Att E_School Officials (Interviews)

School Associated Violent Deaths Surveillance System

Att E_School Official (Interview)

Att E_School Officials (Interviews)

OMB: 0920-0604

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0604 can be found here:

2019-05-02 - Revision of a currently approved collection

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Attachment E

School Official Interview Instrument

Form Approved

OMB NO: 0920-0604

Exp. Date: 4/30/2016

Public reporting burden of this collection of information is estimated at 1 hour and 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/Information Collection Review Office, 1600 Clifton Road, NE, MS D-74, Atlanta, GA 30333; Attn: PRA (0920-0604).

National Center for Injury Prevention and Control

Division of Violence Prevention

National Institute of Justice

National School Safety Center

U.S. Department of Education

School Associated Violent Deaths in the United States

Data Collection Instrument

SCHOOL INTERVIEW

INSTRUCTIONS:

Investigators should record their investigator number in space provided.
Before beginning the interview, be certain to read the telephone script that explains the study and contains the statement of informed consent. DO NOT RECORD ANY IDENTIFYING INFORMATION.
Record the preassigned Event Number in the space provided.
Instructions for the investigator are written in italics, this information should not be read to the respondents.
Information written in bold face is to be read to the respondent, unless specifically stated otherwise.

Date of data collection (code four-digit years) _ _/_ _/_ _ _ _

Investigator Identifier Code _ _

Case ID Number _ _ _ _ _

General Questions

G01. What is (are) your current position(s) in this school/district?

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown Up to five respondents can be captured using the items below. Coding should reflect actual participant number up to five.

G01a. Respondent 1

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G01a.e.1. (specify ....................................)

f) law enforcement official _

g) other _

G01a.g.1. (specify ....................................)

G01b. Respondent 2

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G01b.e.1. (specify ..............................)

f) law enforcement official _

g) other _

G01b.g.1. (specify .............................)

G01c. Respondent 3

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G01c.e.1. (specify ..............................)

f) law enforcement official _

g) other _

G01c.g.1. (specify ................................)

G01d. Respondent 4

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G01d.e.1. (specify ....................................)

f) law enforcement official _

g) other _

G01d.g.1. (specify ....................................)

G01e. Respondent 5

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G01e.e.1 (specify ..............................)

f) law enforcement official _

g) other _

G01e.g.1 (specify ...............................)

G02. What was (were) your position(s) during the period in which this event took place?

Do NOT read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

Up to five respondents can be captured using the items below. Coding should reflect actual participant number up to five.

G02a. Respondent 1

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G02a.e.1. (specify ................................)

f) law enforcement official _

g) other _

G02a.g.1. (specify ....................................)

G02b. Respondent 2

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G02b.e.1. (specify ................................)

f) law enforcement official _

g) other _

G02b.g.1. (specify ..................................)

G02c. Respondent 3

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G02c.e.1. (specify .................................)

f) law enforcement official _

g) other _

G02c.g.1. (specify ....................................)

G02d. Respondent 4

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G02d.e.1. (specify .................................)

f) law enforcement official _

g) other _

G02d.g.1. (specify ....................................)

G02e. Respondent 5

a) principal _

b) teacher _

c) counselor _

d) superintendent _

e) school support staff _

G02e.e.1 (specify ................................)

f) law enforcement official _

g) other _

G02e.g.1 (specify ................................)

G03. Where did the injury event occur? _

Read options

1= on school property

2= on the way to or from the campus*

3= at an off-campus school-sponsored event*

4= on the way to or from a school sponsored event*

6= other* ( G03a- specify..............................................................................................)

8= unknown*

9= refused to answer*

*If option 1 is selected proceed to Question #S01, Page 2.

*If option 3 is selected, skip to Question # SOC01, page 8.

*If option 2, 4, 6, 8 or 9 (Other-Specify) are selected, skip to Question #E02, page E12.

QUESTIONS about the school (for events occurring on school property)

S01. Is the school associated with this death an alternative school? _

(If respondent is unfamiliar with this language, give an example, e.g., trade school, disciplinary school, special education, art school.)

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

S02. Our study defines a school associated violent death as a suicide, homicide or legal intervention related death that occurred on school property, on the way to or from school, or at or on the way to or from a school sponsored event. Has this school ever experienced another violent death that meets this definition? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

S03. Prior to the injury event, did the school recently experience an increase in the size of the student population due to a merger with another school / with other schools? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

S04. At the time when the event occurred did the school use security personnel? _

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to S04a & S04b.

*If answer is 2 -9, skip to Question #S05.

S04a. Number of School Resource Officers/Sworn Law Enforcement Officers __

S04b. Number of Private Security Officers __

S05. During the time when the event of interest occurred, did the school regularly use paid law enforcement or security services---

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

	Code
S05a) Were they full time? (e.g., 8 hours/day)
S05b) At any time during school hours
S05c) While students were arriving and/or leaving
S05d) At selected school activities (e.g., athletic and social events, open houses, science fairs)
S05e) When school/school activities not occurring
S05f) Other
S05f.1) If Other selected, please specify:

S06. Were any of the following security measures in use at the time of this event?

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

Measure		Location or Type of Measure	Code
S06a) Walk Through Metal Detectors
If yes, proceed to S06a1 & S06a2; if no, proceed to S06b.
S06a1)		If yes, how often?
		1 - Daily 2 - 2 to 3 times per week 3 - Weekly 4 - Biweekly 5 - As warranted 6 - Randomly 7 - Never
S06a2)		Where were the walk through metal detectors used? (Answer each option)
		S06a2.a) Main entry
		S06a2.b) Secondary entries
		S06a2.c) Other
		S06a2.c1) If Other selected, please specify:
S06b) Hand Held Metal Detectors
If yes, proceed to S06b1 & S06b2; if no, proceed to S06c.
S06b1)		If yes, how often?
		1 - Daily 2 - 2 to 3 times per week 3 - Weekly 4 - Biweekly 5 - As warranted 6 - Randomly 7 - Never
S06b2)		Where were the walk through metal detectors used? (Answer each option)
		S06b2.a) Main entry
		S06b2.b) Secondary entries
		S062.c) Other
		S06b2.c1) If Other selected, please specify:
S06c) Surveillance Cameras
If yes, proceed to S06c1 – S06ce3; if no, proceed to S06d.
S06c1)		If yes, when were they used? (Answer each option)
		S06c1.a) On school days before classes or official school activities began
		S06c1.b) While classes were being held
		S06c1.c) During lunch, recess, or other breaks,
		S06c1.d) During class changes
		S06c1.e) Immediately after school
		S06c1.f) During after school practice or detention
		S06c1.g) After official activities
		S06c1.h) On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks)
		S06c1.i) Cameras only used as visual detterent
S06c2)		If yes, where were the surveillance cameras used? (Answer each option)
		S06c2.a) Entry/exit areas – exterior
		S06c2.b) Athletic areas
		S06c2.c) Entry/exit areas – interior
		S06c2.d) Corridors
		S06c2.e) Other
		S06c2.e1) If Other selected, please specify:
S06c3)		If yes, when were the surveillance cameras monitored?
		1 - Always 2 - Occasionally 3 - After an incident 4 - Rarely
S06d) Communication Devices
If yes, proceed to S06d1; if no, proceed to S06e.
S06d1)		If yes, what types of devices were used? (Answer each option)
		S06d1.a) 2-way radios
		S06d1.b) 2-way intercom in most classrooms
		S06d1.c) Mass text messages
		S06d1.d) Mass emails
		S06d1.e) Other
		S06d1.e1) If Other selected, please specify:
S06e) Access Restrictions
If yes, proceed to S06e1; if no, proceed to S07.
S06e1)	Proximity or card swipe access for staff
If yes, proceed to S06e1a; if no, proceed to S06e2.
S06e1.a)	If yes, where? (Answer each option)
	S06e1.a1) Main building(s) / areas
	S06e1.a2) Parking lot(s)
	S06e1.a3) Other
	S06e1a31) If Other selected, please specify:
S06e2)	Intrusion Alarm Systems
If yes, proceed to S06e2a & S06e2b; if no, proceed to S07.
S06e2.a)	If yes, where?
		S06e2.a1) Main building(s) / areas
		S06e2.a2) Parking lot(s)
		S06e2.a3) Other
		S06e2.a3.1) If other selected, please specify
S06e2.b)		If yes, when were they used? (Answer each question)
		S06e2.b1) on school days before classes or official school activities began
		S06e2.b2) While classes were being held
		S06e2.b3)During lunch, recess, or other breaks,
		S06e2.b4) During class changes
		S06e2.b5) immediately after school
		S06e2.b6) During after school practice or detention
		S06e2.b7) After official activities
		S06e2.b8) On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks)

S07. At the time of the event, was it a policy of the school to do any of the following?

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown (Answer each option)

School Policies	Code
S07a) Require visitors to sign or check in
S07b) Require visitors to sign or check out
S07c) Control access to school buildings during school hours (e.g., locked or monitored doors)
S07d) Control access to school grounds during school hours (e.g., locked or monitored gates)
S07e) Require students to pass through metal detectors each day
S07f) Require visitors to pass through metal detectors
S07g) Perform one or more random metal detector checks on students
S07h) Require most students to stay on campus at lunchtime
S07i) Perform one or more random sweeps for contraband (e.g., drugs or weapons)
S07j) Require drug testing for any students
S07k) Require students to wear uniforms
S07l) Enforce a dress code
S07m) Provide a printed code of student conduct to students
S07n) Provide a printed code of student conduct to parents
S07o) Provide school lockers to students
S07p) Require clear book bags on school grounds
S07q) Ban book bags on school grounds
S07r) Require students to wear badges or picture IDs
S07s) Require faculty and staff to wear badges or picture IDs
S07t) Provide telephones in most classrooms
S07u) Prohibit all tobacco use on school grounds
S07v) Does the school have a written policy about bullying? (if NO skip to S07x) If YES, answer S07v1)
S07v1) Is the written bullying policy included in a student handbook that goes home for student and parental review?
S07x) Increased security or monitoring during high traffic times (e.g., class changes, lunch time)

S08. What is the school’s protocol for responding to a violent event? (e.g., lockdown procedures, immediate SRO response, etc.)

.........................................................................................................................................................................

S09. What actions did the school take in response to the injury event?

(PROBE FOR: immediate, long-term, policy, environmental, social, curricular)

to be coded later, please note sources

.........................................................................................................................................................................

S10. How many incidents of student weapon carrying were identified by school staff during the year in which the incident took place? (Excluding this event) _ _

00-##=actual number

77=not applicable

88=unknown

99=refused to answer

S11. Please describe what actions the school policy stipulated should be taken by the school when a person is identified with a weapon while under the supervision of the school?

.........................................................................................................................................................................

..........................................................................................................................................................

.........................................................................................................................................................................

QUESTIONS about the off-campus school sponsored event

SOC01. Our study defines a school associated violent death as a suicide, homicide or legal intervention related death that occurred on school property, on the way to or from school, or at or on the way to or from a school sponsored event. Has this school ever experienced another violent death that meets this definition? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

SOC02. During the time when the event of interest occurred, did the school regularly use paid law enforcement or security services at selected school activities (e.g., athletic and social events, open houses, science fairs)? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to SOC02a – SOC02b;

*If answer is 2 -9, skip to Question #SOC03.

SOC02a. Please indicate the Number of Sworn Law Enforcement Officers used. _ _ _

Do NOT read options, code leading zero

00-∞=actual number

777=not applicable

888=unknown

999=refused to answer

SOC02b. Please indicate the Number of Private Security Officers used _ _ _

Do NOT read options, code leading zero

00-∞=actual number

777=not applicable

888=unknown

999=refused to answer

SOC03. Were any of the following security measures in use at the time of this event?

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

Measure		Location or Type of Measure	Code
SOC03a) Walk Through Metal Detectors
If yes, proceed to SOC03a1 & SOC03a2; if no, proceed to SOC03b.
SOC03a1)		If yes, how often?
		1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Randomly 7 Never
SOC03a2)		Where were the walk through metal detectors used? (Answer each option)
		SOC03a2.a) Main entry
		SOC03a2.b) Secondary entries
		SOC03a2.c) Other
		SOC03a2.c1) If Other selected, please specify:
SOC03b) Hand Held Metal Detectors
If yes, proceed to SOC03.b1 & SOC03.b2; if no, proceed to SOC03c.
SOC03b1)		If yes, how often?
		1 Daily 2 2 to 3 times per week 3 Weekly 4 Biweekly 5 As warranted 6 Randomly 7 Never
SOC03b2)		Where were the walk through metal detectors used? (Answer each option)
		SOC03b2.a) Main entry
		SOC03b2.b) Secondary entries
		SOC03b2.c) Other
		SOC03b2.c1) If Other selected, please specify:
SOC03c) Surveillance Cameras
If yes, proceed to SOC03c1 & SOC03c3; if no, proceed to SOC03d.
SOC03c1)		If yes, when were they used? (Answer each option)
		SOC03c1.a) On school days before classes or official school activities began
		SOC03c1.b) While classes were being held
		SOC03c1.c) During lunch, recess, or other breaks
		SOC03c1.d) During class changes
		SOC03c1.e) Immediately after school
		SOC03c1.f) During after school practice or detention
		SOC03c1.g) After official activities
		SOC031.h) On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks)
		SOC03c1.i) Cameras only used as visual detterent
SOC03c2)		If yes, where were the surveillance cameras used? (Answer each option)
		SOC03c2.a) Entry/exit areas – exterior
		SOC03c2.b) Athletic areas
		SOC03c2.c) Entry/exit areas – interior
		SOC03c2.d) Corridors
		SOC03c2.e) Other
		SOC03c2.e1) If Other selected, please specify:
SOC0c3)		If yes, when were the surveillance cameras monitored?
		1 Always 2 Occasionally 3 After an incident 4 Other
		SOC03c3a) If Other selected, please specify:
SOC03d) Communication Devices
If yes, proceed to SOC03d1; if no, proceed to SOC03e.
SOC03d1)		If yes, what types of devices were used? (Answer each option)
		SOC03d1.a) 2-way radios
		SOC03d1.b) 2-way intercom in most classrooms
		SOC03d1.c) Mass text messages
		SOC03d1.d) Mass emails
		SOC03d1.e) Other
		SOC03d1.e1) If Other selected, please specify:
SOC03e) Access Restrictions
If yes, proceed to SOC03e1; if no, proceed to SOC03f.
SOC03e1)	Proximity or card swipe access for staff
If yes, proceed to SOC03e1a; if no, proceed to SOC03f.
SOC03e1a)	If yes, where? (Answer each option)
	SOC03e1.a1) Main building(s) / areas
	SOC03e1.a2) Parking lot(s)
	SOC03e1.a3) Other
	SOC03e1.a3.1) If Other selected, please specify:
SOC03f) Intrusion Alarm Systems
If yes, proceed to SOC03f1 & SOC03f2; if no, proceed to E01..
SOC03f1)		If yes, where? (Answer each option)
		SOC03f1.a) Main building(s) / areas
		SOC03f1.b) Parking lot(s)
		SOC03f1.c) Other
		SOC03f1.c1) If Other selected, please specify:
SOC03f2)		If yes, When were they used? (Answer each option)
		SOC03f2.a) On school days before classes or official school activities began
		SOC03f2.b) While classes were being held
		SOC03f2.c) During lunch, recess, or other breaks
		SOC03f2.d) During class changes
		SOC03f2.e) Immediately after school
		SOC03f2.f) During after school practice or detention
		SOC03f2.g) After official activities
		SOC03f2.h) On days when no classes or school events were held (e.g., weekends, holidays, or official school breaks)

QUESTIONS about the event: SCHOOL INTERVIEW

E01. Where on the campus did the injury event occur?

Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; code all applicable locations

Location	Code
E01a) in a classroom
E01b) in a hallway
E01c) in a cafeteria
E01d) in a gymnasium
E01e) in a locker room
E01f) in an office
E01g) in a stairwell
E01h) in a restroom
E01i) in a break room or lounge
E01j) in an auditorium
E01k) on campus lawn or gardens
E01l) on sporting fields or playground
E01m) in a parking lot
E01n) in a driveway
E01o) at a bus pickup or drop off point
E01p) other indoor location
E01p1) If Other selected, please specify:
E01q) other outdoor location
E01q1) If Other selected, please specify:
E01r) not applicable
E01s) unknown
E01t) refused to answer

If yes to any of 01 - 67 above, Skip to Question #E03, otherwise proceed to question E02.

E02. Where did the off-campus injury event occur? _ _

Read options; code written responses later; code leading zeros

01= on the street, sidewalk, footpath

02= on a bus or public transport vehicle

03= waiting for or getting on or off a bus or public transport vehicle

04= in a privately-owned vehicle / car

05= on private property (E02a :If Private property selected, specify ...................................)

06= at a sporting complex (pool, stadium, off campus gym, rec center etc…)

66= other (E02b: If Other selected, please specify:........................................................)

77= not applicable

88= unknown

99= refused to answer

E03. Which of the following best describes the context in which the injury event occurred? _ _

Read options; code written responses later; code leading zeros

01= on a day when no classes or school events were held (e.g., a weekend, holiday, or an
official school break)

02= on a school day before classes began

03= while classes were being held

04= during a school assembly

05= on a school day during lunch, recess or other break, including class changes

06= immediately after school

07= on a school day during after-school practice or detention

08= on a school day after official activities

09= at a school sporting activity

10= at another official school-sponsored activity

11= on the way to or from a school-sponsored activity

66= other (E03a: If Other selected, please specify:........................................................)

77= not applicable

88= unknown

99= refused to answer

E04. What were the perpetrator’s motives for the fatal injury? (answer each option)

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown;

Motive	Code
E04a) single suicide
E04b) suicide pact
E04c) drug related
E04d) gang related
E04e) robbery, attempted robbery
E04f) rape, attempted sex crime
E04g) dispute over money or property
E04h) dispute over romantic relationship
E04i) dispute related to sporting event
E04j) dispute, other or unspecified
E04k) racially or hate crime motivated
E04l) victim killed by law enforcement or security personnel
E04m) victim killed by civilian during commission of a crime
E04n) act of terrorism
E04o) random victim
E04p) victim was a bystander
E04q) victim was intervener assisting a crime victim
E04r) mimicking a video game, tv, movie, or other violent media
E04s) media-related coverage of a similar event (e.g., violence contagion)
E04t) other
E04t1) If Other selected, please specify

E05. Briefly describe the circumstances of the fatal injury and events leading up to it, including history of prior conflicts between the principles, etc.

Code later

E06. What was the method of fatal injury? (answer each option)

Read options; Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown;

Method	Code
E06a) firearm
E06a1) If Other selected, please specify
E06b) knife, razor, box cutter or other blade
E06c) beaten with club, bat, pipe, chain, or other object
E06d) beaten, no weapon used
E06e) motor vehicle
E06f) hanging/strangulation/asphyxiation by hanging
E06g) poisoning, solid or liquid
E06h) asphyxiation by gas
E06i) other asphyxiation
E06j) other
E06j1) If Other selected, please specify
E06k) not applicable
E06l) unknown
E06m) refused to answer

E07. After a tragedy such as this people look for things, such as comments, notes, threats, or actions that took place prior to the incident that could have signaled a potential risk for this type of behavior. Which of the following did any of the alleged offenders, or victims in the case of suicide, leave as signs that they were considering this action? Please include as many signs as you can think of even if they were things that no one could have recognized as a sign at the time they happened.

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (answer each option)

Sign	Code
{E07a} notes
{E07a1} If yes, specify:
{E07b} journal entry
{E07b1} If yes, specify:
{E07c} social media (e.g. blogs, Twitter, wall postings on social networking sites)
{E07c1} If yes, specify
{E07d} verbal threats
{E07d1} If yes, specify
{E07e} electronic media (e.g., email messages, IM, or texts via cellphone, voice mail, video etc..)
{E07e1} If yes, specify
{E07f} other actions (e.g., playful suggestion that person might commit act, voiced suicidal thoughts)
{E07f1} If yes, specify

E08. Did anyone know about the possibility of this event before it happened? _

Do NOT read options

1=yes (E08a. If yes, specify _________________________________)

2=no*

7=not applicable*

9=unknown/refused to answer*

If yes, proceed to E08a;

*If answer 2 - 9, skip to Question #V01.

E09. What information was known by the bystander(s) in advance of the attack?

Instructions: Capture information for up to five bystanders.

E09a. Code later
________________________________________________________________________________________________________________________________________________________________________________

E09b. Code later
_____________________________________________________________________________________________________________________________________________________________________

E09c. Code later
________________________________________________________________________________________________________________________________________________________________________________

E09d. Code later
_____________________________________________________________________________________________________________________________________________________________________

E09e. Code later
_________________________________________________________________________________________________________________________________________________________________________________________________________________

E10. What relationship did the bystander have to the perpetrator(s)? _ _

Read options; code written responses later

E10a. Bystander #1

01= relatives (E10a1) specify.............)

02= romantic partner

03= close friend

04= classmate

05= faculty/staff

06= fellow student at
school, but not
classmate

07= community /
neighborhood
acquaintance

08= strangers

66= other (E10a2)specify......................)

77=not applicable

88=unknown

99=refused to answer

E10b. Bystander #2

01= relatives (E10b1) specify..................)

02= romantic partner

03= close friend

04= classmate

05= faculty/staff

06= fellow student at
school, but not
classmate

07= community / neighborhood acquaintance

08= strangers

66= other (E10b2)specify......................)

77=not applicable

88=unknown

99=refused to answer

E10c. Bystander #3

01= relatives (E10c1) specify......)

02= romantic partner

03= close friend

04= classmate

05= faculty/staff

06= fellow student at
school, but not
classmate

07= community /
neighborhood
acquaintance

08= strangers

66= other (E10c2) specify.........)

77=not applicable

88=unknown

99=refused to answer

E10d. Bystander #4

01= relatives (E10d1) specify.........)

02= romantic partner

03= close friend

04= classmate

05= faculty/staff

06= fellow student at
school, but not
classmate

07= community /
neighborhood
acquaintance

08= strangers

66= other (E10d2) specify.........)

77=not applicable

88=unknown

99=refused to answer

E10e. Bystander #5

01= relatives (E10e1) specify..........)

02= romantic partner

03= close friend

04= classmate

05= faculty/staff

06= fellow student at
school, but not
classmate

07= community /
neighborhood
acquaintance

08= strangers

66= other (E10e2) specify..........)

77=not applicable

88=unknown

99=refused to answer

E11. Did the bystander share the information he or she learned of the planned violence with

others?

Do NOT read options

1= (E11a. If yes, specify ________________________________________)

2=no*

7=not applicable*

9=unknown/refused to answer*

If yes, proceed to E11a & E11b;

*If answer is 2 -9, skip to Question #V01.

E11b. With whom was this information shared?

Do not read options; Coding instructions: 1=yes, 2=no, 8=unknown. (answer each option)

	Code
{E11b1} no one
{E11b2} parents
{E11b3} other family
{E11b4} peers
{E11b5} school staff
{E11b6} other medical/mental health professional
{E11b7} other
{E11b7a} If Other selected, please specify
{E11b8} not applicable
{E11b9} unknown
{E11b10} refused to answer

QUESTIONS about the Victim: SCHOOL INTERVIEW

V01. How many victims were fatally injured in this event? Write in actual number _ _

V01a. Victim Identification Number Number for this victim is assigned by the primary data collector. _

V02. What was the date of the injury?

Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _

V03. What was the time of the injury? Record in military time _ _ _ _

V04. What was the date of death?

Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _

V05. What was this victim's date of birth?

Record month/date/year, code leading zeros (code four-digit years) _ _/_ _/_ _ _ _

V06. What was this victim's age in years at the time of death? _ _ _

Do NOT read options, code leading zero

01-∞=actual age in years

777=not applicable

888=unknown

999=refused to answer

V07. What was this victim's gender? _ Do NOT read options

1=male

2=female

3=transgender

7=not applicable

8=unknown

9=refused to answer

V08. What was the victim's race? _ _ Do NOT read Options

1 White

2 Black or African American

3 American Indian or Alaska Native

4 Asian Indian

5 Chinese

6 Filipino

7 Japanese

8 Korean

9 Vietnamese

10 Other Asian

11 Native Hawaiian

12 Guamanian or Chamorro

13 Samoan

14 Other Pacific Islander

15 Other (V08a. If Other selected, please specify: _________________ )

88 Unknown—a person’s race is unknown

99 Refused to Answer

V09. Was this victim of Hispanic, Latino/a, or Spanish Origin?

(One or more categories may be selected) Do NOT read options

Coding instructions: 1=yes, 2=no,

	Code
{V09a} Hispanic or Latino/a or Spanish origin
{V09b} Mexican, Mexican American, Chicano/a
{V09c} Puerto Rican
{V09d} Cuban
{V09e} Another Hispanic, Latino, or Spanish origin
{V09f} Unknown
{V09g} Refused to Answer

V10. Which of the following best describes the victim's family structure/living arrangements at the time of death? _ _ Read options

01= two-parent nuclear family

02= single parent household

03= lives with adult relative other than parent

04= lives with legal guardian

05= lives independently

06= foster care

07= residential institution

66= other (V10a: If Other selected, please specify: _________________ )

77=not applicable

88=unknown

99=refused to answer

V11. What was the highest grade or year of school this victim completed? _ _

Do NOT read options, code leading zero

00-12=last completed grades K-12

13=high school equivalency(GED)

14=some college or trade school

15=college graduate or more

16=never attended

66=other (V11a: If Other selected, please specify: _________________ )

77=not applicable

88=unknown

99=refused to answer

V12. Individuals often affiliate with distinct peer groups. To your knowledge, was the victim associated

with any distinct peer group? _ Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused*

If yes, proceed to V12a;

*If answer is 2 -9, skip to Question # V13.

V12a. If yes, what group(s) were they affiliated with?

Code later

V13. In the year prior to this event, did the victim leave an existing peer group?

Do not read options _

1=yes (V13a. If yes, specify _______________________________________)

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V13a;

*If answer is 2 -9, skip to Question # V14.

V14. In the year prior to this event, did the victim join a new peer group? _

Do not read options

1=yes (V14a. If yes, specify ______________________________________)

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V14a;

*If answer is 2 -9, skip to Question # V15.

V15. Did the victim use alcohol or other drugs? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V15a;

*If answer is 2 -9, skip to Question # V16.

V15a. If yes, what types of substances did the victim use?

Code later

............................................................................................................................................................................

V16. Was there evidence that the victim was intoxicated with alcohol or drugs at the time of the fatal incident?

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

V17. At the time of the fatal incident, was the victim perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

V18. Was the victim carrying a weapon at the time of the fatal injury? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V18a;

*If answer is 2 -9, skip to Question # V20.

V18a. If yes, which of the following types of weapon was this victim carrying? (Answer all options)

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

Weapon	Code
{O18a1} firearm
{O18a1.1} If firearm selected, please specify
{O18a2} knife, razor, box cutter or other blade
{O18a3} bat, pipe, chain, or other object
{O18a4} rope or wire
{O18a5} other
{O18a5.1} If other selected, please specify

V18b. Where did this victim obtain these weapons? (Answer all options)

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

Weapons source	Code
{O18b1} from home
{O18b1.1} specify weapon
{O18b2} from friend or relative outside household
{O18b2.1} specify weapon
{O18b3} purchased for himself/herself
{O18b3.1} specify weapon
{O18b4} stolen
{O18b4.1} specify weapon
{O18b5} home-made weapon
{O18b6} weapon of opportunity (used weapon already present in environment / used object in environment as weapon}
{O18b7} from the victim
{O18b7.1} specify weapon
{O18b1} from home
{O18b1.1} specify weapon

V19. What was the victim's affiliation with the school associated with this death? _ _

Do NOT read options, code leading zero

01=a student at this school

02=a student at another school

03=a teacher at this school*

04=administrator at this school*

05=other staff at this school*

06=security guard or police officer*

07=family member of a student*

08=resident of surrounding community*

09=not associated with the school or community*

10=unidentified victim*

66=other* (V20a: If Other selected, please specify: .................................................................)

77=not applicable*

88=unknown*

99=refused to answer*

*If the victim is NOT a student, skip to Question # V41.

V20. During the year prior to this incident, how many times had the victim been found carrying a weapon on school grounds or on the way to or from school? _ _

00-##=actual number of times the victim carried a weapon*

77=not applicable

88=unknown

99=refused to answer

*If answer is zero (0), skip to Question #V21; otherwise proceed to Questions V20a – V20b.

V20a. For the most recent event prior to the date of fatal injury, which of the following types of

weapons was the victim carrying? (Answer all options)

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

Weapon	Code
{V20a1} firearm
{V20a1.1} If firearm selected, please specify
{V20a2} knife, razor, box cutter or other blade
{V20a3} bat, pipe, chain, or other object
{V20a4} rope or wire
{V20a5} other
{V20a5.1} If other selected, please specify

V20b. What, if any, actions did the school take in response to the victim’s most recent incident of weapon carrying?

............................................................................................................................................................................

V21. How many years had the victim attended his or her school? _ _

Do NOT read options; code leading zeros

00=less than one school year

01-12=number of years

13=more than 12 years

77=not applicable

88=unknown

99=refused to answer

V22. How many times in the last year was the victim suspended from his or her school? _

(including in-school suspensions)

Do NOT read options

0=none, never suspended

1-5=actual number of times

6=more than five times

7=not applicable

8=unknown

9=refused to answer

V23. In the last year was the victim expelled from his or her school? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

V24. What extracurricular activities was the victim involved in?

To be coded later

V25. Did the victim experience any school-related crises or traumatic events during the 2 weeks before the fatal incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V25a.

*If answer 2 - 9, skip to Question #V26.

V25a. Please briefly describe the specific school-related crises or traumatic events experienced.

Code later

V26. Was a school-related crisis or traumatic event imminent within two weeks of this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V26a.

*If answer 2 - 9, skip to Question #V27.

V26a. Please briefly describe the specific school-related crises or traumatic events that may have

been imminent.

Code later

V27. Did the victim experience any community-related crises or traumatic events during the 2 weeks before this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V27a.

*If answer 2 - 9, skip to Question #V28.

V27a. Please briefly describe the specific community-related crises or traumatic events

experienced.

Code later

V28. Was a community-related crisis or traumatic event imminent within two weeks of this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V28a.

*If answer 2 - 9, skip to Question #V29.

V28a. Please briefly describe the specific community-related crises or traumatic events that may

have been imminent.

Code later

V29. Did the victim experience any family-related crises or traumatic events during the 2 weeks before this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V29a.

*If answer 2 - 9, skip to Question #V30.

V29a. Please briefly describe the specific family-related crises or traumatic events experienced.

Code later

V30. Was a family-related crisis or traumatic event imminent within two weeks of this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V30a.

*If answer 2 - 9, skip to Question #V31.

V30a. Please briefly describe the specific family-related crises or traumatic events that may have

been imminent.

Code later

V31. Did the victim experience any relationship-related crises or traumatic events during the 2 weeks before the incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V31a.

*If answer 2 - 9, skip to Question #V32.

V31a. Please briefly describe the specific relationship-related crises or traumatic events

experienced.

Code later

V32. Was a relationship-related crisis or traumatic event imminent within two weeks of this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V32a.

*If answer 2 - 9, skip to Question #V33.

V32a. Please briefly describe the specific relationship-related crises or traumatic events that may

have been imminent.

Code later

V33. In the 12 months prior to this event was the victim reported to the principal’s office for any of the following behaviors? Read options, Coding instructions: 1=yes, 2=no, 8=unknown.

(Answer all options)

Behavior	Code
{V33a} disobeying authority figure
{V33b} name calling, taunting, or teasing peers
If yes to V33b, please complete V33b.1 & V33b.2:
V33b.1 Face to face?
V33b.2 Using Electronic means (e.g., phone, computer)?
{V33c} verbal threats
{V33d} sent written threats
{V33e} sent electronic threats
{V33f} bullied peers
{V33g} physically threatened peers
{V33h} physically fought with peers
{V33i} damaged another's personal property
{V33j} damaged school property (tagging, vandalism etc…)
{V33k} stole another's personal property
{V33l} truancy (skipped school)
{V33m} possessed / used illegal substances
{V33n} possessed a weapon
{V33o} physically threatened an authority figure

V34. To the best of your knowledge, in the 12 months prior to this event was this individual victimized in any of the following ways? Read options, Coding instructions: 1=yes, 2=no, 8=unknown.

(Answer all options)

Type	Code
{V34a} called names by peers
{V34b} bullied by peers
{V34c} had personal property damaged or stolen
{V34d} verbally threatened by peers
{V34e} received written threats
{V34f} electronic threats
{V34g} physically threatened by peers
{V34h} physically assaulted by peers

V35. At the time of the event, did this victim have a diagnosed Learning Disability, physical disability, or physical health problem? _

Do not read options

1=yes (V35a. If yes, please specify. ____________________________)

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V35a.

*If answer 2 - 9, skip to Question #V36.

V36. In the year prior to this event, did this victim receive any of the following services?

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

Services	Code
{V36a} guidance counseling / advising
{V36b} social services
{V36c} supplemental educational services (including efforts to address learning disabilities, such as a formal school psychoeducational evaluation)
{V36d} other services
{V36d1} If other selected, please specify:

V37. In the year prior to this event, was this victim ever treated for depression? _

Do not read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

V38. Had the victim ever received professional treatment for any other mental health problem, such as by a psychiatrist/psychologist? _

Do not read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V38a & V38b.

*If answer 2 - 9, skip to Question #V39.

V38a. If yes, what specific kinds of emotional or mental health problems were treated?

To be coded later

V38b. In what type of setting were they treated (e.g., inpatient, outpatient)?

To be coded later

V39. Did this victim have a documented family history of .....

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

	Code
{V40a } alcoholism
{V39b} drug abuse
{V39c} intimate partner violence
{V39d} sexual violence
{V39e} attempted / completed suicide
{V39f} arrests / convictions for violent offenses (e.g., assault, homicide etc…)

V40. Did this victim suffer…

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

	Code
{V40a} physical child abuse
{V40b} sexual child abuse
{V40c} emotional / psychological abuse as a child
{V40d} neglect
{V40e} victimization in intimate partner violence_/ teen dating violence
{V40f} victimization in sexual violence

V41. Which of the following situations best describes this victim's death? _ _

Read options; code leading zero

01= single victim suicide

02= multiple victim suicide (i.e., suicide pact)

03= single victim homicide; unknown number of offenders

04= single victim homicide; single offender

05= single victim homicide; multiple offenders

06= multiple victim homicide; unknown number of offenders

07= multiple victim homicide; single offender

08= multiple victim homicide; multiple offenders

09= combination murder/suicide

10= intention undetermined

66= other (V42a: If Other selected, please specify..........................................................)

77=not applicable

88=unknown

99=refused to answer

V42. Did the victim ever do something to purposely hurt him/herself without wanting to die, such as cutting or burning him/herself on purpose, engaging in the choking game, etc.?

Do not read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes, proceed to V42a & V42b.

*If answer 2 - 9, skip to Question #V43.

V42a. To whom was this self-harm behavior reported? Do not read options

(Answer all options)

	Code
{V42a1} no one
{V42a2} parents
{V42a3} other family
{V42a4} peers
{V42a5} school staff
{V42a6} other medical/mental health professional
{V42a7} other
{V42a7a} If Other selected, please specify:
{V42a8} not applicable
{V42a9} unknown
{V42a10} refused to answer

V42b. What, if any, actions were taken by the school in response to this self-harm behavior?

V43. Do you have any knowledge that this victim had, in the year prior to this event exhibited any of the following signs and symptoms of suicide?

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

Signs	Code
{V43a} Thoughts/threats of suicide*
{V43b} Plans of suicide*
{V43c} Previous suicide attempts*

If yes to any of V43a – V43c, proceed to V43d & V43e.

*If no to all of V43a – V43c, skip to V44.

V43d To whom was this suicidal behavior reported? Do not read options (Answer all options)

	Code
{V43d1} no one
{V43d2} parents
{V43d3} other family
{V43d4} peers
{V43d5} school staff
{V43d6} other medical/mental health professional
{V43d7} other
{V43d7a}: If Other selected, please specify
{V43d8} not applicable
{V43d9} unknown
{V43d10} refused to answer

V43e What, if any, actions were taken by the school in response to this suicidal behavior?

V44. Did perceptions about the victim being gay, bisexual, or transgendered contribute to their victimization? _

Do not read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

V45. Were there any victims that suffered nonfatal injuries at the time of this event? _

Do not read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to V45, proceed to V45a & V45b.

*If answer 2 - 9, skip to V46.

V45a. How many nonfatal injuries occurred at the time of this event? _ _

01-##=actual number of nonfatal injuries

77=not applicable

88=unknown

99=refused to answer

V45b. How many victims that suffered nonfatal injuries required hospital admission? _ _

00-##=actual number of nonfatal injuries that required hospital admission

77=not applicable

88=unknown

99=refused to answer

V46. Is there more than one fatal victim to report and are you ready to complete another victim questionnaire?

Do not read options

1=yes

2=no*

If yes to V46, go back to V01 to complete another "Victim" section starting with Question V01.

*If no, skip to V47.

V47. How many alleged offenders were responsible for the victim's death? _

Do NOT read options (PROBE: alleged offender = legally charged as offender)

0=none, death was self-inflicted

1-5=actual number of offenders*

6=more than 5*

7=not applicable

8=unknown

9=refused to answer

*If there are no data available on any alleged offender, conclude the interview...Otherwise, complete "Offender" section, starting with question #O01

QUESTIONS about Alleged Offender: SCHOOL INTERVIEW

CaseID. Case ID Number Case number is assigned by study coordinator. _ _ _ _ _

O01. How many alleged offenders were officially charged for this incident?

Write in actual number. _ _

O01a. Offender Number

Number for this alleged offender is assigned by the primary data collector. _

O02. What was this alleged offender's date of birth?

Record month/date/year, code leading zeros, code four-digit years _ _/_ _/_ _ _ _

O03. What was this alleged offender's age in years at time of victim's death? _ _ _

Do NOT read options, code leading zero

01-100=actual age in years

777=not applicable

888=unknown

999=refused to answer

O04. What was this alleged offender's gender? _

Do NOT read options

1=male

2=female

3=transgender

7=not applicable

8=unknown

9=refused to answer

O05. What was this alleged offender's race? _

Do NOT read options

1 =White

2 =Black or African American

3 =American Indian or Alaska Native

4 =Asian Indian

5 =Chinese

6=Filipino

7=Japanese

8=Korean

9=Vietnamese

10=Other Asian

11=Native Hawaiian

12=Guamanian or Chamorro

13=Samoan

14=Other Pacific Islander

15=Other (O05a: If Other selected, please specify__________________________________)

88 =Unknown—a person’s race is unknown

99=Refused to Answer

O06. Was this alleged offender of Hispanic, Latino/a, or Spanish Origin?

(One or more categories may be selected) Do NOT read options

Coding instructions: 1=yes, 2=no

	Code
{O06a} Hispanic or Latino/a or Spanish origin
{O06b} Mexican, Mexican American, Chicano/a
{O06c} Puerto Rican
{O06d} Cuban
{O06e} Another Hispanic, Latino, or Spanish origin
{O06f} Unknown
{O06g} Refused to answer

O07. Which of the following best describes this alleged offender's family structure or living arrangements at the time of the victim's death? _ _

01= two-parent nuclear family

02= single parent household

03= lives with adult relative other than parent

04= lives with legal guardian

05= lives independently

06= foster care

07= residential institution

66= other (O07a: If Other selected, please specify__________________________________)

77=not applicable

88=unknown

99=refused to answer

O08. What was the highest grade or year of school this alleged offender completed? _ _

Do NOT read options, code leading zero

00-12=last completed grades K-12

13=high school equivalency

14=some college or trade school

15=college graduate or more

16=never attended

66=other (O08a: If Other selected, please specify__________________________________)

77=not applicable

88=unknown

99=refused to answer

O09. Had this alleged offender ever been arrested before the victim's death? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

O10. Had this alleged offender ever been charged with a crime before the victim's death? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O10, proceed to O10a & O10b.

*If answers 2 – 9, skip to O11.

O10a. What types of charges did the alleged offender face?

Code later

O10b. Which charges resulted in convictions?

Code later

O11. Individuals often affiliate with distinct peer groups. To your knowledge, was the alleged offender associated with any distinct peer group? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused*

If yes to O10, proceed to O11a – O11c.

*If answers 2 – 9, skip to O12.

O11a. What groups were they affiliated with?

Code later

O11b. In the year prior to this event, did the alleged offender leave an existing peer group? _

Do NOT read options

1=yes (O11b1. If yes, specify ____________________)

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O11b, proceed to O11b1.

*If answers 2 – 9, skip to O11c.

O11c. In the year prior to this event, did the alleged offender or join a new peer group? _

Do NOT read options

1=yes (O11c1. If yes, specify _____________________)

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O11c, proceed to O11c1.

*If answers 2 – 9, skip to O12.

O12. Did this alleged offender use alcohol or other drugs at the time of the incident? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O12, proceed to O12a.

*If answers 2 – 9, skip to O13.

O12a. What types of substances did the alleged offender use?

Code later

O13. Was there evidence that this alleged offender was intoxicated with alcohol or other drugs at the time of the victim's death? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

O14. At the time of death, was the alleged offender perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

O15. What was the relationship of this alleged offender to the victim? _ _

Read options; code written responses later

01= relatives (O15a: If relatives selected, specify relationship_______________________)

02= romantic partner

03= close friend

04= classmate

05= faculty/staff

06= fellow student at school, but not classmate

07= community / neighborhood acquaintance

08= strangers

66= other (O15b: If Other selected, please specify__________________________________)

77=not applicable

88=unknown

99=refused to answer

O16. Was this alleged offender carrying a weapon at the time of the fatal injury? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O16, proceed to O16a – O16b.

*If answers 2 – 9, skip to O17.

O16a. At the time of the fatal injury, which of the following types of weapon was this alleged

offender carrying? (Answer all options)

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

Weapon	Code
{O16a1} firearm
{O16a1.1} If firearm selected, please specify
{O16a2} knife, razor, box cutter or other blade
{O16a3} bat, pipe, chain, or other object
{O16a4} rope or wire
{O16a5} other
{O16a5.1} If other selected, please specify

O16b. Where did this alleged offender obtain these weapons? (Answer all options)

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

Weapons source	Code
{O16b1} from home
{O16b1.1} specify weapon
{O16b2} from friend or relative outside household
{O16b2.1} specify weapon
{O16b3} purchased for himself/herself
{O16b3.1} specify weapon
{O16b4} stolen
{O16b4.1} specify weapon
{O16b5} home-made weapon
{O16b6} weapon of opportunity (used weapon already present in environment / used object in environment as weapon}
{O16b7} from the victim
{O16b7.1} specify weapon
{O16b8} other

O17. What was this alleged offender's affiliation with the school associated with the victim's death? _ _

Do NOT read options, code leading zero

01=a student at this school

02=a student at another school

03=a teacher at this school*

04=administrator at this school*

05=other staff at this school*

06=security guard or police officer*

07=family member of a student*

08=family member of a school staff member

09= resident of surrounding community*

10= not associated with the school or community*

11= unidentified offender*

66=other* (O17a: If Other selected, please specify__________________________________)

77=not applicable

88=unknown

99=refused to answer

*If this offender is NOT a student, go to Question O26.

O18. During the year prior to this incident, had the alleged offender ever been found carrying a weapon on school grounds or on the way to or from school? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O18, proceed to O18a – O18b.

*If answers 2 – 9, skip to O19.

O18a. During the year prior to this incident, how many times had this alleged offender been found

carrying a weapon on school grounds or on the way to or from school? _ _

Do NOT read options, code leading zeros

01-##=actual number of times the victim carried a weapon

77=not applicable

88=unknown

99=refused to answer

O18b. For the most recent time the alleged offender was found to be carrying a weapon prior to the

date of fatal injury, was he/she carrying any of the following types of weapon?

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown

(Answer all options)

Weapon	Code
{O18b1} firearm
{O18b1.1} If firearm selected, please specify
{O18b2} knife, razor, box cutter or other blade
{O18b3} bat, pipe, chain, or other object
{O18b4} rope or wire
{O18b5} other
{O18b5.1} If other selected, please specify

If yes to O18b, proceed to O18b6.

*If answers 2 – 9, skip to O19.

O18b6. If yes to any of the above, what, if any, actions did the school take in response to this alleged offender’s most recent incident of weapon carrying?

............................................................................................................................................................................

O19. How many times was this alleged offender suspended from his or her school? (including in school suspensions) _ Do NOT read options

0=none, never suspended or expelled

1-5=actual number of times

6=more than five times

7=not applicable

8=unknown

9=refused to answer

O20. Had this alleged offender been expelled from his or her school, in the 12 months preceding

the event? _ Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

O21. What extracurricular activities was this alleged offender involved in at the time of the fatal incident?

to be coded later; please note the sources.

...........................................................................................................................................................................................

O22. Did the alleged offender experience any school-related crises or traumatic events during the 2 weeks before this incident? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O22, proceed to O22a.

*If answers 2 – 9, skip to O23.

O22a. Please briefly describe the specific school-related crises or traumatic events experienced.

Code later

............................................................................................................................................................................

O23. Was a school-related crisis or traumatic event imminent within two weeks of this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O23, proceed to O23a.

*If answers 2 – 9, skip to O24.

O23a. Please briefly describe the specific school-related crises or traumatic events that may have

been imminent.

Code later

............................................................................................................................................................................

O24. Did the alleged offender experience any community-related crises or traumatic events during the 2 weeks before this incident? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O24, proceed to O24a.

*If answers 2 – 9, skip to O25.

O24a. Please briefly describe the specific community-related crises or traumatic events

experienced.

Code later

............................................................................................................................................................................

O25. Was a community-related crisis or traumatic event imminent within two weeks of this incident?

Do NOT read options _

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O25, proceed to O25a.

*If answers 2 – 9, skip to O26.

O25a. Please briefly describe the specific community-related crises or traumatic events that may

have been imminent.

Code later

............................................................................................................................................................................

O26. Did the alleged offender experience any family-related crises or traumatic events during the 2 weeks before this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O26, proceed to O26a.

*If answers 2 – 9 and victim is a student, skip to O27

*If answers 2 – 9 and victim is NOT a student, skip to O39.

O26a. Please briefly describe the specific family-related crises or traumatic events experienced.

Code later

............................................................................................................................................................................

O27. Was a family-related crisis or traumatic event imminent within two weeks of this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O27, proceed to O27a.

*If answers 2 – 9 and victim is a student, skip to O28.

*If answers 2 – 9 and victim is NOT a student, skip to O39.

O27a. Please briefly describe the specific family-related crises or traumatic events that may have

been imminent.

Code later

............................................................................................................................................................................

O28. Did the alleged offender experience any relationship-related crises or traumatic events during the 2 weeks before this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O28, proceed to O28a.

*If answers 2 – 9 and victim is a student, skip to O29.

*If answers 2 – 9 and victim is NOT a student, skip to O39.

O28a. Please briefly describe the specific relationship-related crises or traumatic events

experienced.

Code later

............................................................................................................................................................................

O29. Was a relationship-related crisis or traumatic event imminent within two weeks of this incident?

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O27, proceed to O29a.

*If answers 2 – 9 and victim is a student, skip to O30.

*If answers 2 – 9 and victim is NOT a student, skip to O39

O29a. Please briefly describe the specific relationship-related crises or traumatic events that may

have been imminent.

Code later

............................................................................................................................................................................

O30. To the best of your knowledge, in the 12 months prior to this event did the alleged offender engage in any of the following behaviors?

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

Behavior	Code
{O30a} disobeying authority figure
{O30b} name-calling, taunting, or teasing peers (If yes, answer O30b1 & O30b2 )
{O30b1} Face to face?
{O30b2} Using Electronic means (e.g., phone, computer)?
{O30c} verbal threats
{O30d} sent written threats
{O30e} sent electronic threats
{O30f} bullied peers
{O30g} physically threatened peers
{O30h} physically fought with peers
{O30i} damaged another's personal property
{O30j} damaged school property (tagging, vandalism etc…)
{O30k} stole another's personal property
{O30l} truancy (skipped school)
{O30m} possessed / used illegal substances
{O30n} possessed a weapon

O31. To the best of your knowledge, in the 12 months prior to this event was this alleged offender

victimized in any of the following ways?

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

Type	Code
{O31a} called names by peers
{O31b} bullied by peers
{O31c} had personal property damaged or stolen
{O31d} verbally threatened by peers
{O31e} received written threats
{O31f} electronic threats
{O31g} physically threatened by peers
{O31h} physically assaulted by peers

O32. At the time of the event, did this alleged offender have a diagnosed Learning Disability, physical disability, or physical health problem? _

Do NOT read options

1=yes (O32a. If yes, specify. ______________________________)

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O32, proceed to O32a.

*If answers 2 – 9, skip to O33.

O33. In the year prior to this event, did this alleged offender receive any of the following services?

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

Services	Code
{O33a} guidance counseling / advising
{O33b} social services
{O33c} supplemental educational services (including efforts to address learning disabilities), such as a formal school psychoeducational evaluation
{O33d} other services
{O33d1} If other services selected, please specify:

O34. In the year prior to this event, was this alleged offender ever treated for depression? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

O35. Had the alleged offender ever received professional treatment for any other emotional or mental

health problem, such as by a psychiatrist/psychologist? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O35, proceed to O35a – O35b.

*If answers 2 – 9, skip to O36.

O35a. If yes, what specific kinds of emotional or mental health problems were treated?

To be coded later

........................................................................................................................................................................................................................................................................................................................................................ ....................................................................................................................................................................................................................................................................................................................................................... .......................................................................................................................................................................................................................................................................................................................................................

O35b. In what type of setting were they treated (e.g., inpatient, outpatient)?

To be coded later

O36. Did this alleged offender have a documented family history of .....

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

	Code
{O36a} alcoholism
{O36b} drug abuse
{O36c} intimate partner violence
{O36d} sexual violence
{O36e}attempted / completed suicide
{O36f} arrests / convictions for violent offenses (e.g., assault, homicide etc…)

O37. Did this alleged offender suffer

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

	Code
{O37a} physical child abuse
{O37b} sexual child abuse
{O37c} emotional / psychological abuse as a child
{O37d} neglect
{O37e} victimization in intimate partner violence_/ teen dating violence
{O37f} victimization in sexual violence

O38. Did the alleged offender ever do something to purposely hurt him/herself without wanting to die, such as cutting or burning him/herself on purpose, engaging in the choking game, etc.?

Do not read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O38, proceed to O38a – O38b.

*If answers 2 – 9, skip to O39.

O38a. To whom was this self-harm behavior reported? Do not read options

(Answer all options)

	Code
{O38a1} no one
{O38a2} parents
{O38a3} other family
{O38a4} peers
{O38a5} school staff
{O38a6} other medical/mental health professional
{O38a7} other
{O38a7a} If Other selected, please specify:
{O38a8} not applicable
{O38a9} unknown
{O38a10} refused to answer

O38b. What, if any, actions were taken by the school in response to this self-harm behavior?

O39. Do you have any knowledge that this alleged offender had, in the year prior to this event exhibited any of the following signs and symptoms of suicide?

Read options, Coding instructions: 1=yes, 2=no, 8=unknown. (Answer all options)

Signs	Code
{O39a} Thoughts/threats of suicide
{O39b} Plans of suicide
{O39c} Previous suicide attempts

If yes to any of O39a – O39c, proceed to O39d – O39e.

*If answers 2 – 9, skip to O40.

O39d. To whom was this suicidal behavior reported?

Do NOT read options (Answer all options)

	Code
{O39d1} no one
{O39d2} parents
{O39d3} other family
{O39d4} peers
{O39d5} school staff
{O39d6} other medical/mental health professional
{O39d7} other
{O39d7a}) If Other selected, please specify
{O39d8} not applicable
{O39d9} unknown
{O39d10} refused to answer

O39e. What, if any, actions were taken by the school in response to this suicidal behavior?

To be coded later

O40. Was this alleged offender fatally injured during the event? _

Do NOT read options

1=yes

2=no*

7=not applicable*

8=unknown*

9=refused to answer*

If yes to O40, proceed to O40a – O40c.

*If answers 2 – 9, skip to O41.

O40a. What was the date of the injury event?

Record month/date/year, code leading zeros (code four-digit years)_ _/_ _/_ _ _ _

O40b. What was the time of the injury event? Record in military time _ _ : _ _

O40c. What was the date of death?

Record month/date/year, code leading zeros (code four-digit years)_ _/_ _/_ _ _ _

O40d. What were the motives for the fatal injury? (Answer all options)

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown;

Motive	Code
{O40d1} single suicide
{O40d2} suicide pact
{O40d3} victim killed by law enforcement or security personnel
{O40d4} victim killed by civilian during commission of a crime
{O40d5} other
{O40d5a} If Other selected, please specify:

O40e. Briefly describe the circumstances of the fatal injury and events leading up to it, including

history of prior conflicts between the principles, etc.

Code later

............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................…………………...................................................................................................................................................................................................................................................................................................................................................................................................................................................................... .....

O40f. What was the method of fatal injury?

Read options, Coding instructions: 1=yes, 2=no, 7=not applicable, 8=unknown; (Answer all options)

Weapon	Code
{O40f1} firearm
{O430f1a}) - If firearm selected, please specify
{O40f2} knife, razor, box cutter or other blade
{O40f3} bat, pipe, chain, or other object
{O40f4} rope or wire
{O40f5} other
{O40f5a} - If Other selected, please specify

O41. Did perceptions about the alleged offender being gay, bisexual, or transgendered contribute to their perpetration?

Do NOT read options _

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

O42. Was there evidence that this alleged offender was targeting a specific person or group? _

Do NOT read options

1=yes

2=no

7=not applicable

8=unknown

9=refused to answer

O43. Was there another alleged offender, in addition to the one we just discussed, involved in this event?

Do NOT read options _

1=yes*

2=no

7=not applicable

8=unknown

9=refused to answer

*If there is a second alleged offender identified as Offender Y, complete a second "Offender" section, starting with Question O01.......otherwise, conclude the interview.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Kristin Marie Holland
File Modified	0000-00-00
File Created	2021-01-24