SE Louisiana Survey for Hurricane Evacuation Planning
OPENING STATEMENT
Hello, I’m calling from [Louisiana State University]. We’re doing a short survey for the Emergency Managers of [Louisiana parishes]. The survey is to find out what government can do to plan for your safety during hurricanes.
We are not collecting any personally identifiable information from you in this survey, and you may refuse to answer any question or end the survey at any time. Would you be willing to participate?
[Use as necessary: DO NOT READ]
* This is not a sales call, we are only interested in your opinion
* Tell them to contact Brant Mitchell, Principal Investigator, at
(225) 578-5939 or Dr. Robert Matthews, Louisiana State University Institutional Review Board, at 578-8692 if they have any questions.]
1 YES – [Skip-1]
2 NO – [No Skip]
Are you sure? We would very much appreciate your help. Your answers will help your local community better prepare for hurricanes.
1 – Continue.
2 – [THANKS – END]
And are you 18 years of age or older?
Yes
No – [Thanks – END]
Q2
In what parish is your home located? [Open-end] [Interviewer: Don’t read. Just mark.] [Any parishes not listed below – SCREEN OUT]
Ascension
Jefferson
Lafourche
Livingston
Orleans
Plaquemines
St. Bernard
St. Charles
St. James
St. John the Baptist
St. Tammany
Tangipahoa
Terrebonne
Other [Thanks – END]
Q1
Do you live in your current residence during the hurricane season from June 1st to November 30th?
1 YES ___ Then let’s begin.
2 NO [Thanks - End the interview] [Optional - Thank you but we need to talk to people who live in their current home during hurricane season.]
HURRICANE RELATED CONCERNS
Q4
To what extent are you concerned about the threat of a hurricane? Are you very concerned, somewhat concerned, or not concerned?
1 VERY CONCERNED
2 SOMEWHAT CONCERNED
3 NOT CONCERNED
4 NOT SURE OR DON'T KNOW
5 NO RESPONSE
Q5
How likely do you think it is that your home would ever be flooded as a result of a hurricane? Is it very likely, somewhat likely, or not very likely?
1 VERY LIKELY
2 SOMEWHAT LIKELY
3 NOT VERY LIKELY
4 NOT SURE OR DON'T KNOW
5 NO RESPONSE
Q6
Is your home located within the levee system, that is, is it located in an area protected by a levee?
1 YES
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
[Ask Q6A only if answer on Q6 was 1 = YES]
Q6A
How confident are you that the current levee system in your [parish] will prevent your home from being flooded in future hurricanes? Are you very confident, somewhat confident, or not confident at all?
1 VERY CONFIDENT
2 SOMEWHAT CONFIDENT
3 NOT CONFIDENT AT ALL
4 NOT SURE OR DON’T KNOW
5 NO RESPONSE
Q7
How likely is it that your home would ever be seriously damaged or destroyed by the winds of a hurricane or damaged by trees blown down by hurricane winds? Is it very likely, somewhat likely, or not very likely?
1 VERY LIKELY
2 SOMEWHAT LIKELY
3 NOT VERY LIKELY
4 NOT SURE OR DON'T KNOW
5 NO RESPONSE
HURRICANE EXPERIENCE
Q8
How many years have you or your family lived in [southern Louisiana?]
[Numeric]
Q9
How many years have you or your family lived in your current home? [Numeric]
Q10
During the time you’ve lived in this residence, have any of the following hazards affected you, your home or the people who live with you? [Read each one and mark if answer is yes.] [Multiple response]
1 FLOODING FROM RAIN
2 FLOODING FROM OVERFLOW OF RIVER, LAKE OR CANAL
3 FLOODING FROM STORM SURGE OR WAVE ACTION FROM THE OCEAN
4 WIND FROM A HURRICANE
6 NOT SURE OR DON’T KNOW
7 NO RESPONSE
Q10a
Are there any other environmental hazards that have affected you, your home, or the people you live with? If so, what are they?
[Open-ended]
None
10b
Text-statement.
Now I have a few brief questions about specific hurricanes.
[KATRINA BLOCK]
Q11
During [Hurricane Katrina], did you OR YOUR HOUSEHOLD evacuate before the storm hit?
1 YES
2 NO
3 Did not live at current residence during [Katrina]
4 NOT SURE OR DON’T KNOW
5 NO RESPONSE
[Ask Q11B only if Q11 = 1 YES}
Q11B
Where did you go? Did you stay in your [parish], go to another [parish] in [Louisiana], or go to another state? [If ANOTHER STATE, ask for the name]
1 WITHIN MY [PARISH]
2 OUTSIDE MY [PARISH] BUT WITHIN [LOUISIANA]
3 WENT TO ANOTHER STATE. SPECIFY:
4 NOT SURE
5 NO RESPONSE
[Ask Q11C only if Q11 = 1 YES]
Q11C
Did you go to the home of a relative or friend, a public shelter, a hotel, or someplace else?
1 HOME OF A RELATIVE OR FRIEND
2 PUBLIC SHELTER
3 HOTEL OR MOTEL
4 SOMEPLACE ELSE OR OTHER, SPECIFY ____________________
5 DON'T KNOW
6 NO RESPONSE
[Ask Q11D only if Q11 = 1 YES]
Q11D
What transportation did you use for this evacuation? [Don’t read list.]
1 PERSONAL VEHICLE (CAR, TRUCK, MOTORCYCLE, RV, ETC.
2 PUBLIC OR GOVERNMENT-ASSISTED EVACUATION VEHICLE
3 COMMERCIAL BUS WHERE A TICKET WAS PURCHASED
4 OTHER. SPECIFY ____________________
5 NOT SURE OR DON’T KNOW
6 NO RESPONSE
[Ask 11E only if Q11E = 1 PERSONAL VEHICLE]
Q11E
How many hours of driving did it take you to get to your final destination? [Numeric]
[Ask 11F only if Q11E = 1 PERSONAL VEHICLE]
Q11F
How many driving hours would you estimate it would take you to make the same trip under normal traffic conditions? [Numeric]
[GUSTAV BLOCK]
Q11G
During Hurricane [Gustav], did you OR YOUR HOUSEHOLD evacuate before the storm hit?
1 YES
2 NO
3 Did not live at current residence during [Gustav]
4 NOT SURE OR DON’T KNOW
5 NO RESPONSE
[Ask Q11H only if Q11G = 1 YES}
Q11H
Where did you go? Did you stay in your [parish], go to another [parish] in [Louisiana], or go to another state? [If ANOTHER STATE, ask for the name]
1 WITHIN MY [PARISH]
2 OUTSIDE MY [PARISH] BUT WITHIN [LOUISIANA]
3 WENT TO ANOTHER STATE. SPECIFY:
4 NOT SURE
5 NO RESPONSE
[Ask Q11I only if Q11G = 1 YES]
Q11I
Did you go to the home of a relative or friend, a public shelter, a hotel, or someplace else?
1 HOME OF A RELATIVE OR FRIEND
2 PUBLIC SHELTER
3 HOTEL OR MOTEL
4 SOMEPLACE ELSE OR OTHER, SPECIFY ____________________
5 DON'T KNOW
6 NO RESPONSE
[Ask Q11J only if Q11G = 1 YES]
Q11J
What transportation did you use for this evacuation? [Don’t read list.]
1 PERSONAL VEHICLE (CAR, TRUCK, MOTORCYCLE, RV, ETC.
2 PUBLIC OR GOVERNMENT-ASSISTED EVACUATION VEHICLE
3 COMMERCIAL BUS WHERE A TICKET WAS PURCHASED
4 OTHER. SPECIFY ____________________
5 NOT SURE OR DON’T KNOW
6 NO RESPONSE
[Ask 11K only if Q11J = 1 PERSONAL VEHICLE]
Q11K
How many hours of driving did it take you to get to your final destination? [Numeric]
[Ask 11L only if Q11J = 1 PERSONAL VEHICLE]
Q11L
How many driving hours would you estimate it would take you to make the same trip under normal traffic conditions? [Numeric]
[ISAAC BLOCK]
Q11M
During Hurricane [Isaac], did you OR YOUR HOUSEHOLD evacuate before the storm hit?
1 YES
2 NO
3 Did not live at current residence during [Isaac]
4 NOT SURE OR DON’T KNOW
5 NO RESPONSE
[Ask Q11N only if Q11M = 1 YES}
Q11N
Where did you go? Did you stay in your [parish], go to another [parish] in [Louisiana], or go to another state? [If ANOTHER STATE, ask for the name]
1 WITHIN MY [PARISH]
2 OUTSIDE MY [PARISH] BUT WITHIN [LOUISIANA]
3 WENT TO ANOTHER STATE. SPECIFY:
4 NOT SURE
5 NO RESPONSE
[Ask Q11O only if Q11M = 1 YES]
Q11O
Did you go to the home of a relative or friend, a public shelter, a hotel, or someplace else?
1 HOME OF A RELATIVE OR FRIEND
2 PUBLIC SHELTER
3 HOTEL OR MOTEL
4 SOMEPLACE ELSE OR OTHER, SPECIFY ____________________
5 DON'T KNOW
6 NO RESPONSE
[Ask Q11P only if Q11M = 1 YES]
Q11P
What transportation did you use for this evacuation? [Don’t read list.]
1 PERSONAL VEHICLE (CAR, TRUCK, MOTORCYCLE, RV, ETC.
2 PUBLIC OR GOVERNMENT-ASSISTED EVACUATION VEHICLE
3 COMMERCIAL BUS WHERE A TICKET WAS PURCHASED
4 OTHER. SPECIFY ____________________
5 NOT SURE OR DON’T KNOW
6 NO RESPONSE
[Ask 11Q only if Q11P = 1 PERSONAL VEHICLE]
Q11Q
How many hours of driving did it take you to get to your final destination? [Numeric]
[Ask 11R only if Q11P = 1 PERSONAL VEHICLE]
Q11R
How many driving hours would you estimate it would take you to make the same trip under normal traffic conditions? [Numeric]
EVACUATION INTENT
Q12
Has your family ever talked or made a plan about what you would do if there was an emergency and you HAD to leave your home?
1 YES
2 NO
3 WOULD NEVER LEAVE UNDER ANY CIRCUMSTANCES
4 NOT SURE OR DON’T KNOW
5 NO RESPONSE
Now I would like you to consider several different future storm possibilities and ask if your household would LIKELY EVACUATE for each.
Q13
What if a hurricane with Category 1 or 2 winds and potentially up to 3 feet of water above ground threatens your neighborhood? How likely is it that you would leave your home? Is it very likely, somewhat likely, or not very likely that you would leave?
1 VERY LIKELY
2 SOMEWHAT LIKELY
3 NOT VERY LIKELY
4 DON'T KNOW
5 NO RESPONSE
Q14
What if for the same storm [if necessary – a hurricane with Category 1 or 2 winds], parish officials RECOMMENDED, but did not ORDER, those in your area to evacuate. How likely is it that you would leave? Is it very likely, somewhat likely, or not very likely?
1 VERY LIKELY
2 SOMEWHAT LIKELY
3 NOT VERY LIKELY
4 DON'T KNOW
5 NO RESPONSE
Q15
What if parish officials ORDERED those living in your area to evacuate for this hurricane [if necessary – a hurricane with Category 1 or 2 winds? How likely is it that your household would leave? Is it very likely, somewhat likely, or not very likely?
1 VERY LIKELY
2 SOMEWHAT LIKELY
3 NOT VERY LIKELY
4 DON'T KNOW
5 NO RESPONSE
Q16
Now, what if a major hurricane, that is, a storm with Category 3 or higher winds, and the possibility of more than 3 feet of water above ground threatens your neighborhood? How likely is it that you would leave your home? Is it very likely, somewhat likely, or not very likely that you would leave?
1 VERY LIKELY
2 SOMEWHAT LIKELY
3 NOT VERY LIKELY
4 NOT SURE OR DON'T KNOW
5 NO RESPONSE
Q17
Suppose for the same storm [if necessary – a storm with Category 3 or higher winds] parish officials RECOMMENDED, but did not ORDER that those in your area evacuate. How likely is it that you would leave? Is it very likely, somewhat likely, or not very likely?
1 VERY LIKELY
2 SOMEWHAT LIKELY
3 NOT VERY LIKELY
4 NOT SURE OR DON'T KNOW
5 NO RESPONSE
Q18
What if officials ORDERED an evacuation for your area for this storm? [if necessary – a storm with Category 3 or higher winds] How likely is it that your household would leave? Is it very likely, somewhat likely, or not very likely?
1 VERY LIKELY
2 SOMEWHAT LIKELY
3 NOT VERY LIKELY
4 NOT SURE OR DON'T KNOW
5 NO RESPONSE
REASONS FOR EVACUATION DECISION
Now, we’d like to know a little more about the specific reasons you think your household would or would not evacuate for a hurricane.
Q19
Let’s first assume that your household decides NOT TO EVACUATE. What do you think would be the MAIN REASONS for the decision for your household to stay in your home? [Open-end.]
17 – None. We always evacuate for hurricanes.
18 NOT SURE OR DON’T KNOW
19 NO RESPONSE
Q20
Now, let’s assume your household decides TO EVACUATE. What do you think would be the MAIN REASONS behind the decision TO LEAVE? [Open-end. Do not read the list. Check all that match their response. If you are not sure, write answer in "OTHER, SPECIFY" and describe. If they insist they would never evacuate, mark #10.] [Multiple response] [This list for interviewers to mark from answers on open-ended questions might be changed based on types of answers given on first pilot interviews.]
1 HOME MIGHT NOT BE SAFE
2 DON’T TRUST THE LEVEE SYSTEM
3 TO PROTECT HOUSEHOLD MEMBERS
4 TO PROTECT CHILDREN IN HOUSEHOLD
5 TO PROTECT ELDERLY IN HOUSEHOLD
6 HAVE HOUSEHOLD MEMBER(S) WITH HEALTH CONCERNS OR MEDICAL NEEDS
7 PREVIOUS EXPERIENCE WHEN STAYED DURING AN EVACUATION
8 WOULD NOT WANT TO BE HERE AFTER THE STORM
9 OTHER, SPECIFY __________________
10 WOULD NEVER EVACUATE NO MATTER WHAT
11 NOT SURE OR DON’T KNOW
12 NO RESPONSE
[Ask Q20A only if on Q20 they answer 1-“Home might not be safe”.]
Q20A
You said you would not be safe and that is one of the reasons you’d evacuate. Why do you think your home might not be safe in a hurricane? [Do not read the list. Check all that match their response. If you are not sure, write answer in "OTHER, SPECIFY" category] [Multiple response]
1 VULNERABLE TO STORM SURGE/FLOODING
2 NOT STRONG ENOUGH TO RESIST WIND, MOBILE HOME OR WEAK CONSTRUCTION
3 NO SHUTTERS OR OTHER PROTECTION AGAINST WIND DAMAGE
4 FIRE HAZARD
5 DON’T TRUST THE LEVEE SYSTEM
6 OTHER, SPECIFY ___________
7 NOT SURE OR DON’T KNOW
8 NO RESPONSE
WHO WOULD LEAVE
Q21
If your household should decide TO evacuate, how many people would leave? [Numeric]
Q22
If your household should decide to evacuate, is anyone from your household likely to remain behind?
1 YES
2 NO
3 NOT SURE OR DON'T KNOW
4 NO RESPONSE
[Ask Q22A only if Q22 = 1 YES]
Q22A
What is the MOST IMPORTANT reason you or they are likely to stay behind? [Don’t read list.]
1 EMERGENCY OFFICIAL
2 MILITARY OR NATIONAL GUARD
3 HAVE OTHER JOB REQUIRING STAY DURING HURRICANE
4 STAY TO PROTECT HOME AFTER STORM
5 WOULD NEVER EVACUATE
6 OTHER, SPECIFY ____________
7 NOT SURE OR DON'T KNOW
8 NO RESPONSE
EVACUATION DESTINATION
Q23
Now let’s assume that you HAD to evacuate for a MAJOR storm, such as a storm with Category 3 or above winds. What type of place would you likely go? Would it be to the home of a relative or friend, to a public shelter north of [New Orleans] area, to a hotel or motel, or someplace else? [If someplace else, get them to specify.]
1 HOME OF A RELATIVE OR FRIEND
2 PUBLIC SHELTER NORTH OF [NEW ORLEANS] AREA
3 HOTEL OR MOTEL
4 SOMEPLACE ELSE OR OTHER, SPECIFY
5 NOT SURE OR DON'T KNOW
6 NO RESPONSE
Q24
If you evacuated for a major storm, in what state would you likely take refuge? [Don’t read.]
1 [LOUISIANA]
2 [MISSISSIPPI]
3 [TEXAS]
4 [ARKANSAS]
5 [TENNESSEE]
6 OTHER: SPECIFY:
7 NOT SURE OR DON’T KNOW
8 NO RESPONSE
Q25
Is there a particular town, city or area in that state you would expect to go to?
1 YES, SPECIFY:
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
Q26
Let’s assume you decided to evacuate for a less serious Category 1 or 2 storm, what type of place would you go? Would it be to the home of a relative or friend, to a public shelter north of [New Orleans] area, to a hotel or motel, or someplace else? [If someplace else, get them to specify.]
1 HOME OF A RELATIVE OR FRIEND
2 LOCAL PUBLIC SHELTER
3 PUBLIC SHELTER NORTH OF [NEW ORLEANS] AREA
4 HOTEL OR MOTEL
5 SOMEPLACE ELSE OR OTHER, SPECIFY
6 SAYS WOULD NEVER EVACUATE
7 NOT SURE OR DON'T KNOW
8 NO RESPONSE
TRANSPORTATION
Q27
What type of transportation would your HOUSEHOLD use if you HAD to evacuate?
1 PERSONAL VEHICLE OR VEHICLES [If necessary: (CAR, TRUCK, MOTORCYCLE, RV, ETC.)]
2 PUBLIC OR GOVERNMENT-ASSISTED EVACUATION VEHICLE
3 COMMERCIAL BUS with a ticket you purchase
4 OTHER. SPECIFY __________
5 NOT SURE OR DON’T KNOW
6 NO RESPONSE
[Ask Q27A if answer to Q27 was PERSONAL VEHICLE OR VEHICLES]
Q27A
How many vehicles would your household take in an evacuation?
0 NONE (Would ride with someone from another household)
1 ONE
2 TWO
3 THREE OR MORE
4 NOT SURE OR DON’T KNOW
5 NO RESPONSE
[Ask Q27B if answer to Q27 was PERSONAL VEHICLE OR VEHICLES]
Q27B
Would a car in your household likely tow anything such as a trailer or boat?
1 YES
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
[Ask Q27C if answer to Q27 was PERSONAL VEHICLE OR VEHICLES]
Q27C
What main highway or highways would you likely use to evacuate for a major storm? [Don’t read list. Just mark up to 3 that are mentioned.]
1 I-10
2 I-85
3 I-12
4 US 190
5 I-55
6 US 61
7 US 11
8 OTHER: SPECIFY ________
9 NOT SURE OR DON’T KNOW
10 NO RESPONSE
[NOTE: Questions Q27D-Q27H are only for [Orleans and Jefferson] - we will program to only display if they live in those parishes]
Q27D
Are you aware of your city’s assisted evaction plan?
Yes
No
9 NOT SURE OR DON’T KNOW
10 NO RESPONSE
Q27E [If YES to Q27D]
Do you know where the nearest pick up point is located from your residence?
Yes
No
9 NOT SURE OR DON’T KNOW
10 NO RESPONSE
Q27F [If YES to Q27D]
Did you use your city’s assisted evacuation system during Hurricane [Gustav]?
Yes
No
9 NOT SURE OR DON’T KNOW
10 NO RESPONSE
Q27G [If YES to Q27F]
Would you use it again?
Yes
No
9 NOT SURE OR DON’T KNOW
10 NO RESPONSE
Q27H [If NO to Q27F]
Please explain why you would not use your city’s assisted evacutaiotn system again:
[Open Ended]
Q28
Are there people in your household who would have difficulty finding transportation in order to evacuate?
1 YES
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
[Ask Q28A if answer to Q28 = 1 YES.]
Q28A
IF SO, HOW MANY?
1 NONE
2 ONE
3 TWO
4 THREE OR MORE
5 NOT SURE OR DON’T KNOW
4 NO RESPONSE
[Ask 28B if answer to Q28 = 1 YES]
Q28B
Would any of those who would have difficulty finding transportation in order to evacuate have medical needs or disabilities that would require special attention during an evacuation?
1 YES
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
Ask Q28C only if answer to 28B = YES]
Q28C
How many people in your household who would have difficulty finding transportation have medical needs or disabilities that would require special attention?
1 NONE
2 ONE
3 TWO
4 THREE OR MORE
5 NOT SURE OR DON’T KNOW
4 NO RESPONSE
[Ask Q28D if answer to Q28C = 2, 3 or 4]
Q28D
I’m going to read a list of reasons why they would need special help in order to evacuate? Please answer yes or no for each.
1 Do they REQUIRE OXYGEN OR anOTHER ELECTRICALLY DEPENDENT MEDICAL DEVICE?
2 Do they have a PHYSICAL DISABILITY THAT REQUIRES WHEELCHAIR ALL THE TIME?
3 Do they have a PHYSICAL DISABILITY THAT MAKES WALKING DIFFICULT?
4 Do they have a HEARING OR VISION PROBLEM?
5 Do they have a MENTAL OR EMOTIONAL PROBLEM?
Q28E
Are there any other reasons they would need special help in order to evacuate? If so, what are they?
[Open-ended]
Q29
Are there people in your household who would likely go to a public shelter and who have disabilities or medical needs that would require special attention in a shelter?
1 YES
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
[Ask Q29A if answer to Q29 = 1 YES]
Q29A
If so, how many people in your household who would likely go to a public shelter have medical needs or disabilities that would require special help at the shelter?
1 NONE
2 ONE
3 TWO
4 THREE OR MORE
5 NOT SURE OR DON’T KNOW
6 NO RESPONSE
[Ask Q29B if answer to Q29 = YES]
Q29B
Would a caregiver accompany anyone with special medical or physical needs?
1 YES
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
INFORMATION SOURCES
Q30
If a hurricane threatens your area, where would you get MOST of your information as you make your evacuation decision? [Don’t read list. Mark their first answer.]
1 LOCAL TV SUCH AS WWL, WGNO, WDSU, WVUE
2 LOCAL RADIO SUCH AS WWL
3 CABLE OR SATELLITE TV SUCH AS CNN, NBC, CBS, FOX
4 THE WEATHER CHANNEL
5 INTERNET
6 SOCIAL MEDIA SUCH AS FACEBOOK, TWITTER, TUMBLR
7 MOBILE APP FOR EMERGENCY INFORMATION
8 NOAA WEATHER RADIO
9 FRIENDS OR FAMILY
10 OTHER, SPECIFY _____________
11 NOT SURE OR DON'T KNOW
12 NO RESPONSE
Q31
Does your household have access to the web or Internet?
1 YES
2 NO
3 NOT SURE OR DON'T KNOW
4 NO RESPONSE
[Ask Q31A only if Q31 = 1 YES]
Q31A
What Internet sites would you likely use for hurricane information? [Do not read list. Check all that match. If you are not sure, write answer in "OTHER, SPECIFY"] [Multiple response]
1 LOCAL TV STATION WEBSITE
2 NATIONAL TV NEWS WEBSITE
3 NATIONAL HURRICANE CENTER WEBSITE
4 LOCAL NATIONAL WEATHER SERVICE WEBSITE
5 WEATHER CHANNEL WEBSITE
6 PARISH WEBSITE
7 OTHER: SPECIFY _____________
8 NOT SURE OR DON’T KNOW
9 NO RESPONSE
Q32
If you lose electricity or are on the road evacuating, what is likely to be your MAIN way to get information? [Don’t read. Mark first answer given.]
1 RADIO
2 PHONE CALLS
3 INTERNET SOURCES ACCESSED THROUGH SMART PHONE
4 ELECTRONIC SIGNS
5 OTHER. SPECIFY: _________
Don’t know / not sure
No response
EVACUATION TIMING
Q33
If a hurricane is predicted to impact your area three days from now and you decided to evacuate, are you most likely to leave today, tomorrow or two days from now?
1 TODAY
2 TOMORROW
3 TWO DAYS FROM NOW
4 NOT SURE OR DON'T KNOW
5 SAYS WILL NOT LEAVE
6 NO RESPONSE
Q34
If you HAD to evacuate, would the work or school requirements of any member of your household delay when you could leave?
1 YES
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
Q35
If you HAD to evacuate, would obtaining agreement from family members outside your household be likely to affect how quickly you would be able to leave?
1 YES
2 NO
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
PETS
Q36
If you have a family pet or pets, what would you do with them if you had to evacuate? [Don’t read. Mark one.]
1 TAKE THEM WITH YOU
2 LEAVE THEM AT HOME
3 TAKE THEM TO A BOARDING PLACE
4 LEAVE THEM WITH FAMILY OR FRIENDS
5 SOMEONE WOULD STAY WITH THEM
6 DON'T HAVE ANY PETS
7 Evacuate to a pet friendly shelter
8 NOT SURE OR DON'T KNOW
9 NO RESPONSE
HOUSING ATTRIBUTES AND DEMOGRAPHICS
We're almost done! I just have a few general background questions and we will be finished
Q37
Which of the following best describes your residence? Is it a detached single family home, a duplex, triplex or fourplex, a multi-unit building or apartment complex or a mobile or manufactured home?
1 DETACHED SINGLE FAMILY HOME
2 DUPLEX, TRIPLEX, FOURPLEX
3 MULTI-UNIT BUILDING OR APARTMENT COMPLEX
4 MOBILE OR MANUFACTURED HOME
5 OTHER: SPECIFY
6 NOT SURE OR DON’T KNOW
7 NO RESPONSE
Q38
Do you own it or do you pay rent
1 OWN
2 RENT
3 NOT SURE OR DON’T KNOW
4 NO RESPONSE
Q38a
And what is your zip code?
Q39
As a remdiner this survey is designed to help state and local government in preparing evacuation plans for your area.
Could you please give me the town you live in, and the nearest street intersection to you? Town first.
Q-town
Town: [Open-End]
Q-street
Street intersection [open-end]
Q40
Including yourself, how many people live in your household? [Numeric]
Q41
What year you were born? [Numbers only – 4 digit 1880-1997]
Q42
How many of the people living in your household are under 12 years old? [Numeric]
Q43
And how many people living in your household are 65 OR OLDER? [Numeric]
Q44
Which of these ranges is the best estimate of your HOUSEHOLD’S total annual income? Is it less than $10,000 a year, between $10,000 and $20,000, between $20,000 and $50,000, between $50,000 and $80,000, between $80,000 and $100,000 or over $100,000?
1 LESS THAN $10,000
2 $10,001 - $20,000
3 $20,001 - $50,000
4 $50,001 - $80,000
5 $80,01 - $100,000
6 OVER $100,000
7 NOT SURE OR DON’T KNOW
8 NO RESPONSE
Q45
What is the primary language spoken in your home? [Don’t read.]
1 ENGLISH
2 SPANISH
3 OTHER: SPECIFY ___________
4 NOT SURE OR DON’T KNOW
5 NO RESPONSE
Q46
What is the highest level of education you've completed? [Don’t read.]
1 GRADE SCHOOL
2 SOME HIGH SCHOOL
3 HIGH SCHOOL GRADUATE
4 VOCATIONAL OR TECHNICAL SCHOOL OR SOME COLLEGE
5 COLLEGE GRADUATE
6 POST-GRADUATE DEGREE
8 NOT SURE OR DON'T KNOW
9 NO RESPONSE
Q47
How would you describe your ethnic background or race? [Don’t read.]
Race:
AMERICAN INDIAN OR ALASKA NATIVE
ASIAN
BLACK OR AFRICAN AMERICAN
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER
WHITE
ETHNICITY:
HISPANIC OR LATINO
NOT HISPANIC OR LATINO
Q48
Which of the following best describes your current situation in reference to a job outside the home? [Read list.]
1 EMPLOYED FULL TIME (35 HOURS OR MORE A WEEK)
2 EMPLOYED PART-TIME (LESS THAN 35 HOURS A WEEK)
3 UNEMPLOYED
4 RETIRED
5 STAY AT HOME CAREGIVER OF CHILDREN, DISABLED OR ELDERLY
6 FULL-TIME STUDENT
7 NOT SURE OR DON’T KNOW
8 NO RESPONSE
Q49
Well, that concludes the interview. I'd like to thank you for taking the time to help your emergency managers. Do you have any comments that you would like me to write down on what we have discussed in this survey?
1 YES
2 NO
3 DON'T KNOW [NO SABE]
[Ask Q49A only if Q49 = 1 YES}
Q49A
WRITE COMMENTS IF ANY
[open-end]
Q50
[Interviewer: please enter the gender of the respondent, ask only if seems necessary]
1 MALE
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Hugh |
| File Modified | 0000-00-00 |
| File Created | 2021-01-24 |