App F_Study Protocol

App F_Study Interview Protocol.docx

The National Intimate Partner and Sexual Violence Survey (NISVS)

App F_Study Protocol

OMB: 0920-0822

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Appendix F

NISVS-3 Questionnaire - Cognitive Study Protocol

cognitive Study introduction:

Thank you for participating in this study. In this interview, we’re not just interested in your answers to these questions; we are interested in what you think about the questions. We want to make sure the questions make sense and that you are familiar with all the words we use. So, after some of the questions, we may ask you additional follow-up items, such as “tell me in your own words what this question is asking" or "Was it easy or hard to come up with your answer?" This will help us determine if we are asking the right questions.

Even though some of our questions may make it sound like we are giving you a test, there are no right or wrong answers to these questions. Our main goal is to make sure that the questions are understandable. While I’m only going to ask follow-up items on a few questions, you can help us by pointing out any questions you find confusing or unclear. That way we can fix these problems before we use these questions in the future. Also, if you think a question could be understood in more than one way, that is useful for us to know as well because we'd like everyone we interview to interpret our questions in the same way.

_____________________________________________________________________________

Section CF: Control Form

PROBE: XXX is going to read you the introduction that we will use for the real interview to see how well it is understood; and then I will ask you some follow-up questions about this introduction.

(CF_INTRO1a)

Hello, I am calling on behalf of the Centers for Disease Control and Prevention, the CDC. The CDC is conducting a study on health and injuries. My name is __________. I am an interviewer with RTI International and I am part of the research team. Let me assure you that this is not a sales call.

(CF_INTRO1b)

You have been randomly chosen to participate in an important study. This call may be monitored or recorded for quality assurance purposes. The Centers for Disease Control and prevention is doing a telephone study of up to 12,500 people. Men and women age 18 and older will be asked questions about their health and injuries they may have experienced. The data we are collecting are very important, and will be used to inform prevention efforts.

The survey will take approximately 25 minutes, on average. Since some of the questions are personal, we suggest that you be in a private setting during the survey.

(CF_INTRO1c)

There are minimal benefits or risks to being in this voluntary study. In order to keep your information private, the answers you give us will be combined with the answers from other people who are in the survey. No information that could personally identify you will be given to the CDC or anyone else. You can skip any question or stop the interview at any time.

If you complete the survey, as a token of our appreciation we will send you a check for $10.

(CF_INTRO1d)

If you choose to receive the money, I will go to a separate computer file after we finish the survey and collect your name and address so that we can mail the check to you. Your name and address will not be connected to the information you provide in the survey, and will be erased from our files at the end of this study.

If you have questions or concerns about participating in the study, you may call the Survey Manager, Jessica Williams, at 1-866-784-1958 extension #6558. If you have any questions about your rights as a research participant, please contact RTI’s Office of Research Protection toll-free at 1-866-214-2043

May we begin?

PROBE 1: Can you tell me in your own words what this introduction is telling you?

PROBE 2: What part or parts of the introduction did you find most helpful in understanding what this study is about?

PROBE 3: Were any parts of the introduction confusing? [IF YES] What parts?

PROBE 4: Did the introduction answer all of the questions that you had about the study? [IF NO] What other questions do you have about the study?

PROBE 5: Were there any parts of the introduction that you thought were unnecessary and should be removed from such an introduction? [IF SO] What parts?

PROBE 6: We read several sentences to you before mentioning that you will receive $10 if you complete this survey. Do you think that we should mention that information sooner, or would it make no difference to you?

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INTERVIEWER READS BUT DOES NOT PROBE:

CF1, CF2, CF2_1, CF2_2, CF3, CF3_1, CF4, CF5, CF6, CFMOSTLY, NUM_ADULTS, CF6SELF, CF6_1, CF7, CF8_MEN, CF8_WOMEN, CFNCHK, CFSELECT, CF10, CF11, CF15, CF16

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Section A: Respondent Characteristics

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INTERVIEWER READS BUT DOES NOT PROBE:

A1MO/A1YR, A1_CHK, A2, A3, A4, A5, A6, A6a, A6b, A7, A7a, A8, A9, A10, A10a, A11, A11a, A12, A12a

_____________________________________________________________________________

Section B: Health Questions

(B_INTRO)

The following questions are about health conditions that you may have.

Have you ever been told by a doctor, nurse, or other health professional that you had …

INTERVIEWER: THE LEAD-IN PHRASE MUST BE READ BEFORE THE FIRST ITEM IN EACH SECTION BELOW. READ AS NECESSARY FOR THE REMAINING ITEMS.

ITEM	QUESTION	YES	NO	DK	REF
B01	… Asthma?	1	2	-1	-2
B02	… Irritable Bowel Syndrome or IBS?	1	2	-1	-2
B03	… Diabetes?	1	2	-1	-2
B04	… High Blood Pressure?	1	2	-1	-2

PROBE 1: How did you come up with your answer to the last question about high blood pressure?

PROBE 2: Who were you supposed to include as having told you that you had blood pressure?

PROBE 3: [IF NECESSARY] Were you thinking about doctors, nurses, or other health professionals – or someone else?

PROBE 4: Did you understand that we were asking about actual medical diagnosis by a doctor, nurse, or other health professional?

PROBE 5: Do you think that saying “Have you ever been told by a doctor, nurse or other health professional that you had…”once before those four items was enough or do we need to repeat this phrase again? If so, how often do you think you would need to be reminded who we were asking about?

Now I am going to ask you about current health issues you may be experiencing.

Do you have …

ITEM	QUESTION	YES	NO	DK	REF
B05	… frequent headaches?	1	2	-1	-2
B06	… chronic pain?	1	2	-1	-2
B07	… difficulty sleeping?	1	2	-1	-2
B08	… serious difficulty hearing?	1	2	-1	-2

PROBE 1: Do you think anyone would have a problem answering the last question?

PROBE 2: Do you think that reading just the health issues for each of these is clear or do you think that anyone would need to be asked the full question for each of these, such as, “Do you have chronic pain” or “Do you have difficulty sleeping”.

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INTERVIEWER SKIPS B9 – B13

_____________________________________________________________________________

VICTIMIZATION INTRODUCTION

(V_INTRO)

The next set of questions asks about experiences that may or may not have happened to you. There will be some questions about physical injuries, harassing behaviors, and unwanted sexual activity.

Remember, you don’t have to answer any question that you don’t want to. We suggest that you be in a private setting during the survey. If, at any time, you do not feel physically or emotionally safe, you can just say “Goodbye”. I will understand and I will not call you back. You can call me back if you’d like at 888-vvv-vvvv, ext. vvvv.

Do you have any questions? ANSWER ALL “R” QUESTIONS BEFORE CONTINUING

CONTINUE

V_CHK

Shall we continue?

1	YES
2	NO ……………………	{BREAKOFF: THANK & END}
-1	DON’T KNOW ………	{BREAKOFF: THANK & END}
-2	REFUSED ……………	{BREAKOFF: THANK & END}

PROBE 1: Can you tell me in your own words what this introduction means?

PROBE 2: [IF NECESSARY] What types of questions will we be asking about according to the introduction just read? [IF NECESSARY] What topics do you think we will be asking about?

PROBE 3: The introduction stated that we would be asking some questions about physical injuries. What do you think that includes?

PROBE 4: Did you think this introduction was clear? Helpful? Friendly?

_____________________________________________________________________________

Section C: Stalking

(C_INTRO)

I’m going to ask you some detailed questions about times when someone may have given you unwanted attention by repeatedly contacting you, following you, or harassing you. When answering, please think about anyone who may have done these things to you, including strangers or someone you knew such as a romantic or sexual partner, a family member, a friend, teacher, co-worker or supervisor, or someone you have known for only a short time.

Please DO NOT include bill collectors, telephone solicitors, other sales people, or others following or contacting you as part of their job.

PROBE 1: What types of questions will we be asking about according to the introduction just read? [IF NECESSARY] What topics do you think we will be asking about?

PROBE 2: Based on the information just read to you, what kinds of people should be included in your answers to the following questions?

PROBE 3: Are there any kinds of people who should not be included in your answers?

PROBE 4: Was the introduction clear or was there anything confusing?

ITEM	QUESTION	YES	NO	DK	REF
Has anyone ever … INTERVIEWER: THE LEAD-IN PHRASE (“HAS ANYONE EVER”) MUST BE READ BEFORE THE FIRST ITEM BELOW IN EACH SECTION. READ AS NECESSARY FOR THE REMAINING ITEMS.
C01	… followed you around and watched you when you did not want them to?	1	2	-1	-2
C02	… approached you or showed up in places, such as your home, work, or school when you did not want them to?	1	2	-1	-2
C03	… used GPS technology or equipment to monitor or track your location when you did not want them to? This includes GPS technology used in a phone or in social media, such as Facebook. IF NECESSARY: GPS is Global Positioning Tracking	1	2	-1	-2
Has anyone ever …
C04	… left strange or potentially threatening items for you to find?	1	2	-1	-2
C05	… sneaked into your home or car and did things to scare you by letting you know they had been there?	1	2	-1	-2
C06	… used technology such as a hidden camera, recorder, or computer software to spy on you from a distance?	1	2	-1	-2
Has anyone ever …
C07	… made unwanted phone calls to you, including hang-ups and voice messages?	1	2	-1	-2
C08	… sent you unwanted text messages, photo messages, emails, or messages through Facebook, Twitter, or other social media?	1	2	-1	-2
C09	… sent you cards, letters, flowers, or presents when they knew you didn’t want them to?	1	2	-1	-2

PROBE 1: For the questions you answered “Yes” to, how easy or difficult was it to decide whether someone had ever done those things?[IF NECESSARY, READ BACK QUESTIONS TO WHICH THE RESPONDENT ANSWERED “YES” TO THE RESPONDENT]

PROBE 2: Have there been any occasions where someone did one of these things to you, but you weren’t certain if it should count or not? Why?

PROBE 3: How easy or difficult was it for you to remember whether any of these things have happened to you?

PROBE 4: Are there any behaviors on the list that you don’t understand?

PROBE 5: Are there any behaviors that you think we should have included, but we didn’t? [IF YES] What are they?

PROBE 6: In these questions, what timeframe were we asking about when things happened to you?

You said that someone had {FILL: LIST OF STALKING BEHAVIORS ENDORSED FROM ABOVE – USE THE STALKING BEHAVIOR FILLS (APPENDIX II); SEPARATE LAST TWO BEHAVIORS WITH THE WORD “and”}.

C10	Did anyone do any of these things to you on more than one occasion?
	1	YES
	2	NO ……………………	{SKIP TO D_INTRO1a}
	-1	DON’T KNOW ………	{SKIP TO D_INTRO1a}
	-2	REFUSED ……………	{SKIP TO D_INTRO1a}
	-3	LEGITIMATE SKIP

PROBE 1: What does “more than one occasion” mean to you in this question?

PROBE 2: If something had occurred at two different times on the same day would you consider that to be “more than one occasion”?

C11a	Thinking about the people who did these things to you on more than one occasion, how many of these people ever made threats to physically harm you? [A VALUE OF 10 = 10 OR MORE PEOPLE]
	_ _	[RANGE 0-10]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

PROBE 1: What types of people or relationships did you include or think about when answering this question?

PROBE 2: [IF NECESSARY] This question asked you to think about the people who did “these things” to you on more than on occasion. What “things” do you think this question referring to?

PROBE 3: What does “threats to physically harm you” mean to you in this question?

PROBE 4: Did you include instances where someone made threats to physically harm you but you did not feel fearful or threatened?

PROBE 5: Were there any situations or instances that you may have encountered but you were not sure if you should include them or not?

C11b	Still thinking about ALL of the people who followed, contacted or harassed you on more than one occasion, how many of these people ever made you fearful or feel threatened, or concerned for your safety or the safety of others when these things happened? [A VALUE OF 10 = 10 OR MORE PEOPLE]
	_ _	[RANGE 0-10]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

PROBE 1: Did you include ALL of people who followed, contacted, or harassed you on more than one occasion or just ones that had ever made threats to physically harm you?

PROBE 2: What does “made you fearful”, “feel threatened”, “concerned for your safety or the safety of others” mean to you as it was used in this question?

PROBE 3: Were there any situations that you did not include because they did not make you feel afraid or threatened or concerned for your safety? Do you think others may have felt afraid, threatened, or concerned for their safety in those same situations?

PROBE 4: If there were situations or instances that made you feel fearful but not concerned for your safety or safety of others, would you include them here?

C12_01	Please think about the first time anyone made threats to physically harm you or made you feel fearful or feel threatened, or concerned for your safety or the safety of others, when they {FILL: LIST OF STALKING BEHAVIORS ENDORSED IN C01 – C09; – USE THE STALKNG BEHAVIOR FILLS (APPENDIX II)}) of these things happened to you. How did you know or what was your relationship to the person who did any of these things to you the FIRST time? IF NECESSARY: Was this person male or female? [USE THE RELATIONSHIP/SEX TEMPLATE (APPENDIX I)]
	_ _ _	[RANGE 100-XXX]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Who did you include when responding to this question? Why?

PROBE 2: Who are we asking you to think about when responding to this question?

PROBE 3: Did you only include people you noted above had made you feel fearful or threatened?

PROBE 4: When we first read the question, did you understand what we were asking for?

PROBE 5: What does “the FIRST time” mean to you in this question?

PROBE 6: How easy or difficult was it to remember what your relationship was with the person who did any of these things to you the FIRST time?

C13	How old were you the first time this person did any of these things to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110 YEARS] …………	{IF AGE > 18, SKIP TO C12_02}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

C14a		Approximately how old was this person the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
		_ _ _		[RANGE 0-110 YEARS] ……….. {SKIP TO C12_02}
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

C14b	Was this person less than 5 years older than you or 5 or more years older than you the first time {FILL: he/she} did any of these things to you?
	1	LT 5 YEARS OLDER	:
	2	5+ YEARS OLDER
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

ITEM	QUESTION	RELATIONSHIP [RANGE: 100-650]	NO MORE	DK	REF	LEGIT SKIP
C12_02	How did you know or what was your relationship with the 2^nd person who did any of these things to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT	_ _ _	996	-1	-2	-3
C12_03	How did you know the 3^rd person who did any of these things to you?	_ _ _	996	-1	-2	-3
C12_04	The 4^th person?	_ _ _	996	-1	-2	-3
C12_05	The 5^th person?	_ _ _	996	-1	-2	-3
:	:
C12_09	The 9^th person?	_ _ _	996	-1	-2	-3
C12_10	The 10^th person?	_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [IF ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)?

C15			I want to confirm that the FIRST romantic or sexual partner who EVER did any of these things to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM C12_01 – C12_10}. Is this correct?
		1		YES …………………………….	{SKIP TO C17}
		2		NO	{GO TO C16}
		-1		DON’T KNOW	{SKIP TO C17}
		-2		REFUSED	{SKIP TO C17}
		-3		LEGITIMATE SKIP	{SKIP TO C17}
NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?
C16			What was your relationship to the first romantic or sexual partner who did any of these things to you?
	_ _ _			[RANGE 100-199]
	-3			LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

C17	How old were you the first time this person did any of these things to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110 YEARS]	{IF AGE > 18 YEARS, SKIP TO C19}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

C18a		Approximately how old was this person the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
		_ _ _		[RANGE 0-110 YEARS] ….. { SKIP TO C19}
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER ASKS 18b BUT DOES NOT PROBE.

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C19	Think about {FILL: “the person” (C11a +C11b=1) / “all of the people”} who made threats to physically harm you or made you feel threatened, fearful, or concerned for your safety or the safety of others, when {FILL: he/she} {FILL: LIST OF STALKING BEHAVIORS ENDORSED IN C01 – D09; – USE THE STALKNG BEHAVIOR FILLS (APPENDIX II)}). How many did any of these things to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 = 5 OR MORE PEOPLE]
	_	[RANGE: 0 - 5] …………………… {IF 0, SKIP TO D_INTRO1a}
	-1	DON’T KNOW ...…………….........	{SKIP TO D_INTRO1a}
	-2	REFUSED …………………………	{SKIP TO D_INTRO1a}
	-3	LEGITIMATE SKIP

NOTE: Were more than five relationships are reported? If so, how many?

PROBE 1: How easy or difficult was it to remember how many people did any of these things to you in the past 12 months?

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INTERVIEWER ASKS C20 BUT DOES NOT PROBE.

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OVERALL PROBES:

PROBE 1: In this section we have asked several questions about times when someone may have given you unwanted attention by repeatedly contacting you, following you, or harassing you. Were there any particular questions that you were unsure what was meant by the questions or what should be included in your answers?

PROBE 2: How did it make you feel to be asked these questions and to have to think about your answers to these questions?

PROBE 3: Did the order in which we asked the questions seem to makes sense to you or did any questions seem out of order? Are there any questions that we should consider moving?

___________________________________________________________________________

Section D: Sexual Violence PART 1 – verbal harassment and sexual coercion

(D_INTRO1a)

I’m going to ask you some detailed questions about times when you may have experienced unwanted sexual situations with anyone, including strangers or someone you knew such as a romantic or sexual partner, a family member, a friend, teacher, co-worker or supervisor, or someone you have known for only a short time. These questions are detailed and the language is explicit, which some people may find upsetting. It is important that I ask the questions this way so that you understand what I mean. Your answers will help us to learn how often these things happen. You can skip questions you don’t want to answer and you can stop at any time.

First, I’m going to ask you about unwanted sexual situations, including verbal harassment and unwanted touching.

D_CHK1

Shall we continue?

1	YES
2	NO …………………….	{BREAK-OFF: THANK & END}
-1	DON’T KNOW ……….	{BREAK-OFF: THANK & END}
-2	REFUSED …………….	{BREAK-OFF: THANK & END}

PROBE 1: What does the phrase “unwanted sexual situations” mean to you as used in this introduction?

PROBE 2: Is the phrase “unwanted sexual situations” clear to you or would you use something different to describe this?

PROBE 3: Was the introduction clear or was there anything confusing?

PROBE 4: Based on the information just read to you, what kinds of people or relationships should be included in your answers to the following questions?

PROBE 5: Are there any kinds of people who should not be included in your answers?

ITEM

QUESTION

RANGE

[1-10]

NONE

REF

LEGIT SKIP

D01

While you were in a public place, how many people have ever verbally harassed you in a sexual way that made you feel uncomfortable?

_ _

{SKIP

-1

-2

D03}

-3

PROBE 1: What does “while you were in a public place” mean to you as it was used in this question?

PROBE 2: What does “verbally harassed you in a sexual way” mean to you in this question?

PROBE 3: Do you think we need to provide examples of what we mean by “verbally harassed you in a sexual way”?

PROBE 4: What types of situations should you include when you’re thinking about your response to this question?

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INTERVIEWER READS BUT DOESN”T PROBE:

D02, D03, D04

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D05_01	Think about the first time anyone {FILL: LIST OF UNWANTED TOUCHING BEHAVIORS ENDORSED IN D03 – D04) – USE THE UNWANTED TOUCHING BEHAVIOR FILLS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or”} when you did not want it to happen. How did you know or what was your relationship with the person who did any of these things to you the FIRST time? IF NECESSARY: “Was this person male or female?” [CODE USING RELATIONSHIP/SEX TEMPLATE (APPENDIX I)]
	_ _ _	[RANGE 100 – XXX]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Who did you include when responding to this question? Why?

PROBE 2: Who are we asking you to think about when responding to this question?

PROBE 3: When we first read the question, did you understand what we were asking for?

PROBE 4: What does “the FIRST time” mean to you in this question?

D06	How old were you the first time this person did any of these things to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110 YEARS] …..	{IF AGE > 18 SKIP TO (D05)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

D07a	Approximately how old was “this person” the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-139, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-189, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110 YEARS] ………. {SKIP TO (D08) }
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER READS D07 BUT DOES NOT PROBE

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ITEM	QUESTION	RELATIONSHIP [RANGE: 100-650]	NO MORE	DK	REF	LEGITSKIP
D05_02	How did you know or what was your relationship with the 2^nd person who did {FILL: “this” (JUST D03) / “any of these things”} to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT.	_ _ _	996	-1	-2	-3
D05_03	How did you know the 3^rd person who did {FILL: “this” (JUST D03) / “any of these things”} to you?	_ _ _	996	-1	-2	-3
D05_04	The 4^th person?	_ _ _	996	-1	-2	-3
D05_05	The 5^th person?	_ _ _	996	-1	-2	-3
:	:
D05_09	The 9^th person?	_ _ _	996	-1	-2	-3
D05_10	The 10^th person?	_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [IF ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)?

D08		I want to confirm that the FIRST romantic or sexual partner who EVER did any of these things to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM D05_01 – D05_10 }. Is this correct?
	1		YES …………………………….	{CODE RELATIONSHIP IN D09}
	2		NO
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

D09		What was your relationship to the first romantic or sexual partner who did {FILL: “this” (JUST D03) / “any of these things”} to you?
	_ _ _		[RANGE 100-199]
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

D10	How old were you the first time this person did {FILL: “this” (JUST D03) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110 YEARS] ……….	{IF AGE > 18 YEARS, SKIP TO D12}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

D11a		Approximately how old was this person the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
		_ _ _		[RANGE 0-110] …….. {SKIP TO D12}
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER READS D11B BUT DOES NOT PROBE

D12	Thinking about the {FILL: “person” (ONLY ONE OF D03 OR D04, ONE PERSON) / “people”} who {FILL: D03 AND/OR D04 BEHAVIORS AS APPROPRIATE – USE THE SEXUAL VIOLENCE BEHAVIOR FILLS (APPENDIX II)} how many did {FILL: “this” (JUST D03) / “these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 = 5 OR MORE PEOPLE]
	_	[RANGE: 0 - 5]
	-1	DON’T KNOW ...……………………..........	{SKIP TO D_INTRO2a}
	-2	REFUSED ……………………………………….	{SKIP TO D_INTRO2a}
	-3	LEGITIMATE SKIP

NOTE: Were more than five relationships are reported? If so, how many?

PROBE 1: How easy or difficult was it to remember how many people did any of these things to you in the past 12 months?

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INTERVIEWER READS D13 BUT DOES NOT PROBE

D14		Approximately how many times in total did {FILL: “this” (IF JUST D03) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer”; IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW; IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” (IF JUST D03) / “these things”} to you in the past 12 months.
	1		ONE TIME
	2		TWO TO FIVE TIMES
	3		SIX TO TEN TIMES
	4		ELEVEN TO TWENTY TIMES
	5		MORE THAN TWENTY TIMES
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

(D_INTRO2a)

Sometimes unwanted sex happens after a person is pressured into it, such as through verbal and emotional pressure and other nonphysical kinds of pressure. The following questions are about times when someone may have used verbal or other nonphysical pressure to make you have sex when you didn’t want to.

PROBE 1: Can you explain to me what types of questions you think we will be asking about in this section? [IF NECESSARY] What topics do you think we will be asking about?

PROBE 2: What does the phrase “verbal and emotional pressure” mean to you?

PROBE 3: What does the phrase “other nonphysical kinds of pressure” mean to you?

How many people have you had vaginal, oral, or anal sex with after they pressured you by doing any of the

following?

ITEM	QUESTION	RANGE [1-10]	NONE			DK		REF		LEGIT SKIP
D15	Telling you lies, making promises about the future they knew were untrue, threatening to end your relationship, or threatening to spread rumors about you?	_ _		0			-1		-2		-3
D16	Wearing you down by repeatedly asking for sex, or showing they were unhappy?	_ _			0		-1		-2		-3
D17	Using their influence or authority over you, for example, your boss or your teacher?	_ _			0		-1		-2		-3

PROBE 1: When we asked about someone using their influence or authority over you, what we were asking about?

PROBE 2: What kinds of sex should respondents include when answering this question?

PROBE 3: Did you remember we were asking for the number of people you have had vaginal, oral, or anal sex with after they pressured you?

PROBE 4: Do you think we need to remind you about this more often?

D18_01

Think about the first time any of these things happened to you.

How did you know or what was your relationship with the person who did any of these things to you the FIRST time?

IF NECESSARY: “Was this person male or female?”

[CODE USING RELATIONSHIP/SEX TEMPLATE (APPENDIX I)]

_ _ _

[RANGE 100-XXX]

-3

LEGITIMATE SKIP

-1

DON’T KNOW

-2

REFUSED

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

D19	How old were you the first time this person did any of these things to you? [RECORD AGE IN YEARS; A VAUE OF 0 = LESS THAN 1 YEAR]
	_ _ _	[RANGE 0-110 YEARS] ………	{IF AGE > 18, SKIP TO (D18)}
	-3	LEGITIMATE SKIP
	-1	DON’T KNOW
	-2	REFUSED

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

D20a		Approximately how old was this person the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did {FILL: “this” / “any of these”} things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
		_ _ _		[RANGE 0-110] …….. {SKIP TO D12}
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

-----------------------------------------------------------------------------------------------------------------------------------------

INTERVIEWER READS D20B BUT DOES NOT PROBE.

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ITEM	QUESTION	RELATIONSHIP [RANGE: 100-650]	NO MORE	DK	REF	LEGIT SKIP
D18_02	How did you know or what was your relationship with the 2^nd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things” to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT.	_ _ _	996	-1	-2	-3
D18_03	How did you know the 3^rd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you?	_ _ _	996	-1	-2	-3
D18_04	The 4^th person?	_ _ _	996	-1	-2	-3
D18_05	The 5^th person?	_ _ _	996	-1	-2	-3
:	:
D18_09	The 9^th person?	_ _ _	996	-1	-2	-3
D18_10	The 10^th person?	_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [IF ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)?

D21		I want to confirm that the FIRST romantic or sexual partner who EVER did {FILL: “this” (JUST D17) / “any of these things“} to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM D18_01-D18-10}. Is this correct?
	1		YES …………………………….	{CODE RELATIONSHIP IN D22}
	2		NO
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

D22		What was your relationship to the first romantic or sexual partner who did {FILL: “this” (JUST D17) / “any of these things”} to you?
	_ _ _		[RANGE 100-199]
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

D23	How old were you the first time this person did {FILL: “this” (JUST D17) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110 YEARS] ……….	{IF AGE > 18 YEARS, SKIP TO D25}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

D24a		Approximately how old was this person the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
		_ _ _		[RANGE 0-110] …….. {SKIP TO D25}
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

---------------------------------------------------------------------------------------------------------------------

INTERVIEWER ASKS D24B, D25, D26 BUT DOES NOT PROBE.

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	D27			Thinking about the {FILL: “person” (ONE BEHAVIOR, ONE PERSON) / “people”} who {FILL: LIST OF COERCIVE BEHAVIORS ENDORSED IN D15 – D17 – USE THE COERCIVE BEHAVIOR FILLS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or”..}, how many did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 = 5 OR MORE PEOPLE]
				_ _		[RANGE: 0 – 5]
				-1		DON’T KNOW ...………………..……..	{SKIP TO E_INTRO1a}
				-2		REFUSED ………………………………….	{SKIP TO E_INTRO1a}
				-3		LEGITIMATE SKIP
	PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months? --------------------------------------------------------------------------------------------------------------------- INTERVIEWER ASKS D28 BUT DOES NOT PROBE. ---------------------------------------------------------------------------------------------------------------------
D29			Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer” IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.
		1			ONE TIME
		2			TWO TO FIVE TIMES
		3			SIX TO TEN TIMES
		4			ELEVEN TO TWENTY TIMES
		5			MORE THAN TWENTY TIMES
		-1			DON’T KNOW
		-2			REFUSED
		-3			LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

OVERALL PROBES:

PROBE 1: In this section we have asked several questions about times when you may have experienced unwanted sexual situations with anyone, including strangers or someone you knew such as a romantic or sexual partner, a family member, a friend, teacher, co-worker or supervisor, or someone you have known for only a short time. Were there any particular questions that you were unsure what was meant by the questions or what should be included in your answers?

PROBE 2: How did it make you feel to be asked these questions and to have to think about your answers to these questions?

PROBE 3: Did the order in which we asked the questions seem to makes sense to you or did any questions seem out of order? Are there any questions that we should consider moving?

_____________________________________________________________________________

SECTION E: SEXUAL VIOLENCE PART 2—RAPE AND MADE TO PENETRATE

E_INTRO1a

In this section I will ask you about situations in which you experienced unwanted sex or sexual contact, which is sexual contact that you did not consent to and that you did not want to happen.

Sometimes unwanted sex or sexual contact happens when a person is unable to consent to it or stop it from happening because they were too drunk, high, drugged, or passed out from alcohol, drugs, or medications. This can include times when they voluntarily consumed alcohol or drugs or times when they were given alcohol or drugs without their knowledge or consent. Please remember that even if someone uses alcohol or drugs, what happens to them is not their fault.

PROBE 1: Can you tell me in your own words what this introduction means?

PROBE 2: What types of questions will we be asking about according to the introduction just read? [IF NECESSARY] What topics do you think we will be asking about?

PROBE 3: What does the phrase “unable to consent or stop it from happening” mean to you as used in this introduction?

PROBE 4: Based on the information just read to you, what kinds of situation should be included in your answers to the following questions?

PROBE 5: Are there any kinds of situations that should not be included in your answers?

PROBE 6: What does the entire phrase “unable to consent or stop it from happening BECAUSE they were too drunk, high, drugged, or passed out from alcohol, drugs, or medications” mean to you?

PROBE 7: Is there anything confusing or unclear about the introduction?

ASK OF FEMALES ONLY

ITEM	QUESTION	RANGE: [1-10]		NONE		DK		REF	LEGIT SKIP
When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many PEOPLE ever did the following when you did not want them to?
E01	Put their mouth on your vagina or anus?	_ _	0		-1		-2		-3
E02	Put their fingers or an object in your vagina or anus?	_ _	0		-1		-2		-3
When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many MALES ever did the following when you did not want them to …
E03	Put their penis in your vagina?	_ _	0		-1		-2		-3
E04	Put their penis in your anus?	_ _	0		-1		-2		-3
E05	Put their penis in your mouth?	_ _	0		-1		-2		-3

ASK OF MALES ONLY

ITEM	QUESTION	RANGE: [1-10]		NONE		DK		REF	LEGIT SKIP
When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many PEOPLE ever did the following when you did not want them to?
E06	Put their fingers or an object in your anus?	_ _	0		-1		-2			-3
When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many FEMALES ever did the following when you did not want them to …
E07	Made you put your penis in their vagina?	_ _	0		-1		-2			-3
E08	Made you put your penis in their mouth?	_ _	0		-1		-2			-3
E09	Made you put your mouth on their vagina?	_ _	0		-1		-2			-3
PROBE 1: We just read the behavior as “put your penis in their mouth”. Do you think it would be more clear to say “put their mouth on your penis?”
When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many MALES ever did the following when you did not want them to …
E10	Made you put your penis in their mouth or anus?	_ _	0		-1		-2			-3
E11	Put their penis in your mouth or anus?	_ _	0		-1		-2			-3
E12	Put their mouth on your anus?	_ _	0		-1		-2			-3

PROBE 1: Can you explain to me in your own words what types of situations we just asked about?

PROBE 2: Who did we ask about having done these things to you in these questions?

PROBE 3: In your opinion, was this set of questions asking about consensual sex while drunk or intoxicated?

PROBE 4: When answering these questions, how easy or difficult was it to distinguish between the different acts we asked about?

PROBE 5: Did the order in which we asked the questions seem to makes sense to you or did any questions seem out of order? Are there any questions that we should consider moving?

The next two questions are about your exposure to alcohol or drugs. Thinking about the times when {FILL: “this” (ONE BEHAVIOR) / “any of these things”} happened to you when you were unable to consent to sex or stop it from happening …

ITEM	QUESTION	YES	NO	DK	REF	LEGIT SKIP
E13	… do you think you were ever given alcohol without your knowledge?	1	2	-1	-2	-3
E14	… do you think you were ever given other drugs without your knowledge?	1	2	-1	-2	-3

PROBE 1: How easy or difficult was it to answer these two questions?

PROBE 2: What types of experiences did you think the last two questions were asking about?

E15_01	Think about the first time anyone {FILL: LIST OF A/D RAPE BEHAVIORS ENDORSED IN E01 –E05 (FEMALE “R”) / E06, E11 – E12 (MALE “R”) – USE THE RAPE BEHAVIOR FILLS (APPENDIX II); SEPARATE LAST TWO BEHAVIORS WITH THE WORD “or” } when you were unable to consent to sex or stop it from happening , because you were too drunk, high, drugged, or passed out from alcohol or drugs. How did you know or what was your relationship with the person who did any of these things to you the FIRST time? IF NECESSARY: “Was this person male or female?” [CODE USING RELATIONSHIP/SEX TEMPLATE (APPENDIX I)
	_ _ _	[RANGE 100-XXX]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Who did you include when responding to this question? Why?

PROBE 2: Who are we asking you to think about when responding to this question?

PROBE 3: What situations are we asking you to think about when responding to this question?

PROBE 4: When we first read the question, did you understand what we were asking for?

PROBE 5: What does “the FIRST time” mean to you in this question?

E16	How old were you the first time this person did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VAUE OF 0 = LESS THAN 1 YEAR]
	_ _ _	[RANGE 0-110] ……………………	{IF AGE > 18, SKIP TO (E15)}
	-3	LEGITIMATE SKIP
	-1	DON’T KNOW
	-2	REFUSED

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E17a		Approximately how old was this person the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did {FILL: “this” / “any of these”} things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE] [RECORD AGE IN YEARS
		_ _ _		[RANGE 0-110] …….. {SKIP TO (E15)}
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

------------------------------------------------------------------------------------------------------------------------------------------

INTERVIEWER READS E17B BUT DOES NOT PROBE

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ITEM	QUESTION	RELATIONSHIP [RANGE: 100-650]	NO MORE	DK	REF	LEGIT SKIP
E15_02	How did you know or what was your relationship with the 2^nd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things” to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT.	_ _ _	996	-1	-2	-3
E15_03	How did you know the 3^rd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you?	_ _ _	996	-1	-2	-3
E15_04	The 4^th person?	_ _ _	996	-1	-2	-3
E15_05	The 5^th person?	_ _ _	996	-1	-2	-3
:	:
E15_09	The 9^th person?	_ _ _	996	-1	-2	-3
E15_10	The 10^th person?	_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [IF ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)?

E18		I want to confirm that the FIRST romantic or sexual partner who EVER did any of these things to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM E15_01 – E15_10}. Is this correct?
	1		YES …………………………….	{CODE RELATIONSHIP IN E19]
	2		NO
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E19		What was your relationship to the first romantic or sexual partner who did any of these things to you?
	_ _ _		[RANGE 100-189]
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E20	How old were you the first time this person did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] ……………………….	{IF AGE > 18, SKIP TO E22}
	-3	LEGITIMATE SKIP
	-1	DON’T KNOW
	-2	REFUSED

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E21a	Approximately how old was {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E20} the first time {FILL: “he” (INTIMATE RELATIONSHIP CODES 101 - 139) / “she” (INTIMATE RELATIONSHIP CODES 151-189)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110 YEARS] ….. {SKIP TO E22}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

------------------------------------------------------------------------------------------------------------------------------------------

INTERVIEWER READS E21B, E22, E23_01 – E23_05 BUT DOES NOT PROBE

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E24		Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer”; IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW; IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.
	1		ONE TIME
	2		TWO TO FIVE TIMES
	3		SIX TO TEN TIMES
	4		ELEVEN TO TWENTY TIMES
	5		MORE THAN TWENTY TIMES
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

(E_INTRO1c)

“Now I am going to ask you about some of the other things that have happened to you.

E25_01	Think about the first time anyone {FILL: LIST OF MTP BEHAVIORS ENDORSED (MALES, E07 – E10) - USE THE MTP BEHAVIOR FILLS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or” } when you were unable to consent to sex or stop it from happening, because you were too drunk, high, drugged, or passed out from alcohol or drugs? How did you know or what was your relationship with the person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you the FIRST time. IF NECESSARY: “Was this person male or female?” [CODE USING THE RELATIONSHIP/SEX TEMPLATE (APPENDIX I)]
	_ _ _	[RANGE 100-XXX]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Who did you include when responding to this question? Why?

PROBE 2: Who are we asking you to think about when responding to this question?

PROBE 3: What situations are we asking you to think about when responding to this question?

PROBE 4: When we first read the question, did you understand what we were asking for?

PROBE 5: What does “the FIRST time” mean to you in this question?

E26	How old were you the first time anyone did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] ……..	{IF AGE > 18, SKIP TO (E25)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E27a	Approximately how old was “this person” the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110 YEARS]	{SKIP TO (E25)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER READS E27B BUT DOES NOT PROBE

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ITEM	QUESTION	RELATIONSHIP [RANGE: 100-650]	NO MORE	DK	REF	LEGIT SKIP
E25_02	How did you know or what was your relationship with the 2^nd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT.	_ _ _	996	-1	-2	-3
E25_03	How did you know the 3^rd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you?	_ _ _	996	-1	-2	-3
E25_04	The 4^th person?	_ _ _	996	-1	-2	-3
E25_05	The 5^th person?	_ _ _	996	-1	-2	-3
:	:
E25_09	The 9^th person?	_ _ _	996	-1	-2	-3
E25_10	The 10^th person?	_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [IF ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)? Do you think other people will tell us about their relationships that meet this definition in time order?

E26		I want to confirm that the FIRST romantic or sexual partner who EVER did any of these things to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM E25_01 – E25_10}. Is this correct?
	1		YES …………………………….	{CODE RELATIONSHIP IN E27]
	2		NO
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E27		What was your relationship to the first romantic or sexual partner who did any of these things to you?
	_ _ _		[RANGE 100-189]
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E28	How old were you the first time this person did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] …………………………	{IF AGE > 18, SKIP TO D40}
	-3	LEGITIMATE SKIP
	-1	DON’T KNOW
	-2	REFUSED

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E29a	Approximately how old was {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E27} the first time {FILL: “he” (INTIMATE RELATIONSHIP CODES 101 - 139) / “she” (INTIMATE RELATIONSHIP CODES 151-189)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110 YEARS]	{SKIP TO E30}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER READS E29B BUT DOES NOT PROBE

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E30	Thinking about the {FILL: “person” (ONE BEHAVIOR, ONE PERSON) / “people”)} who {FILL: LIST OF MTP BEHAVIORS ENDORSED IN E07 – E10 (MALES) – USE THE MTP BEHAVIORS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or”..} when you were unable to consent to sex or stop it from happening , because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 = 5 OR MORE PEOPLE]
	__	[RANGE: 0 – 5]
	-1	DON’T KNOW ...……………............	{SKIP TO E_INTRO2a}
	-2	REFUSED ………………………………….	{SKIP TO E_INTRO2a}
	-3	LEGITIMATE SKIP
PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months? ------------------------------------------------------------------------------------------------------------------ INTERVIEWER READS E31 BUT DOES NOT PROBE ------------------------------------------------------------------------------------------------------------------

E32		Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer”; IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW; IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.
	1		ONE TIME
	2		TWO TO FIVE TIMES
	3		SIX TO TEN TIMES
	4		ELEVEN TO TWENTY TIMES
	5		MORE THAN TWENTY TIMES
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

UNWANTED SEX DUE TO THREATS OF HARM/PHYSICAL FORCE

(E_INTRO2a)

Some people are threatened with harm or physically forced to have sex or sexual contact when they don’t want to. Examples of physical force are being pinned or held down, using violence or threats of violence, or not physically stopping after you said no. To be clear, we are asking only about times when sex was unwanted and you did not give consent.

PROBE 1: Can you tell me in your own words what this introduction means?

PROBE 2: What types of questions will we be asking about according to the introduction just read? [IF NECESSARY] What topics do you think we will be asking about?

PROBE 3: What does the phrase “threatened with harm or physically forced to have sex” mean to you as used in this introduction?

PROBE 4: Based on the information just read to you, what kinds of situation should be included in your answers to the following questions?

PROBE 5: Are there any kinds of situations that should not be included in your answers?

PROBE 6: Is there anything confusing or unclear about the introduction?

ASK OF FEMALE Rs ONLY

ITEM	QUESTION	RANGE: [1-10]		NONE		DK		REF	LEGIT SKIP
How many PEOPLE have ever used physical force or threats of physical harm to …
E33	… put their mouth on your vagina or anus?	_ _	0		-1		-2			-3
E34	… put their fingers or an object in your vagina or anus?	_ _	0		-1		-2			-3
How many MALES have ever used physical force or threats of physical harm to …
E35	… put their penis in your vagina?	_ _	0		-1		-2			-3
E36	… put their penis in your anus?	_ _	0		-1		-2			-3
E37	… put their penis in your mouth?	_ _	0		-1		-2			-3

ASK OF MALE Rs ONLY

ITEM	QUESTION	RANGE: [1-10]		NONE		DK		REF	LEGIT SKIP
How many PEOPLE have ever used physical force or threats of physical harm to …
E38	… put their fingers or an object in your anus?	_ _	0		-1		-2			-3
How many FEMALES have ever used physical force or threats of physical harm to …
E39	… make you put your penis in their vagina?	_ _	0		-1		-2			-3
E40	… make you put your penis in their mouth?	_ _	0		-1		-2			-3
E41	… make you put your mouth on their vagina?	_ _	0		-1		-2			-3
How many MALES have ever used physical force or threats of physical harm to …
E42	… make you put your penis in their mouth or anus?	_ _	0		-1		-2			-3
E43	… put their penis in your mouth or anus?	_ _	0		-1		-2			-3
E44	… put their mouth on your anus?	_ _	0		-1		-2			-3

PROBE 1: Can you explain to me in your own words what types of situations we just asked about?

PROBE 2: Who did we ask about having done these things to you in these questions?

PROBE 3: When answering these questions, how easy or difficult was it to distinguish between the different acts we asked about?

PROBE 4: Did the order in which we asked the questions seem to makes sense to you or did any questions seem out of order? Are there any questions that we should consider moving?-

E45_01	Think about the first time anyone {FILL: LIST OF FORCED RAPE BEHAVIORS ENDORSED IN E53-E57 (FEMALE “R”) / E38, E43-E44 (MALE “R”) – USE THE RAPE BEHAVIOR FILLS (APPENDIX II); SEPARATE LAST TWO BEHAVIORS WITH THE WORD “or” } using physical force or threats of harm . How did you know or what was your relationship with the person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you the FIRST time? IF NECESSARY: “Was this person male or female?” [CODE USING RELATIONSHIP/SEX TEMPLATE (APPENDIX I)
	_ _ _	[RANGE 100-XXX]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Who did you include when responding to this question? Why?

PROBE 2: Who are we asking you to think about when responding to this question?

PROBE 3: What situations are we asking you to think about when responding to this question?

PROBE 4: When we first read the question, did you understand what we were asking for?

PROBE 5: What does “the FIRST time” mean to you in this question?

E46	How old were you the first time this person did any of these things to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] ….. {IF AGE > 18, SKIP TO (E45)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E47a	Approximately how old was “this person” the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110] ….. {SKIP TO (E45)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

ITEM	QUESTION	RELATIONSHIP [RANGE: 100-650]	NO MORE	DK	REF	LEGIT SKIP
E45_02	How did you know or what was your relationship with the 2^nd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things” to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT.	_ _ _	996	-1	-2	-3
E45_03	How did you know the 3^rd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you?	_ _ _	996	-1	-2	-3
E45_04	The 4^th person?	_ _ _	996	-1	-2	-3
E45_05	The 5^th person?	_ _ _	996	-1	-2	-3
:	:
E45_09	The 9^th person?	_ _ _	996	-1	-2	-3
E45_10	The 10^th person?	_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [IF ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)?

E48		I want to confirm that the FIRST romantic or sexual partner who EVER did any of these things to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM THE PULL-DOWN MENU}. Is this correct?
	1		YES …………………………….	{CODE RELATIONSHIP IN E49]
	2		NO
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E49		What was your relationship to the first romantic or sexual partner who did any of these things to you?
	_ _ _		[RANGE 100-189]
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E50	How old were you the first time {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E49} did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] …………………………	{IF AGE > 18, SKIP TO E52}
	-3	LEGITIMATE SKIP
	-1	DON’T KNOW
	-2	REFUSED

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E51a	Approximately how old was {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E49} the first time {FILL: “he” (INTIMATE RELATIONSHIP CODES 101 - 139) / “she” (INTIMATE RELATIONSHIP CODES 151-189)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110] ..…. {SKIP TO E52}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

-------------------------------------------------------------------------------------------------------------------

INTERVIEWER READS BUT DOESN’T PROBE E51B, E52, E53

-------------------------------------------------------------------------------------------------------------------

E54		Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer”; IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW; IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.
	1		ONE TIME
	2		TWO TO FIVE TIMES
	3		SIX TO TEN TIMES
	4		ELEVEN TO TWENTY TIMES
	5		MORE THAN TWENTY TIMES
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

E_INTRO2b

“Now I am going to ask you about some of the other things that have happened to you.

E55_01	Think about the first time anyone FILL: LIST OF MTP BEHAVIORS ENDORSED (MALES, E39 – E42 ) - USE THE MTP BEHAVIOR FILLS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or”} using physical force or threats of harm. How did you know or what was your relationship with the person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you the FIRST time? IF NECESSARY: “Was this person male or female?” [CODE USING THE RELATIONSHIP/SEX TEMPLATE (APPENDIX I)]
	_ _ _	[RANGE 100-XXX]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Who did you include when responding to this question? Why?

PROBE 2: Who are we asking you to think about when responding to this question?

PROBE 3: What situations are we asking you to think about when responding to this question?

PROBE 4: When we first read the question, did you understand what we were asking for?

PROBE 5: What does “the FIRST time” mean to you in this question?

E56	How old were you the first time this person did any of these things to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] ….. {IF AGE > 18, SKIP TO (E55)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E57a	Approximately how old was “this person” the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE] [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110] ….. {SKIP TO (E55)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER READS E57B BUT DOES NOT PROBE

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ITEM	QUESTION	RELATIONSHIP [RANGE: 100-650]	NO MORE	DK	REF	LEGIT SKIP
E55_02	How did you know or what was your relationship with the 2^nd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT.	_ _ _	996	-1	-2	-3
E55_03	How did you know the 3^rd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you?	_ _ _	996	-1	-2	-3
E55_04	The 4^th person?	_ _ _	996	-1	-2	-3
E55_05	The 5^th person?	_ _ _	996	-1	-2	-3
:	:
E55_09	The 9^th person?	_ _ _	996	-1	-2	-3
E55_10	The 10^th person?	_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [IF ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)?

E58		I want to confirm that the FIRST romantic or sexual partner who EVER did any of these things to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM E55_01 – E55_10}. Is this correct?
	1		YES …………………………….	{CODE RELATIONSHIP IN E59]
	2		NO
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E59

What was your relationship to the first intimate partner who did any of these things to you?

_ _ _

[RANGE 100-189]

-3

LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E60	How old were you the first time {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E59} did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] ……………………….	{IF AGE > 18, SKIP TO E62}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

D61a	Approximately how old was {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E60} the first time {FILL: “he” (INTIMATE RELATIONSHIP CODES 101 - 139) / “she” (INTIMATE RELATIONSHIP CODES 151-189)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110 YEARS] ………. {SKIP TO E62}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER READS E61B, E62 BUT DOES NOT PROBE

E62	Thinking about the {FILL: “person” (ONE BEHAVIOR, ONE PERSON) / “people” } who {FILL: LIST OF MTP BEHAVIORS ENDORSED IN E39 – E42 (MALES) – USE THE MTP BEHAVIORS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or”..} using physical force or threats of violence, how many did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 = 5 OR MORE PEOPLE]
	_ _	[RANGE: 0 – 5]
	-1	DON’T KNOW ...……………............	{SKIP TO E_INTRO3a}
	-2	REFUSED ………………………………….	{SKIP TO E_INTRO3b}
	-3	LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months? ----------------------------------------------------------------------------------------------------------------------------------------- INTERVIEWER READS E63_01 – E63_05 BUT DOES NOT PROBE
E64		Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer”; IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW; IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.
	1		ONE TIME
	2		TWO TO FIVE TIMES
	3		SIX TO TEN TIMES
	4		ELEVEN TO TWENTY TIMES
	5		MORE THAN TWENTY TIMES
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

ATTEMPTED PHYSICALLY FORCED SEX

(E_INTRO3a)

The next set of questions are about times when someone ATTEMPTED to have sex or sexual contact with you by using physical force or threats of harm but sex did NOT happen. Examples of physical force are being pinned or held down, using violence or threats of violence, or not physically stopping after you said no. To be clear, we are asking only about times when sex was unwanted and you did not give consent.

PROBE 1: Can you tell me in your own words what this introduction means?

PROBE 2: What types of questions will we be asking about according to the introduction just read? [IF NECESSARY] What topics do you think we will be asking about?

PROBE 3: What does the phrase “not physically stopping after you said no” mean to you as used in this introduction?

PROBE 4: Based on the information just read to you, what kinds of situation should be included in your answers to the following questions?

PROBE 5: Are there any kinds of situations that should not be included in your answers?

PROBE 6: Is there anything confusing or unclear about the introduction?

ASK OF FEMALE Rs ONLY

ITEM	QUESTION	RANGE: [1-10]		NONE		DK		REF	LEGIT SKIP
How many PEOPLE have ever used physical force or threats of physical harm to …
E65	… TRY to put their mouth on your vagina or anus but it did not happen?	_ _	0		-1		-2		-3
How many MALES have ever used physical force or threats of physical harm to …
E66	…TRY to put their penis in your vagina, anus or mouth, but it did not happen?	_ _	0		-1		-2		-3

ASK OF MALE Rs ONLY

ITEM	QUESTION	RANGE: [1-10]		NONE		DK		REF	LEGIT SKIP
How many PEOPLE have ever used physical force or threats of physical harm to …
E67	… TRY to make you put your penis in their mouth, but it did not happen?	_ _	0		-1		-2		-3
How many FEMALES have ever used physical force or threats of physical harm to …
E68	… TRY to make you put your penis in their vagina, but it did not happen?	_ _	0		-1		-2		-3
E69	… TRY to make you put your mouth on their vagina but it did not happen?	_ _	0		-1		-2		-3
How many MALES have ever used physical force or threats of physical harm to …
E70	… TRY to put their penis in your mouth or anus, but it did not happen?	_ _	0		-1		-2		-3
E71	… TRY to put their mouth on your anus, but it did not happen?	_ _	0		-1		-2		-3

PROBE 1: Can you explain to me in your own words what types of situations we just asked about?

PROBE 2: Who did we ask about having done these things to you in these questions?

PROBE 3: Did the order in which we asked the questions seem to makes sense to you or did any questions seem out of order? Are there any questions that we should consider moving?-

E72_01	Think about the first time anyone {FILL: LIST OF RAPE BEHAVIORS ENDORSED IN E65-E66 (FEMALES) / E70-E71 (MALES) – USE THE RAPE BEHAVIOR FILLS (APPENDIX II); SEPARATE LAST TWO BEHAVIORS WITH THE WORD “or” } using physical force or threats of harm, but sex DID NOT happen? How did you know or what was your relationship with the person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you the FIRST time? IF NECESSARY: “Was this person male or female?” [CODE USING RELATIONSHIP/SEX TEMPLATE (APPENDIX I)
	_ _ _	[RANGE 100-XXX]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Who did you include when responding to this question? Why?

PROBE 2: Who are we asking you to think about when responding to this question?

PROBE 3: What situations are we asking you to think about when responding to this question?

PROBE 4: When we first read the question, did you understand what we were asking for?

PROBE 5: What does “the FIRST time” mean to you in this question?

E73	How old were you the first time this person did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] …..	{IF AGE > 18, SKIP TO (E72)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E74a	Approximately how old was “this person” the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110] ….. {SKIP TO (E72)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER READS BUT DOES NOT PROBE E74B

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ITEM	QUESTION	RELATIONSHIP [RANGE: 100-650]		NO MORE	DK	REF	LEGIT SKIP
E72_02	How did you know or what was your relationship with the 2^nd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things” to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT.		_ _ _	996	-1	-2	-3
E72_03	How did you know the 3^rd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you?		_ _ _	996	-1	-2	-3
E72_04	The 4^th person?		_ _ _	996	-1	-2	-3
E72_05	The 5^th person?		_ _ _	996	-1	-2	-3
:	:
E72_09	The 9^th person?		_ _ _	996	-1	-2	-3
E72_10	The 10^th person?		_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [IF ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)?

E75	I want to confirm that the FIRST romantic or sexual partner who EVER did any of these things to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM E75_01 – E75_10 }. Is this correct?
		1	YES …………………….	{CODE RELATIONSHIP IN E76]
		2	NO
		-1	DON’T KNOW
		-2	REFUSED
		-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E76		What was your relationship to the first intimate partner who did any of these things to you?
	_ _ _		[RANGE 100-189]
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E77	How old were you the first time {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E76} did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] ………………………	{IF AGE > 18, SKIP TO E79}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E78a	Approximately how old was {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E76} the first time {FILL: “he” (INTIMATE RELATIONSHIP CODES 101 – 139) / “she” (INTIMATE RELATIONSHIP CODES 151-189)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110 YEARS] …… {SKIP TP E79}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

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INTERVIEWER READS BUT DOES NOT PROBE E78B, E79, E80_01-E80_05

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E81		Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer”; IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW; IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.
	1		ONE TIME
	2		TWO TO FIVE TIMES
	3		SIX TO TEN TIMES
	4		ELEVEN TO TWENTY TIMES
	5		MORE THAN TWENTY TIMES
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

(E_INTRO3b)

“Now I am going to ask you about some of the other things that have happened to you.

E82_01	Think about the first time anyone {FILL: LIST OF MTP BEHAVIORS ENDORSED (MALES, E67 – E69) - USE THE MTP BEHAVIOR FILLS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or”} using physical force or threats of harm. How did you know or what was your relationship with the person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you the FIRST time? IF NECESSARY: “Was this person male or female?” [CODE USING THE RELATIONSHIP/SEX TEMPLATE (APPENDIX I)]
	_ _ _	[RANGE 100-XXX]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Who did you include when responding to this question? Why?

PROBE 2: Who are we asking you to think about when responding to this question?

PROBE 3: What situations are we asking you to think about when responding to this question?

PROBE 4: When we first read the question, did you understand what we were asking for?

PROBE 5: What does “the FIRST time” mean to you in this question?

E83	How old were you the first time this person did {FILL: “this” / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110 YEARS]	{IF AGE > 18, SKIP TP (E81)}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E84a	Approximately how old was “this person” the first time {FILL: “he” (RELATIONSHIP CODES 100-139, 200-239, 300-339, 400-439, 500-539, 600) / “she” (RELATIONSHIP CODES 150-189, 250-289, 350-389, 450-489, 550-589, 650)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110] ….. {SKIP TO (E81) }
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

------------------------------------------------------------------------------------------------------------------------------------------

INTERVIEWER READS E84B BUT DOES NOT PROBE

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(E81)

[IF SUM E67 – E69 (MALES) > 1, ASK …]

ITEM	QUESTION	RELATIONSHIP	NO MORE	DK	REF		LEGIT SKIP
E81_02	How did you know or what was your relationship with the 2^nd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? IF NECESSARY: Was this person male or female? INTERVIEWER: CODE 996 (NO MORE) THE FIRST TIME THE R INDICATES THAT THERE ARE NO ADDITIONAL RELATIONSHIPS TO REPORT.	_ _ _	996	-1	-2	-3
E81_03	How did you know the 3^rd person who did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you?	_ _ _	996	-1	-2	-3
E81_04	The 4^th person?	_ _ _	996	-1	-2	-3
E81_05	The 5^th person?	_ _ _	996	-1	-2	-3
:	:
E81_09	The 9^th person?	_ _ _	996	-1	-2	-3
E81_10	The 10^th person?	_ _ _	996	-1	-2	-3

PROBE 1: In what order did you provide these relationships? [ORDER OTHER THAN CHRONOLOGICAL] How did you decide what order to report these relationships?

PROBE 2: [IF NECESSARY] Did you tell us about the relationships in the order they happened (over time)?

E85	I want to confirm that the FIRST romantic or sexual partner who EVER did any of these things to you was {FILL: “a” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” {FILL: FIRST INTIMATE RELATIONSHIP FROM E81_01 – E81_10 }. Is this correct?
		1	YES …………………………..	{CODE RELATIONSHIP IN E86}
		2	NO
		-1	DON’T KNOW
		-2	REFUSED
		-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E86	What was your relationship to the first romantic or sexual partner who did any of these things to you?
		_ _ _	[RANGE 100-189]
		-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

E87	How old were you the first time {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E86} did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110] …………………………	{IF AGE > 18, SKIP TO E89}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time this person did any of these things to you?

E88a	Approximately how old was {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP E86} the first time {FILL: “he” (INTIMATE RELATIONSHIP CODES 101 - 139) / “she” (INTIMATE RELATIONSHIP CODES 151-189)} did any of these things to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110 YEARS] …. {SKIP TP E89}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old this person was the first time he/she did any of these things to you?

------------------------------------------------------------------------------------------------------------------------------------------

INTERVIEWER READS E88B BUT DOES NOT PROBE

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E89	Thinking about the {FILL: “person” (ONE BEHAVIOR, ONE PERSON) / “people”} who {FILL: LIST OF MTP BEHAVIORS ENDORSED E67 – E69 (MALES) – USE THE MTP BEHAVIORS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or”..} using physical force or threats of violence, how many did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 = 5 OR MORE PEOPLE]
	_	[RANGE: 0 – 5]
	-1	DON’T KNOW ...……………............	{SKIP TO F_INTRO }
	-2	REFUSED ………………………………….	{SKIP TO F_INTRO }
	-3	LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months? ----------------------------------------------------------------------------------------------------------------------------------------- INTERVIEWER READS E90_01 – E90_05 BUT DOES NOT PROBE -----------------------------------------------------------------------------------------------------------------------------------------
E91		Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer”; IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW; IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.
	1		ONE TIME
	2		TWO TO FIVE TIMES
	3		SIX TO TEN TIMES
	4		ELEVEN TO TWENTY TIMES
	5		MORE THAN TWENTY TIMES
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

--------------------------------------------------------------------------------------------------------------------------------

INTERVIEWER READS E_INTRO4, E92, E93, E94, E95, E96 BUT DOES NOT PROBE

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OVERALL PROBES:

PROBE 1: In this section we asked several questions about situations in which you experienced unwanted sex or sexual contact that you did not consent to and that you did not want to happen. Were there any questions that you were unsure what was meant or what should be included?

PROBE 2: How did it make you feel to be asked these questions and to have to think about your answers to these question?

PROBE 3: Did the order in which we asked the questions seem to makes sense or did any questions seem out of order? Are there any questions that we should consider moving?

PROBE 4: How easy or difficult was it for you to remember whether any of these things have happened to you?

PROBE 5: Were there any questions that were confusing or hard to understand?

PROBE 6: IF MULTIPLE TYPES OF SV VIOLENCE (Alcohol/Drug Rape, Forced Rape, Attempted Rape, Sexual Coercion) How difficult or easy was it for you to keep track of the different types of circumstances we discussed throughout the last section?

SECTION F: PSYCHOLOGICAL AGGRESSION

(F_INTRO)

The next questions ask about experiences you may have had with your romantic or sexual partners. When I ask about your romantic or sexual partners, I want you to think about anybody you have been involved with romantically or sexually, which might include spouses, boyfriends, girlfriends, people you have dated, people you were seeing, or people you hooked up with.

INTERVIEWER: IF R ASKS IF THEY SHOULD INCLUDE, OR IF R INDICATES INCLUDING PHYSICAL VIOLENCE, TELL THE R PHYSICAL VIOLENCE DOES NOT COUNT HERE.

ITEM	QUESTION	RANGE: [1-10]		NONE		DK		REF
How many of your current or ex-romantic or sexual partners have ever ... INTERVIEWER: THE LEAD-IN PHRASE (“HOW MANY OF YOUR…HAVE EVER”) MUST BE READ BEFORE THE FIRST ITEM BELOW IN EACH SECTION. READ AS NECESSARY FOR THE REMAINING ITEMS.
F01	… insulted, humiliated, or made fun of you in front of others?	_ _	0		-1		-2
F02	… kept you from having your own money?	_ _	0		-1		-2
F03	… tried to keep you from seeing or talking to your family or friends?	_ _	0		-1		-2
F04	… kept track of you by demanding to know where you were and what you were doing?	_ _	0		-1		-2
How many of your current or ex-romantic or sexual partners have ever ...
F05	… made threats to physically harm you?	_ _	0		-1		-2
F06	… threatened to hurt themselves or commit suicide because they were upset with you?	_ _	0		-1		-2
F07	… made decisions that should have been yours to make?	_ _	0		-1		-2
F08	… destroyed something that was important to you?	_ _	0		-1		-2

PROBE 1: Have there been any occasions where someone did one of these things to you, but you weren’t certain if it should count or not? Why?

PROBE 2: How easy or difficult was it to remember whether any of these things had happened to you?

PROBE 3: In these questions, who were we asking for you to report having done these things to you?

PROBE 4: In these questions, what timeframe were we asking about when these things happened to you?

PROBE 5: Did you remember that we were asking for the number of current or ex-romantic or sexual partners who have ever done these things?

PROBE 6: Would it be helpful if we reminded you about this more often?

F09	How old were you the first time a current or ex-romantic or sexual partner did {FILL: “this” (ONE BEHAVIOR, ONE PERSON) / “any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110 YEARS] ……….	{IF AGE > 18 YEARS, SKIP TO F11}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

F10a	Approximately how old was “this person” the first time {FILL: “he” (RELATIONSHIP CODES 100-139,) / “she” (RELATIONSHIP CODES 150-189)} did {FILL: “this” (ONE BEHAVAIOR) / ”any of these things”} to you? [IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
		_ _ _	[RANGE 0-110 YEARS] ………. {SKIP TO F12}
		-1	DON’T KNOW
		-2	REFUSED
		-3	LEGITIMATE SKIP

PROBE 1: Was it easy or hard to remember how old you were and how old “this person” was the first time this/any of these things happened?

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INTERVIEWER READS BUT DOES NOT PROBE:

F10b

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	F11		How many current or ex-romantic or sexual partners have done {FILL: “this” (JUST ONE OF F01-F08) / “any of these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 = 5 OR MORE PEOPLE]
			_			[RANGE: 0-5]
			-1			DON’T KNOW ...……………..................	{SKIP TO G_INTRO1a}
			-2			REFUSED ……………………………………….	{SKIP TO G_INTRO1a}
			-3			LEGITIMATE SKIP
PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

F12				Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer” IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW IF NECESSARY: “In total” refers to your combined experiences across all current or ex-romantic sexual partners in the past 12 months.
		1			ONE TIME
		2			TWO TO FIVE TIMES
		3			SIX TO TEN TIMES
		4			ELEVEN TO TWENTY TIMES
		5			MORE THAN TWENTY TIMES

PROBE 1: (IF ASKED F12) How easy or difficult was it to remember how many times these things happened in the past 12 months?

OVERALL PROBES

PROBE 1: Were there any behaviors that someone might have done toward you, but you weren’t sure if they counted or not?

PROBE 2: Were there other behaviors we should have asked you about but didn’t?

PROBE 3: How easy or difficult is it to remember whether any of these things happened?

PROBE 4: How did it make you feel to be asked these questions and to have to think about your answers to these questions?

SECTION G: PHYSICAL VIOLENCE

(G_INTRO1a)

The next questions are related to physical acts you may have experienced with your romantic or sexual partners.

ITEM	QUESTION	RANGE [1-10]		NONE		DK		REF
How many of your current or ex-romantic or sexual partners have ever…
G01	… slapped you?	_ _	0		-1		-2
G02	Pushed or shoved you?	_ _	0		-1		-2

G03	How old were you the first time a current or ex-romantic or sexual partner did {FILL: “this” (JUST G01) / ”any of these things”} to you? [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

PROBE 1: Was it easy or hard to remember how old you were the first time a current or ex-romantic or sexual partner did any of these things to you?

G04	How many current or ex-romantic or sexual partners have done {FILL: “this” (JUST G01)/ “any of these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 =5 OR MORE PEOPLE]
	__	[RANGE: 0 - 5]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: Were more than five relationships are reported? If so, how many?

PROBE 1: How easy or difficult was it to remember how many people did any of these things to you in the past 12 months?

(G_INTRO1b)

We want to continue to ask you about other physical acts you might have ever experienced by a current or ex-romantic or sexual partner in your lifetime.

ITEM	QUESTION	RANGE [1-10]		NONE		DK		REF
How many of your current or ex-romantic or sexual partners have ever … INTERVIEWER: THE LEAD-IN PHRASE (“HOW MANY OF YOUR…HAVE EVER”) MUST BE READ BEFORE THE FIRST ITEM BELOW IN EACH SECTION. READ AS NECESSARY FOR THE REMAINING ITEMS.
G05	… hit you with a fist or something hard?	_ _	0		-1		-2
G06	… kicked you?	_ _	0		-1		-2
G07	… hurt you by pulling your hair?	_ _	0		-1		-2
How many of your current or ex-romantic or sexual partners have ever …
G08	… slammed you against something?	_ _	0		-1		-2
G09	… tried to hurt you by choking or suffocating you?	_ _	0		-1		-2
How many of your current or ex-romantic or sexual partners have ever …
G10	… beaten you?	_ _	0		-1		-2
G11	… burned you on purpose?	_ _	0		-1		-2
G12	… used a knife on you?	_ _	0		-1		-2
G13	… used a gun on you?	_ _	0		-1		-2

PROBE 1: Have there been any occasions where someone did one of these things to you, but you weren’t certain if it should count or not? Why?

PROBE 2: How easy or difficult was it to remember whether any of these things had happened to you?

PROBE 3: In these questions, who were we asking for you to report having done these things to you?

PROBE 4: In these questions, what timeframe were we asking about when these things happened to you?

PROBE 5: Did you remember that we were asking for the number of current or ex-romantic or sexual partners who have ever done these things?

PROBE 6: Do you think you needed to be reminded bout this more often?

G14	How old were you the first time a current or ex-romantic or sexual partner {FILL: LIST OF SEVERE PHYSICAL ACT BEHAVIORS ENDORSED IN G05-G13 – USE THE SEVERE PHYSICAL VIOLENCE BEHAVIOR FILLS (APPENDIX II) - SEPARATE THE LAST TWO BEHAVIORS ENDORSED WITH “or”}. [RECORD AGE IN YEARS; A VALUE OF 0 = LESS THAN 1 YEAR OLD]
	_ _ _	[RANGE 0-110]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: Was it easy or hard to remember how old you were the first time a current or ex-romantic or sexual partner did any of these things to you?

G15	How many current or ex-romantic or sexual partners have done {FILL: “this” (ONE BEHAVIOR, ONE PERSON)/ “these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? [A VALUE OF 5 = 5 OR MORE PEOPLE]
	__	[RANGE: 0 – 5]
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

PROBE 1: How easy or difficult was it for you to answer how many times this happened in the past 12 months?

G16		Think about {FILL: “the person” (ONLY ONE OF G01, G02, G05 – G13 ENDORSED AND ONLY 1 PERSON) / “all of the people”} who {FILL: ENDORSED BEHAVIORS G01, G02, G05-G13 - USE THE PHYSICAL VIOLENCE BEHAVIOR FILLS (APPENDIX II); SEPARATE THE LAST TWO BEHAVIORS WITH THE WORD “or”} in your lifetime. What was your relationship with the current or ex-romantic or sexual partner who did {FILL: “this” (ONE BEHAVIOR)/ “any of these things”} to you the FIRST time IF NECESSARY: “Was this person male or female?” [CODE USING RELATIONSHIP/SEX TEMPLATE (APPENDIX I)]
	_ _ _		[RANGE 100-199]
	-1		DON’T KNOW
	-2		REFUSED
	-3		LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

PROBE 1: How easy or difficult was it what your relationship was with the person who did this/any of these things to you the FIRST time?

PROBE 2: When we first read the question, did you understand what we were asking for?

PROBE 3: What does “the FIRST time” meant to you in this question?

G17a	Approximately how old was {FILL: “this person” (INTIMATE RELATIONSHIP CODES 111, 112, 139, 161, 162, 189)/ “your” INTIMATE RELATIONSHIP G16} the first time {FILL: “he” (INTIMATE RELATIONSHIP CODES 101 - 139) / “she” (INTIMATE RELATIONSHIP CODES 151-189)} did {FILL: “this” (ONE BEHAVIOR) / “any of these things”} to you? IF NECESSARY: IF “R” PROVIDES A RANGE OR “R” DOES NOT KNOW, ASK THEM TO APPROXIMATE [RECORD AGE IN YEARS]
	_ _ _	[RANGE 0-110] …… {SIP TO G18}
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?

---------------------------------------------------------------------------------------------------------------------

IF G17a is DK/REFUSED INTERVIEWER READS BUT DOES NOT PROBE:

G17b

---------------------------------------------------------------------------------------------------------------------

	G18			What was your relationship with the {FILL: “first” (SUM G04+G15>1)} current or ex-romantic or sexual partner who did {FILL: “this” (ONE BEHAVIOR)/ “any of these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “Was this person male or female?” [CODE USING RELATIONSHIP/SEX TEMPLATE (APPENDIX I)]
				_ _ _		[RANGE 100-139, 150-189]
				-1		DON’T KNOW
				-2		REFUSED
				-3		LEGITIMATE SKIP
NOTE: How did the respondent think through this question? Is there any confusion? Any problems with the current order of the question?
G19			Approximately how many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}? IF NECESSARY: “I just need an approximate answer” IF “R” GIVES A RESPONSE THAT SPANS CATEGORIES: “Would you say …” READ AFFECTED RESPONSE OPTIONS BELOW IF “R” DOES NOT KNOW: “Would you say …” READ RESPONSE OPTIONS 1-5 BELOW. IF NECESSARY: “In total” refers to your combined experiences across all of the people who did {FILL: “this” ONE BEHAVIOR) / “these things”} to you in the past 12 months.]
		1			ONE TIME
		2			TWO TO FIVE TIMES
		3			SIX TO TEN TIMES
		4			ELEVEN TO TWENTY TIMES
		5			MORE THAN TWENTY TIMES
		-1			DON’T KNOW
		-2			REFUSED
		-3			LEGITIMATE SKIP

PROBE 1: How easy or difficult was it to remember how many times these things happened in the past 12 months?

OVERALL PROBES

PROBE 1: Were there any behaviors that someone might have done toward you, but you weren’t sure if they counted or not?

PROBE 2: Were there other behaviors we should have asked you about but didn’t?

PROBE 3: How easy or difficult is it to remember whether some of these things happened?

PROBE 4: How did it make you feel to be asked these questions and to have to think about your answers to these questions?

_____________________________________________________________________________

SECTION H: INTIMATE PARTNER VIOLENCE FOLLOW-UP

(H_INTRO)

We want to talk now about the consequences of the different experiences that you have shared with us involving a current or ex-romantic or sexual partner. These could be physical acts, unwanted sexual situations, or repeated unwanted attempts to contact, follow, or harass you. We are interested in understanding the consequence of these experiences for you.

PROBE 1: Can you tell me in your own words what this introduction means?

PROBE 2: [IF NECESSARY] What types of questions will we be asking about according to the introduction I just read? [IF NECESSARY] What topics do you think we will be asking about?

PROBE 3: Did you think this introduction was clear or was anything confusing?

You told me previously that current or ex romantic or sexual partners have {fill: all endorsed behaviors from all sections – See Appendix II*}.

ITEM	QUESTION	YES	NO	DK	REF	LEGIT SKIP
H01	When any of those things happened, … were you ever concerned for your safety?	1	2 {SKIP	-1 TO	-2 H03}	-3
H02	Were you concerned for your safety in the past 12 months?	1	2	-1	-2	-3
H03	… were you ever fearful for yourself or someone close to you?	1	2 {SKIP	-1 TO	-2 H05}	-3
H04	Were you fearful in the past 12 months?	1	2	-1	-2	-3

Thinking back to the physical acts, unwanted sexual situations, or repeated unwanted attempts to contact, follow, or harass you by a current or ex romantic or sexual partner …

ITEM	QUESTION	YES	NO	DK	REF	LEGIT SKIP
H05	… did you ever have nightmares?	1	2	-1	-2	-3
H06	… did you ever try hard not to think about or go out of your way to avoid being reminded of the things that were done to you?	1	2	-1	-2	-3
H07	… did you ever feel like you were constantly on guard, watchful, or easily startled?	1	2	-1	-2	-3
H08	… did you ever feel numb or detached from others, your activities, or your surroundings?	1	2	-1	-2	-3

PROBE 1: What types of situations or behaviors should you include when you’re thinking about your response to these questions?

PROBE 2: Have there been any occasions when you experienced these types of things, but you weren’t certain if it should count or not? Why?

PROBE 3: How easy or difficult was it to remember whether you had experienced these things?

PROBE 4: Did you remember that we were asking you to think back to the physical acts, unwanted sexual situations, or repeated unwanted attempts to contact, follow, or harass you by a current or ex romantic or sexual partner?

PROBE 5: Do you think you needed to be reminded bout this more often?

You told me that you {FILL: LIST PTSD SYMPTOMS ENDORSED IN H05-H08 – USE THE SYMPTOMS OF PTSD BEHAVIOR FILLS (APPENDIX II); SEPARATE THE LAST TWO SYMPTOMS WITH THE WORD “or”} because of what a current or ex-romantic or sexual partner did to you.

H09	Did you ever feel this way in the past 12 months?
	1	YES
	2	NO
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

Because of what a current or ex-romantic or sexual partner did to you, did you ever experience …

ITEM	QUESTION	YES	NO	DK	REF	LEGIT SKIP
H10	… minor bruises or scratches?	1	2	-1	-2	-3
H11	… cuts, major bruises, or black eyes?	1	2	-1	-2	-3
H12	… any other physical injuries?	1	2 {SKIP	-1 TO	-2 H18}	-3

PROBE 1: What were we asking you to think about when responding to these questions?

PROBE 2: What types of situations were you thinking about?

I am going to read you a list of other possible injuries. Please tell me which of these you have experienced because of the physical acts, unwanted sexual situations, or repeated unwanted attempts to contact, follow, or harass you by a current or ex romantic or sexual partner.

ITEM	QUESTION	YES	NO	DK	REF	LEGIT SKIP
H13	Injury to any ligaments, muscles or tendons?	1	2	-1	-2	-3
H14	Broken bones or teeth?	1	2	-1	-2	-3
H15	Back or neck injury?	1	2	-1	-2	-3
H16	Being knocked out after getting hit, slammed against something or choked?	1	2	-1	-2	-3
H17	A head injury?	1	2	-1	-2	-3

PROBE 1: What types of experiences did you include when answering these questions?

PROBE 2: What types of people or relationships should be included when answering these questions?

PROBE 3: What types of physical acts, unwanted sexual situations, or repeated unwanted attempts to contact, follow or harass you were you thinking about?

PROBE 4: In your opinion, is the question asking you about injuries you received as a result of the experiences you told us about earlier or is it asking for something else?

PROBE 5: Did you remember we were asking you to include injuries you have experienced because of the physical acts, unwanted sexual situations, or repeated unwanted attempts to contact, follow, or harass you by a current or ex romantic or sexual partner?

PROBE 6: Do you think you needed to be reminded about this more often?

ITEM	QUESTION		YES			NO			DK			REF		LEGIT SKIP
H18	Did you ever experience mental or emotional harm because of what a current or ex-romantic or sexual partner did to you?		1	2			-1			-2			-3
[IF ANY OF H10-H12 OR H18 IS YES, ASK H19]
H19	Did you ever need medical care because of what a current or ex-romantic or sexual partner did to you?		1	2 {SKIP			-1 TO			-2 H21}			-3
H20	Were you able to get the medical care you needed?	1			2			-1			-2				-3
H21	Were you injured in the past 12 months because of any of the things a current or ex-romantic or sexual partner did to you?	1			2 {SKIP			-1 TO			-2 H23}				-3
[IF H19=YES AND H21=YES, ASK…]
H22	Did you need medical care for any of these injuries in the past 12 months?	1			2			-1			-2				-3

Now I am going to read you a list of services and other types of assistance you might have needed.

ITEM	QUESTION	YES		NO		DK		REF		LEGIT SKIP
H23	Have you ever talked to a crisis hotline operator about what a current or ex-romantic or sexual partner did to you?	1	2		-1		-2		-3
H24	Did you ever need housing services because of the things a current or ex-romantic or sexual partner did to you?	1	2		-1		-2		-3
H25	Did you ever need victim’s advocate services?	1	2		-1		-2		-3
H26	Did you ever need help from law enforcement because of the things a current or ex-romantic or sexual partner did to you?	1	2 {SKIP		-1 TO		-2 H28}		-3
H27	Did you need help from law enforcement in the past 12 months?	1	2		-1		-2		-3
H28	Did you ever need legal services or the advice of an attorney?	1	2		-1		-2		-3

PROBE 1: What instances or situations should a respondent include when answering the last question, “Did you ever need legal services or the advice of an attorney?”

PROBE 2: [IF YES to H28] What specific types of situations or services did you include in your answer?

ITEM	QUESTION	RANGE: [1-365 DAYS]		NO DAYS		DK		REF		NA
H29	About how many days of work did you ever have to miss when a current or ex-romantic or sexual partner did these things to you?	_ _ _	0 {SKIP		-1 TO		-2 H31}		-3
H30	In the past 12 months how many days of work did you have to miss when a current or ex-romantic or sexual partner did these things to you?	_ _ _	0		-1		-2		-3
H31	About how many days of school did you ever have to miss when a current or ex-romantic or sexual partner did these things to you?	_ _ _	0 -1 -2 -3 {SKIP TO H33}
H32	In the past 12 months how many days of school did you have to miss when a current or ex-romantic or sexual partner did these things to you?	_ _ _	0		-1		-2		-3

PROBE 1: These questions ask about how many days of work or school that you have had to miss because an ex-romantic or sexual partner did these things to you. What types of things did they do that you were thinking about?

PROBE 2: When you answered the questions about work, tell me about instances you thought about including or did include in your answer?

PROBE 3: How easy or difficult was it to think about how many days of work you ever had to miss? Can you tell me how you thought through that?

PROBE 4: When you answered the questions about school, tell me what instances you thought about including or did include in your answer?

PROBE 5: How easy or difficult was it to think about how many days of work you ever had to miss because of school? Can you tell me how you thought through that?

These next two questions are about children under the age of 18.

H33	Did a child under the age of 18 currently living in your household ever see or hear their parent or guardian being pushed, slapped, hit, punched, or beat up by that person’s current or ex romantic or sexual partner?
	1	YES
	2	NO
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

H34	Did a child under the age of 18 currently living in your household ever see or hear their parent or guardian being insulted, humiliated, or threatened with physical harm by that person’s current or ex romantic or sexual partner?
	1	YES
	2	NO
	-1	DON’T KNOW
	-2	REFUSED
	-3	LEGITIMATE SKIP

PROBE 1: How do you feel about being asked about children within your household in these questions?

______________________________________________________________________________

SECTION J: NORMATIVE BEHAVIORS

(J_INTRO)

We have asked you about your experiences related to health and injuries. The next section is going to ask you about your thoughts about some of the topics we discussed. I want your honest opinion about each of these statements. There are no right or wrong answers.

PROBE 1: Based on the introduction just read to you, what do you think is different about the questions we are going to be asking now compared to those questions you have already answered?

PROBE 2: Can you tell me in your own words what this introduction is telling you?

For each of the following questions, please tell me whether you: Strongly Agree, Agree, Neither Agree nor Disagree, Disagree, or Strongly Disagree.

ITEM	STATEMENT	Strongly Agree	Agree	Neither	Disagree	Strongly Disagree	DK	REF
J03	Men and women should have equal say in all aspects of their relationship.	1	2	3	4	5	-1	-2
J04	Hitting or slapping is sometimes ok within an intimate relationship.	1	2	3	4	5	-1	-2
J05	It is not necessary to get consent before sexual activity if you are in a relationship with that person.	1	2	3	4	5	-1	-2
J06	When a friend makes disrespectful comments about their romantic or sexual partner, I indicate my disapproval to that friend.	1	2	3	4	5	-1	-2
J07	When someone makes sexual comments, jokes, or gestures, I say something to try to get them to stop.	1	2	3	4	5	-1	-2

PROBE 1: How easy or difficult was it for you to answer these questions.

PROBE 2: Did you understand that we are asking about your opinions on these statements?

Next, we want to know more about how you feel about helping others who are at risk of intimate partner violence.

For each of the following questions, please tell me whether you: Strongly Agree, Agree, Neither Agree nor Disagree, Disagree, or Strongly Disagree.

ITEM	STATEMENT		Strongly Agree	Agree	Neither	Disagree	Strongly Disagree	DK	REF
J08	I feel that intimate partner violence between other people is a private matter and is not my concern.		1	2	3	4	5	-1	-2
J09		I have doubts that I could recognize situations that could result in someone else being a victim of intimate partner violence.	1	2	3	4	5	-1	-2
J10		I have doubts that I would know what to say or do to stop intimate partner violence among others if I were to see a situation that could turn violent between intimate partners.	1	2	3	4	5	-1	-2
J11		Even when I’m not involved and it’s not about me, I can make a difference in helping to prevent violence by intimate partners.	1	2	3	4	5	-1	-2
J12		People can be taught what to do or say to help stop intimate partner violence from happening between others in the first place.	1	2	3	4	5	-1	-2

PROBE 1: What were your answer options for those last questions?

PROBE 2: [FOR RESPONDENTS THAT ENDORSED PHYSICAL VIOLENCE]: How easy or difficult was it for you to answer these questions?

PROBE 3: Were there any questions here you thought were confusing or weren’t sure how to answer? IF SO, which ones and why?

Now we would like to know your opinions about helping others when they are at risk for sexual violence. Sexual violence includes sex or sexual contact that is both unwanted and without the person’s consent. Examples of sexual violence are physically forced sex, attempted forced sex, or having sex with someone when they are unable to consent or stop it because they are too drunk, high, drugged or passed out.

For each of the following questions, please tell me whether you: Strongly agree, Agree, Neither agree nor disagree, Disagree, or Strongly disagree.

ITEM	STATEMENT	Strongly Agree	Agree	Neither	Disagree	Strongly Disagree	DK	REF
J13	I feel that sexual violence between other people is a private matter and is not my concern	1	2	3	4	5	-1	-2
J14	I have doubts about my ability to recognize situations that could result in someone else being a victim of sexual violence.	1	2	3	4	5	-1	-2
J15	I have doubts that I would know what to say or do to stop sexual violence if I were to see a situation that could result in someone else being a victim.	1	2	3	4	5	-1	-2
J16	Even when I’m not involved and it’s not about me, I can make a difference in helping to prevent sexual violence.	1	2	3	4	5	-1	-2
J17	People can be taught what to do or say to help stop sexual violence from happening between others in the first place.	1	2	3	4	5	-1	-2

PROBE 1: What were your answer options for those last questions?

PROBE 2: [FOR RESPONDENTS THAT ENDORSED SEXUAL VIOLENCE] How easy it or difficult was it for you to answer these questions?

PROBE 3: Were there any questions here you thought were confusing or weren’t sure how to answer? IF SO, which ones and why?

OVERALL PROBES:

PROBE 1: Do you think this set of questions should be at the end of the survey or would it be better to move them earlier in the survey?

PROBE2: Is there anything about these questions that you would change?

PROBE 3: How honest do you think people will be when answering these questions?

SECTION: WRAP-UP

---------------------------------------------------------------------------------------------------------------------

INTERVIEWER READS BUT DOES NOT PROBE:

---------------------------------------------------------------------------------------------------------------------

Debriefing Items

PROBE 1: We currently introduce the survey as a study on health and injuries and then give more details when we move to the sections about violence. Do you think we should describe it in a different way?

PROBE 2: More specifically, what would you think of our introducing the study by saying, “The CDC is conducting a study on health, aggression, and injuries” instead of “The CDC is conducting a study on health and injuries”?

PROBE 3: We switched directions and topics a lot in this survey. How easy or difficult was it for you to follow along and answer the questions?

PROBE 4: Were there any questions I asked that were confusing or unclear to you?

PROBE 5: Were there any questions you think I should have asked about, but I didn’t?

PROBE 6: Did any of the questions seem repetitive, like you had already answered them? Which ones?

PROBE 7: The current order of the survey first asks about stalking, then sexual violence, then physical violence. Do you have any concerns about the order in which these sections were asked?

PROBE 8: Were there any particular questions that you found particularly upsetting?

PROBE 9: How did it make you feel to be asked these types of questions and to have to think about your answers to these questions?

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	National Survey on Violence Against Women and Men
Author	brhodes
File Modified	0000-00-00
File Created	2021-01-24