations do you think this question is asking
about?
We want to make sure this language is understandable to youth your age.
o
What do you think is meant by “passed out”?
o
How about “unconscious”?
o
“Blacked out”?
o
What about “unable to consent because you were drunk or high”?

NCVS-R CIR Testing Round 1

Page 15

IF YES TO 7a OR 7c, CONTINUE. OTHERWISE, GO TO #8.
7_1. (IF SEXUAL CONTACT HAS ALREADY BEEN REPORTED: Other than the sexual
contact you told me about earlier in this interview,) How many times did someone have,
or try to have these types of sexual contact with you in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times
7_2.
•
•
•

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident

IF NO INCIDENTS WERE REPORTED IN THE SCREENER, GO TO 8B
8. 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 INCIDENTS HAPPENED IN THE SAME MONTH/YEAR, ASK:
8a. In (MONTH/YEAR), you reported (READ ITEMS FROM DATA SHEET). Were these part of the
same incident, or were they separate incidents?
1
2

Same incident (MARK DUPLICATE COLUMN FOR INCIDENTS ON DATA SHEET
THAT BELONG TOGETHER)
Separate incident

NCVS-R CIR Testing Round 1

Page 16

8b. I want to make sure we’ve captured everything that has happened to you. 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
2

Yes – CONTINUE (MARK “OTHER CRIME” BOX IN A NEW ROW ON DATA SHEET)
No – GO TO NOTE BEFORE #9

8c. What happened? (IF ANY ELEMENTS ON DATA SHEET ARE MENTIONED, MARK
APPROPRIATE BOX/ES)
1
2
3
4
5
6
7
8
9
10

R mentioned vehicle theft
R mentioned vehicle part theft
R mentioned something being stolen
R mentioned something attempted to be stolen
R mentioned break-in
R mentioned vandalism
R mentioned attack or threatened attack
R mentioned sexual attack
Incident did not happen to R directly
Other/not a crime __________________________________________________

YOUTH: IF NO INCIDENTS ON DATA SHEET, SKIP TO VIGNETTES.
ADULTS: IF NO INCIDENTS ON DATA SHEET, SKIP TO CLOSING QUESTIONS.
9. Thank you. Now I’d like to ask you some more questions about a specific incident that
happened to you in the past 12 months.
INTERVIEWER: LOOK AT DATA SHEET AND SELECT INCIDENT WITH THE MOST CHECK-MARKS.
IN THE CASE OF A TIE, SELECT THE MOST RECENT INCIDENT.
For these next questions, let’s focus just on what happened in the incident in (MONTH/YEAR)
when you said the following things happened:
• (LIST WHAT HAPPENED FROM SCREENER INCIDENT DATA FORM)

Now I’d like to ask you some specific questions about what happened. Every now and then, I
am going to stop and ask you some follow-ups on the questions I asked so that we can
understand how you are interpreting the questions.

NCVS-R CIR Testing Round 1

Page 17

Location Series (ADULTS AND YOUTH)
Check data entry sheet. If there is an “X” in the “Break-in” column for the incident being
asked about, ask A1. Otherwise go to note before A2.
A1.
Earlier you said there was a break-in or attempted break-in as part of this incident. Did
someone break in or try to break into…? (READ CATEGORIES OUT LOUD UNTIL R SAYS
YES TO SOMETHING)
1. your house or apartment
2. into a garage, shed, or other detached building on your property
3. into a second home or vacation home
4. into a hotel or motel room where you or someone else in your household was staying
5. (VOL: A motor vehicle)
6. or into some other place? (SPECIFY)
If A1 is code 1 or 2, go to Presence Series
If A1 is code 3, 4 or 6, go to Loc1.
If A1 is code 5, continue.
Check data entry sheet. If there is an “X” in the “Vehicle theft” column for the incident being
asked about, OR if code 5 in A1, ask A2. Otherwise, go to note before A4.
A2.
Where was the (car/vehicle) when this happened – (READ CATEGORIES OUT LOUD
UNTIL R SAYS YES TO SOMETHING)
1. on your property, such as in a driveway or your own garage,
2. in a garage or parking lot associated with where you live,
3. in some other garage or parking lot,
4. on the street near where you live,
5. on the street but not near where you live,
6. or somewhere else?
PROBE FOR A2:
IF RESPONSE IS CODE 2: What do you think is meant by “associated with where you live”?
IF RESPONSE IS CODE 4 or 5: How did you decide whether to select “near where you live” or
“not near where you live”?
IF RESPONSE IS CODE 6: Where was the vehicle?
If A2 is code 1 or 4, go to Presence Series
NCVS-R CIR Testing Round 1

Page 18

If A2 is code 2 or 3, continue
If A2 is code 5 or 6, go to Loc1 on page 19
A3.

In what type of a parking lot or garage did this incident happen -- [CIR10f]
1.
2.
3.
4.

a commercial parking lot or garage,
a noncommercial parking lot or garage,
an apartment or townhouse parking lot or garage,
or some other kind of parking lot or garage?

PROBE FOR A3:
Was this question hard or easy to answer? Explain.

If A2 is code 2, go to Presence series on page 24
If A2 is code 3, go to Loc1 on page 20
Check data entry sheet – if NO “X” in columns for “Break-in” or “Vehicle theft”, continue.
A4.
Where did this incident happen – (READ CATEGORIES OUT LOUD UNTIL R SAYS YES TO
SOMETHING) [CIR10a modified]
1. inside your home or lodging,
2. somewhere else on your property,
3. inside somewhere else where you were staying overnight or longer,
4. at your place of work,
5. at school,
6. or somewhere else? (specify)
PROBE FOR A4:
Was it hard or easy for you to decide on your answer to this question? Explain.
The first category I read to you was “inside your home or lodging”. What do you think of as
“lodging”?
The second category I read to you was “somewhere else on your property”. What were you
thinking of when I said that? [IF NEEDED] What is meant by “on your property”?
[ADULTS] I also read a category of “at your place of work”. What were you thinking of when I
said that? What would you include as being “at work”?

NCVS-R CIR Testing Round 1

Page 19

If A4 is code 1 or 2, go to Presence series on page 24
Otherwise, continue.
Loc1. Did this happen in the city, town, village, or rural area where you live (now)?
1. Yes - Go to Loc2
2. No – Go to Loc1a
Loc1a. In what city, town, or village did this incident occur? [CIR7b]
_____________________________________
Loc1b. In what state did it occur? [CIR8a] _____________________________________
In what county did it occur? [CIR8b] _____________________________________
Loc1c. (Ask or verify) Is this the same county and state as your present residence? [CIR8c]
1. Yes
2. No
If A4 is code 4, go to Loc6.
If A4 is code 5 go to Loc3.
Otherwise, continue.
Loc2. I’m going to read you a list of places where this might have happened. Please tell me
which one BEST describes where this happened. Did this happen…
1. somewhere very near your home or lodging – GO TO Loc2c
2. at, in, or near the home of a relative, friend, or neighbor – GO TO Loc2d
3. at a commercial place like a store, restaurant, or office building – GO TO Loc2e
4. in a parking lot or garage – GO TO Loc2f
5. in an open area, on the street, or on public transportation – GO TO Loc2h
6. or somewhere else? (specify) – GO TO Loc8
Loc2c. Where near your home or lodging did this incident happen? (READ IF NECESSARY)
[CIR10c]
1. Apartment hall, storage area, laundry room (does not include apartment parking
lot/garage)
2. Own yard, sidewalk, driveway, carport, unenclosed porch (does not include
apartment yards)
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3. On street immediately adjacent to own home or lodging
4. Other (specify)
Go to Probes after Loc2h.
Loc2d. Where at, in, or near a friend’s/relative’s/neighbor’s home did this incident happen?
(READ IF NECESSARY) [CIR10d]
1. At or in the home or other building on their property
2. Yard, sidewalk, driveway, carport (does not include apartment yards)
3. Apartment hall, storage area, laundry room (does not include apartment parking
lot/garage)
4. On street immediately adjacent to their home
5. Other (specify)
Go to Probes after Loc2h.
Loc2e. At what type of a commercial place did this incident happen? (READ IF NECESSARY)
[CIR10e]
1. a restaurant, bar, nightclub
2. a bank
3. a gas station
4. another commercial building, such as a store
5. an office
6. a factory or warehouse
7. Other (specify)
Go to Probes after Loc2h.
Loc2f. In what type of parking lot or garage did this incident happen? (READ IF NECESSARY)
[CIR10f]
1. Commercial parking lot/garage
2. Noncommercial parking lot/garage
3. Apartment/townhouse parking lot/garage
4. Other (specify)
Go to Probes after Loc2h.
Loc2h. Where in an open area, on the street, or on public transportation did this incident
happen? (READ IF NECESSARY) [CIR10h]
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1. In apartment yard, park, field, playground (other than school)
2. On the street (other than immediately adjacent to own/friend’s/relative’s/neighbor’s
home)
3. On public transportation or in station (bus, train, plane, airport, depot, etc.)
4. Other (specify)

PROBES FOR Loc2:
Earlier I said that I was going to be reading a list of places where this might have happened.
What did you think I was going to be asking?
The first category I read was “somewhere very near your home.” What do you think is meant by
“very near”?
The second category I read was “at, in, or near the home of a relative, friend or neighbor.”
What do you think this category was referring to?
PROBES FOR Loc2c-h:
Then I asked you for more detail about where the incident happened. (RE-READ ITEM AND
CATEGORIES) How did you decide which category to pick?
IF NEEDED: Tell me more about where the incident actually happened.

If R answered Loc2e, or Loc2f, go to Loc6.
If R answered Loc2c, Loc2d, or Loc2h, go to Loc8.
If incident happened at school and did not involve a motor vehicle:
Loc3. You said this happened at school. Did this happen inside a school building or somewhere
else on school property (school parking area, play area, school bus, etc)? [CIR 10g]
1. Inside a school building
2. On school property (school parking area, play area, school bus, etc.)
3. Other (specify)
If code 1 in Loc3, continue.
If code 2 or 3 in Loc3, go to Loc6.

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Loc4. Was it your school? [CIR17a]
1. Yes
2. No
Loc5. In what part of the school building did it happen? [CIR17b]
1. Classroom
2. Hallway/stairwell
3. Bathroom/locker room
4. Other (library, gym, auditorium, cafeteria)
Loc6. Did the incident happen in an area restricted to certain people or was it open to the
public at the time? [CIR17c]
1. Open to public
2. Restricted to certain people (or nobody had a right to be there)
3. Don’t know
4. Other
PROBES for Loc6:
What do you think this question is asking?
[IF NEEDED] How did you decide on your answer?
Suppose this happened in a parking lot at a workplace. How would you answer this?
And what if it happened outside on the grounds of a work building or school. How would you
answer this?

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Loc8. Did it happen outdoors, indoors, or both? [CIR17e]
1. Indoors (inside a building or enclosed space)
2. Outdoors
3. Both
IF CODE 3 IN Loc8:
How did you decide on your answer?

If code 1 in Loc2 (at or very near R’s home), go to Presence series on page 24.
Otherwise, continue.
Loc9. How far away from home did this happen? PROBE: Was it within a mile, 5 miles, 50
miles or more? Enter the code for the first answer category that the respondent is sure
of. [CIR19]
1.
2.
3.
4.
5.
6.

At, in, or near the building containing the respondent's home/next door
A mile or less
Five miles or less
Fifty miles or less
More than 50 miles
Don't know how far

PROBES FOR Loc9:
Did you have any difficulty in deciding on your answer?

GO TO PRESENCE SERIES.

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Presence Series (ADULTS AND YOUTH)
Check data entry sheet. If there is an “X” in the “Attack” or “Sexual contact” column for the
incident being asked about, go to PR4. Otherwise, continue.
PR1. Were you (or any other member of this household) aware of this incident as it was
happening?
1. Yes
2. No
PROBES FOR PR1:
What does it mean to be “aware” of an incident as it is happening?
IF NEEDED: Does it mean you need to actually be there and see that it is happening?
How did you decide on your answer?

If “Yes” to PR1, continue.
If “No” to PR1, go to Police Involvement Series on page 26
PR2.

Who was aware of it – only you, only someone else in the household, or you and
someone else in your household?
1. Only respondent
2. Only someone else in the household
3. Both respondent and someone else in household

PROBES FOR PR2 IF R SEEMED TO HAVE DIFFICULTY:
How did you decide on your answer?

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If code 1 or 3 in PR2
PR3. Did you personally see or have any contact with the offender while the incident was
happening?
1. Yes
2. No
PROBES FOR PR3:
What does it mean to “have any contact with the offender”?
How is this the same or different from being “aware” of the incident?

Check data entry sheet. If there is an “X” in the “Attack” or “Sexual contact” column for the
incident being asked about, OR If code 2 or 3 in PR2, continue. Otherwise go to Police
Involvement series.
PR4. Did someone else in your household personally see or have any contact with the
offender while the incident was happening?
1. Yes
2. No
PROBES FOR PR4 ONLY IF R SEEMED TO HAVE DIFFICULTY WITH THE QUESTION:
What do you think this question is asking?
Was it hard or easy to decide on your answer? Explain.

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Police Involvement (PI) Series (Adults and Youth)
PI1.

Were the police informed or did they find out about this incident in any way? [CIR 115]
1. Yes
2. No
3. Don’t Know

PROBES FOR PI1 ONLY IF R SEEMED TO HAVE DIFFICULTY:
What do you think this question is asking?
IF NEEDED: What is meant by “informed”?
How did you decide on your answer?

If code 1 in PI1, go to PI4.
If code 2 in PI1, continue
If code 3 in PI1, go to Victim Services Series
PI2a. We would like to learn more about why people who experience crime do not report it to
the police. Why did you decide not to contact the police? READ IF NECESSARY - Was the
reason because you dealt with it another way, it wasn't important enough to you,
insurance wouldn't cover it, police couldn't do anything, police wouldn't help, you were
afraid of the police or something the police might do, you were afraid of something else
happening, or was there some other reason? PROBE: Any other reason? Enter all that
apply. [CIR117a, modified as was done for the 2014 ITSQ]
1.
Dealt with another way - GO TO PI2b
2.
Not important enough to respondent - GO TO PI2c
3.
Insurance wouldn’t cover it - GO TO PI2i
4.
Police couldn’t do anything - GO TO PI12d
5.
Police wouldn’t help - GO TO PI12e
6.
Afraid of police or something they might do - GO TO PI2f
7.
Other consequences for the victim - GO TO PI2g
8.
Other reason - GO TO PI2h
9.
Respondent not present or doesn’t know why it wasn’t reported - GO TO PI2h
If code 1 in PI2a
PI2b. Probe as needed: Did you report it to some other authority, did you take care of it
yourself, was someone else already taking care of it, or did something else happen?
Code all that apply.
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1.
2.
3.
4.

Reported to another official (workplace guard, apt manager, school official, etc.)
I took care of it myself or informally
Someone else already dealing with it
Something else – Specify _

Check PI2a for other responses and if none, go to PI2i
If code 2 in PI2a
PI2c. Probe as needed: Why did you think it wasn’t important enough? Code all that apply.
1.
I recovered my property
2.
It was not serious enough
3.
Not worth the trouble, loss less than insurance deductible, etc.
4.
Child offender(s), ‘kid stuff’
5.
Not clear it was a crime or that harm was intended
6.
Other – Specify _
Check PI2a for other responses and if none, go to PI2i
If code 4 in PI2a
PI2d. Probe as needed: Why did you think the police couldn’t do anything? Code all that apply.
1.
Didn’t find out until too late
2.
Could not recover or identify property
3.
Could not find or identify offender
4.
Other – Specify _
Check PI2a for other responses and if none, go to PI2i
If code 5 in PI2a
PI2e. Probe as needed: Why did you think the police wouldn’t do anything? Code all that
apply.
1.
Police wouldn’t think it was important enough, wouldn’t want to be bothered or
get involved
2.
Police would not be sympathetic
3.
Didn’t think police would believe me
4.
Police would be inefficient, ineffective (they’d arrive late or not at all, wouldn’t
do a good job, etc.)
5.
Systemic injustice; cannot get justice from the police
6.
Police would reject my sexual orientation, race, ethnicity
7.
Police would refuse to take report
8.
Police would not see me as a victim in this incident
9.
Police would think I caused the incident
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10.

Other – Specify

Check PI2a for other responses and if none, go to PI2i
If code 6 in PI2a
PI2f. Probe as needed: Why were you afraid of the police or what they might do? Code all
that apply.
1.
Afraid or distrust the police
2.
Police would not keep it confidential
3.
Police would harass/insult respondent, cause respondent trouble
4.
Offender was police officer
5.
Other – Specify
Check PI2a for other responses and if none, go to PI2i
If code 7 in PI2a
PI2g. Probe as needed: What were you afraid might happen? Code all that apply.
1.
Didn’t want to make more trouble for myself
2.
Might lose a job or other source of income if reported; could lose home, financial
support
3.
Did not want further humiliation
4.
Afraid of reprisal by offender or others
5.
Private or personal matter; domestic situation
6.
Fear of being deported
7.
Other – Specify
Check PI2a for other responses and if none, go to PI2i
If code 8 or 9 in PI2a
PI2h. Probe as needed: Can you tell me a little more about why the incident was not reported
to the police? Code all that apply.
1.
Did not want to get offender in trouble with the law
2.
Was advised not to report to police
3.
Did not want to or could not take time – too inconvenient
4.
Did not want to go to court
5.
Other – Specify __
PI2i.

Check item. Is more than one reason marked in PI2a-h? [CIR 117c]
1.
Yes - CONTINUE
2.
No - GO TO PROBES AFTER PI3

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PI3.

Which of these would you say was the most important reason why the incident was not
reported to the police? [CIR 118]

PROBES FOR PI2a:
These questions were about why you decided not to report the incident to the police. What
does it mean to “report” something to the police?
(IF CATEGORIES IN PI2a WERE READ ALOUD) What did you think about the order of the reasons
that I read out loud to you? (RE-READ CATEGORIES)
What did you think about the way I asked these questions, first asking for a reason, then asking
for more detail about that reason?

ALL, GO TO PI19.
PI4.

Who informed the police? If more than one person, choose lowest-numbered applicable
response. [CIR 116a] (DO NOT READ CATEGORIES, CODE LOWEST NUMBER THAT
APPLIES)
1.
Respondent
2.
Other household member
3.
School employee or School Resource Officer
4.
Other official (e.g., security guard, building manager, etc.)
5.
Some other person
6.
Police were at scene
7.
Offender was police officer
8.
Some other way – specify

If code 1, 2, 3, 4 or 5 in PI4, continue.
If code 6, 7, or 8 in PI4, go to PI17.

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PI5.

(IF R: How did you first notify the police?/IF NOT R: How were the police first notified?)
[New] (READ IF NECESSARY)
1.
By telephone
2.
Approached officer or police car
3.
Went to police station
4.
Reported using the Internet
5.
Don’t know –someone else notified the police
6.
Some other way – specify

PROBES FOR PI5:
IF NEEDED: What is meant by “notify”?
IF YOU READ CATEGORIES TO R: Can you think of any other ways the police could be notified?

If code 1 in PI5, continue.
If code 2 or 3 in PI5, go to PI7.
If code 4, 5 or 6 in PI5, go to note before PI10.
PI6.

(Did you call/Was the call to) 911, another police number, or a general city number or
city hotline number, or another number? [New]
1.
911/emergency number
2.
Another police number
3.
General city number/hotline
4.
Don’t know
5.
Other – Specify _

PROBES FOR PI6:
How easy or difficult was it to remember what number was called?

PI7.

Would you describe this as an emergency, or was it a non-emergency or routine contact
with the police? [New]
1.
Emergency contact
2.
Non-emergency/routine contact
3.
Don’t know

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PROBES FOR PI7:
What would you consider an emergency contact?
What would you consider a non-emergency or routine contact?

PI8. Was the crime still under way when the police were first contacted, or was it over?
[New]
1.
Still under way
2.
Crime was over
3.
Don’t know
PROBES FOR PI8:
What do you think this question is asking?
What do you think I meant when I said when the police were “first contacted”?
How easy or difficult is it to remember what was happening when the police were first
contacted?

If code 1 or 3 in PI8, go to PI12.
Otherwise, continue.
PI9.

How long after the crime did you contact the police/were the police contacted)? Was it
within 5 minutes, within 10 minutes, within an hour, within a day, or longer? [New]
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

PROBES FOR PI9:
How easy or difficult was this to answer?
How confident are you that the answer you gave is correct?

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If code 1 in PI4, continue. Otherwise, go to PI12
PI10. Besides the fact that it was a crime, did YOU have any other reason for reporting this
incident to the police? Probe: Any other reason? Enter all that apply. STRUCTURED
PROBE - Did you report it to get help with this incident, to recover your loss, to stop or
punish the offender, to let police know about it, or was there some other reason? [CIR
119a]
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 reason – Specify __
12.
No other reason
If more than one reason is marked in PI10:
PI11. Which of these would you say was the most important reason why the incident was
reported to the police?

PROBES FOR PI10 IF STRUCTURED PROBE WAS USED:
I read you different reasons why you might have reported the incident to the police [RE-READ
CATEGORIES]. What did you think about the categories I read?
What did you think about the order of those categories?

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PI12. Did the police come when they found out about the incident, did you go to the police
station to file a report, did they just take a report over the phone, or did they deal with
it just using the mail or the Internet? [CIR 121, modified]
1. Police came
1a. Told to go to a police station to file a report
2. Took report over the phone
3. Dealt with it using the mail
4.
Dealt with it using the Internet
5.
Took phone report with follow-up through the mail or internet
6.
[VOL] Police did nothing
PROBES FOR PI12:
Are there any options missing from the list that I read to you?

If code 2 or 5 in PI12
PI13. How satisfied were you with how the phone report was taken? Would you say you were
. . . [New]
1.
Extremely satisfied,
2.
Very satisfied,
3.
Moderately satisfied,
4.
Slightly satisfied, or
5.
Not at all satisfied?
PROBES FOR PI13:
How did you decide on your answer to this question?

If code 1a, 2, 3, 4, 5 or 6 in PI12
PI14. Do you think the police should have come when they were contacted, or that the
incident was handled appropriately? [New]
1
Police should have come
2
It was handled appropriately
3.
Don’t Know
PROBES FOR PI14:
How did you decide on your answer to this question?

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All in PI14, go to PI19.
If code 1 in PI12:
PI15. How satisfied were you with the time it took the police to come after they were
contacted? Would you say you were . . . [New]
1.
Extremely satisfied,
2.
Somewhat satisfied,
3.
Neither satisfied or dissatisfied,
4.
Somewhat dissatisfied, or
5.
Extremely dissatisfied?
PROBES FOR PI15:
How did you decide on your answer to this question?

PI16. Had the police told (you/the person who contacted them) how long it would take them
to get there? [New]
1.
Yes
2.
No
PROBES FOR PI16:
How easy or difficult was it to recall what the police told you about how long it would take?

PI17. What did they do while they were (there/here) to try to solve the crime? (DO NOT READ
CATEGORIES) Mark all that apply. Probe: Anything else? [CIR 123a, modified]
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:
8.
Did nothing to try to solve the crime
9.
Don’t know
PROBES FOR PI17:
Was this easy or hard to answer? Explain.

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PI18. What (else) did they do while they were (there/here) to provide help or assistance? (DO
NOT READ CATEGORIES) Mark all that apply. Probe: Anything else? [CIR 123a, modified]
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
4a.
Gave a brochure or flyer listing victim's rights under the law
4b.
Gave a brochure or flyer listing services that might be available
5.
Gave advice about services or organizations that could help
6.
Contacted emergency medical services
7.
Other – Specify _
8.
Did nothing to help
9.
Don’t Know
PROBES FOR PI18:
This question asked what the police did to provide “help or assistance”? What do you think is
meant by that?

Ask all:
PI19. Did you (or anyone in your household) have any later contact with the police about the
incident? [CIR124]
1.
Yes
2.
No
3.
Don’t know
If code 1 in PI19, continue.
If code 2 or 3 in PI19 and code 1 in PI1, go to statement before PI23
If code 2 or 3 in PI19 and code 2 or 3 in PI1, go to Victim Services
PI20. Did the police get in touch with you or did you get in touch with them? [CIR125a]
1.
Police contacted respondent or other HHLD member
2.
Respondent (or other HHLD member) contacted the police
3.
Both
4.
Don’t Know
5.
Other – Specify ____________________

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If code 1, 2 or 3 in PI20, continue.
Otherwise, skip to PI22.
PI21. Was that in person, by phone, through the mail, or over the Internet? [CIR 126,
modified]
1.
In person
2.
By telephone
3.
Through the mail
4.
Over the Internet
5.
Any combination of reasons
PROBES FOR PI21:
Which contact were you thinking about when you answered this question? The initial contact,
or the later contact?

PI22

What did the police do in following up this incident? Probe: Anything else? Mark all that
apply. [CIR 127a]
1.
Took report
2.
Questioned witnesses or suspects
3.
Did or promised surveillance/investigation
4.
Recovered property
5.
Made arrest
6.
Gave advice about services or organizations that could help
7.
Stayed in touch with household respondent
8.
Other – Specify _
9.
Nothing (to respondent’s knowledge)
10.
Don’t know

PROBES FOR PI22:
How much do you actually know about what the police did in following up about the incident?

Now we have a few questions about how you feel the police handled this incident. If more
than one officer was involved, please think how all of them would be rated as a group.
PI23. How respectfully would you say that you were treated by the police? Would you say
they were . . . [New]
1.
Not at all respectful,
2.
Slightly respectful,
3.
Moderately respectful,
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4.
5.

Very respectful, or
Extremely respectful?

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PI24

When you talked to the police, how polite were they? Would you say they were . . .
[New]
1.
Not at all polite,
2.
Slightly polite,
3.
Moderately polite,
4.
Very polite, or
5.
Extremely polite?

If code 1 or 2 in PI23 or code 1 or 2 in PI24:
PI25. Why do you think the police were disrespectful or impolite? [New]
Specify
PI26. How interested were the police in hearing the details about this incident? Would you
say they were . . . [New]
1.
Not at all interested,
2.
Slightly interested,
3.
Moderately interested,
4.
Very interested, or
5.
Extremely interested?
??
VOL: DK, NA
PI27. How satisfied were you with the amount of time they gave you to tell the police your
story. Were you . . . [New]
1.
Extremely dissatisfied,
2.
Somewhat dissatisfied,
3.
Neither satisfied or dissatisfied,
4.
Somewhat satisfied, or
5.
Extremely satisfied?
PI28. How satisfied were you that the police did everything they could do to address the
reason you contacted them? [New]
1.
Extremely dissatisfied,
2.
Somewhat dissatisfied,
3.
Neither satisfied or dissatisfied,
4.
Somewhat satisfied, or
5.
Extremely satisfied?
PI29. How much understanding and support do you think the police involved showed to you?
Would you say they offered you . . . [New]
1.
No understanding and support at all
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2.
3.
4.
5.

A little, or
A moderate amount,
A lot,
A great deal,

PI30. Overall, how professional would you say that the police were? Would you say that they
were . . . [New]
1.
Not at all professional
2.
somewhat professional
3.
Moderately professional
4.
Very professional
5.
Extremely professional
PI31. Taking the whole experience into account, how satisfied are you with the way you were
treated during this contact by the police? Would you say they were . . . [New]
1.
Extremely dissatisfied,
2.
Somewhat dissatisfied,
3.
Neither satisfied or dissatisfied,
4.
Somewhat satisfied, or
5.
Extremely satisfied?
PI32. Taking the whole experience into account, how effectively did the police handle the
incident? Would you say they were . . . [New]
1.
Not at all effective,
2.
Slightly effective,
3.
Moderately effective,
4.
Very effective, or
5.
Extremely effective?

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PROBES FOR PI23-32:
What did you think about this series of questions?
How easy or difficult were they to answer?
If you dealt with more than one police officer, or interacted with the police on multiple
occasions, how did you take this into account when answering the questions?

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Victim Services (VS) Series (Adults and Youth)
1. (Other than the police,) Did you tell anyone about this incident?
1. Yes
2. No
3. Don’t know
If code 1 in #1, continue. Otherwise skip to VS1.
1a. Which of the following people did you tell about the incident? [Any others?] (READ
CATEGORIES)
1. A Parent
2. One of your children
3. Other family member
4. Friend
5. Neighbor
6. Teacher or school administrator
7. Supervisor (if R > 15)
8. Coworker or classmate
9. Leader or member of a community or religious organization
10. Medical professional
11. Other – specify__________________________________
VS1.

Did you try to get information or help concerning this incident from any agency or
program – other than the police – that assists victims of crime?
1. Yes
2. No
3. Don’t know

PROBES FOR VS1:
What types of offices or agencies might offer this type of assistance?

NCVS-R CIR Testing Round 1

Page 42

VS3.

Did you receive any services or assistance from any agency or program?
1. Yes
2. No
3. Don’t know

PROBES FOR VS3:
What type of programs or agencies did you think this question was asking about?
What do you think is meant by “services”?
What about “assistance”?

If code 1 in VS3, continue.
If code 2 or 3 in VS3 and VS1=1 then go to VS6.
If code 2 or 3 in VS3 and VS1=2 then go to VS7.
VS4.

What type of services did you receive—did you get . . .
A. Crisis hotline counseling?
1. Yes
2. No
B. Other counseling or therapy?
1. Yes
2. No
C. Direct legal services, including free or low cost assistance from an
attorney?
D. Other justice system-related services, such as notification of case
developments, court support or accompaniment?
1. Yes
2. No
E. Assistance getting a restraining, protection, or no-contact order?
1. Yes
2. No
F. Short term or emergency financial assistance?
1. Yes
2. No

NCVS-R CIR Testing Round 1

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G. Shelter or safehouse services?
1. Yes
2. No
H. Safety planning?
1. Yes
2. No
I. Help or advocacy with health care?
1. Yes
2. No
J. Any other services?
1. Yes (Specify)
2. No
PROBES FOR VS4:
IF YES TO ANY: Tell me more about the services you received.
IF NEEDED: How did you decide which category/ies to say yes to?

VS5.

Were there any services that you tried to get but did not receive?
1. Yes
2. No

If code 1 in VS5 or [code 1 in VS1 AND code 2 to VS3], continue.
Otherwise go to note before VS7.
VS6. Why did you not receive the services or assistance that you sought? Was it because…
A. Services were not available in your local area?
1. Yes
2. No
B. You did not have transportation to and from the services?
1. Yes
2. No
C. You did not have childcare [in order to get or use the services]?
1. Yes
2. No
NCVS-R CIR Testing Round 1

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D.

E.

F.

G.

H.

I.

3. Not applicable
The service provider could not help you because they did not have
enough resources (e.g., no beds available in shelter)?
1. Yes
2. No
You were unable to take time off of work or school?
1. Yes
2. No
There were language barriers?
1. Yes
2. No
You were told you were not eligible for services?
1. Yes
2. No
It was taking too much time or effort to get the services
1. Yes
2. No
Some other reason?
1. Yes (Specify)
2. No

PROBES FOR VS6:
IF YES TO ANY: Tell me more about the services you sought but never received.
ASK ALL: Are there any other reasons why someone might seek out services or compensation
and not receive it?

NCVS-R CIR Testing Round 1

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If code 2 (No) to both VS1 and VS3, continue.
Otherwise, go to Closing questions.
VS7. Why didn’t you seek victim assistance or services? Was it because…?
A. You did not want services?
1. Yes - Go to closing questions
2. No - Continue
B. You did not know of services that were available in your local area?
1. Yes
2. No
C. You did not have transportation to and from the services?
1. Yes
2. No
D. You did not have childcare?
1. Yes
2. No
3. Not applicable
E. You were unable to take time off of work or school to seek services?
1. Yes
2. No
F. There were language barriers?
1. Yes
2. No
G. You did not think you were eligible for services?
1. Yes
2. No
H. Some other reason?
1. Yes (Specify)
2. No
PROBES FOR VS7:
IF YES TO ANY IN B-I: Tell me more about the reason you never sought out victim assistance or
services.
ASK ALL: Can you think of any other reasons why someone might not seek out services or
victim assistance?
NCVS-R CIR Testing Round 1

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CLOSING PROBES
ASK ALL:
Finally, please describe in your own words what happened. Provide as much detail as you
can, including what happened, who the offender was, where it happened, who was present,
whether there was a weapon, whether anyone was hurt, etc…
What overall reactions did you have to the questions I asked in this interview?
How well did the questions capture what happened to you?
Earlier in this interview, you told me the narrative of what happened to you during this
incident.
•
•
•
•

How well did the questions I asked you about the LOCATION of the incident capture
where your incident happened? (Explain)
How well did the questions I asked about who was present during the incident capture
what happened? (Explain)
How easy or hard was it to recall details about the role the police played during the
incident?
How well did the victim services questions capture the reasons why you (did/did not)
access victim services after the incident?

NCVS-R CIR Testing Round 1

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VIGNETTES FOR YOUTH: (ONLY IF NO VICTIMIZATIONS REPORTED IN SCREENER)
Now I’d like to read you a few different situations and then will ask you some questions
about the person in the situation. (Respondent is given a copy of the situation to read
along with.)
L1: (on school property, getting on bus) Aiden’s book is stolen out of his backpack as he is getting
on the school bus to go home. How should Aiden answer the following questions?
A4.
Where did this incident happen – (READ CATEGORIES OUT LOUD UNTIL R SAYS YES TO
SOMETHING) [CIR10a modified]
1. inside Aiden’s home or lodging,
2. somewhere else on his property,
3. inside somewhere else where he was staying overnight or longer,
4. at his place of work,
5. at school,
6. or somewhere else? (specify)
PROBES FOR A4:
Was this easy or hard to answer? Explain.
(IF NOT CODE 5) How did you decide on your answer?
Loc3. Did this happen inside a school building or somewhere else on school property, such as
a school parking area, play area, school bus, etc? [CIR 10g]
1. Inside a school building
2. On school property (school parking area, play area, school bus, etc.)
3. Other (specify)
PROBES FOR Loc3:
Was this easy or hard to answer? Explain.
How did you decide on your answer?

NCVS-R CIR Testing Round 1

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Loc6. Did the incident happen in an area restricted to certain people or was it open to the
public at the time? [CIR17c]
1. Open to public
2. Restricted to certain people (or nobody had a right to be there)
3. Don’t know
4. Other
PROBES FOR Loc6:
What do you think is meant by “an area restricted to certain people”?
Here is the next situation.
L2: (on home property) Aria’s scooter is stolen from her front yard. How should Aria answer these
questions?
A4.
Where did this incident happen – (READ CATEGORIES OUT LOUD UNTIL R SAYS YES TO
SOMETHING) [CIR10a modified]
1. inside Aria’s home or lodging,
2. somewhere else on her property,
3. inside somewhere else where she was staying overnight or longer,
4. at her place of work,
5. at school,
6. or somewhere else? (specify)
PROBES FOR Loc6:
Was this easy or hard to answer? Explain.
What do you think is meant by the category that said “somewhere else on her property”?
(IF NOT CODE 2) How did you decide on your answer?

NCVS-R CIR Testing Round 1

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Here is the next situation.
L3: (At mall) Elijah’s cell phone is stolen while he is at the mall. How should Elijah answer these
questions?
A4.
Where did this incident happen – (READ CATEGORIES OUT LOUD UNTIL R SAYS YES TO
SOMETHING) [CIR10a modified]
1. inside Elijah’s home or lodging,
2. somewhere else on his property,
3. inside somewhere else where he was staying overnight or longer,
4. at his place of work,
5. at school,
6. or somewhere else? (specify)
PROBES FOR A4:
Was this easy or hard to answer? Explain.
(IF NOT CODE 6) How did you decide on your answer?
Loc2. I’m going to read you a list of places where this might have happened. Please tell me
which one BEST describes where this happened. Did this happen…
1. somewhere very near Elijah’s home or lodging
2. at, in, or near the home of a relative, friend, or neighbor
3. at a commercial place like a store, restaurant, or office building – GO TO Loc2e
4. in a parking lot or garage – GO TO Loc2f
5. in an open area, on the street, or on public transportation – GO TO Loc2h
6. or somewhere else? – (specify)
PROBES FOR Loc2:
Was this easy or hard to answer? Explain.
What do you think is meant by a “commercial” place?

NCVS-R CIR Testing Round 1

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If Loc2=3
Loc2e. At what type of a commercial place did this incident happen? (READ IF NECESSARY)
[CIR10e]
1. a restaurant, bar, nightclub
2. a bank
3. a gas station
4. another commercial building, such as a store
5. an office
6. a factory or warehouse
7. Other (specify)
PROBES FOR Loc2e:
Was this easy or hard to answer? Explain.
(IF NOT CODE 4) How did you come up with your answer?

NCVS-R CIR Testing Round 1

Page 51

Now I’d like to read you a few different types of situations and then will ask you some
questions about the person in the situation. (Respondent is given a copy of the story to
read along with.)
Here is the first situation.
P1: (Slept through) Jackson wakes up in the morning and his parents tell him that while they were all
sleeping, someone broke into the garage and stole their bicycles. How should Jackson answer these
questions?
PR1.

Was Jackson (or any other member of his household) aware of this incident as it was
happening?
1. Yes
2. No

PROBES FOR PR1:
Was this easy or hard to answer? Explain.
(IF NOT CODE 2) How did you decide on your answer?
Here is the next situation.
P2: (Sees person, but not their face) Riley is looking out the window during her math class and
thinks she sees someone trying to steal her bike. She bangs on the window and the person runs off.
She did not see the person’s face. How should Riley answer these questions?
PR1.

Was Riley or any other member of her household aware of this incident as it was
happening?
1. Yes
2. No

PROBES FOR PR1:
Was this easy or hard to answer? Explain.
(IF NOT CODE 1) How did you decide on your answer?
PR2.

(IF YES) Who was aware of it – only Riley, only someone else in her household, or both
her and someone else in her household?
1. Only Riley
2. Only someone else in her household

NCVS-R CIR Testing Round 1

Page 52

3. Both Riley and someone else in her household
PROBES FOR PR2:
Was this easy or hard to answer? Explain.
(IF NOT CODE 1) How did you decide on your answer?
If code 1 or 3 in PR2
PR3. Did Riley personally see or have any contact with the offender while the incident was
happening?
1. Yes
2. No
PROBES FOR PR3:
Was this easy or hard to answer? Explain.
How did you decide on your answer?

NCVS-R CIR Testing Round 1

Page 53

Here is the last situation.
P3: (Non-family member is aware) Lucas accidentally leaves his cellphone in the lunch room at
school. Later, Julia tells him that she saw another student take it off the table. How should Lucas
answer these questions?
PR1.

Was Lucas or any other member of his household aware of this incident as it was
happening?
1. Yes
2. No

PROBES FOR PR1:
Was this easy or hard to answer? Explain.
(IF NOT CODE 2) How did you decide on your answer?

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.
This interview may have brought up some sensitive issues for you. In case you would
like to talk to someone after this interview, here is a list of resources that you can use.
HAND RESOURCES LIST TO RESPONDENT.
Thank you for your time.

NCVS-R CIR Testing Round 1

Page 54

Attachment A2_CIR Round 2

NCVS-R: CIR COGNITIVE INTERVIEW PROTOCOL
Round 2
Date: Time__ ID #:__Interviewer Initials:
1. Introduction
Thank you for taking the time to help us out today. The session will take approximately
an hour and a half. 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, which is part of the
U.S. Department of Justice. 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 people’s experiences with crime and victimization. (YOUTH:
Anyone age 12 or older is eligible to be selected for this national survey.) Westat is
looking at ways these questions can be improved.
Today, I will be showing you a series of questions being considered for the NCVS.
When we’re ready to start, I am going to turn this computer screen to you to fill out the
questions. Every now and then, I will stop you and we will talk about the answers you
gave.
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 listened to by the project or the BJS staff. It will be destroyed
when the project is over. When we are finished, we will give you (ADULTS: 60/YOUTH:
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
ADULTS: 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.

NCVS-R CIR Testing Round 2

Page 1

YOUTH: HAND THE ASSENT FORM TO PARTICIPANT, ANSWER ANY QUESTIONS,
AND OBTAIN ASSENT BEFORE CONTINUING. This form contains all of the things I
just told you about your rights in this interview. Please read it over and if you are willing
to take part in the study, I will sign both copies.
[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? I am going to turn the computer
screen to you, and will watch along with you as you answer the questions. Every now
and then we’ll stop to talk about the questions.
Spontaneous Probing Strategy
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 OR AS THEY ARE ANSWERING IT, IMMEDIATELY PROBE TO
UNDERSTAND THE NATURE OF THE PROBLEM.
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.
• Tell me more about what you thought that question was asking?
• How did you decide on your answer?

NCVS-R CIR Testing Round 2

Page 2

SCREENER
INTRO1. The next questions will ask about things that may have happened to you in the past 12
months--that is since [MONTH x] of 2016. In this study, it is important to report only events
that happened since that month. Can you think of anything that was happening in your own life
at that time, such as a birthday, a vacation, changing jobs, or anything like that?
_________________________
As you are asked about different kinds of experiences, please think carefully about when things
happened, and only tell me about things that happened during or after [MONTH X 2016].
INTRO2. This survey will cover the following types of things: having items stolen; break-ins;
someone destroying your property; physical attacks; and unwanted sexual contact.
VEHICLE THEFT (ADULTS ONLY)
The first questions are about vehicles.
1. At any point in the past 12 months, have you or anyone else in the household owned a car,
van, truck, motorcycle, or other motor vehicle?
Yes - GO TO 1A
No - GO TO 3
1A. How many motor vehicles have you or someone in your household owned over the past 12
months? Please include any you no longer own.
_____________ motor vehicles
1B. In the past 12 months, did anyone steal or try to steal (this vehicle/one of these vehicles)?
1
2

Yes - CONTINUE
No – GO TO 2

1_1.

How many times did this happen in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times

NCVS-R CIR Testing Round 2

Page 3

1_2.
•
•
•

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET [Attachment E] FOR EACH INCIDENT
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. MARK APPROPRIATE BOXES ON INCIDENT DATA
SHEET FOR THAT INCIDENT.
1_3. For the next questions, only focus on the incident when someone stole or tried to steal a
vehicle in (MONTH /YEAR).
Most recent
A. Were any items or
belongings stolen from the
vehicle, such as a cell
phone, money, or any
other items that were in
the vehicle?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. (IF CODE 1 IN B) 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?

NCVS-R CIR Testing Round 2

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

Page 4

2. The next question asks about theft of vehicle parts. This might include things like:
•
•
•
•
•
•

a tire,
a hubcap,
a GPS or audio system,
a battery, airbag, or catalytic converter,
gasoline,
or any other vehicle parts.

In the past 12 months, did anyone steal or try to steal any parts from (this vehicle/one of these
vehicles)?
1
2

Yes – GO TO 2_1
No – GO TO 3

2_1.

How many times did this happen in the past 12 months?
1
2
3
4

2_2.
•
•
•

Once
Twice
Three times
Four or more times

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
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. MARK APPROPRIATE BOXES ON INCIDENT DATA
SHEET FOR THAT INCIDENT.

NCVS-R CIR Testing Round 2

Page 5

2_3. For the next questions, focus only on the incident in which someone stole or tried to steal
vehicle parts in (MONTH/YEAR).
Most recent
A. Other than the vehicle
parts, was anything else
stolen from the vehicle,
such as a cell phone,
money, or any other items
that were in the vehicle?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. (IF CODE 1 IN B) 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?

NCVS-R CIR Testing Round 2

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

Page 6

THEFT (ADULTS AND YOUTH)
3. The next question asks about anything that might have been stolen. This might include things
like:
•
•
•
•
•
•

money,
jewelry,
clothing,
cell phones,
TVs or other electronics,
or anything else that belongs to you.

In the past 12 months, was something that belongs to you stolen? Do NOT include someone
stealing your personal information or account numbers.
1
2

Yes
No

3b. (IF Q3=YES: Other than what you have already mentioned,) Did anyone try to steal anything
that belongs to you in the past 12 months, but not actually steal it?
1
2

Yes
No

CONCURRENT PROBES FOR YOUTH ONLY:
What kinds of things get stolen from kids these days? (IF NECESSARY: If you had to
guess, what would you say are the top 3 things that get stolen from kids?)
Where do things get stolen from kids these days?
I also asked you if anyone tried to steal anything from you. What do you think I meant
by that?
IF YES TO #3 OR #3b, CONTINUE. ELSE GO TO #4.
3_1. How many times did someone steal or try to steal something 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?

NCVS-R CIR Testing Round 2

Page 7

•
•
•

IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT

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. ASK QUESTIONS A-D FOR EACH INCIDENT BEFORE
MOVING TO THE NEXT COLUMN. MARK APPROPRIATE BOXES ON INCIDENT DATA SHEET FOR
THAT INCIDENT.
3_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
Most recent
A. Did anyone break in, or
try to break in, to your
home or another building
on your property as part of
this incident?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. (IF CODE 1 IN B) 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?

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

CONCURRENT PROBES FOR YOUTH ONLY:
IF Q3_3C WAS ASKED
I just asked you about sexual contact that you DID NOT CONSENT TO and that YOU
DID NOT WANT to happen. What do you think this question was asking about?
What do you think is meant when the question said “Did not consent and did not want it
to happen”?

NCVS-R CIR Testing Round 2

Page 8

BREAK-IN (ADULTS ONLY)
4. The next few questions ask about break-ins. This might have happened by someone:
•
•
•
•
•

forcing a door or window,
pushing past someone,
jimmying a lock,
cutting a screen,
or entering through an open door or window.

(Other than what you have already mentioned,) In the past 12 months, did anyone break in or
try to break into your home, garage or shed?

1
2

Yes
No

4b. In the past 12 months, did anyone break in or try to break into a hotel or motel room or
vacation home where you or someone else in your household was staying?
1
2

Yes - CONTINUE
No – GO TO #5

IF YES TO #4 OR #4b, CONTINUE. ELSE GO TO #5.
4_1. (IF BREAK-IN HAS ALREADY BEEN MENTIONED: Other than the break-in(s) that
you told me about earlier in this interview,) How many times did someone break in or
try to break in during 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) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident

NCVS-R CIR Testing Round 2

Page 9

FOR EACH INCIDENT IN 4_2, COMPLETE 4_3. MARK APPROPRIATE BOXES ON INCIDENT DATA
SHEET FOR THAT INCIDENT.
4_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
Most recent
A. Was anything stolen as
part of this incident?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. 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?

NCVS-R CIR Testing Round 2

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

Page 10

VANDALISM (ADULTS ONLY)
5. Vandalism is when someone deliberately damages or destroys something belonging to you.
This might include things like:
•
•
•

breaking windows,
slashing tires,
or painting graffiti on walls.

In the past 12 months, has anyone vandalized your home, car, or something else that belongs
to you or someone else living here?
1
2

Yes - CONTINUE
No – GO TO #6

5_1.

How many times did this happen 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 events) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT

•
•

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. MARK APPROPRIATE BOXES ON INCIDENT DATA
SHEET FOR THAT INCIDENT.

NCVS-R CIR Testing Round 2

Page 11

5_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
Most recent
A. Was anything stolen as
part of the incident?
B. Were you physically
attacked, or threatened
with an attack, during this
incident?
C. 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?

NCVS-R CIR Testing Round 2

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

Page 12

ATTACKS (ADULTS AND YOUTH)
6. The next question asks about any physical attacks against you personally, even if it was done
by someone you know well. This might include things like:
• someone attacking you with a weapon or something used as a weapon
• someone throwing something at you
• someone grabbing, slapping, punching or choking you,
• or any other type of attack or use of force against you.
(Other than what you have already mentioned) In the past 12 months, has anyone attacked or
threatened to attack you?
1
2

Yes – GO TO 6_1
No – GO TO 7

CONCURRENT PROBES FOR YOUTH ONLY:
When you hear the word “attack”, what do you think of?
What are some different ways that people your age are attacked by others?
This question also used the phrase “use of force against you”. What do you think that
means?
What do you think is meant by a “threatened attack”?
6_1. (IF ATTACK HAS ALREADY BEEN REPORTED: Other than the attack(s) or threat(s)
you told me about earlier in this interview,) How many times were you attacked or
threatened in the past 12 months?
1
2
3
4
6_2.
•
•
•

Once
Twice
Three times
Four or more times

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
a. Most recent incident
b. Next most recent incident
c. Next most recent incident

NCVS-R CIR Testing Round 2

Page 13

d. Next most recent incident
FOR EACH INCIDENT IN 6_2, COMPLETE 6_3. RECORD INFO ON INCIDENT DATA SHEET.
6_3. For the next question, focus only on the incident that happened in (MONTH/YEAR).
Most recent
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

Next most
recent

1 Yes
2 No

Next most
recent

1 Yes
2 No

Next most
recent

1 Yes
2 No

UNWANTED SEXUAL CONTACT (ADULTS AND YOUTH)
The next questions are sensitive and I want to remind you that the information you provide is
confidential. The question asks about sexual contact that you DID NOT CONSENT TO and that
YOU DID NOT WANT to happen. This could have been done by someone you know well,
someone you casually know, or a stranger, and can happen to both (IF ADULT: men and
women/IF YOUTH: boys and girls).
Please include someone having sexual contact or trying to have sexual contact with you by
holding or pinning you, hitting or kicking you, or using some other type of force or threat of
force.
7a. (Other than what you have already mentioned,) In the past 12 months, has anyone had, or
tried to have sexual contact with you by touching or penetrating your (ADULTS: sexual body
parts/YOUTH: private parts) that you DID NOT CONSENT TO and that YOU DID NOT WANT to
happen?
1
2

Yes
No

7c. 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
2

Yes
No

NCVS-R CIR Testing Round 2

Page 14

CONCURRENT PROBES FOR YOUTH ONLY:
I asked about sexual contact in the past 12 months that you DID NOT CONSENT TO
and that YOU DID NOT WANT to happen.
First of all, what do you think the phrase “sexual contact that you DID NOT CONSENT
TO” means?
What do you think is meant by “sexual contact that YOU DID NOT WANT TO
HAPPEN”?
I also reminded you before I read these questions that the information you provide is
confidential. What do you think I meant by that? Why do you think I said that before I
read the question?
Then I asked you whether 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. What types of situations do you think this question is asking
about?
We want to make sure this language is understandable to youth your age.
o
What do you think is meant by “passed out”?
o
How about “unconscious”?
o
“Blacked out”?
o
What about “unable to consent because you were drunk or high”?

IF YES TO 7a OR 7c, CONTINUE. OTHERWISE, GO TO #8.
7_1. (IF SEXUAL CONTACT HAS ALREADY BEEN REPORTED: Other than the sexual
contact you told me about earlier in this interview,) How many times did someone have,
or try to have these types of sexual contact with you in the past 12 months?
1
Once
2
Twice
3
Three times
4
Four or more times

NCVS-R CIR Testing Round 2

Page 15

7_2.
•
•
•

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
a. Most recent incident
b. Next most recent incident
c. Next most recent incident
d. Next most recent incident

IF NO INCIDENTS WERE REPORTED IN THE SCREENER, GO TO 8B
8. So far, you have reported the following incidents.
REVIEW INCIDENT DATA SHEET WITH RESPONDENT
IF ANY INCIDENTS HAPPENED IN THE SAME MONTH/YEAR, ASK:
8a. In (MONTH/YEAR), you reported (READ ITEMS FROM DATA SHEET). Were these part of the
same incident, or were they separate incidents?
1
2

Same incident (MARK DUPLICATE COLUMN FOR INCIDENTS ON DATA SHEET
THAT BELONG TOGETHER)
Separate incident

8b. We want to make sure we’ve captured everything that has happened to you. 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
2

Yes – CONTINUE (MARK “OTHER CRIME” BOX IN A NEW ROW ON DATA SHEET)
No – GO TO NOTE BEFORE #9

8c. What type of a crime did you think it was? (IF ANY ELEMENTS ON DATA SHEET ARE
MENTIONED, MARK APPROPRIATE BOX/ES)
1
2
3
4
5
6

Someone stole or tried to steal something belonging to me
Someone broke in or tried to break into my home or property
Someone vandalized my home or property
Someone attacked me or tried to attack me
Someone attacked me sexually
Something else _____________________ (DOES NOT TRIGGER CIR)

NCVS-R CIR Testing Round 2

Page 16

YOUTH: IF NO INCIDENTS ON DATA SHEET, SKIP TO VIGNETTES.
ADULTS: IF NO INCIDENTS ON DATA SHEET, SKIP TO CLOSING QUESTIONS.

NCVS-R CIR Testing Round 2

Page 17

Crime Incident Report (Adults and Youth)
Thank you. Next are some more questions about a specific incident that happened to you in the past 12 months. Every now and
then, I am going to stop and ask you some follow-ups on the questions I asked so that we can understand how you are interpreting
the questions.
SELECT INCIDENT BASED ON HOW RESPONDENT WAS RECRUITED. IF RESPONDENT DID NOT REPORT THE TYPE OF INCIDENT FOR
WHICH THEY WERE RECRUITED, SELECT THE INCIDENT THAT HAS THE MOST CHECK MARKS ON THE DATA ENTRY SHEET.
Row # from Data Entry Sheet that is going to be the focus of the Crime Incident Report: ___________
For these next questions, let’s focus just on what happened in the incident in (MONTH/YEAR) when you said you experienced (read
all appropriate items from data entry sheet, and mark off items in column A).
Row Type of crime

1
2
3
3a
4
5
6
7

Series

Vehicle theft
Vehicle part theft
Theft
Attempted Theft
Break-in
Vandalism
Attack
Sexual contact

D
D
A
B
C
H
I

Source of crime
A. Screener
B. CIR
Data Entry
Form

C. CIR module
completed (Mark
here when you
have completed
the CIR section)

D. Victim present
during crime
(Enter from
column J of Data
Entry Form)

Once all eligible sections have been completed in sections A-I, if there are any X’s in column D of the table above, go to section VO (Victim
Offender Relationship). Otherwise, go to Self-Protection section.

NCVS-R CIR Testing Round 2

Page 18

What Happened: I Series – Attack/Threatened Attack
Check page 16. If there is an X in Row 6, Column A or B, continue. Else go back to Page 16 for
next section to ask about.
I1.

Earlier you mentioned that someone attacked you as part of the incident in
(MONTH/YEAR). Did the offender have a weapon such as a gun or knife, or something to
use as a weapon, such as a bottle or wrench? [CIR22]
1. Yes
2. No
3. DK

If code 1 in I1:
I2.
What was the weapon? [CIR23a] (DO NOT READ CATEGORIES)
1.
2.
3.
4.
5.
6.
I3.

Hand gun (pistol, revolver, etc.)
Other gun (rifle, shotgun, etc.)
Knife
Other sharp object (scissors, ice pick, axe, etc.)
Blunt object (rock, club, blackjack, etc.)
Other - Specify Did the offender hit you, knock you down or actually attack you in any way? [CIR24]
1. Yes
2. No
3. DK

If code 2 in I3:
I4.
Did the offender TRY to attack you? [CIR25]
1. Yes
2. No
3. DK
If code 2 in I4:
I5.
Did the offender THREATEN you with harm in any way? [CIR26]
1. Yes
2. No
3. DK
NCVS-R CIR Testing Round 2

Page 19

If code 2 in I5:
I6.
What actually happened? [CIR27a]
_____________________________
If code 1 in I4:
I7.
How did the offender TRY to attack you? For example, did the offender try to hit you or
stab you? [CIR28a]
___________________________

If code 1 in I5:
I8.
How were you threatened? For example, did the offender threaten to hit you or stab
you? [CIR28c] (Same response options as I7.)
_____________________________

If code 1 in I3:
I9.
How were you attacked? For example, did the offender hit you or stab you? [CIR29amodified]
_____________________________
I10.

Did the offender THREATEN to hurt you before you were actually attacked? [CIR30a]
1. Yes
2. No
3. DK

(ASK ALL)
I11.

Were you injured in any way during this incident?
1. Yes
2. No

All in Section I, Go back to page 16 to determine if any other Series need to be asked. (MARK
X IN ROW 6, COLUMN C)

NCVS-R CIR Testing Round 2

Page 20

What Happened: C Series – Break-ins
Check page 16. If there is an X in Row 4, Column A or B, continue.
C1.
Earlier you mentioned that someone broke in or tried to break in during the incident
that happened in (MONTH/YEAR). Did someone break in or try to break into – [READ
CATEGORIES] [CIR10b, modified]
1. your (house/apartment),
2. into a garage, shed, or other detached building on your property,
3. into a second home or vacation home,
4. into a hotel or motel room where you or someone else in your household was
staying, or
5. into some other place (SPECIFY)?
ALL IN C1:
How easy or difficult was it to decide on your answer? (Explain)

C2.

Did the offender actually get inside? [CIR12, modified]
1. Yes
2. No
3. DK

If code 2 or 3 in C2:
C3.
Did the offender TRY to get inside? [CIR13, modified]
1. Yes
2. No Return to page 16 to determine if other Series need to be asked (DO NOT MARK X
IN ROW 4, COLUMN C)
3. DK
If code 1 or 3 in C2 or C3, continue.
Otherwise, go to C5.
C4.
Was there any evidence, such as a broken lock or broken window, that the offender(s)
(IF C2=1: got in by force/IF C3=1: TRIED to get in by force)? [CIR14]
1. Yes
2. No
3. DK

NCVS-R CIR Testing Round 2

Page 21

If “Yes” to C4:
C4A. What was the evidence? Record verbatim for testing. [CIR15a, modified]
____________________________________________________________
Check page 16. If there are NO X’s in Rows 3 or 3a, Column A or B, continue.
Else go back to Page 16 for next section to ask about (AND MARK X IN ROW 4, COL C).
C5.

Was anything belonging to you (or others in the household) stolen? [CIR88, modified]
1. Yes - Mark X in Row 3, Column B on page 16, and continue
2. No

C6.

Did the person TRY to steal anything belonging to you (or others in the household), but
not actually steal it? [CIR89, modified]
1. Yes - Mark X in Row 3a, Column B on page 16, and continue
2. No
3. DK

ALL IN C6:
Tell me more about your answer. How did you know the person tried to steal something?

All in Section C, Go back to page 16 to determine if any other Series need to be asked. (MARK
X IN ROW 4, COLUMN C)

NCVS-R CIR Testing Round 2

Page 22

D. Motor Vehicle Theft/Parts Theft/Attempted Theft
Check page 16. If there is an X in Row 1, Column A or B, continue. Else go back to Page 16 for
next section to ask about.
If A1 or B1 = car/vehicle or vehicle parts, go to D3. Otherwise, continue.
D2.

Earlier you mentioned that someone stole or tried to steal (a vehicle/ vehicle parts/a
vehicle and parts) in (MONTH/YEAR). [Was the (car/motor vehicle)/Were the parts]
actually taken, or did someone just TRY to take (it/them)? [New item]
1. Actually taken
2. Tried to take
3. (VOL) Both
4. DK

OPTIONAL PROBE FOR D2:
How did you decide on your answer?

D3.

Did the (car/motor vehicle) belong to you personally, to someone else in the household,
or to both you and other household members? [CIR 97a]
1. You
2. Someone else
3. Both you and someone else
4. DK

Check page 16. If vehicle theft (X in Row 1, Columns A or B), and code 1 in D2, continue.
Otherwise, Go to D6.
D4.
98]

Had permission to use the (car/motor vehicle) ever been given to the offender(s)? [CIR

1. Yes
2. No
3. DK
If code 1 in D4, continue. Otherwise, Go to D6.

NCVS-R CIR Testing Round 2

Page 23

D5.

Did the offender return the (car/motor vehicle) this time? [CIR 99]
1. Yes
2. No
3. DK

D6.

Where was the (car/vehicle) when this happened –? (READ IF NECESSARY) [New item]
1. on your property, such as in a driveway or your own garage
2. in a garage or parking lot associated with where you live
3. in some other garage or parking lot
4. on the street; or
5. somewhere else
6. DK

OPTIONAL PROBE FOR D6:
How did you decide on your answer?

If code 3 in D6, continue. Otherwise, Go to Note after D7.
D7.
Ask if necessary: In what type of a parking lot or garage did this incident happen?
[CIR10f]
_______________________________________________
All in Section D, Go back to page 16 to determine if any other Series need to be asked. (MARK
X IN ROW 1 OR 2, COLUMN C, AS APPROPRIATE based on response to D2)

NCVS-R CIR Testing Round 2

Page 24

A. Theft
Check page 16. If there is an X in Row 3, Column A or B, continue. Else go back to Page 16 for
next section to ask about.
A1.

Earlier you mentioned that something was stolen (during the incident that happened) in
(MONTH/YEAR). What was stolen? [DO NOT READ CATEGORIES] Probe: Anything else?
[CIR96a]
1
2
3
4
5
6
7

Cash
Purse/wallet
Credit cards, check, bank cards
Car or other motor vehicle
Part of a motor vehicle, including unattached parts, gasoline
Other _____________________________
Nothing stolen – attempt only - Go to B Series (Mark X in Row 3a, Column B on
Page 16)
8
Nothing stolen/No attempt/Nothing happened (reporting error) - Return to page
16 to determine if other Series need to be asked (DO NOT MARK X IN ROW 3,
COLUMN C)
9
Nothing stolen/No attempt – something else happened - Return to page 16 to
determine if other Series need to be asked (DO NOT MARK X IN ROW 3,
COLUMN C)
If code 4 in A1, Mark X in Row 1, Column B on Page 16; if nothing else is marked in A1, Go to
D Series.
If code 5 in A1, Mark X in Row 2, Column B on Page 16; if nothing else is marked in A1, Go to
D Series.
If code 2 in A1, continue.
If code 1 in A1, go to A4.
Otherwise, go to A5.
A3.
Did the stolen (purse/wallet) contain any money? [CIR96d]
1. Yes - Continue
2. No – Go to A5
If “Yes” in A3 or “cash” in A1:
A4.
How much cash was taken? [CIR96e]
$_______.00
ALL IN A4:
How easy or difficult was it to remember how much cash was taken?

NCVS-R CIR Testing Round 2

Page 25

How accurate is your answer?
Would you prefer to type in the actual amount, or to be given ranges of dollar amounts?

Ask if more than one person in household:
A5.
Did the stolen (property/money) belong to you personally, to someone else in the
household, or to both you and other household members? [CIR97a]
1. You
2. Someone else in the household
3. Both you and someone else in household
If “cash,” “purse,” or “wallet” in A1 and codes 1 or 3 in A5:
A6.
Was the (cash/purse/wallet) on your person, for instance, in a pocket or being held?
[CIR102a]
1. Yes
2. No
ALL IN A6:
What do you think is meant by “on your person”?

If one-person household or codes 1 or 3 in A5:
A7.
Was there anything (else) the offender(s) took directly from you, for instance, from your
pocket or hands, or something that you were wearing? [CIR102b]
1. Yes - Continue
2. No - Go to A9
A8.

Which items did the offender(s) take directly from you? [CIR103]
_____________________________________________________________________

A9.

Where did this happen – (READ CATEGORIES) [CIR10a modified]
1. inside your home or lodging
2. somewhere else on your property,
3. inside somewhere else where you were staying overnight or longer
4. at your place of work,
5. at school, or
6. somewhere else? ___________________

NCVS-R CIR Testing Round 2

Page 26

7. (VOL) from a vehicle

NCVS-R CIR Testing Round 2

Page 27

ALL IN A9:
Was this question clear, or was it confusing in any way? Explain.
The second category I read was “somewhere else on your property.” What could some examples of this
be? (IF A9=2: Tell me more about where on your property this happened)
Another category I read was “inside somewhere else where you were staying overnight or longer.” What
do you think this category was referring to? (IF A9=3: Tell me more about where you were when this
happened)

If code 1 or 3 in A9:
A10. Did the person who stole (this/these things) live there or have a right to be there, as, for
example, a guest or repair person? [CIR11]
1. Yes
2. No
3. Don’t know
ALL IN A10:
What do you think this question is asking?

Check page 16, row 4. If blank and if code 2 or 3 in A10 or codes 1-3 in A9:
A11. Did the person who stole (this/these things) break in or try to break in? [New, probably
need to use something closer to CIR12]
1. Yes - Mark X in Row 4, Column B on page 16, and continue
2. No
Check page 16, row 4. If blank and if code 2 in A9:
A12. Did someone break in or try to break in to a garage, shed, or other building on your
property (to steal/try to steal) (this/these things))? [NEW ITEM]
1. Yes - Mark X in Row 4, Column B on page 16, and continue
2. No
IF YES TO A12:
Can you tell me more about what type of property was broken into?

NCVS-R CIR Testing Round 2

Page 28

If code 7 in A9, continue.
Otherwise, go back to page 16 to check for next Series to ask. (MARK X IN ROW 3, COLUMN C)
A13. Where was the (car/vehicle) when this happened – [READ CATEGORIES]
1. on your property, such as in a driveway or your own garage
2. in a garage or parking lot associated with where you live
3. in some other garage or parking lot
4. on the street, or
5. somewhere else?
ALL IN A13:
What did you think about these categories?

If code 3 in A13
A14. In what type of a parking lot or garage did this incident happen? [CIR10f]
______________________________
All in Section A, Go back to page 16 to determine if any other Series need to be asked. (MARK
X IN ROW 3, COLUMN C)

NCVS-R CIR Testing Round 2

Page 29

B. Attempted Theft
Check page 16. If there is an X in Row 3a, Column A or B, continue. Else go back to Page 16 for
next section to ask about.
B1.
Earlier you mentioned that someone tried to steal something (during the incident that
happened) in (MONTH/YEAR). What did the offender try to take? [CIR90a]
1
2
3
4
5
6
7

Cash
Purse/wallet
Credit cards, check, bank cards
Car or other motor vehicle
Part of a motor vehicle, including unattached parts, gasoline
Other _____________________________
Nothing stolen/No attempt/Nothing happened (reporting error) - Return to page
16 to determine if other Series need to be asked (DO NOT MARK X IN ROW 3a,
COLUMN C)
8
Nothing stolen/No attempt – something else happened - Return to page 16 to
determine if other Series need to be asked (DO NOT MARK X IN ROW 3a,
COLUMN C)
9
Don’t know
If code 4 in B1, Mark X in Row 1, Column B on Page 16; if no other responses in B1, Go to D
Series.
If code 5 in B1, Mark X in Row 2, Column B on Page 16; if no other responses, Go to D Series.
Otherwise, continue.
B2.
Did the (property/money) the offender tried to take belong to you personally, to
someone else in the household, or to both you and other household members? [CIR91a]
1. You
2. Someone else in the household
3. Both you and someone else in household
If codes 1 or 2 in B1 and code 1 or 3 in B2:
B3.
Was the (cash/purse/wallet) on your person, for instance, in a pocket or being held?
[CIR93]
1. Yes
2. No
ALL IN B3:
What do you think is meant by “on your person”?

NCVS-R CIR Testing Round 2

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B4.

Was there anything (else) the offender(s) tried to take directly from you, for instance,
from your pocket or hands, or something that you were wearing? [CIR94]
1. Yes
2. No

ALL IN B4:
What do you think is meant by “take directly from you”?

Check page 16 – if Row 4, Column C is blank, continue.
Otherwise, go to next eligible series.
B5.
Where did this happen – [CIR10a modified]
1. inside your home or lodging,
2. somewhere else on your property,
3. inside somewhere else where you were staying overnight or longer,
4. at your place of work,
5. at school, or
6. somewhere else?
7. (VOL) from a vehicle
ALL IN B5:
What do you think about the categories I read in this question?
The second category I read was “somewhere else on your property.” What could some examples of this
be?
Another category I read was “inside somewhere else where you were staying overnight or longer.” What
do you think this category was referring to?

If code 1 or 3 in B5:
B6.
Did the person who tried to steal (this/these things) live there or have a right to be
there, as, for example, a guest or repair person? [CIR11]
1. Yes
2. No
3. DK
ALL IN B6:
What do you think this question is asking?

NCVS-R CIR Testing Round 2

Page 31

Check page 16, row 4. If blank and if code 2 or 3 in B6 or codes 1-3 in B5:
B7.
Did the person who tried to steal (this/these things) break in or try to break in? [New,
probably need to use something closer to CIR12]
1. Yes - Mark X in Row 4, Column B on page 16, and continue
2. No
ALL IN B7:
What do you think of as a break in?

If code 7 in B5, continue.
Otherwise, go back to page 16 to check for next Series to ask. (MARK X IN ROW 3a, COLUMN
C)
B8.
Where was the (car/vehicle) when this happened – [READ CATEGORIES]
1. on your property, such as in a driveway or your own garage
2. in a garage or parking lot associated with where you live
3. in some other garage or parking lot
4. on the street, or
5. somewhere else?
ALL IN B8:
What do you think about the categories I read in this question?

If code 3 in B8:
B9.
In what type of a parking lot or garage did this incident happen? [CIR10f]
________________________________________________
All in Section B, Go back to page 16 to determine if any other Series need to be asked. (MARK
X IN ROW 3a, COLUMN C)

NCVS-R CIR Testing Round 2

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What Happened: H Series – Vandalism
Check page 16. If there is an X in Row 5, Column A or B, and NO X’s in Rows 1-4 or 6 (column
A or B) continue. Else go back to Page 16 for next section to ask about.
H1.

Earlier you mentioned that someone vandalized your property in (MONTH/YEAR). What
kind of property was damaged or destroyed in this/these act(s) of vandalism? [2009
Supplement, 61a] [DO NOT READ CATEGORIES]
1.
2.
3.
4.
5.
6.
7.
8.
9.

H2.

Motor vehicle (including parts)
Bicycle (including parts)
Mailbox
House window/screen/door
Yard or garden (trees, shrubs, fence, etc.) Furniture, other household goods
Clothing
Animal (pet, livestock, etc.)
Gate or fence
Other (Specify)

What kind of damage was done in this/these act(s) of vandalism? [2009 Supplement,
62a]

_________________________________

ALL IN H2:
How easy or difficult was it to describe the type of damage that was done? Explain.

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If code 4 in H1, continue. Otherwise go to H5.
H3.

Do you think the offender was trying to get into your (house/apartment)?
1. Yes
2. No
3. DK

If code 1 in H3, continue. Otherwise go to H5.
H4.

Did the offender actually get inside?
1. Yes
2. No
3. DK

If code 1 in H3 or H4, check page 16, row 4. If columns A and B are blank, mark X in column B.
If code 1, 2, 6, or 7 or 9 to H1, continue. Otherwise go to note after H5.
H5.

Where did this vandalism happen? [READ CATEGORIES] (NEW)
1.
2.
3.
4.

in or around your (house/apartment)
at your place of work
at school
or, somewhere else ___________________________

ALL IN H5:
What do you think is meant by “in or around your house/apartment”?.

All in Section H, Go back to page 16 to determine if any other Series need to be asked. (MARK
X IN ROW 5, COLUMN C)

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Check data entry sheet. If there is an “X” in the “R present”, “Attack” or “Sexual contact” column for
the incident being asked about, go to PR4. Otherwise, continue.
PR1.

Were you (or any other member of this household) aware of this incident as it was happening?
1. Yes
2. No

PROBES FOR PR1:
What does it mean to be “aware” of an incident as it is happening?
IF NEEDED: Does it mean you need to actually be there and see that it is happening?
How did you decide on your answer?

If “Yes” to PR1, continue.
If “No” to PR1, go to Police Involvement Series on page 26
PR2.

Who was aware of it – only you, only someone else in the household, or you and someone else
in your household?
1. Only respondent
2. Only someone else in the household
3. Both respondent and someone else in household

PROBES FOR PR2 IF R SEEMED TO HAVE DIFFICULTY:
How did you decide on your answer?

If code 1 or 3 in PR2
PR3. Did you personally see or have any contact with the offender while the incident was happening?
1. Yes
2. No
PROBES FOR PR3:
What does it mean to “have any contact with the offender”?
How is this the same or different from being “aware” of the incident?

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Check data entry sheet. If there is an “X” in the “R present”, “Attack” or “Sexual contact” column for
the incident being asked about, OR If code 2 or 3 in PR2, continue. Otherwise go to Police
Involvement series.
PR4. Did someone else in your household personally see or have any contact with the offender while
the incident was happening?
1. Yes
2. No
PROBES FOR PR4 ONLY IF R SEEMED TO HAVE DIFFICULTY WITH THE QUESTION:
What do you think this question is asking?
Did you have any problem in deciding on your answer? Explain.

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Victim-offender Relationship (VOR) Series
VOR0. Ask or verify - Which household members were present and aware of the incident as it was
happening?
1. Respondent only – Skip to VOR3
2. Respondent and other household member(s) - Skip to VOR3
3. Only other household member(s), not respondent – Continue to VOR1
4. No one was present/aware – Continue to VOR1
VOR1. Do you know or have you learned anything about the offender(s) - for instance, whether there
was one or more than one offender involved, whether it was someone young or old, or male or
female? [CIR 56]

1. Yes
2. No
3. DK
ALL IN VOR1:
What do you think this question is asking?
(IF R ANSWERS WITH RESPONSE OTHER THAN YES/NO) Tell me how you decided how to answer this
question.

If code 1 in VOR1, continue. Otherwise, go to Narrative.
VOR2. How sure are you of this information? Do you have a suspicion, are you fairly sure or are you
certain? [CIR 57]

1. Suspicion
2. Fairly sure
3. Certain
ALL IN VOR2:
What do you think this question is asking?
How did you decide on your response?

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If incident involved attack (Row 6 on page 16), go to VOR4. Otherwise, continue.
VOR3. How did you learn about the offender(s)? [DO NOT READ CATEGORIES] [CIR 58a]
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Respondent saw or heard offender
From other member of household who was eyewitness
From eyewitness(es) other than household member(s)
From police
Other person (not eyewitness)
Offender(s) admitted it
Offender(s) had threatened to do it
Stolen property found on offender's property or in offender's possession
Figured it out by who had motive, opportunity, or had done it before
Other - Specify _____________

ALL IN VOR3:
What do you think this question is asking?

VOR4. Was the crime committed by only one or by more than one offender? [CIR60]

1. One – Go to VOR6
2. More than one – Go to VOR14
3. DK - Continue
VOR5. Do you know anything about one of the offenders? [CIR 61]

1. Yes
2. No
3. DK
If code 1 to VOR5, continue. Otherwise, go to Self-Protection section.
VOR6. Was the offender someone you knew or a stranger you had never seen before? [CIR62]

1. Knew
2. Stranger had never seen before
3. DK

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If code 1 to VOR6, go to VOR8. Otherwise, continue.
VOR7. Would you be able to recognize the offender if you saw him/her? [CIR63]

1. Yes
2. Not sure (possibly or probably)
3. No
If code 1 or 2 in VOR7, go to VOR9. If code 3 in VOR7, go to note before VOR11.
VOR8. How well did you know the offender - by sight only, casual acquaintance, or well known? [CIR64]

1. By sight only
2. A casual acquaintance
3. Well known
If code 1 in VOR8, continue. Otherwise, go to VOR10.
VOR9. 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? [CIR65a]

1. Yes
2. No
All in VOR9, go to note before VOR11.
VOR10. How did you know the offender? For example, was the offender a friend, someone you were
seeing or dating, etc.? [CIR66a]

_______________________________________________

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If code 2 in VOR6 or code 1 in VOR8, continue. Otherwise, go to note before VOR12.
VOR11. What, if anything, do you know about who the offender is? For example, is the offender a
neighbor, (schoolmate), (co-worker), or friend of a friend? [DO NOT READ CATEGORIES] [New
item]
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Friend of a friend
Schoolmate
Neighbor
Customer/client
Patient
Current or former Employee
Current or former Co-worker
Teacher/school staff
Other – Specify
Someone of whom I have no knowledge

ALL IN VOR11:
Earlier you said the person was a stranger, or someone you knew by sight only. What did you think
about being asked this question about what you know about who the offender is?
IF NOT CODE 10: Can you tell me more about what you know about the offender?
All in VOR11, go to probe after VOR22.
VOR12. Did this person ever live with you? [2006 SVS]

1. Yes
2. No
If “yes” in VOR12, Continue. Otherwise, go to probe after VOR22.
VOR13. Was this person living with you at the time of this incident? [adapted from 2006 SVS]

1. Yes
2. No
3. DK
All in VOR13, go to probe after VOR22.
VOR14. How many offenders were there? [CIR74]
__________

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VOR15. Were any of the offenders known to you, or were they strangers you had never seen before?
[CIR75]
1. All known
2. Some known
3. All strangers
4. Don’t know
If code 3 or 4 in VOR15, continue. Otherwise go to VOR17.
VOR16. Would you be able to recognize any of them if you saw them? [CIR76]

1. Yes – Go to VOR18
2. Not sure (possibly or probably) – Go to VOR18
3. No – Go to note before VOR20
If code 1 or 2 in VOR15:
VOR17. How well did you know the offender(s) - by sight only, casual acquaintance, or well known?
[CIR77a]

1. By sight only
2. A casual acquaintance
3. Well known
If code 1 in VOR17, continue. Otherwise, go to VOR19.
VOR18. 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? [CIR78a]

1. Yes
2. No
All in VOR18, go to note before VOR20.

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VOR19. How did you know them? For example, were they friends, someone you were seeing or dating,
etc.? [CIR79a]
___________________________________________________
If code 3 in VOR15 or code 1 in VOR17, continue. Otherwise, go to probe after VOR22.
VOR20. What, if anything, do you know about who they are? For example, are they neighbors,
(schoolmates), (co-workers), or friends of a friend? [New item]
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Friend of a friend
Schoolmate
Neighbor
Customer/client
Patient
Current or former Employee
Current or former Co-worker
Teacher/school staff
Other – Specify
Someone of whom I have no knowledge

ALL IN VOR20:
Earlier you said they were (all strangers/ people you knew by sight only). What did you think about
being asked this question about what you know about who the offenders are?
ALL IN VOR20, GO TO PROBE AFTER VOR22.
VOR21. Did any of them ever live with you? [2006 SVS]

1. Yes
2. No
If code 1 in VOR21:
VOR22. Was one or more of them living with you at the time of this incident? [adapted from 2006 SVS]

1. Yes
2. No

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ASK ALL:
This series of questions asked how you knew the offender(s). How well did they capture your
relationship or connection to the person(s) who did this? (Explain)
Were any of the questions confusing? (Explain)
Was it difficult to remember details about any of the questions I asked? (Explain)

All go to Self-Protection series:

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Self-Protection (SP) Series
If incident involved attack (Row 6 on page 16), or VOR0=1 or 2, continue. Otherwise go to Community
Measures.
SP1. Did you do anything with the idea of protecting YOURSELF or your PROPERTY while the incident
was going on? [CIR41a]

1. Yes
2. No
3. DK
ALL IN SP1:
What do you think this question is asking?

If code 2 or 3 in SP1, continue. Otherwise go to SP3.
SP2. Was there anything you did or tried to do about the incident while it was going on? [CIR41b]

1. Yes
2. No
3. DK
ALL IN SP2:
What do you think this question is asking? How is this different from the prior question that asked “Did
you do anything with the idea of protecting YOURSELF or your PROPERTY while the incident was going
on?”

If code 1 in SP1 or code 1 in SP2, continue. Otherwise go to SP11.
SP3. Did you do any of the following during the incident? [READ CATEGORIES] (Mark all that apply)

SP3b

1. Did you attack or try to attack the offender – Go to SP3a
2. Did you defend yourself or your property without physically attacking the offender? – Go to
3. Did you chase or warn off the offender? – Go to SP3c
4. Did you say something to try to stop the offender? – Go to SP3d
5. Did you get help or try to get help? – Go to SP3e

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6. Did you do anything else? – Go to SP3f
SP3a. Earlier, you said you attacked or tried to attack the offender. How did you attack or try to attack
the offender? (Read categories if necessary) [CIR42a, 1-6]
1. Attacked offender with gun; fired gun
2. Attacked with other weapon
3. Attacked without weapon (hit, kicked, etc.)
4. Threatened offender with gun
5. Threatened offender with other weapon
6. Threatened to injure, no weapon
7. Some other way (specify)
Go to SP4.
SP3b. Earlier, you said you defended yourself or your property without physically attacking the offender.
How did you do this? (Read categories if necessary) [CIR42a, 7-8]
1. Defended self (struggled, ducked, blocked blows)
2. Defended property (e.g., held onto property)
3. Some other way (specify)
Go to SP4.
SP3c. Earlier, you said you chased or warned off the offender. How did you do this? (Read categories if
necessary) [CIR42a, 9-10]
1. Chased, tried to catch or hold offender
2. Scared or warned off the offender (yelled at, threatened to call police)
3. Some other way (specify)
Go to SP4.
SP3d. Earlier, you said you said something to try to stop the offender. How did you do this? (Read
categories if necessary) [CIR42a, 11-12]
1. Stalled or did what they asked to avoid being injured
2. Argued, reasoned, pleaded or bargained
3. Some other way (specify)
Go to SP4.
SP3e. Earlier, you said you tried to get help. What did you do? (Read categories if necessary) [CIR42a,
13-6]

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1. Ran or drove away, tried to get away, hid, locked door
2. Called the police or guard
3. Tried to attract attention of someone else, warned others
4. Some other way (specify)
Go to SP4.
SP3f. What (else) did you do? [DO NOT READ CATEGORIES]
1. Screamed from pain or fear
2. Other (specify)
AFTER SP3 AND FOLLOW-UPS ARE ASKED:
How well did these questions capture what you did in response to the attack? Explain.
If SP3c=YES:
I asked “Did you chase or warn off the offender?” What do you think is meant by “warn off”?
Check page 16. If row 6 or 7 is marked in column C (attack or sexual contact), continue. Otherwise go
to SP5.
SP4. Did you take these actions before, after or at the same time you were first attacked? (Mark all that
apply) (New)
1.
2.
3.

Before
After
Same time

ALL IN SP4:
Was it hard or easy for you to decide how to answer this question? Explain.

If I11=yes)
SP5. Did you take these actions before, after, or at the same time that you were injured? (Mark all that
apply) (CIR43a)
1.
2.
3.

Before
After
Same time

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SP6.
Did (any of) your action(s) help the situation in any way? [Probe: Did your action(s) help you
avoid injury, protect your property, escape from the offender - or were they helpful in some other way?]
(CIR43b)
1.
2.
3.

Yes
No
DK

If yes to SP6, continue. Otherwise go to SP8.
SP7.

How were they helpful? [Probe] Any other way? (CIR44a)
_______________________________________________

SP8.
Did (any of) your action(s) make the situation worse in any way? [Probe:] Did your action(s) lead
to injury, greater injury, loss of property, make the offender angrier, or make the situation worse in
some other way? (CIR45)
1.
2.
3.

Yes
No
DK

If yes to SP8, continue. Otherwise go to SP10.

SP9.

How did they make the situation worse? Probe: Any other way? (CIR46a)
___________________________

SP10. Was anyone present during the incident besides you and the offender? (Other than children
under age 12.) (CIR47)
1.
2.
3.

Yes
No
DK

If yes to SP10, continue. Otherwise go to SP18.
SP11.

Did anyone else do or try to do anything about the incident while it was going on? (New)

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1.
2.
3.

Yes
No
DK

If yes to SP11, continue. Otherwise go to SP18.
SP12. Who took these actions – was it someone who was with you, someone who was with the
offender(s), or a bystander? (Mark all that apply) (New)
1.
2.
3.
4.

Someone who was with me
Someone who was with the offender
A bystander
I don’t know who the person was with.

YOUTH:
What do you think is meant by “a bystander”?
SP13.

What did the other person(s) do? Anything else? (New)

__________________________________________
SP14. Did the actions of (this person/any of these people) help the situation in any way? (CIR48)
1.
2.
3.

Yes
No
DK

If yes to SP14, continue. Otherwise go to SP16.
SP15.

How were they helpful? [Probe] Any other way? (CIR49a)
____________________________________________

SP16. Did the actions of (this person/any of these people) make the situation worse in any way?
(CIR50)
1.
2.
3.

Yes
No
DK

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If yes to SP16, continue. Otherwise go to SP18.
SP17.

How did they make the situation worse? Probe: Any other way? (CIR46a)
__________________________________________________

SP18. Not counting yourself, were any of the persons present during the incident harmed (Pause),
threatened with harm (Pause), or robbed by force or threat of harm? (Do not include yourself, the
offender, or children under 12 years of age.) (CIR52)
1.
2.
3.

Yes
No
DK

If yes to SP18, continue. Otherwise go to SP20.
SP19. How many? (Do not include yourself, the offender or children under 12 years of age.) (CIR53)
_____________ Number of persons
SP20. How many of these persons are members of your household now? (Do not include yourself, the
offender or children under 12 years of age.) (CIR54a)
_____________ Number of persons
If SP20>0, continue. Otherwise go to probe after SP21 , then Narrative.
SP21. Who are these household members? (Do not include yourself, the offender or children under
12 years of age) (CIR54b)
__________________
__________________
__________________
ASK ALL:
This series of questions asked about different ways you or others might have reacted during the
incident. How well did they capture what actually happened? (Explain)
Were any of the questions confusing? (Explain)
Was it difficult to remember details about any of the questions I asked? (Explain)

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Narrative
Finally, please describe in your own words what happened. Provide as much detail as you
can, including what happened, who the offender was, where it happened, who was present,
whether there was a weapon, whether anyone was hurt, etc… The more detail you can provide,
the better, even if it is repeating some of what you’ve already told me.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

ASK ALL:
What overall reactions did you have to the questions I asked in this interview?
How well did the questions capture what happened to you?
Just now, you told me what happened to you in your own words.
•
•
•

How well did the survey questions about what happened capture what actually happened?
(Explain)
How well did the questions I asked about your relationship to the offender capture how you
knew the person? (Explain)
How easy or hard was it to recall details about how you protected yourself during the incident?

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Community Measures Series

CM1. Now we have some questions about this neighborhood. By your neighborhood we mean the area
within a fifteen minute walk from your home. How worried are you about each of the following. . . . .
Are you... extremely worried, very worried, somewhat worried, slightly worried, or not at all worried
about…
a. being mugged or robbed in your neighborhood?
1
Extremely worried
2
Very worried
3
Somewhat worried
4
Slightly worried
5
Not at all worried
b. having your home broken into and something stolen?
1
Extremely worried
2
Very worried
3
Somewhat worried
4
Slightly worried
5
Not at all worried
ASK ALL:
How easy or difficult was it to decide which answers to give for these items? Explain.
These questions ask about “your neighborhood”. What do you think that means?
We included a definition of neighborhood that said “the area within a 15 minute walk from your home.”
What do you think about that definition?

CM2. We have a few more questions about your neighborhood. Remember, by your neighborhood we
mean the area within a fifteen minute walk from your home. In your neighborhood, how much of a
problem is . . . . A very big problem, a fairly big problem, not a very big problem, or not a problem at all?
a. vandalism, graffiti or other deliberate damage to property?
1
A very big problem
2
A fairly big problem
3
Not a very big problem
4
Not a problem at all
b. people being drunk or rowdy in public places?
1
A very big problem

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2
3
4

A fairly big problem
Not a very big problem
Not a problem at all

c. burned, abandoned or boarded-up buildings?
1
A very big problem
2
A fairly big problem
3
Not a very big problem
4
Not a problem at all
d. people using or dealing drugs illegally?
1
A very big problem
2
A fairly big problem
3
Not a very big problem
4
Not a problem at all
ASK ALL:
How easy or difficult was it to decide which answers to give for these items? Explain.

CM3. If a group of neighborhood youth were skipping school and hanging out on a street corner, how
likely is it that your neighbors would do something about it? Would you say … very likely, likely, unlikely,
or very unlikely?
1
2
3
4

Very likely
Likely
Unlikely
Very unlikely

CM4. If some youth were spray-painting graffiti on a local building, how likely is it that your neighbors
would do something about it? Would you say … very likely, somewhat likely, neither likely nor
unlikely, somewhat unlikely, or very unlikely?
1
2
3
4

Very likely
Likely
Unlikely
Very unlikely

CM5. Now I’m going to read some statements that may or may not apply to your neighborhood … by
your neighborhood we mean the area within a fifteen minute walk from your home.… For each
one, please tell me whether you strongly agree, agree, disagree, or strongly disagree.

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a.

This is a close-knit community.
1
2
3
4

b.

People around here are willing to help their neighbors.
1
2
3
4

c.

Strongly agree
Agree
Disagree
Strongly disagree

Strongly agree
Agree
Disagree
Strongly disagree

People in this neighborhood can be trusted.
1
2
3
4

Strongly agree
Agree
Disagree
Strongly disagree

PROBES
•

How well did the questions I asked about your community capture the type of community you
live in?

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VIGNETTES FOR YOUTH: (ONLY IF NO VICTIMIZATIONS REPORTED IN SCREENER)
Now I’d like to read you a few different situations and then will ask you some questions about
the person in the situation. (Respondent is given a copy of the situation to read along with.)
Here is the first situation.

T1: Haley left her coat in the car while she was at the mall with her mom. She had $5 in her coat
pocket. When they got back to their car, it had been broken into, and her coat and the $5 was gone.
How should she answer these questions?
A1.

What was stolen?
A coat and $5

A4.

How much cash was taken? [CIR96e]
$5

A5.

Did the stolen property and money belong to Haley personally, to someone else in the
household, or to both Haley and other household members? [CIR97a]
1. Haley
2. Someone else in the household
3. Both Haley and someone else in household

Probe for A5:
How did you decide how to answer this question?
A9.

Where did this happen – (READ CATEGORIES) [CIR10a modified]
1. inside Haley’s home or lodging
2. somewhere else on her property,
3. inside somewhere else where she was staying overnight or longer
4. at her place of work,
5. at school, or
6. somewhere else? ___________________
7. (VOL: from a vehicle)

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Probe for A9:
Was it hard or easy to decide which answer to give for this question? Explain.
(IF NOT CODE 6 or 7) How did you decide on your answer?
A13.

(IF A9=7) Where was the (car/vehicle) when this happened – [READ CATEGORIES]
1. on her property, such as in a driveway or her own garage
2. in a garage or parking lot associated with where she lives
3. in some other garage or parking lot
4. on the street, or
5. somewhere else?

A14.

(IF A13=3) In what type of a parking lot or garage did this incident happen? [CIR10f]
______________________________

Ask all:
How easy or hard were these questions to answer? Explain.
(IF NOT CODE 3 IN A13) How did you decide on your answer?

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Here is the next situation.

T2: Conner and his brother have a soccer net in their back yard. One day when Conner gets home
from school, he sees that someone has stolen the net and their soccer ball from the yard. How
should he answer these questions?
A1.

What was stolen?
Net and soccer ball

A5.

Did the stolen property belong to Conner personally, to someone else in the household,
or to both Conner and other household members? [CIR97a]
1. Conner
2. Someone else in the household
3. Both Conner and someone else in household

Probe for A5:
Was it hard or easy to decide how to answer this question? Explain.
What do you think “property” means in this question? Who do you think the net and ball
belong to in this story?
A9.

Where did this happen – (READ CATEGORIES) [CIR10a modified]
1. inside Conner’s home or lodging
2. somewhere else on his property,
3. inside somewhere else where he was staying overnight or longer
4. at his place of work,
5. at school, or
6. somewhere else? ___________________
7. (VOL: from a vehicle)

Probe for A9:
Was it hard or easy to decide which answer to give for this question? Explain.
The second category I read was “somewhere else on his property.” What do you think
“property” means in this question?
(IF NOT CODE 2 IN A9) How did you come up with your answer to this question?

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If code 2 in A9:
A12. Did someone break in or try to break in to a garage, shed, or other building on Conner’s
property (to steal/try to steal) (this/these things))? [NEW ITEM]
1. Yes
2. No

Ask all:
How easy or hard was this question to answer? Explain.

Now I’d like to read you a few different types of situations and then will ask you some questions
about the person in the situation. (Respondent is given a copy of the story to read along with.)
Here is the first situation.

A1: (completed attack) Anna is walking down the hallway at school and someone shoves her and
runs off. She does not see who did it, but her neck hurts later when she gets home from school.
How should she answer these questions?
I3.

Did the offender hit Anna, knock her down or actually attack her in any way? [CIR24]
1. Yes – Go to I9
2. No
3. DK

If code 2 or 3 in I3:
How easy or hard was this question to answer?
(IF NOT CODE 1) How did you decide which answer to give for this question?
I10.

Did the offender THREATEN to hurt her before she was actually attacked? [CIR30a]
1. Yes
2. No
3. DK

NCVS-R CIR Testing Round 2

Page 57

If code 2 or 3 in I10:
What do you think this question is asking? (IF NEEDED) What would an example be of someone
threatening to hurt someone before actually attacking them?

I11.

Was Anna injured in any way during this incident?
1. Yes
2. No

If code 1 in I11:
How did you decide which answer to give for this question?

Ask all:
How easy or hard were these questions to answer? Explain.
Here is the next situation:
A2: (threatened attack) At the park after school, a group of kids with knives and bats surround
Nathan and say they are going to beat him up if he doesn’t give them his cellphone. An adult comes
by, and the group walks away before anything happens. How should he answer these questions?
I1.

Did the offenders have a weapon such as a gun or knife, or something to use as a weapon,
such as a bottle or wrench? [CIR22]
1. Yes
2. No
3. DK

I3.

Did the offenders hit Nathan, knock him down or actually attack him in any way? [CIR24]
1. Yes – Go to I9
2. No
3. DK

If code 2 in I3:
I4.
Did the offenders TRY to attack Nathan? [CIR25]
1. Yes
2. No
3. DK

NCVS-R CIR Testing Round 2

Page 58

Ask all in I4:
What does it mean to “try” to attack someone?
If code 2 in I4:
I5.
Did the offenders THREATEN him with harm in any way? [CIR26]
1. Yes
2. No
3. DK
Ask all in I5:
What does it mean to “threaten” someone with harm?
If code 1 in I5:
I8.
How was he threatened? For example, did the offenders threaten to hit or stab him?
[CIR28c]
_____________________________ SKIP TO I11

I11.

Was Nathan injured in any way during this incident?
1. Yes
2. No

Ask all:
How easy or hard were these questions to answer? Explain.

NCVS-R CIR Testing Round 2

Page 59

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.
This interview may have brought up some sensitive issues for you. In case you would like to talk
to someone after this interview, here is a list of resources that you can use.

HAND RESOURCES LIST TO RESPONDENT.

Thank you for your time.

NCVS-R CIR Testing Round 2

Page 60

Attachment A3_Youth screener testing_long cues

NCVS-R Screener Round 1 Youth Testing
Interleaf

Cue Length

Yes

Long

Police Ask-All Items
PQ1. I am going to read some questions about experiences you may have had with police
officers or sheriff’s deputies in your area during the past 6 months.
Have you had contact with police in your area in any of the following ways during the
past 6 months? Please exclude contact with guards or other security personnel who are
not part of the police.
……
a. During the past 6 months, have you reported any
kind of crime, disturbance or suspicious activity to
police in your area?
b. Have you reported a non-crime emergency such as
a traffic accident or medical emergency to your police
in your area?
c. Have you participated in a community meeting,
block watch or other anti-crime activity when the
police in your area were present?
d. Other than what you have already mentioned, have
you contacted the police in your area for something
else during the past 6 months?

e. (AGES 16+ ONLY) During the past 6 months, have
you been stopped by the police in your area while
driving a motor vehicle?
f. (During the past 6 months) Have you been stopped
by the police in your area while a passenger in a
motor vehicle?
g. Have you been stopped or approached by the
police in your area while in a public place, but not a

Yes
1

No
2

1

2

1

2

1

2

Yes
1

No
2

1

2

1

2

moving vehicle? This includes being in a parked
vehicle.
h. During the past 6 months, have you been involved
in a traffic accident that was reported to the police in
your area?
i. Have you been arrested by the police in your area?
j. Have you been stopped or approached by the police
in your area in the last 6 months for something I
haven’t mentioned?
k. Do you have any personal, family or social contact
with police officers?
l. Do you know any of the police officers that work in
your in your area by name or by sight?

1

2

1
1

2
2

1

2

1

2

INTERVIEWER: READ ALL RESPONSE CATEGORIES OUT LOUD, EXCEPT “DON’T KNOW.”
PQ2. We would like to know your views of the police in your area (IF ALL NO IN PQ1: 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.
a. How would you rate the police in your area on treating people respectfully? Would you
say they are …
1.
2.
3.
4.
5.
6.

very respectful,
somewhat respectful,
neither respectful or disrespectful,
somewhat disrespectful, or
very disrespectful?
(don’t know)

b. In your opinion, how much time and attention do the police in your area give to what
people have to say before making their decisions? Would you say that the police give
people …
1.
2.
3.
4.
5.
6.

great deal of time,
a lot of time,
a moderate amount of time,
a little time, or
no time at all
(don’t know)

Round 1 Youth Screener Testing – Long, Interleaf

Page 2

c. In your opinion, how consistent are the police in your area in applying the laws in the
same way to everyone? Would you say they are …
1.
2.
3.
4.
5.
6.
d.

very consistent,
somewhat consistent,
neither consistent nor inconsistent,
somewhat inconsistent, or
very inconsistent?
(don’t know)
In your opinion, how would you rate the police in your area on treating people fairly,
regardless of who they are? Would you say they are…

1.
2.
3.
4.
5.
6.

very fair
somewhat fair
neither fair nor unfair
somewhat unfair, or
very unfair?
(don’t know)

e. How much of the time can the police in your area be trusted to make decisions that are
right? Would you say they can ….
1.
2.
3.
4.
5.
6.

always be trusted,
usually can be trusted,
sometimes can be trusted,
rarely can be trusted, or
never can be trusted?
(don’t know)

f. Taking everything into account, how would you rate the job the police in your area are
doing? Would you rate them as doing a…
1.
2.
3.
4.
5.
6.

very good job,
a somewhat good job,
neither a good nor a bad job,
a somewhat bad job, or
a very bad job?
(don’t know)

g. How effective are the police in your area at preventing crime in this area?
1. Extremely effective
2. Very effective
3. Moderately effective
Round 1 Youth Screener Testing – Long, Interleaf

Page 3

4. Slightly effective
5. Not at all effective
6. (don’t know)

Round 1 Youth Screener Testing – Long, Interleaf

Page 4

h. How effective are the police in your area in catching the people who commit crime in
this area? Would you say they are …
1.
2.
3.
4.
5.
6.

Extremely effective
Very effective
Moderately effective
Slightly effective
Not at all effective
(don’t know)

i.

How effective are the police in your area at addressing the issues that really concern
people in this area? Would you say they are …

1.
2.
3.
4.
5.
6.

Extremely effective
Very effective
Moderately effective
Slightly effective
Not at all effective
(don’t know)

INTERVIEWER: STOP HERE AND ADMINISTER PROBES ON POLICE ITEMS.

Round 1 Youth Screener Testing – Long, Interleaf

Page 5

INTRO1. The next questions will ask about things that may have happened to you in the past 12
months--that is since [MONTH x] of 2016. In this study, it is important to report only events
that happened since that month. Can you think of anything that was happening in your own life
at that time, such as a birthday, a vacation, or something happening at school?
_________________________
As I ask you about different kinds of experiences, please think carefully about when things
happened, and only tell me about things that happened during or after [MONTH X 2016].
INTRO2. This survey will cover the following types of things: having items stolen; physical
attacks; and unwanted sexual contact.
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.
THEFT
1_a. In the period from (12 MONTHS AGO) to (6 MONTHS AGO), was something belonging to
you or your children under 12 stolen?
1. Now I’ll ask about different things that might have been stolen from you in the past 6
months, that is, since (MONTH 6 MONTHS AGO, YEAR). This may have happened to you while
you were at home, (IF AGES 15+: at work or) school, or somewhere else. In the past 6 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 backpack?
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
Yes
No
months, was anything of yours stolen out of a vehicle?
e) Was anything stolen from your porch, lawn, garage, or other part
Yes
No
of your property, such as a bicycle?
f) Were any other things that belong to you stolen in the past 12
Yes
No
months?
1h. Other than what you’ve already told me, in the past 12 months, did anyone TRY to steal
anything that belongs to you?
1
2

Yes
No

PROBE FOR 1h:
What do you think this question was asking about?
Round 1 Youth Screener Testing – Long, Interleaf

Page 6

IF YES TO ANY IN #1a-h, CONTINUE. ELSE GO TO #2.
1_1. How many times did someone steal or try to steal something 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”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET [Attachment E] FOR EACH INCIDENT
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. ASK QUESTIONS A-E FOR EACH INCIDENT BEFORE
MOVING TO THE NEXT COLUMN.

Round 1 Youth Screener Testing – Long, Interleaf

Page 7

1_3. For the next questions, focus only on the incident that happened in (MONTH/YEAR).
Most recent
A. Were you physically
attacked, or threatened
with an attack, during this
incident?
B. (IF YES IN 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?

Next most
recent

Next most
recent

Next most
recent

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

1 Yes
2 No

ATTACKS
2. The next few questions ask about any physical attacks against you personally. These may
have happened at your home or while you were (IF AGES 15+: at work,) at school, or away from
home.
(IF ANY ATTACK WAS REPORTED AS PART OF OTHER INCIDENTS, READ: 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
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.

Round 1 Youth Screener Testing – Long, Interleaf

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Page 8

2f. (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 2h
2g. (IF YES TO 2f) How were you threatened? Was it face-to-face, by phone or text, or online?
1
2
3
4

Face-to-face
By phone or text
Online
Some other way (e.g., by mail, to a third party)

2h. People sometimes don’t think of attacks by someone they know, like a boyfriend or
girlfriend, someone at school, 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 #3

(IF YES TO ANY IN 5A-E) OR (FACE TO FACE IN 2G) OR (YES TO 2H), CONTINUE. ELSE GO TO #3.
2_1.

How many times were you attacked or threatened in the past 12 months?
1
2
3
4

2_2.
•
•
•

Once
Twice
Three times
Four or more times

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
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.
Round 1 Youth Screener Testing – Long, Interleaf

Page 9

2_3. For the next question, focus only on the incident that happened in (MONTH/YEAR).
Most recent
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

Next most
recent

1 Yes
2 No

Round 1 Youth Screener Testing – Long, Interleaf

Next most
recent

1 Yes
2 No

Next most
recent

1 Yes
2 No

Page 10

UNWANTED SEXUAL CONTACT
3. 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 private parts. 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: 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
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 TRY 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?

Yes

No

Yes

No

Yes

No

Yes

No

(IF YES TO ANY IN 3A-D, CONTINUE. ELSE GO TO #4)
3_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
3_2.
•
•
•

In what month and year did (this/these) happen?
IF UNABLE TO PROVIDE EXACT MONTH, RECORD VERBATIM RESPONSE, SUCH AS
“SPRING”
IF DK, CONFIRM THAT INCIDENT HAPPENED IN PAST 12 MONTHS
ADD ROW TO INCIDENT DATA SHEET FOR EACH INCIDENT
a. Most recent incident
b. Next most recent incident
c. Next most recent incident

Round 1 Youth Screener Testing – Long, Interleaf

Page 11

d. Next most recent incident
4. Before we move on, I’d like to review the different incidents that you’ve reported to me.
IF NO INCIDENTS WERE REPORTED IN THE SCREENER, GO TO 4B
REVIEW INCIDENT DATA SHEET WITH RESPONDENT
IF ANY INCIDENTS HAPPENED IN THE SAME MONTH/YEAR, ASK:
4a. In (MONTH/YEAR), you reported (READ ITEMS FROM DATA SHEET). Were these part of the
same incident, or were they separate incidents?
1
2

Same incident (MARK DUPLICATE COLUMN FOR INCIDENTS ON DATA SHEET
THAT BELONG TOGETHER)
Separate incident

4b. I want to make sure we’ve captured everything that has happened to you. 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
2

Yes – CONTINUE (MARK “OTHER CRIME” BOX IN A NEW ROW ON DATA SHEET)
No – GO TO END

4c. What happened?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
INTERVIEWER: LOOK AT DATA SHEET AND SELECT INCIDENT WITH THE MOST CHECK-MARKS.
IN THE CASE OF A TIE, SELECT THE MOST RECENT INCIDENT.
Now I’d like you to tell me a little more about what happened in the incident in (MONTH/YEAR)
when you said the following things happened:
• (LIST WHAT HAPPENED FROM SCREENER INCIDENT DATA FORM)
Please describe in your own words what happened. Provide as much detail as you
can, including what happened, who the offender was, where it happened, who was there when
it happened, whether there was a weapon, whether anyone was hurt, etc…
INTERVIEWER: STOP HERE AND GO TO PROBES.
Round 1 Youth Screener Testing – Long, Interleaf

Page 12

Attachment A3A_Youth screener testing_long cues_protocol

NCVS-R: SCREENER COGNITIVE INTERVIEW YOUTH
SCREENER TESTING PROTOCOL
Long Cues
Interleaf

Cue Length

Yes

Long

Date:_______________ Time_____ ID #:_____Interviewer Initials:_______________
1. Introduction
Thank you for taking the time to help us out today. The session will take approximately
an hour and a half. 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, which is part of the
U.S. Department of Justice. We are interested in how people think about 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. Anyone age 12 or older is eligible to be
selected for this national survey.
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.
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 listened to by the project or the BJS staff. It will be destroyed
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 ASSENT FORM TO PARTICIPANT, ANSWER ANY QUESTIONS, AND
OBTAIN ASSENT BEFORE CONTINUING. This form contains all of the things I just
NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

1

told you about your rights in this interview. Please read it over and if you are willing to
take part in the study, I will sign both copies.
[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. BEGIN WITH POLICE ASK-ALL ITEMS.
OTHERWISE BEGIN WITH SCREENER ITEMS.

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 OR AS THEY ARE ANSWERING IT, IMMEDIATELY PROBE TO
UNDERSTAND THE NATURE OF THE PROBLEM.
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.
• Tell me more about what you thought that question was asking?
• How did you decide on your answer?

IF RESPONDENT REMEMBERS AN ADDITIONAL INCIDENT AT ANY POINT
DURING THE PROBING, MAKE A NOTE IN THE PROTOCOL AND FOLLOW-UP
IMMEDIATELY TO ASK:
•
•

What made you think of that particular incident just now?
Can you tell me more about what happened to you in that incident?

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

2

GENERAL PROBES TO ASK AFTER POLICE ITEMS:
DO NOT SPEND MORE THAN 15 MINUTES ON THESE PROBES
PQ1: Now I’d like to focus just on the first question I asked, which said:
Have you had contact with police in your area in any of the following ways during
the past 6 months? Please exclude contact with guards or other security
personnel who are not part of the police.
What, in your own words, is this saying?
When you think about “police in your area”, what comes to mind?
What about an SRO, or school resource officer? Were you thinking about that
type of person when you answered these questions? Is that person a police
officer, or some other type of security person?
What kinds of contact or interactions with police were you thinking about?
IF NEEDED: What about the phrase “in your area”, what geographic area comes
to mind when you hear that?
(FOR EACH YES RESPONSE TO ITEMS A-L) Can you tell me more about what you
were thinking about when you said yes to this item?
I’ve asked you about a number of ways you might have dealt with members of the local
police. Can you think of any (other) way you have dealt with or gotten to know police
officers or sheriff’s deputies? (IF ANY NEW WAY MENTIONED: How long ago was
that? How well do you know them?)

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

3

PQ2: Then I asked you a series of items to rate the police in your area. What did you
think about this series of items?
How easy or difficult was it to answer these questions?
Which police were you thinking about when you answered these questions?
(LISTEN FOR: local police, police from other local areas, only the police I’ve interacted
with, etc.)
How did you decide on your answers to these questions? (LISTEN FOR: based
on experiences you’ve had, what you hear in the media, other people’s experiences)
Before we move on, do you have any other feedback on this series of questions?

RETURN TO QUESTIONNAIRE TO ASK SCREENING ITEMS:

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

4

GENERAL PROBES TO ASK AFTER SCREENING ITEMS:
Now I’d like to ask you some questions about the questions I just asked.
A.1

First, what did you think about this series of questions I 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 Was there anything you didn’t 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, I asked you to think about something that happened
to you in (Month/Year)? How helpful was that to remember what
happened to you in the past 12 months?

THEFT
First I asked you if something belonging to you was stolen.


What kinds of things get stolen from kids these days? (IF NECESSARY: If you
had to guess, what would you say are the top 3 things that get stolen from kids?)



Where do things get stolen from kids these days?



I also asked you if anyone tried to steal anything from you. What do you think I
meant by that?



(IF YES) You said yes to (READ ITEMS). Can you tell me briefly about what
happened to you?
o (IF NEEDED) Can you tell me more about why you decided to say yes
to this particular item?
o How easy or difficult was it to remember the month and year when
this/these happened?
o (IF INTERLEAF ITEM 1_3B WAS ASKED) I also asked you if anyone
had, or tried 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. What do you think this question was asking about?

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

5



What do you think is meant when the question said “Did not
consent and did not want it to happen”?

ATTACKS
Now let’s talk about the questions I asked about if anyone attacked you or tried to attack
you.


When you hear the word “attack”, what do you think of?



What are some different ways that people your age are attacked by others?



In one of the questions, I asked if someone had attacked you with something that
was used as a weapon, like a baseball bat, scissors, or a stick. Can you think of
any other objects that someone could use as a weapon to attack a person?



When I asked if someone “tried” to attack you, what do you think that means?



What are some of the places where a youth might be attacked?



(IF YES TO ANY) You said yes to (READ ITEMS). Can you tell me briefly about
what happened to you?
o (IF NEEDED) Can you tell me more about why you decided to say yes
to this particular item?
o How easy or difficult was it to remember the month and year when this
happened?
o (IF YES TO ANY INTERLEAF ITEMS, PROBE ON ANY CONFUSION
NOTED DURING INTERVIEW)



(ASK ALL) I also asked whether anyone “threatened to attack you but did not
actually do it”. What do you think is meant by a “threatened attack”?
o If someone threatened you in a text or in social media, like Snapchat or
Instagram, would you say yes or no to this question?



(ASK ALL) Then I asked you to think about any attacks by someone you know,
like a boyfriend or girlfriend, someone at school, 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? (Explain)
o What do you think is meant by the phrase “boyfriend or girlfriend”?
What’s the best language to use these days to refer to relationships
between boys and girls?

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

6

SEXUAL CONTACT
Then I asked about sexual contact in the past 12 months that you DID NOT CONSENT
TO and that YOU DID NOT WANT to happen.
•
•

First of all, what do you think the phrase “sexual contact that you DID NOT
CONSENT TO” means?
What do you think is meant by “sexual contact that YOU DID NOT WANT TO
HAPPEN”?

I also reminded you before I read these questions that the information you provide is
confidential.
•
•

What do you think I meant by that?
Why do you think I said that before I read the question?

Then I asked if anyone “forcibly” touched or grabbed your private parts.
•

What do you think is meant by “forcibly”?
o And when you hear “private parts”, what parts of your body does that
include?

Then I asked you whether 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.
•
•

What types of situations do you think this question is asking about?
We want to make sure this language is understandable to youth your age.
o What do you think is meant by “passed out”?
o How about “unconscious”?
o “Blacked out”?
o What about “unable to consent because you were drunk or high”?

Next, 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?
[IF ANY ADDITIONAL INCIDENTS MENTIONED IN Q8b] Can you tell me more
about what happened in this incident?
o What made you think about this incident now, at this point in the interview,
rather than earlier?
We’ve talked about a lot of different types of things today.
o Did all of the things you told me about happen in the past 12 months?
o is there ANYTHING else that happened to you in the past 12 months that
we haven’t talked about today?
 [IF YES] What happened?

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

7

NARRATIVE
Finally, I asked you to tell me the story of what happened to you during the incident.
How did you feel about sharing the details of the incident?
If an interviewer came to your home to administer this survey, how would you feel about
sharing this level of detail?

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

8

Vignettes – IF NO VICTIMIZATIONS WERE REPORTED, OR IF TIME PERMITS
Now I’d like to read you a few different situations and then will ask you some questions
about the person in the situation. Listen carefully to the story, and if you want me to
repeat anything, I will.
Here is the first situation.
T1: (Attempted theft – Q1a=NO, Q1h=YES) While Joe is at the library looking for a book, he sees
someone looking through his backpack that he left on the table. As Joe walks back towards his
backpack, the person quickly walks away. Nothing seems to be missing. How should Joe answer
these questions?
1. These questions ask about different things that might have been stolen from Joe. This may
have happened to Joe while at home, at school, or somewhere else. In the past 12 months…
a) Was something belonging to Joe stolen, such as things that he
Yes
No
carries, like a cell phone, money, a wallet, purse, or backpack?
1h. (Besides what you’ve already told me), in the past 12 months, did anyone TRY to steal
anything belonging to Joe?
1
2

Yes
No

PROBES:
• How would you describe what happened to Joe in your own words?
•

Help me understand how you came up with your answers to the questions. (IF NEEDED:
What part of the story led you to answer this way?)

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

9

Let’s go through one more situation.
T2: (Theft of item not on cue list – Q1B OR 1C-YES) Tia left her scooter in her driveway after
school. When she goes back outside after dinner, the scooter is gone. How should Tia answer these
questions?
1. In the past 12 months…
a) Was something belonging to Tia stolen, such as things that she
carries, like a cell phone, money, a wallet, purse, or backpack?
b) Was anything stolen from her porch, lawn, garage, or other part
of her property, such as a bicycle?
c) Were any other things that belong to Tia stolen in the past 12
months?

Yes

No

Yes

No

Yes

No

PROBES:
•

How would you describe what happened to Tia in your own words?

•

Help me understand how you came up with your answers to the questions. (IF NEEDED:
What part of the story led you to answer this way?)

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

10

Now I’d like to read you a few different situations, and then will ask you some questions
about the person in the situation.
A1: (Verbal threat – Q2A-E=NO, Q2F=YES, Q2G=1) Lucilla gets into an argument with a boy in
the cafeteria at school. The boy tells Lucilla that he is going to come after her and she better watch
out. How should Lucilla answer these question?
2. In the past 12 months…
a) Has anyone attacked or tried to attack Lucilla with a weapon,
for instance, a gun or knife?
b) Has anyone attacked or tried to attack her 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 her by throwing
something at her, such as a rock or bottle?
d) Has anyone attacked or tried to attack her by slapping,
grabbing, kicking, punching, or choking her?
e) Has anyone attacked, tried to attack, or used force against
Lucilla in any other way in the past 12 months? Please mention
it even if you are not certain it was a crime.

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

2f. In the past 12 months, did anyone THREATEN to attack Lucilla, but not actually do it?
Yes - CONTINUE
No – SKIP TO 2h
2g. (IF YES TO 2f) How was Lucilla threatened? Was it face-to-face, by phone or text, or online?
1
2
3
4

Face-to-face
By phone or text
Online
Some other way (e.g., by mail, to a third party)

PROBES:
•

How would you describe what happened to Lucilla in your own words?

•

Help me understand how you came up with your answers to the questions. (IF NEEDED:
What part of the story led you to answer this way?)

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

11

Let’s go through one more situation.
A2: (Attempted attack – Q2D=YES) Langston is riding the school bus home, and a student on the
bus throws a punch at him. Langston ducks out of the way, and doesn’t get hit or hurt. How should
Langston answer these questions?
2. In the past 12 months…
a) Has anyone attacked or tried to attack Langston with a weapon,
for instance, a gun or knife?
b) Has anyone attacked or tried to attack him 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 him by throwing
something at him, such as a rock or bottle?
d) Has anyone attacked or tried to attack him by slapping,
grabbing, kicking, punching, or choking him?
e) Has anyone attacked, tried to attack, or used force against
Langston in any other way in the past 12 months? Please
mention it even if you are not certain it was a crime.

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

2f. In the past 12 months, did anyone THREATEN to attack Langston, but not actually do it?
Yes - CONTINUE
No – SKIP TO 2h
2g. (IF YES TO 2f) How was Langston threatened? Was it face-to-face, by phone or text, or
online?
1
2
3
4

Face-to-face
By phone or text
Online
Some other way (e.g., by mail, to a third party)

PROBES:
•

How would you describe what happened to Langston in your own words?

•

Help me understand how you came up with your answers to the questions. (IF NEEDED:
What part of the story led you to answer this way?)

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

12

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.
This interview may have brought up some sensitive issues for you. In case you would
like to talk to someone after this interview, here is a list of resources that you can use.
HAND RESOURCES LIST TO RESPONDENT.
Thank you for your time.

NCVS-R Youth Protocol for Screener Testing – Long, Interleaf

13

Attachment B1_Letter to VSO

U.S. Department of Justice
Office of Justice Programs
Bureau of Justice Statistics
Washington, D.C. 20531

February 9, 2017
[NAME, TITLE]
[VSO]
[ADDRESS]
[CITY, STATE ZIP]

Dear [NAME],

We are contacting your organization for research support. The Bureau of Justice Statistics (BJS)
is in the process of redesigning the National Crime and Victimization Survey (NCVS), which is
the primary source of national data on personal and household victimizations, both reported and
not reported to police. The NCVS was last redesigned more than two decades ago and the
content needs to be updated to better capture the experiences of survivors of crime today.
As part of the redesign effort, we are reaching out to the public, including survivors, so that we
can gather feedback on the new and revised survey questions. We are reaching out to your
organization in the hopes that you can help us identify adult and juvenile (ages 12-17) survivors
who may be able to participate in a personal interview at some point in the next few months to
provide feedback about the clarity and appropriateness of the survey questions. We are
particularly hoping to interview recent (past 12 month) survivors of theft, robbery, assault, and
sexual assault.
BJS has asked Westat, a Rockville, MD based research company, to conduct these interviews.
We anticipate that the interviews will take about 90 minutes and survivors who are willing to
participate will be compensated $40-60 for their time.
If you are willing to help, we would ask that you send this letter, along with the attached
messaging for potential survey volunteers, to your contacts at your earliest convenience
(preferably no later than XXX). Survivors who are interested in participating can contact Westat
immediately to set up their interviews. We do request that parents of youth ages 12 to 17 contact
Westat, rather than the youth making the phone call.
We are planning on conducting interviews over the next several months, and may ask that you
send a follow-up contact if you are willing to do so.

This is a completely voluntary study. Respondents can skip any items they are uncomfortable
answering and are not required to participate. Further, BJS will not publish any data identifiable
specific to an individual. 1 To protect the identity of the respondents, no identifying information
will be kept on the final data file. The testing design and procedures have been reviewed by the
Westat IRB. Note that the interviews will be stopped if requested by the respondent or if the
respondent shows signs of emotional distress.
I hope that this letter is able to address any concerns you may have, and we are available at any
time to speak with you or a representative of your organization should you desire any additional
information.
If you have any questions, please contact me:
[email protected]
202-514-5083

We appreciate your help with this important research.
Sincerely,

Jenna Truman
NCVS Redesign Project Manager

1

BJS has obtained clearance from the Office of Management and Budget (OMB) to conduct this
work, under a pledge of confidentiality based on governing statutes Title 42 USC, Section 3735
and 3789g, which establish the allowable use of data collected by BJS. Under these sections, data
collected by BJS shall be used only for statistical or research purposes and shall be gathered in a
manner that precludes their use for law enforcement or any purpose relating to a particular
individual other than statistical or research purposes (Section 3735). BJS staff, other federal
employees, and Westat staff (the data collection agent) shall not use or reveal any research or
statistical information identifiable to any specific private person for any purpose other than the
research and statistical purposes for which it was obtained.

Attachment B2_Recruitment for Victims

FLYER/EMAIL MESSAGING FOR RECRUITING VICTIMS THRU VSP CHANNELS
The Bureau of Justice Statistics (BJS), part of the Department of Justice, conducts a national
victimization survey based on a randomly selected set of households each year. Everyone in
these households, age 12 and older, is asked questions about their experiences with crime so
that BJS can estimate victimization in the United States.
BJS is testing some new questions for this survey; we want to be sure that the questions make
sense to different types of people. BJS has asked Westat, a research company, to help test
these questions with victims of crime.
If you have been the victim of a crime in the past 12 months, or have a child ages 12 to 17 who
has been the victim of a crime, Westat would like to schedule a one-on-one interview with
you/your child.
All interviews will be confidential and written parental consent is required for 12 to 17 year olds
in order to participate.
The study is taking place in a number of locations around the country, and takes approximately
90 minutes. To find out if you and/or your youth are eligible for an interview, please call Westat
at xxxx and say you are calling about the “BJS Victim Survey.” If you are ages 12 to 17, your
parent or guardian must make this call.
Participants in the study will be paid cash to help offset the costs of participation.
-

Adults will receive $60.
Youth (ages 12-17) will receive $40. The parent or guardian will also receive $20 to help
offset travel expenses.

We hope that you are willing to help us with this important research. Thank you.

Attachment C1_Craigslist Ad

Research participants needed (Adults receive $60, Youth
receive $40)

Westat is seeking children (age 12-17) and adults (18 years and older) to help test some survey
questions to be used 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 90 minutes and will be held at Westat in Rockville, MD. Participants in
the study will be paid cash to help offset the costs of participation
-

Adults will receive $60.
Youth (ages 12-17) will receive $40. The parent or guardian will also receive $20
to help offset travel expenses.

In the interview, participants will be asked to answer and 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 C2_Recruitment Screener

ID #_________________

NCVS-R
Recruiting Screener
Hello, this is [NAME] from [Focus Groups of Cleveland/Observation Baltimore/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. Bureau of Justice Statistics
with. Let me first tell you a little about it. The Bureau of Justice Statistics 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 both adults and youth who are
interested in helping us by answering the questions and giving their reactions to them. If
you are interested and eligible, we will invite you to an in-person interview, which will
take about 90 minutes. At the end of the in-person interview you will receive $60 cash to
help pay for your expenses in getting here. And if you have a youth ages 12 to 17 in your
household, we are also interested in interviewing youth in a separate interview. Youth
will receive $40 cash at the end of the interview. The parent or guardian will also receive
$20 to help offset travel expenses. To see if you or a youth are eligible for the study, I
need to ask you a few questions. This will only take about 5 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 6 MONTHS AGO
6 MONTHS AGO OR MORE
NEVER
REF
DK
IF LESS THAN 6 MONTHS AGO, REF OR DK, INELIGIBLE. THANK AND END.

1

ID #_________________
IF INELIGIBLE: Thank you for taking the time to answer these questions. You’re not
eligible to participate in the study at this time.
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

1

2

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

a. Someone stole or tried to steal your vehicle or parts from
your vehicle
b. Someone stole something else or tried to steal something
from you

home

Did any other type of crime happen to you over the past 12
months? (If yes, specify)

_______________________________________________
_______________________________________________

(IF NO TO ALL IN #5, SKIP TO #9. OTHERWISE, CONTINUE)

2

ID #_________________
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

9.

Are you the parent or guardian of a youth ages 12 to 17? (RECRUIT A MIX)
YES
NO
REF
DK

IF NO TO ALL IN Q5 AND NO TO Q9, THANK AND TERMINATE.
IF YES IN Q9, CONTINUE. ELSE GO TO END.
3

ID #_________________
10. During the last 12 months, did any of the following happen to any of your children
between the ages of 12 and 17? (RECRUIT A MIX)
YES

NO

1

2

b. Someone attacked or tried to attack your child

1

2

c. Did any other type of crime happen to this child over the past

1

2

a. Someone stole something or tried to steal something from
your child

12 months? (If yes, specify)
_______________________________________________
_______________________________________________

(IF YES TO ANY IN Q10, COLLECT AGE AND GENDER OF THAT CHILD. IF NO TO ALL IN
Q10, COLLECT AGE AND GENDER OF ANY CHILD AGES 12 TO 17 IN HH)
11.
(IF YES TO ANY IN Q10) What is the age of the child that you were thinking about
when you answered yes to (this/these) question(s)?
(IF NO TO ALL IN Q10) What is the age of one of your children who is between the ages
of 12 and 17?
____________

12.

What is this child’s gender?

MALE
FEMALE
DK
REF

4

ID #_________________
13. Is this child of Hispanic, Latino, or Spanish origin?
YES
NO
REF
DK

14.

What is this child’s race? Please select one or more.
White
Black or African American
Asian
Native Hawaiian or other Pacific Islander
American Indian or Alaska Native

RECORD RESPONDENT NAME AND CONTACT INFORMATION ON CONTACT
INFORMATION SHEET.

5

ID #_________________

Contact Information
IF ANY IN Q5=YES AND Q9=NO: It appears you are eligible for our study. We’d like to
schedule an interview to take place at {LOCATION}.
This will take about 90 minutes and we will pay you $60 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).
IF ANY IN Q5=YES AND Q9=YES: You and your child are both eligible for our study. If you are
willing to be interviewed, and to allow us to also interview your youth, we’d like to schedule
separate interviews with each of you 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 both of you. This will take about 90 minutes for each of you, but we can schedule the
interviews at the same time. We will pay you $60 cash, and your child $40 in cash. May I please
have your full name, your {son/daughter}’s first name, and your 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).
IF ALL IN Q5=NO AND Q9=YES: Your child is eligible for our study. If you are willing to allow
your child to be interviewed, and if she/he is willing to participate, we’d like to schedule an
interview with him/her 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 him/her. This will take about 90 minutes and we will pay your child $40 in cash. If you need
to drive your child to the interview, we will also pay you $20 to cover your transportation costs.
May I please have your full name, your {son/daughter}’s first name, and your 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).
Adult Name

________________________________________________________________

Youth First Name

__________________________________________________________

Address ____________________________________________________________________
Adult Phone Number __________________________________________________________
Youth Phone Number __________________________________________________________
Adult Email Address____________________________________________________________
6

ID #_________________

We’d like to audio record the interview(s). 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 the interview(s), please call
back so that we can schedule someone in your place, OK? You can reach me at: [Recruiter’s
Phone Number].

IF Q9=YES: We will also need you to sign a consent form to interview your child. I will send you
the form via email. After you have reviewed and signed the form, you can return it to us via
email, fax, or you can have your child bring it to the interview. Thank you! Please look for an
email from Westat later today.

CONSENT FORM EMAIL TEXT
TO PARENT OR GUARDIAN OF ____________
Thank you for your interest in the research project we are doing for the US Bureau of Justice
Statistics . Attached you will find the parental consent form for the study. Please review this form
thoroughly. If you agree to let your child participate, sign and date the form. Your child will also
be asked if (he/she) agrees to participate in the interview. You can return the form to us by
email at [INSERT EMAIL ADDRESS] or by fax at [INSERT FAX NUMBER], or your child may
bring the consent form to the scheduled interview. We will only conduct the interview if we have
received your signed form and if your child agrees to participate.
Please let me know if you have any questions by emailing me at [EMAIL ADDRESS] or calling
[TOLL-FREE NUMBER].
Thank you,

7

Attachment D_Consent Assent Resources

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 improve the survey questions.
Sponsorship: Westat is conducting this project on behalf of 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 then ask you 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 one and a half hours.
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).
To help keep everything private:
• Your name will not be recorded on the interview notes or reported in any reports.
• Everything that you say will be confidential – that is, no one outside the research team
will know what you told us.
Benefits and risks: There are no known benefits for you to take part, but your answers will help
us improve the survey. There is a risk that some of the questions that we will ask you to talk
about are about private and sensitive things that may bother you. If thinking about the questions
upsets you or makes you sad, you may want to talk with a counselor. If you would like to talk
with a counselor, we will provide you a list of resources at the end of the session.
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 $60 cash for 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 ___________

Parental Consent Form
RE: ______________________________________________
Name of Youth

The Bureau of Justice Statistics is revising some questions for a national survey they conduct. Before these
changes take place, we are talking to youth about some of the questions being considered for the survey.
We would like your child’s help by asking him/her some of the new and revised questions on the survey. These
questions will be used to collect data on different types of crimes that may or may not have happened to your
child. We are interested in whether your child understands the questions and if they make sense to him/her. This
will help us figure out whether the questions are clear and whether youth who take part in the survey will
understand them.
We would like your permission to ask your child to participate in the interview. If you (and your child) agree,
he/she will spend about an hour and a half talking with a Westat researcher about the questions and will receive
$40 when we are finished. If you have driven your child to the interview, you will also receive $20 to help
reimburse you for travel costs.
It is entirely up to you whether we ask your child to participate, and then it is up to your child – your child does
not have to do this. If your child agrees to do the survey, he/she can stop answering questions at any point. If
there is a question that your child does not want to answer or talk about, he/she can skip it.
In order to have a complete record of all comments, we would like to audio-record the interview. Recordings
allow us to carefully review the discussion and draw the proper conclusions.
To help keep everything private:
• Your child’s name will not be recorded on the interview notes or reported in any reports.
• Everything that he/she says will be confidential – that is, no one outside the research team will know
your child’s answers.
There are no known benefits to taking part, but their answers will help us improve the survey. There is a risk
that some of the questions that we will ask your child to talk about are about private and sensitive things that
may bother them. If thinking about the questions upsets or makes your child sad, he/she may want to talk with
a counselor. If he/she would like to talk to a counselor, we have provided a list of resources on the back of this
form and will also provide those resources to your child.
If you have questions about your child’s rights as a study participant, you can call 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.
Please indicate your choice by checking one of the boxes below and signing and dating the form.
Yes, I give my permission for you to ask my child to meet with a Westat researcher to talk about
questions that might be asked on a national survey and agree that the interview can be recorded.
Yes, I give my permission for you to ask my child to meet with a Westat researcher to talk about
questions that might be asked on a national survey but do not want the interview to be recorded.
No, I do not give you permission to talk with my child.
___________________________________
Your signature

_____________________________________
Date

Youth Assent Form
The Bureau of Justice Statistics is revising some questions for a national survey they conduct. Before these
changes take place, we are talking to youth about some of the questions that might be included in the survey.
We would like your help today by asking you some of the questions that we would like to add to the survey.
These questions will be used to collect data on different types of crimes that may or may not have happened to
you. We are interested in your feedback on the questions. This will help us figure out whether the questions are
clear and whether other young people will understand them.
If you agree to participate, we will spend about an hour and a half talking about the questions and you will
receive $40 when we are finished.
You do not have to take part in this study – your participation is completely voluntary. If you agree to take part,
you can stop answering questions at any point. If there is a question that you do not want to answer or talk about,
you can skip it.
In order to have a complete record of all comments, we would like to audio-record the interview. Recordings
allow us to carefully review the discussion and draw the proper conclusions.
To help keep everything private:
• Your name will not be recorded on the interview notes or reported in any reports.
• Everything that you say will be confidential – that is, no one outside the research team will know your
answers.
There are no known benefits for you to take part, but your answers will help us improve the survey. There is a
risk that some of the questions that we will ask you to talk about are about private and sensitive things that
may bother you. If thinking about the questions upsets you or makes you sad, you may want to talk with a
counselor. If you would like to talk with a counselor, we will provide you a list of resources at the end of the
session.
If you have questions about your rights as a study participant, you can call 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.
Do you have any questions?
RESEARCHER: Indicate youth’s choice by checking one of the boxes below and signing and dating the form.
Yes, youth agreed to talk about questions that might be asked on a national survey and parent/youth
both agreed to be recorded.
Yes, youth agreed to talk about questions that might be asked on a national survey but parent or youth
did not agree to be recorded.
No, youth did not agree.

___________________________________
Researcher signature

_____________________________________
Date

Resources

The National Domestic Violence Hotline:
Telephone: 1-800-799-7233
Website: www.thehotline.org

The National Suicide Prevention Hotline:
Telephone: 1-800-273-8255
Website: www.suicidepreventionhotline.org

The National Sex Assault Hotline:
Telephone: 1-800-656-4673
Website: www.rainn.org

Attachment E_Data entry sheet

Incident Data Sheet

Incident #
1
2
3
4
5
6
7
8
9
10

Screening
item

Mo/Yr

Vehicle
theft

Vehicle
parts

Theft

Attempted
Theft

Break-In

Vandalism

R present

Attack

Sexual
contact

Other crime Duplicate?