18-Month Survey
Ready to Work Partnership Grants Evaluation 18-Month Follow-up Survey
RTW_OMB_18 Month Survey_FINAL 10 20
18-Month Survey
OMB: 1291-0010
Hello, my name is [ ]. May I please speak with _____?
Thank you for taking the time to talk with me today. I work for Abt SRBI. Abt SRBI is an independent research company and we are helping the U.S. Department of Labor with this study of job training programs. We are conducting this survey to help understand how well training and employment programs work to help people find and keep jobs. Thank you for agreeing to participate in this job training evaluation.
This interview will include questions on your participation in education and training activities, and your employment experiences. This interview will take about 40 minutes to complete. When we are done, we will send you a $25 money order or gift card, as a token of appreciation for your time. We need to talk with everyone who agreed to participate in the study. Your participation in this study and your experiences will help policymakers and program administrators better understand how to help people find jobs.
Before we begin the survey, I would like to remind you that your participation in this survey is voluntary. That means you may choose not to answer any question, or you may stop the interview if you wish, but we hope you don’t. Your responses to these questions will in no way affect your participation in any programs or your receipt of any kinds of public benefits or services. I want to assure you that all of your responses on this survey will be kept private to the extent permitted by law; your name will not appear in any written reports we produce. The information you provide will be kept private.
According to the Paperwork Reduction Act (PRA), an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is ****-**** and it expires xx/xx/xxxx. If you have comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, please send them to [Contact Name]; [Contact Address]; Attn: OMB-PRA (xxxxxxx).Do you have any questions before we begin?
Let’s begin now.
Screener/Verification:
First I just need to verify that I am speaking with the correct person.
A1. What is your date of birth? ___________
Respondent’s Birthday: ________ / ________ / ____________
MM DD YYYY
REFUSED 97
DON’T KNOW 98
IF DOB AGREES WITH THE BIRTH DATE ON THE FILE, SKIP TO B1. ELSE, CONTINUE.
A2. What are the last 4 digits of your Social Security Number?
RECORD LAST 4 DIGITS: ___ ___ ___ ___
REFUSED 97
DON’T KNOW 98
IF THE 4 DIGITS GIVEN BY RESPONDENT AGREE WITH THE NUMBER ON THE FILE, SKIP TO B1.
IF SSN IS MISSING IN THE SAMPLE OR IS A MISMATCH WITH WHAT IS ENTERED AND THERE IS A MISMATCH IN DOB, DISPLAY DISCONTINUED TEXT:
DISCONTINUED TEXT: I’m sorry. I was unable to pull up the correct questionnaire. I will need to check with my supervisor to look into the problem. I will re-contact you when the problem is resolved. Thank you for your time.
Note for OMB Review:
Yellow text boxes indicate sources for questions. Interviewers will
not see these boxes. They will only be visible to instrument
reviewers.
The main item sources are: The
follow-up survey for the Green Jobs and Health Care (GJ-HC) Impact
Evaluation, conducted by Abt Associates for the Department of Labor
(DOL) (OMB No. 1205-0506). The
36-month combined follow-up survey for the Pathways for Advancing
Careers and Education (PACE) Evaluation and the Health Profession
Opportunity Grants (HPOG) Evaluation, currently being conducted by
Abt Associates for the Administration for Children and Families
(ACF) at the Department of Health and Human Services (OMB No.
0970-0394). The
15-month follow-up survey for the PACE Evaluation, being conducted
by Abt Associates for ACF (OMB No. 0970-0397). The
Baseline Information Form (BIF) for the Ready to Work (RTW)
Evaluation, conducted by Abt Associates for DOL (OMB No.
1205-0507). The
15-month follow-up survey for the Workforce Investment Act (WIA)
Adult and Dislocated Worker Program Gold Standard Evaluation,
developed by Mathematica Policy Research for DOL (OMB No.
1205-0504). New
questions are identified as such.
Note for OMB Review: Grey text boxes provide explanations on question order and section structure. Interviewers will not see these boxes. They will only be visible to instrument reviewers. |
Most of the questions in this interview refer back to the time when you applied to the [NAME OF RTW GRANT-FUNDED PROGRAM PROVIDER] for a program called [NAME OF RTW GRANT-FUNDED PROGRAM] on [Random Assignment Date (henceforth RAD)]. If I say that date as part of the questions, we will ask you to recall things that have happened since then. You may recall signing a consent form and completing a short survey at that time as part of this study.
To start, I would like to discuss the types of classes, courses, or training you have participated in since [RAD], either through [NAME OF RTW GRANT-FUNDED PROGRAM] or from schools and other training providers you found on your own.
Source: Unless otherwise noted, all questions in Section B
(“Training and Education”) come
from the GJ-HC
Follow-Up Survey.
B1a. To begin, since [RAD], have you attended any adult basic education classes for improving reading and math skills, or GED classes?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B1b. What about courses for credit towards a college degree? This can include courses offered by a community college, a 2-year or a 4-year college on the campus, or offered online. Please do not include recreational courses or other kinds of courses that don’t provide credit towards a college degree.
Since [RAD] have you attended any “for credit” college courses?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B1c. And what about vocational courses or training programs for a specific job, trade, or occupation? By vocational training, we mean courses or programs where you are trained for a specific occupation, which usually leads to a certificate, license, or credential. Please do not include courses for college credit, or on-the-job training programs.
Since [RAD] have you attended any vocational or job-specific training programs?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B1d. Since [RAD], have you attended any courses focusing on study skills, workplace skills, or general life skills? Here we mean courses like those on how to be a successful student, how to take tests, how to manage your time, how to work well within a team, how to manage your finances, how to be a good employee, and other skills of that nature. We’re only talking about courses we have not yet discussed.
PROBE: These courses might be called workshops or group discussions. These courses and workshops may cover topics such as career planning, critical thinking, time management, staying motivated, and acting professional (for example, how to dress, show good attendance habits, or be respectful).
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B2.
[If Respondent was assigned to treatment group, and B1b/B1c/B1d
all = 2, R, or D]:
Our records indicate that approximately
18 months ago, you enrolled in the [NAME OF RTW GRANT-FUNDED PROGRAM]
program offered by [NAME OF RTW GRANT-FUNDED PROGRAM PROVIDER]. Do
you remember participating in that program?
Yes 1
No 2 (SKIP TO B4)
REFUSED 97 (SKIP TO B4)
DON’T KNOW 98 (SKIP TO B4)
B3. [If B2 = 1]: What types of classes did you take at [NAME OF RTW GRANT-FUNDED PROGRAM PROVIDER]? Were they…
SELECT ALL THAT APPLY:
Adult basic education or GED classes, 1
Courses for credit towards a college degree, 2
A vocational or training program for a specific job, trade, or occupation, or 3
Courses focusing on study skills, workplace skills, or general life skills? 4
REFUSED 97
DON’T KNOW 98
B4. [If B1a = 1 or B3 = 1]:
How many adult basic
education courses or GED programs have you participated in since
[RAD]? If the classes were held over multiple sessions, please count
that as one course. Please include all courses that you started, even
if you did not complete them.
PROBE: We are only asking for courses that started after [RAD].
| | NUMBER OF PROGRAMS
REFUSED 97
DON’T KNOW 98
B5. [If B1b = 1 or B3 = 2]:
Overall, how many for-credit
college programs have you participated in since [RAD]?
Please
include those that you started, even if you did not complete them.
IF
MORE THAN ONE, PROBE:
Were these separate programs, or
different courses for the same program?
INTERVIEWER: Do
not report multiple courses that are part of one degree program.
Only report the number of separate credential/degree programs.
| | NUMBER OF PROGRAMS
REFUSED 97
DON’T KNOW 98
B6. [If B1c = 1 or B3 = 3]:
Overall, how many vocational
training or job-specific training programs have you participated in
since [RAD]? Please include those that you started, even if you did
not complete them.
IF
MORE THAN ONE, PROBE:
Were these separate programs, or
different courses for the same program?
INTERVIEWER: Do
not report multiple courses that are part of one program.
Only
report the number of separate credential/degree programs.
| | NUMBER OF PROGRAMS
REFUSED 97
DON’T KNOW 98
B7. [If B1d = 1 or B3 = 4]:
Overall, how many courses
focusing on study skills, workplace skills, or general life skills
have you participated in since [RAD]? Please include all courses that
you started, even if you did not complete them.
| | NUMBER OF PROGRAMS
REFUSED 97
DON’T KNOW 98
I am now going to ask you a few questions about the program/programs you mentioned above. If you don’t know the exact information, your best guess is fine.
NOTE: Questions B8 through B18 will be asked for each of the following types of programs attended:
For the sake of brevity, in this document we do not repeat the questions for each type of program, but instances where questions vary by program type are noted. The set of questions will only be asked of those respondents who reported that they participated in at least one program of the given type in Questions B1a through B1d or B3. |
B8a. For [GIVEN TYPE OF PROGRAM] please tell me who offered this program?
IF PROVIDER UNKNOWN, PROBE: Where did you attend this program?
ONE: ___________________________________________
TWO: ___________________________________________
THREE: _________________________________________
FOUR: __________________________________________
FIVE: ___________________________________________
REFUSED 97
DON’T KNOW 98
NOTE: School/training provider names used to guide interview flow.
B8b. Please tell me the names of each program you took at [FILL NAME
OF PROVIDER IN
B8a ONE/TWO/THREE/FOUR/FIVE].
ONE: ___________________________________________
TWO: ___________________________________________
THREE: _________________________________________
FOUR: __________________________________________
FIVE: ___________________________________________
REFUSED 97
DON’T KNOW 98
NOTE: Program names used to guide interview flow.
B9. [Repeat
for each provider listed in B8a]:
And what type of place is
[FILL NAME OF PROVIDER IN B8a]?
SELECT ONE FOR EACH OF (ONE/TWO/THREE/FOUR/FIVE):
Company where respondent works, 1
Community college/2-year college, 2
4-year college or university, 3
State unemployment or employment office, 4
American Job Center/Workforce Center, 5
Adult education/adult high school/community school/night school, 6
Private company that provides training, 7
Community-based organization/non-profit organization, or 8
Someplace else? (SPECIFY)______________ 99
REFUSED 97
DON’T KNOW 98
NOTE: For each provider listed in Question B8a, Questions B10 through B22 will be asked for each program listed in Question B8b. |
B10. When did you start taking [PROGRAM NAME] offered by [PROVIDER NAME]?
| | | / | | | / | | | | |
MONTH DAY YEAR
REFUSED 97
DON’T KNOW 98
B11. Did you complete the [PROGRAM NAME] offered by [PROVIDER NAME] by finishing all of the coursework or program requirements, or are you still taking the training, or did you stop taking the training?
Completed the (course/training program), 1
Still taking the (course/training program), 2
Stopped taking the (course/training program)/dropped out, 3 (SKIP TO B13)
REFUSED 97
DON’T KNOW 98
B12. When (did/will) [PROGRAM NAME] at [PROVIDER NAME] end?
| | | / | | | / | | | | | (SKIP TO B14)
MONTH DAY YEAR
REFUSED 97
DON’T KNOW 98
B13. [If B11 = 3]: When did you stop taking [PROGRAM NAME] at [PROVIDER NAME]?
| | | / | | | / | | | | |
MONTH DAY YEAR
REFUSED 97
DON’T KNOW 98
Source: New question
B14. If you took multiple courses for this program, spread over multiple months or semesters, for how many total weeks were you attending class, combined, across all of these courses? If you were taking two or more courses at the same time, only count those weeks once. Your best guess is fine.
______________________ WEEKS (SKIP TO B16)
Did not take multiple courses 1
Took multiple courses, but took them at the same time 2
REFUSED 97
DON’T KNOW 98
Source: New question
B15. Do you think the number of weeks you were attending class was roughly between…
1 to 8 weeks, 1
9 to 16 weeks, 2
17 to 24 weeks, 3
25 to 40 weeks, 4
41 to 80 weeks, or 5
More than 80 weeks? 6
REFUSED 97
DON’T KNOW 98
Source: WIA Gold Standard 15-Month Survey
B16. How many hours per week (did/do) you attend [PROGRAM NAME] in a typical week?
PROBE: Do not include time spent outside of class studying or doing homework. Only time spent attending class should be included.
IF RESPONDENT SAYS THEY TOOK ONLINE CLASSES,
PROBE: Only include the time you spent online actually taking classes. Do not include time spent studying or doing homework.
______________________ (HOURS) (SKIP TO B18)
REFUSED 97
DON’T KNOW 98
Source: WIA Gold Standard 15-Month Survey
B17. Would you say you attend(ed) class for [PROGRAM NAME]...?
Less than 1 hour per week, 1
1 or more but less than 5 hours per week, 2
5 or more but less than 10 hours per week, 3
10 or more but less than 20 hours per week, 4
20 or more but less than 30 hours per week, 5
30 or more but less than 40 hours per week, 6
40 or more hours per week? 7
REFUSED 97
DON’T KNOW 98
B18. [If B11 = 3]: What was the main reason that you stopped taking [PROGRAM NAME]?
Poor grades 1
Courses or program poorly taught 2
Started other school/training 3
Not enough money to continue 4
Not enough time to continue 5
Not interested/didn’t like the program 6
Didn’t think it would help me find a job 7
Illness 8
Pregnancy 9
Child care issues 10
Other family reasons 11
Transportation/logistical issues 12
Personal problems 13
Found job/re-employed 14
Other (SPECIFY)____________________________ 99
REFUSED 97
DON’T KNOW 98
Source: Modified GJ-HC Follow-Up Survey
B19. [For adult basic education and GED courses only]:
[If
B11 = 1]: Did you take and pass a test for the GED or receive
another type of certificate?
PROBE: If response is “yes” or “no,” probe for which answer category.
Yes – GED 1
Yes – Other 2
No – additional classes required 3
No – took GED but did not pass it 4
No – finished but did not pass the coursework or required exam(s) 5
No – did not take a test 6
No – no certificate offered 7
REFUSED 97
DON’T KNOW 98
Source: Modified PACE 15-Month Survey
B20a.
[Questions 20a – 20i for for-credit college programs only]:
In what major field of study or type of work (was/is)
[PROGRAM NAME]?
REFUSED 97
DON’T KNOW 98
B20b. [If B11 = 1 or 2]: How many credits (did you/will you) earn for completing this program?
PROBE:
Only
count credits that count toward a college degree such as an
Associate or Bachelor’s degree.
(CREDITS)
REFUSED 97
DON’T KNOW 98
Source: Modified GJ-HC Follow-Up Survey
B20c. [If B11 = 1]:Were you awarded a diploma, certificate or academic degree?
PROBE: If response is “no,” probe for which answer category.
Yes 1
No – additional classes required 2 (SKIP TO B20h)
No – finished but did not pass the coursework or required exam(s) 3 (SKIP TO B20h)
REFUSED 97 (SKIP TO B20h)
DON’T KNOW 98 (SKIP TO B20h)
Source: Modified GJ-HC Follow-Up Survey (Additions from
(Additional answer
choices from HPOG/PACE 36-Month Survey)
B20d. [If B11 = 1 and B20c = 1]: What type of diploma, certificate, or degree were you awarded?
A diploma or certificate requiring less than a full year’s worth of credit 1
A diploma or certificate requiring a full year or more’s worth
of credit
(but less than an Associates Degree) 2
Associates Degree 3
Bachelor’s Degree 4
Master’s Degree 5
Doctorate/PhD 6
Professional degree (MD, JD, etc.) 7
Other (SPECIFY)____________________________ 99
REFUSED 97
DON’T KNOW 98
Source: HPOG/PACE 36-Month Survey
B20e.
[If B11 = 1]: When did you receive this diploma, certificate
or degree?
Please give me the month and year.
| | | / | | | | |
MONTH YEAR
REFUSED 97
DON’T KNOW 98
B20f. [If B11 = 1 and B20d = 1 or 2]: Were you awarded this diploma or certificate from…?
PROBE: Some certificates or diplomas are awarded by the state, or by an industry or professional association. These tend to be professional certifications or a license showing that you are qualified to perform a specific job, like Certified Medical Assistant, Licensed Realtor, or an IT certification.
The school/college/university? 1 (SKIP TO B20h)
A federal, state, or local government, 2
A professional or trade association, 3
A business or company, 4
Another group or organization (SPECIFY)_________________________ 99
REFUSED 97
DON’T KNOW 98
B20g. [If B11 = 1 and B20f = 2, 3, 4, or 99]: What is the name of the professional, state, or industry certification, license, or credential you received?
REFUSED 97
DON’T KNOW 98
B20h. Have you obtained a job in this field since taking [PROGRAM NAME]?
Yes 1
No 2 (SKIP TO B21a)
REFUSED 97
DON’T KNOW 98
B20i. [If B20h = 1]: In your opinion, how useful (is/was) the knowledge from this program to that job? (Is/Was) it…
Useful, 1
Somewhat useful, 2
Not useful, or 3
Too soon to know? 4
REFUSED 97
DON’T KNOW 98
B21a.
[Questions 21a through 21l for vocational training
programs only]:
What is the primary job, trade, or work
that you are being prepared to perform?
REFUSED 97
DON’T KNOW 98
Source: New question
B21b. (Does/Did) [PROGRAM NAME] include realistic settings to practice your skills?
PROBE: For example, opportunities to draw blood, change adult diapers, weld parts together, or hook up local computer networks?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Source: New question
B21c. (Does/Did) [PROGRAM NAME] include trips to visit potential employers?
PROBE: For example, to observe the work being done, to talk to current workers in the field, or to listen to employers talk about the skills they value in their future employees?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Source: Modified GJ-HC Follow-Up Survey
B21d. [If B11 = 1]: Were you awarded a training certificate, license, or credential?
PROBE: If response is “no,” probe for which answer category.
Yes 1
No – program did not offer one 2 (SKIP TO B21i)
No – additional classes required 3 (SKIP TO B21i)
No – finished but did not pass the coursework or required exam(s) 4 (SKIP TO B21i)
REFUSED 97
DON’T KNOW 98
B21e. [If B11 = 1 and B21d= 1]: When did you receive this training certificate, license, or credential?
| | | / | | | | |
MONTH YEAR
REFUSED 97
DON’T KNOW 98
Source: HPOG/PACE 36-Month Survey
B21f. [If B11 = 1]: Who issued the certificate, license, or credential?
PROBE: Some certificates or diplomas are awarded by the state, or by an industry or professional association. These tend to be professional certifications or a license showing that you are qualified to perform a specific job, like Certified Medical Assistant, Licensed Realtor, or an IT certification.
The training program/school, 1 (SKIP TO B21h)
A federal, state, or local government, 2
A professional or trade association, 3
A business or company, 4
Another group or organization (SPECIFY)_______________________ 99
REFUSED 97
DON’T KNOW 98
B21g. [If B11 = 1 and B21f = 2, 3, 4, or 99]: What is the name of the professional, state, or industry certification, license, or credential you received?
REFUSED 97
DON’T KNOW 98
B21h. [If B11 = 1]: What kind of work is this certification or license for? For example: teaching, vocational nursing, computer network administration, auditing, or truck driving.
REFUSED 97
DON’T KNOW 98
B21i. Did you get a new job as a result of taking [PROGRAM NAME]?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B21j. [If B21i = 1]: In your opinion, how useful (is/was) the knowledge from this program to that job? (Is/Was) it…
Useful, 1
Somewhat useful, 2
Not useful, or 3
Too soon to know? 4
REFUSED 97
DON’T KNOW 98
B21k. Did you receive a promotion at a job as a result of taking [PROGRAM NAME]?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B21l. [If B21k = 1]: In your opinion, how useful (is/was) the knowledge from this program to your new position after your promotion? (Is/Was) it…
Useful, 1
Somewhat useful, 2
Not useful, or 3
Too soon to know? 4
REFUSED 97
DON’T KNOW 98
B22. [For study skills, workplace skills, or general life-skills
programs only]:
[If B11 = 1]: Did you receive a training
certificate, license, or credential?
PROBE: If response is “no,” probe for which answer category.
Yes 1
No – additional classes required 2
No – finished but did not pass the coursework or required exam(s) 3
No – no certificate offered 4
REFUSED 97
DON’T KNOW 98
B23. [All]: In addition to any certificates, licenses, or credentials that we have already discussed, did you receive any additional certificates, licenses, or credentials since [RAD]?
Yes 1
No 2 (SKIP TO B31a)
REFUSED 97
DON’T KNOW 98
B24. How many additional certificates, licenses, or credentials did you receive since [RAD]?
| | | NUMBER
REFUSED 97
DON’T KNOW 98
NOTE: Questions B25 through B30 are asked of every
certificate, license, or credential reported |
B25. When did you receive this training certificate, license, or credential?
| | | / | | | | |
MONTH YEAR
REFUSED 97
DON’T KNOW 98
Source: HPOG/PACE 36-Month Survey
B26. Who issued the certificate, license, or credential?
A federal, state, or local government, 1
A professional or trade association, 2
A business or company, 3
Another group or organization (SPECIFY)_________________________ 99
REFUSED 97
DON’T KNOW 98
B27. What is the name of the professional, state, or industry certification, license, or credential you received?
REFUSED 97
DON’T KNOW 98
B28. What kind of work is this certification or license for? For example: teaching, vocational nursing, computer network administration, auditing, or truck driving.
REFUSED 97
DON’T KNOW 98
B29. Did you get a new job as a result of receiving this certificate, license, or credential?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B30.
In your opinion, how useful (is/was) this certificate, license, or
credential to that job?
(Is/Was) it…
Useful, 1
Somewhat useful, 2
Not useful, or 3
Too soon to know? 4
REFUSED 97
DON’T KNOW 98
Source: Modified GJ-HC Follow-Up Survey
B31a. Since
[RAD], have worked in an unpaid internship?
An internship is a
temporary position with an organization, pubic agency, or company. An
unpaid internship is an internship for which you were not paid a wage
or salary.
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B31b. Since
[RAD], have you worked in a paid internship?
An internship is a
temporary position with an organization, pubic agency, or company. A
paid internship is one for which you were paid a wage or salary.
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B31c. Since [RAD], have you worked in an on-the-job training position, where you were paid and the employer received a subsidy for your wage?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
NOTE: Questions B32 through B43 will be asked for each of the unpaid or paid internships, or on-the-job training positions. As above, for the sake of brevity, in this document we do not repeat the questions for each type of training. The set of questions will only be asked of those respondents who reported that they participated in at least one training of the given type in Question B31a through B31c. |
B32. For each (paid internship, unpaid internship, period of on-the-job training), please tell me where you received this training.
IF
PROVIDER UNKNOWN, PROBE: For instance, this could be the
organization
or company where you trained or did your
internship.
ONE: ___________________________________________
TWO: ___________________________________________
THREE: _________________________________________
FOUR: __________________________________________
FIVE: ___________________________________________
REFUSED 97
DON’T KNOW 98
NOTE: Training location names only used to guide interview flow.
NOTE: Questions B33 through B43 are asked of every internship/on-the-job training listed in B32. |
Source: Modified GJ-HC Follow-Up Survey
B33. And what type of place is [FILL NAME LISTED IN B32]?
SELECT ONE FOR EACH OF (ONE/TWO/THREE/FOUR/FIVE):
Company where respondent is a regular full- or part-time employee, 1
Another private for-profit company where respondent is not otherwise employed, 2
A public-sector employer other than a training center, 3
A not-for-profit
organization (including an educational institution), other than one
that focuses on employment training, 4
A public-sector training center, 5
A not-for-profit
organization (including an educational institution) that focuses
on
employment training, or 6
Someplace else? (SPECIFY)____________________________ 99
REFUSED 97
DON’T KNOW 98
B34. When did you start this (internship/on-the-job training)?
| | | / | | | / | | | | |
MONTH DAY YEAR
REFUSED 97
DON’T KNOW 98
B35. When (did/will) the (internship/on-the-job training) end?
| | | / | | | / | | | | |
MONTH DAY YEAR
REFUSED 97
DON’T KNOW 98
B36. On average, how many hours per week (do/did) you spend in this (internship/on-the-job training)?
______________________ (HOURS) (SKIP TO B38)
REFUSED 97
DON’T KNOW 98
B37. Would you say...?
Less than 5 hours per week, 1
5 or more, but less than 10 hours per week, 2
10 or more, but less than 20 hours per week, 3
20 or more, but less than 30 hours per week, 4
30 or more, but less than 40 hours per week, 5
40 or more hours per week? 6
REFUSED 97
DON’T KNOW 98
B38. What kind of work were you learning in this (internship/on-the-job training)?
PROBE: What type of job was this training for?
REFUSED 97
DON’T KNOW 98
B39. Did this (internship/on-the-job training) turn into a permanent position?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
B40. Did you get a new job as a result of this (internship/on-the-job training)?
Yes 1
No 2 (SKIP TO B42)
REFUSED 97
DON’T KNOW 98
B41. In your opinion, how useful (is/was) the training and experience you received in the (internship/on-the-job training) to that job? (Is/was) it…
Useful, 1
Somewhat useful, 2
Not useful, or 3
Too soon to know? 4
REFUSED 97
DON’T KNOW 98
B42. Did you receive a promotion at a job as a result of this (internship/on-the-job training)?
Yes 1
No 2 (SKIP TO B44)
REFUSED 97
DON’T KNOW 98
B43. In your opinion, how useful (is/was) the training and experience you received in the (internship/on-the-job training) to your new position after your promotion? (Is/was) it…
Useful, 1
Somewhat useful, 2
Not useful, or 3
Too soon to know? 4
REFUSED 97
DON’T KNOW 98
Source: Modified PACE 15-Month Survey
B44. [All]: Now consider all the types of courses and training programs you have received since [RAD]. I’m going to read a list of “general skills” topics that are sometimes covered. Across all of these courses and training programs combined, for each skill listed below, please tell me whether it received a great deal of attention, some attention, or no attention at all.
|
SELECT ONE RESPONSE PER ROW |
||||
|
Great Deal of Attention |
Some Attention |
No Attention |
REF |
DK |
a. Career planning. |
1□ |
2□ |
3□ |
97□ |
98□ |
b. Study skills, such as locating information, taking notes, and preparing for classes and exams. |
1□ |
2□ |
3□ |
97□ |
98□ |
c. Finding a job or moving to a different job. |
1□ |
2□ |
3□ |
97□ |
98□ |
d. Critical thinking and problem-solving skills. |
1□ |
2□ |
3□ |
97□ |
98□ |
e. Finding help with problems at school, work, or home. |
1□ |
2□ |
3□ |
97□ |
98□ |
f. Finding and applying for financial aid for school. |
1□ |
2□ |
3□ |
97□ |
98□ |
g. Managing time effectively. |
1□ |
2□ |
3□ |
97□ |
98□ |
h. Working in groups. |
1□ |
2□ |
3□ |
97□ |
98□ |
i. Communicating well (for example, good listening and speaking skills). |
1□ |
2□ |
3□ |
97□ |
98□ |
j. Managing stress, anger, and frustration. |
1□ |
2□ |
3□ |
97□ |
98□ |
k. Staying motivated. |
1□ |
2□ |
3□ |
97□ |
98□ |
l. Acting professionally (for example, how to dress, show good attendance habits, be respectful). |
1□ |
2□ |
3□ |
97□ |
98□ |
m. Managing money and personal finances. |
1□ |
2□ |
3□ |
97□ |
98□ |
n. Handling parenting and other family responsibilities. |
1□ |
2□ |
3□ |
97□ |
98□ |
In the next set of questions we are interested in the types of assistance and services you may have received from the places you took the courses or training programs that we have just discussed.
Source: Unless otherwise noted, all questions in Section C
(“Training-Related Supports”) come from the GJ-HC
Follow-Up Survey.
NOTE: Questions C1 and C2 will be asked for each of the types of training discussed in Section B:
As above, for the sake of brevity, in this document we do not repeat the questions for each type of program. The set of questions will only be asked of those respondents who reported that they participated in at least one program of the given type in Questions B1a through B1d or B3, and will be asked of each provider listed in Question B8a. |
C1. I am interested in help you may have received paying for tuition for the course(s)/training program(s) you took at [PROVIDER NAME]. I’m going to read a list of funding sources that you might have used to pay for tuition. For each item, please tell me if the funding source helped pay for these expenses since [RAD].
|
SELECT ONE RESPONSE PER ROW |
|||
|
Yes |
No |
REF |
DK |
a. Program was free of charge. |
1□ |
2□ |
97□ |
98□ |
b. Financial support from [PROVIDER NAME]. |
1□ |
2□ |
97□ |
98□ |
c. Your own earnings. |
1□ |
2□ |
97□ |
98□ |
d. Earnings from a spouse or partner. |
1□ |
2□ |
97□ |
98□ |
e. Savings – either your own, or a spouse or partner’s savings. |
1□ |
2□ |
97□ |
98□ |
f. Financial help from a parent or other family member. |
1□ |
2□ |
97□ |
98□ |
g. Loans in your name. |
1□ |
2□ |
97□ |
98□ |
h. Loans in your parents’ name. |
1□ |
2□ |
97□ |
98□ |
i. Pell grant or other government grant or scholarship – not counting loans that you have to pay back. |
1□ |
2□ |
97□ |
98□ |
j. Grants or scholarships from any non-government source, such as a community-based or non-profit organizations – not counting loans that you have to pay back. |
1□ |
2□ |
97□ |
98□ |
k. Financial support from your employer. |
1□ |
2□ |
97□ |
98□ |
l. Funds from a one-stop career center or state unemployment/employment office. |
1□ |
2□ |
97□ |
98□ |
m. Another funding source |
1□ |
2□ |
97□ |
98□ |
Source: Modified GJ-HC Follow-Up Survey (Additions from
(additions from
HPOG/PACE 36-Month Survey)
C2. Now I want to ask about any additional support services you may have received from [PROVIDER NAME]. For each type of assistance, please tell me if you received this type of assistance at any time since [RAD].
-
NOTE: See grid on following page for list of types of assistance, and response options.
C2a. [If C2 = 1]: How many times did you receive this type of support service since [RAD] from [PROVIDER NAME]?
C2b. [If C2a = R, D]: If you don’t remember a specific number of times, can you provide a range?
|
C2 |
C2a |
C2b |
||||||||||
|
Yes |
No |
REF |
DK |
How many times? |
REF |
DK |
1-2 times? |
3-4 times? |
5-6 times? |
7+ times? |
REF |
DK |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
|
|
97□ |
98□ |
|
97□ |
98□ |
|
|
|
|
|
|
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
|
1□ |
2□ |
97□ |
98□ |
____ |
97□ |
98□ |
1□ |
2□ |
3□ |
4□ |
97□ |
98□ |
C3. Now we want to ask about assistance that you may have received from other types of organizations. Since [RAD], did you receive any of the following types of assistance from any organization, including, but not limited to, the education or training providers we already talked about:
SELECT ALL THAT APPLY:
Career counseling? 1
Job placement assistance? 2
Job readiness training? 3
Assistance with mental health issues? 4
Assistance with other issues, such as housing, or substance abuse? 5
Clothes or uniforms? 6
Child care assistance? 7
Assistance with transportation? 8
Tools? 9
Books or supplies? 10
Any other type of assistance? (SPECIFY)______________ 99
REFUSED 97
DON’T KNOW 98
Source: Modified PACE 15-Month Survey
C4.
[If Respondent assigned to treatment group]:
Overall,
how useful was the [NAME OF RTW GRANT-FUNDED PROGRAM] in helping you
do each of the following?
Would you say it was very useful,
somewhat useful, or not at all useful?
|
SELECT ONE RESPONSE PER ROW |
||||
|
Very Useful |
Somewhat Useful |
Not at All Useful |
REF |
DK |
a. Did the services you received help you train for work in a particular occupation? |
1 □ |
2 □ |
3 □ |
97 □ |
98 □ |
b. Did the services provided help you continue your education in the long term? |
1 □ |
2 □ |
3 □ |
97 □ |
98 □ |
c. Did the services provided help you find a job? |
1 □ |
2 □ |
3 □ |
97 □ |
98 □ |
d. Did the services provided help you get a job which offers opportunities for advancement? |
1 □ |
2 □ |
3 □ |
97 □ |
98 □ |
The next set of questions cover a wide range of beliefs and attitudes about yourself and about work.
Source: PACE 15-Month Survey
Core Self Evaluation
D1. I’m going to read a series of statements about your
feelings about different aspects of life.
For each one, please
tell me whether you strongly agree, somewhat agree, somewhat
disagree, or strongly disagree with that statement:
|
SELECT ONE RESPONSE PER ROW |
|||||
|
Strongly Agree |
Somewhat Agree |
Somewhat Disagree |
Strongly Disagree |
REF |
DK |
a. I am confident I get the success I deserve in life. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
b. Sometimes I feel depressed. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
c. When I try, I generally succeed. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
d. Sometimes when I fail I feel worthless. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
e. I complete tasks successfully. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
f. Sometimes, I do not feel in control of my work. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
g. Overall, I am satisfied with myself. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
h. I am filled with doubts about my competence. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
i. I determine what will happen in my life. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
j. I do not feel in control of my success in my career. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
k. I am capable of coping with most of my problems. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
l. There are times when things look pretty bleak and hopeless to me. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
Source: PACE 15-Month Survey
“Grit” Scale
D2. Next, I’m going to read some statements about how people
approach various tasks in life.
For each, please tell me if
you strongly agree, somewhat agree, somewhat disagree, or strongly
disagree that the statement applies to you. Be honest—there
are no right or wrong answers!
|
SELECT ONE RESPONSE PER ROW |
|||||
|
Strongly Agree |
Somewhat Agree |
Somewhat Disagree |
Strongly Disagree |
REF |
DK |
a. New ideas and projects sometimes distract me from previous ones. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
b. Setbacks don’t discourage me. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
c. I have been obsessed with a certain idea or project for a short time, but later lost interest. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
d. I am a hard worker. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
e. I often set a goal, but later choose to pursue a different one. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
f. I often have difficulty maintaining my focus on projects that take more than a few months to complete. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
g. I finish whatever I begin. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
h. I am diligent. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
Source: PACE 15-Month Survey, HPOG/PACE 36-Month Survey
Perceived Stress Scale
D3. In the past month, how often have you felt:
|
SELECT ONE RESPONSE PER ROW |
||||||
|
Very Often |
Fairly Often |
Sometimes |
Almost Never |
Never |
REF |
DK |
a. That you were unable to control the important things in life? |
1 □ |
2 □ |
3 □ |
4 □ |
5 □ |
97 □ |
98 □ |
b. Confident about your ability to handle your personal problems? |
1 □ |
2 □ |
3 □ |
4 □ |
5 □ |
97 □ |
98 □ |
c. That things were going your way? |
1 □ |
2 □ |
3 □ |
4 □ |
5 □ |
97 □ |
98 □ |
d. That difficulties were piling up so high that you could not overcome them? |
1 □ |
2 □ |
3 □ |
4 □ |
5 □ |
97 □ |
98 □ |
Source: HPOG/PACE 36-Month Survey
Level of Personal Support
D4. The following statements are about help from other people. Please indicate whether you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with each item.
|
SELECT ONE RESPONSE PER ROW |
|||||
|
Strongly Agree |
Somewhat Agree |
Somewhat Disagree |
Strongly Disagree |
REF |
DK |
a. There are people I can depend on to help me if I really need it. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
b. I feel that I do not have close personal relationships with other people. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
c. There is no one I can turn to for guidance in times of stress. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
d. There are people who enjoy the same social activities that I do. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
e. I do not think other people respect my skills and abilities. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
f. If something went wrong, no one would come to my assistance. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
g. I have close relationships that provide me with a sense of emotional security and well-being. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
h. I have relationships where my competence and skills are recognized. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
i. There is no one who shares my interests and concerns. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
j. There is a trustworthy person I could turn to for advice if I were having problems. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
Confidence in Career Knowledge
D5. When it comes to careers, some people are more certain than others that they know where they are headed and how to get there. Please indicate for each item whether you strongly agree, somewhat agree, somewhat disagree, or strongly disagree that it reflects your career situation:
|
SELECT ONE RESPONSE PER ROW |
|||||
|
Strongly Agree |
Somewhat Agree |
Somewhat Disagree |
Strongly Disagree |
REF |
DK |
a. I’m not sure how to accurately assess my abilities and challenges. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
b. I know how to make a plan that will help me achieve my goals for the next 5 years. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
c. I know how to get help from staff and teachers with any issues that might arise when I am at school. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
d. I’m not sure what type of job is best for me. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
e. I know the type of employer I want to work for. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
f. I know the occupation I want to be in. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
g. I’m not sure what kind of education and training program is best for me. |
1 □ |
2 □ |
3 □ |
4 □ |
97 □ |
98 □ |
Source: All remaining questions in this section are from the GJ-HC
Follow-Up Survey
and the RTW Baseline Information Form.
Barriers to Work
D6a. Would you say finding quality child care you can afford has limited your ability to work during the past month?
Very much, 1
A little, or 2
Not at all? 3
Not applicable 4
REFUSED 97
DON’T KNOW 98
D6b. Would you say finding quality child care you can afford has limited your ability to work between [RAD] and before the past month?
Very much, 1
A little, or 2
Not at all? 3
Not applicable 4
REFUSED 97
DON’T KNOW 98
D7a. Would you say problems with transportation have limited your ability to work during the past month?
Very much, 1
A little, or 2
Not at all? 3
REFUSED 97
DON’T KNOW 98
D7b. Would you say problems with transportation have limited your ability to work between [RAD] and before the past month?
Very much, 1
A little, or 2
Not at all? 3
REFUSED 97
DON’T KNOW 98
D8a. Do you have a physical, emotional, or other health condition that has limited the kind or amount of work you could do during the past month?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
D8b. Do you have a physical, emotional, or other health condition that has limited the kind or amount of work you could do between [RAD] and before the past month?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Reservation Wage
D9. How much must a job pay per hour for it to make sense for you to take it?
IF NECESSARY, PROBE:
What is the lowest hourly wage you are willing to accept?
Think
about the costs of taking a job, which might include child care and
transportation.
AMOUNT $| | | |.| | | PER HOUR
REFUSED 97
DON’T KNOW 98
This next set of questions are about your employment experiences.
Source: Unless otherwise noted, all questions in Section E
(“Employment”) come from the
GJ-HC Follow-Up
Survey.
E1. Are you currently working at a job for pay?
Please include
any full- or part-time jobs, self-employment, temporary positions,
odd jobs, side jobs such as babysitting, gardening, or housekeeping,
under-the-table jobs, business ventures, or other types of paid jobs
that you have had.
PROBE: Please remember to include any type of job that you have for pay.
Yes 1 (SKIP TO E3)
No 2
REFUSED 97
DON’T KNOW 98
E2. Which of the following best describes your work-related activities last week? Were you…
Retired, 1
Unable to work because of a disability, 2
Attending school or a long-term training program, 3
On active military duty, 4
On temporary layoff (waiting for callback), 5
Without a job, looking for work, 6
Without a job, not looking for work, 7
Sick or on maternity leave, or 8
Doing something else? (SPECIFY)____________________________ 99
REFUSED 97
DON’T KNOW 98
E3. [Including your current job(s)] how / How) many different jobs have you had since [RAD]?
PROBE: Please include any full- or part-time jobs, self-employment, temporary positions, odd jobs, side jobs such as babysitting, gardening, or housekeeping, under-the-table jobs, business ventures, or other types of paid jobs that you have had.
| | | NUMBER OF JOBS
None 1 (SKIP TO F1)
REFUSED 97 (SKIP TO F1)
DON’T
KNOW 98 (SKIP
TO F1)
Source: Modified GJ-HC Follow-Up Survey
(“Main job” language from HPOG/PACE 36-Month Survey)
E4. Where are you currently working?/Where did you work most recently since [RAD]?
If you currently have more than one job, answer this for your “main” job. This would be the job where you work the most hours, of if you work the same number of hours at more than one job, the one where you’ve worked the longest.
PROBE: What is the name of the company or employer you work(ed) for?
COMPANY/EMPLOYER:
REFUSED 97
DON’T
KNOW 98
NOTE: Company name used to guide interview flow.
E5. What month, day, and year did you start working at [JOB NAME]?
PROBE: If you cannot remember the exact day, can you remember if it was in the beginning, middle, or end of the month?
| | | / | | | / | | | | |
MONTH DAY YEAR
REFUSED 97
DON’T KNOW 98
E6. [IF E1=2] What month, day, and year did you stop working at [JOB NAME]?
| | | / | | | / | | | | |
MONTH DAY YEAR
REFUSED 97
DON’T KNOW 98
Source: WIA Gold Standard 15-Month Survey
E7.
Which of the following best describes your employment at [JOB NAME]?
(Are/were) you working:
As a regular full-time or part-time employee, 1
For a temporary help agency, 2
For a company that contracts out you or your services, 3
As an on-call employee, 4
As an independent contractor or independent consultant, 5
As a free-lance worker, 6
As a day laborer, 7
As self-employed, or 8
As something else? (SPECIFY)____________________________ 99
REFUSED 97
DON’T KNOW 98
Source: HPOG/PACE 36-Month Survey
E8.
What kind of work [do you do in your current job/did you do in your
most recent job],
that is, what [is/was] your occupation at
[JOB NAME]?
OCCUPATION:
REFUSED 97
DON’T
KNOW 98
E9. What kind of company is [JOB NAME]? What do they make, do, or sell?
PROBE, if necessary: What was the major product or service of [JOB NAME]?
REFUSED 97
DON’T KNOW 98
E10. How many hours (do/did) you work in a typical week at [JOB NAME] (now/just before you left)? Please include any regular overtime hours.
| | | HOURS PER WEEK (SKIP TO E12)
REFUSED 97
DON’T
KNOW 98
E11. Would you say you worked...?
Up to 5 hours per week, 1
5 or more but less than 10 hours per week, 2
10 or more but less than 15 hours per week, 3
15 or more but less than 25 hours per week, 4
25 or more but less than 35 hours per week, 5
35 or more but less than 40 hours per week, 6
40 or more but less than 50 hours per week, 7
More than 50 hours per week? 8
REFUSED 97
DON’T KNOW 98
E12. (Do/Did) you usually work a regular daytime schedule, or some other schedule at [JOB NAME]?
A regular daytime schedule (anytime between 6am to 6pm) 1 (SKIP TO E14)
Some other schedule 2
REFUSED 97
DON’T
KNOW 98
E13. Which of the following best describes the hours you usually (work/worked) at [JOB NAME]?
A regular evening shift (anytime between 2pm to midnight), 1
A regular night shift (anytime around 9pm to 8am), 2
A rotating shift–one that changes periodically from day to evening or night, 3
A split shift–one consisting of two distinct periods each day, 4
An irregular schedule arranged by your employer, or 5
Some other schedule? (SPECIFY)______________________ 99
REFUSED 97
DON’T KNOW 98
Source: GJ-HC Follow-Up Survey, HPOG/PACE 36-Month Survey
E14. (Are/Were)
any of the following benefits available to you at [JOB NAME]?
If
you (had) wanted it, (could you receive/could you have received) ...
|
SELECT ONE RESPONSE PER ROW |
|||
|
Yes |
No |
REF |
DK |
a. Health insurance? |
1 □ |
2 □ |
97 □ |
98 □ |
b. Paid vacation days? |
1 □ |
2 □ |
97 □ |
98 □ |
c. Paid holidays? |
1 □ |
2 □ |
97 □ |
98 □ |
d. Paid sick days? |
1 □ |
2 □ |
97 □ |
98 □ |
e. Retirement or pension benefits? |
1 □ |
2 □ |
97 □ |
98 □ |
E15. [Are/Were] you covered or represented by a union at your job with [JOB NAME]?
Yes 1
No 2
REFUSED 97
DON’T KNOW 98
Source: HPOG/PACE 36-Month Survey
E16. How much do you agree or disagree with the following statement: “There [are/were] many opportunities for career advancement for me with [JOB NAME].” Would you say you…
Strongly agree 1
Agree 2
Disagree 3
Strongly disagree 4
REFUSED 97
DON’T
KNOW 98
E17. How much (do/did) you earn, before taxes and other deductions, at [JOB NAME] (now/just before you left)? Please include tips, commissions, bonuses, and regular overtime.
AMOUNT $ |__| | |, | | | |.| | | (SKIP TO F1)
Per hour 1
Per week 2
Per year 3
Once every two weeks 4
Twice a month 5
Per month 6
In-kind only 7
Not yet paid 8
Per day 9
Per job 10
Commission 11
Commission plus (per hour) 12
Commission plus (per week) 13
Commission plus (per month) 14
Commission plus (per year) 15
Some other pay period 99
REFUSED 97
DON’T KNOW 98
E18. I’ll read some ranges. Please try to estimate your annual pay at [JOB NAME] [now/just before you left]. Would you say your annual earnings [are/were]…
Less than $10,000, 1
$10,000 or more, but less than $20,000, 2
$20,000 or more, but less than $30,000, 3
$30,000 or more, but less than $40,000, 4
$40,000 or more, but less than $50,000, 5
$50,000 or more, but less than $75,000, 6
$75,000 or more, but less than $100,000, 7
Or more than $100,000? 8
REFUSED 97
DON’T KNOW 98
In this next set of questions, we are interested in learning more about your household.
Source: All questions in Section F (“Household Composition”)
come from the GJ-HC Follow-Up Survey.
F1.
How many people, including yourself, currently make up your
household?
By household, we mean people who live together and
share finances, including dependents.
| | | # PEOPLE IN HOUSEHOLD
REFUSED 97
DON’T KNOW 98
F2. How many members of your household are children under 12?
| | | # CHILDREN UNDER 12
REFUSED 97
DON’T KNOW 98
Now, I am going to ask you some questions about your personal and household income in the last month. I want to assure you that none of your answers will be discussed with anyone. [IF RESPONDENT HAS OTHER HOUSEHOLD MEMBERS:] I will ask you first about your personal income, then I will ask about the income of other members of your household.
Source: GJ-HC Follow-Up Survey
G1. Last month, did you receive any (INSERT ITEM FROM CHART BELOW)… ?
G1a. How much did you receive from (INSERT ITEM) last month?
PROBE (as needed):
The Unemployment Insurance program, also known as UI, provides workers, who lose their jobs through no fault of their own, with weekly unemployment insurance payments.
Temporary Assistance to Needy Families (TANF), also known as [STATE WELFARE NAME] and formerly known as Aid to Families with Dependent Children (AFDC), provides financial help for children and their parents or relatives who are living with them. Monthly cash payments help pay for food, clothing, housing, utilities, furniture, transportation, telephone, laundry, household equipment, medical supplies not paid for by Medicaid, and other basic needs.
The Supplemental Nutrition and Assistance Program (SNAP) is the new name for the USDA program formerly known as Food Stamps. It puts money on a EBT card that is used to buy food.
The Special Supplemental Nutrition Program for Women, Infant and Children, popularly known as WIC, is a nutrition program that helps pregnant women, new mothers, and young children eat well, learn about nutrition, and stay healthy. WIC provides nutrition education and counseling, nutritious foods, and help accessing health care to low-income women, infants, and children.
Supplemental Security Income (SSI) is a federal government benefit program providing cash to meet basic needs for food, clothing, and shelter to persons who are blind or otherwise disabled, have little or no other income, and who meet the living arrangement requirements. Social Security Disability Insurance (SSDI) benefits are payable to disabled workers, disabled widow(er)s or adults disabled since childhood, who are otherwise eligible. The monthly disability payment is based on the social security earnings record of the insured worker under whose social security number the disability claim is filed.
Workers Compensation is a form of insurance that provides wage replacement and medical benefits for employees who are injured in the course of employment.
General Assistance (GA) is a term used to denote welfare programs that benefit adults without dependents (single persons, or less commonly, childless married couples). Trade Adjustment Assistance (TAA) and Alternative Trade Adjustment Assistance (ATAA) help trade-affected workers who have lost their jobs as a result of increased imports or shifts in production out of the United States. Certified individuals may be eligible to receive one or more program benefits and services, depending on what is needed to return them to employment.
|
G1 |
G1a |
|||||
|
Yes |
No |
REF |
DK |
Amount |
REF |
DK |
a. Unemployment Insurance benefits (UI)? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
b. Temporary Assistance for Needy Families (TANF)? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
c. Supplemental Nutrition Assistance Program
(SNAP), |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
d. WIC benefits? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
e. SSI, SSDI, or other disability insurance? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
f. Worker’s Compensation? |
|
|
|
|
|
|
|
g. Other benefits such as General Assistance, Trade Adjustment Assistance (TAA) or Alternative Trade Adjustment Assistance (ATAA) benefits? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
h. Section 8 or Public Housing? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
i. Social Security checks from the government for |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
j. Other retirement benefits such as a government or private pension or annuity? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
k. Interest or dividends? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
l. Alimony, child support, or rent payments or financial support from friends or relatives? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
m. Another source of income? Please specify (_______). |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
Source: HPOG/PACE 36-Month Survey
Expanded probe from GJ-HC Follow-Up Survey
G2. Thinking of all of the income you received last month, what was your total personal income in [PRIOR MONTH]?
PROBE: Please include income from all possible sources such as job earnings, benefits, self-employment, regular jobs, and earnings from odd jobs, side jobs, under-the-table jobs, and other activities, social security, pensions, rent, interest and dividends, unemployment compensation, welfare, other public assistance, food stamps, child support, and money from any other sources. (Please do not include any refunds of federal, state, or local income taxes you paid in past years.) Your best estimate is fine.
PROBE, IF TOTAL INCOME IS REFUSED: Your answers to these questions will help the researchers better understand the problems people face when they are trying to work and make ends meet. Neither your name nor any other information that would identify you is kept with your answers. Could you provide your best estimate?
$ (SKIP TO G3)
REFUSED 97
DON’T KNOW 98
Source: HPOG/PACE 36-Month Survey
G2a. Would you say your total personal income in [PRIOR MONTH] was…
None ($0) 1
$500 or less 2
$501 to $1,000 3
$1,001 to $1,500 4
$1,501 to $2,000 5
$2,001 to $2,500 6
$2,501 to $3,000 7
$3,000 to $3,501 8
$3,501 to $4,000 9
$4,001 or more 10
REFUSED 97
DON’T KNOW 98
Source: Modified GJ-HC Follow-Up Survey
G3.
Last month, did anyone else in your household receive any (INSERT
FROM CHART)… ?
By household, we mean people who live
together and share finances. Please consider anyone who lived in your
household for at least half of [PRIOR MONTH] when answering.
G3a. [If G3 = 1]: How much did other people in your household receive from (INSERT ITEM) last month, altogether?
|
G3 |
G3a |
|||||
|
Yes |
No |
REF |
DK |
Amount |
REF |
DK |
a. Unemployment Insurance benefits (UI)? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
b. Temporary Assistance for Needy Families (TANF)? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
c. Supplemental Nutrition Assistance Program
(SNAP), |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
d. WIC benefits? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
e. SSI, SSDI, or other disability insurance? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
f. Worker’s Compensation? |
|
|
|
|
|
|
|
g. Other benefits such as General Assistance, Trade Adjustment Assistance (TAA) or Alternative Trade Adjustment Assistance (ATAA) benefits? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
h. Section 8 or Public Housing? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
i. Social Security checks from the government for |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
j. Other retirement benefits such as a government or private pension or annuity? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
k. Interest or dividends? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
l. Alimony, child support, or rent payments or financial support from friends or relatives? |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
m. Another source of income? Please specify (_______). |
1 □ |
2 □ |
97 □ |
98 □ |
$| | | |.| | | ENTER AMOUNT |
97 □ |
98 □ |
Source: HPOG/PACE 36-Month Survey
G4. Thinking of all of the income received by you and the people in your household last month, what was the total income for everyone living together in your household in [PRIOR MONTH]?
PROBE:
By
household, we mean people who live together and share finances.
Please consider anyone who lived in your household for at least
half of [PRIOR MONTH] when you answer this question, including
yourself.
$ (SKIP TO END)
REFUSED 97
DON’T KNOW 98
Source: HPOG/PACE 36-Month Survey
G4a. Which of the following categories best describes the combined income of you and other members of your household? Would you say that the combined income in [PRIOR MONTH] was…
None ($0) 1
$1000 or less 2
$1,001 to $2,000 3
$2,001 to $3,000 4
$3,001 to $4,000 5
$4,001 to $5,000 6
$5,001 to $6,000 7
$6,001 to $7,000 8
$7,001 to $8,000 9
$8,001 or more 10
REFUSED 97
DON’T KNOW 98
A-
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Abt Single-Sided Body Template |
| Author | Jan Nicholson |
| File Modified | 0000-00-00 |
| File Created | 2021-01-23 |
© 2024 OMB.report | Privacy Policy