2 Protocol V2 (Renter)
Generic Clearance for Questionnaire Pretesting Research
Enclosure 2_Renter Protocol_revised
NYCHVS Cognitive Interviews
OMB: 0607-0725
2021 NYCHVS Redesign Research
Protocol 2 (Renter Occupied)
Cognitive Interview Protocol Guide
PARTICIPANT ID #: _________________________ DATE: ____ / ____ /2019
COGNITIVE INTERVIEWER NAME:
START TIME: ______: ______ AM / PM
|
|
(Cognitive Interviewer: Read/Paraphrase)
INTRODUCTION
Thank you for your time today. My name is _____ and I work for [the US Census Bureau/________). Let me begin by telling you a little more about what we’ll be doing today. The United States Census Bureau counts the population in the U.S. and also conducts various kinds of surveys.
Today, with your help, we will test some new questions that were developed for the New York City Housing and Vacancy Survey. I’m going to play the part of a Census interviewer who knocks on your door to ask you these survey questions. Then I’m going to ask you some follow up questions to find out how well the survey is working. We are going to use your comments and experiences as well as the comments and experiences of other people to help improve the survey. I did not create the survey, so please don’t feel like you have to hold back on your thoughts to be polite to me. We appreciate your help so we can make the survey work well for everyone.
CONSENT
COGNITIVE INTERVIEWER: PLACE THE CONSENT FORM IN FRONT OF PARTICIPANT, THEN READ:
Before we start, I would like to tell you about this document [show them consent form]. Then I’m going to give you some time to read it and you can ask me any questions you may have. This document explains a little bit about this interview and provides information about your rights as a participant. It says that your participation is voluntary, which means that you can refuse to answer any question that you don’t want to answer and you can end the interview at any time. It also says that your answers are confidential. That means that your name and identifying information like your address will not be associated with any answers that you give today. For example, if you tell me that a certain question is confusing, I won’t ever write in a report that [NAME] said this question is confusing. I would write something like, “3 people said this question was confusing.” Finally, this document asks for your permission to have this session audio recorded. This helps me out so I don’t have to take so many notes while we are talking. Only myself and my colleagues who are working on this project will be able to listen to the tape and it will only be used for research purposes. Please take a minute to read this over, and let me know if you have any questions. [LET THEM READ THE FORM.] Okay, do you have any questions for me? [ONCE ALL QUESTIONS ARE ANSWERED] Okay, please print your name here [point], sign your name here [point], and put the date here [point]. I’ll sign it as well, and I have another copy for you to keep.
PARTICIPANT READS AND SIGNS FORM. IF PARTICIPANT PROVIDES CONSENT TO HAVE THE SESSION AUDIO TAPED: I will now turn on the audio recorder. IF PARTICIPANT DOES NOT PROVIDE CONSET TO HAVE THE SESSION AUDIO TAPED, DO YOUR BEST TO TAKE NOTES.
THINK ALOUD
Thank you. I’d like you to answer the questions as you would if we were at your doorstep, with one big difference. What I would like you to do is tell me what you are thinking and feeling as you come up with your answers. Instead of thinking to yourself, I’d like you to think out loud, and I will remind you to do this from time to time. I will also ask you some questions about your answers. I am really interested in how these questions work for you, so there are no right or wrong answers.
[ENGLISH INTERVIEWS ASK R TO PRACTICE THINK ALOUD FIRST. SPANISH INTERVIEWS SKIP TO MODEL THINK ALOUD.]
Let’s do a practice question before we start: Please think aloud as you answer the question, how many windows are in your home?
[GIVE FEEDBACK ON THE THINK ALOUD THEY DID. EITHER YOU HAD A GOOD UNDERSTANDING OF HOW THEY CAME UP WITH THE WINDOWS OR PROBE SO YOU CAN GET A SENSE OF HOW THEY CAME UP WITH THE NUMBER THEY JUST TOLD YOU. YOU
CAN ALSO MODEL THE THINK ALOUD FOR THEM, I.E., “For example, if I were answering for my apartment and thinking out loud, I would say, “Well, there’s a window in my bedroom, and a window in the living room, and there’s a little window in my front door, but that door looks out into the hallway and not outside. Should I count that? I think that doesn’t count. Okay, so I’m going to say two windows.” An explanation like that helps me to understand how you came up with your answer, and it lets me know that maybe some people will count windows inside a building and some people will only count them if you can see outside the building through the window. With that information, we can come up with some suggestions for how to improve the question.]
SECTION II. COGNITIVE INTERVIEW |
Great, that’s what I want you to do throughout our session. I will remind you to think aloud if you get quiet.
Do you have any questions before we begin? [INTERVIEWER: ANSWER QUESTIONS.] Okay, let’s get started.
[INTERVIEWER: REMIND R TO THINK ALOUD THROUGHOUT. PROBE ON ANY UNCODEABLE RESPONSES, DIFFICULTY, HESITATIONS, LAUGHTER, ETC., THE RESPONDENT SHOWS, EVEN IF NO PROBES ARE WRITTEN AT THAT QUESTION. WE ARE PROBING SEMI-RETROSPECTIVELY, SO TAKE NOTE OF THESE HESITATIONS AND HOLD FOLLOW-UP PROBES UNTIL YOU GET TO THE BOX WITH PROBES AT THE END OF EACH SECTION.]
[Half of owners get housing quality/compare current & last home/housing search and half get income/debt/assets.]
FLASHCARD INSTRUCTION–:
For some questions, I will show you a card that has the answer options written down. When you give me your answer, you can tell me the answer or the number next to your answer.
HOUSING QUALITY
Next, I’m going to ask about the condition of your [FILL: apartment / home].
[INTERVIEWER: Use tally sheet for maintenance deficiencies if the question has a check mark.]
C24. At
any time during this winter, was there a breakdown in your heating
equipment; that is, was it completely unusable for 6 consecutive
hours or longer?
1. Yes
2.
No
999. I did not live here during this winter
(VOL) DK
(VOL) RF
C25. How many times did this happen?
2. One
3.
Two
4. Three
5. Four or more times
(VOL) DK
(VOL) RF
C26. During
this winter when your regular heating system was working, did you, at
any time, have to use additional sources of heat because your regular
system did not provide enough heat? Additional sources may be the
kitchen stove, a fireplace, or a portable heater?
1. Yes
2.
No
999. I did not live here during this winter
(VOL) DK
(VOL) RF
C28. At any time during this winter was there a time when you did not have hot water for at least 6 hours?
1. Yes
2.
No
999. I did not live here during this winter
(VOL) DK
(VOL) RF
C30. During the past month, about how many cockroaches did you see in this [apartment /house] on a typical day?
1. None
2. 1
to 5
3. 6 to 19
4. 20 or more
5. Don’t know/ Not
sure
999. I did not live here during past month
(VOL) DK
(VOL) RF
C29. At
any time in the last 90 days have you seen any mice or rats, or signs
of mice or rats in this building?
1. Yes
2.
No
999. I did not live here during the past 90 days
(VOL) DK
(VOL) RF
C31. Is this building serviced by an exterminator regularly, only when needed, irregularly, or not at all?
1. Regularly
2.
Only when needed
3. Irregularly
4. Not at all
(VOL) DK
(VOL) RF
C36. Is
there any broken plaster or peeling paint on the ceiling or inside
walls?
1. Yes (go to
C37)
2. No (go to C32)
(VOL) DK
(VOL) RF
C37. Is the area of broken plaster or peeling paint larger than 8 1/2 inches by 11 inches?
1. Yes
2. No
(VOL) DK (go to C32)
(VOL) RF (go to C32)
C32. Does
this apartment (house) have open cracks or holes in the interior
walls or ceiling?
1. Yes (go to
C33)
2. No (go to C34)
(VOL) DK (go to C34)
(VOL) RF (go to C34)
C33. Is the crack or hole larger than 8 1/2 inches by 11 inches?
1.
Yes
2. No
(VOL) DK
(VOL) RF
C34. Does
this apartment (house) have holes in the floors?
1. Yes (go to
C35)
2. No (go to C6)
(VOL) DK (go to C6)
(VOL) RF (go to C6)
C35. Is the hole larger than 8 1/2 inches by 11 inches?
1.
Yes
2. No
(VOL) DK
(VOL) RF
[IF YES TO C32 ASK for C33, C35]
Tell me more about your answer.
How big would you say the hole is?
C6. Was
there any time in the last three months when the toilet or toilets in
this apartment were not working for six consecutive hours?
1. Yes
2.
No
3. No toilet in this apartment (house)
999. I did not live here during the last 3 months
(VOL) DK
(VOL) RF
C38. Has
water leaked into your [apartment/house] in the last 12 months,
excluding leaks resulting from your own plumbing fixtures backing up
or overflowing? [IF NEEDED: Do you still have a leak?]
1. Yes, I had a
leak (go to C39)
2. Yes, I still have a leak (go to C39.1)
3.
No (go to C19.5)
999. I did not live here during the last 12 months
(VOL) DK (go to C19.5)
(VOL) RF (go to C19.5)
[For C38]
In your own words, what is this question asking?
C39. How severe was the leak? [INTERVIEWER: Show flashcard C39]
1. Very Severe
(go to C40)
2. Serious (go to C40)
3. Moderate (go to
C40)
4. Slight (go to C40)
(VOL) DK (go to C40)
(VOL) RF (go to C40)
C39.1. How severe is the leak?
1. Very Severe
(go to C19.5)
2. Serious (go to C19.5)
3. Moderate (go to
C19.5)
4. Slight (go to C19.5)
(VOL) DK (go to C19.5)
(VOL) RF (go to C19.5)
[for C39, C39.1]
Tell me more about your answer.
What does “severe” mean to you in this question?
C40. Was the leak properly repaired?
1. Yes
2. No
(VOL) DK
(VOL) RF
C19.5. Is there mold in your [apartment/house], excluding your bathrooms?
1. Yes (go to
C20)
2. No (go to C45)
(VOL) DK (go to C45)
[for C40, C19.5]
Tell me more about your answer.
C20. Is the mold covering an area greater than or equal to the size of an 8 1/2" x 11" piece of paper in your [apartment/house]?
1. Yes
2.
No
DK/RF
C45. Is this [apartment/house] now under renovation?
1. Yes (go to
C45.1)
2. No (go to C27)
(VOL) DK (go to C27)
(VOL) RF (go to C27)
C45.1. [See Tally Sheet. Ask if “Yes” to C24, C26, C29, C36, C32, C34, C6, OR C38. Else skip to TO C27.] Can any of the problems in your apartment/home be attributed to the renovation work?
1.
Yes
2. No
(VOL) DK
(VOL) RF
C27. Does your [apartment/house] have functioning air conditioning? Would you say central air conditioning, one or more window air conditioners, or no air conditioning? [INTERVIEWER: Show flashcard C27]
1. Yes, central
air conditioning (go to B44)
2. Yes, one or more window air
conditioners (go to B44)
3. No (go to C17)
4. Don't know/
not sure (go to C17)
B44. [Ask if C27 = 1 or 2] Do you ever keep your A/C off due to cost when you would otherwise want to use it?
1.
Yes
2. No
(VOL) DK
(VOL) RF
B45. In a typical summer month, how many hours do you use your air conditioning during the day?
_________
999. I did not live here during a typical summer month
(VOL) DK
(VOL) RF
B46. In a typical summer month, how many hours do you use your air conditioning at night?
_________
999. I did not live here during a typical summer month
(VOL) DK
(VOL) RF
[B45, B46]
Tell me more about your answer.
How easy or difficult was it to answer the question?
C17. Last winter, for any reason, was your [apartment/house] so cold for 24 hours or more that you and the other people who live here were uncomfortable?
[INTERVIEWER: Do not count visitors, only household members]
1. Yes
2.
No
DK/RF
999. I did not live here during the last winter
C19. Last winter, how often was it so hot in your [apartment/house] because of your heat that you had to open the windows? [INTERVIEWER: Show flashcard C19]
1. Most days
2.
Some days
3. A few days
4. Never
999. I did not live here during the last winter
(VOL) DK
(VOL) RF
[See Tally Sheet. If reported any maintenance deficiencies at C24, C26, C29, C36, C32, C34, C6, OR C38, ask C41 to C44. Else skip to C47.]
C41. We just talked about a lot of different housing issues. As a reminder, you told me that you have experienced [FILL FROM TALLY SHEET: a breakdown in your heating equipment/a need to use additional sources of heat/seeing signs of mice or rats/broken plaster or peeling paint/cracks or holes in the interior walls or ceiling/holes in the floors/toilets not working/water leaking into your (apartment/house)].
Please think about these issues you had. I'm going to read a list of things people sometimes do in order to get a housing problem fixed. For each one, please tell me whether it is something you did to get any of those issues resolved.
Did you seek help by contacting the building superintendent, managing agent, or building owner?
1. Yes
2.
No
3. Don't know
4. Refused
C42. Did you contact 311?
1. Yes
2.
No
3. Don't know
4. Refused
C43. Did you or someone you know make repairs or pay someone to fix the problem?
1. Yes
2.
No
3. Don't know
4. Refused
C44. [Ask if C41, C42, and/or C43 = “Yes”] Think about all the things you did to try to fix any issue or issues in your home or building. Which of the following statements best matches your experience? [INTERVIEWER: Show flashcard C44]
[for C44]
What does “Issues are resolved adequately” mean to you
in this question?
2. Issues are resolved
adequately
3. Issues take a long time to resolve
4. Issues
are not resolved
5. Don't Know
6. Refused
C47. How much of a problem are noisy neighbors in your building? [INTERVIEWER: Show flashcard C47,C48]
A. A big
problem
B. Somewhat of a problem
C. Not a problem
D. I
do not see this in my building
Don't know
Refused
C48. How much of a problem is street noise? [INTERVIEWER: Show flashcard C47, C48]
A. A big
problem
B. Somewhat of a problem
C. Not a problem
D.
I do not see this in my building
<777> Don't know
<888>
Refused
C49. How often do you smell cigarette smoke or marijuana in your home that comes from another home or apartment or from outside?
1 Every day (go
to C4)
2 A few times per week (go to C4)
3 A few times per
month (go to C4)
4 A few times per year (go to C50)
5 Not
at all (go to C4)
(VOL) DK (go to C4)
(VOL) RF (go to C4)
C50. Was that cigarette smoke, marijuana, or both?
1. Cigarette
2.
Marijuana
3. Both
(VOL) DK
(VOL) RF
[for C50]
Tell me more about your answer.
C4. Does this [apartment /house] have complete plumbing facilities? [INTERVIEWER: Show flashcard C4] IF NEEDED: That is, hot and cold piped water, a flush toilet and a bathtub or shower?]
1. Yes, has
complete plumbing facilities (go to C5)
2. No, has some but not
all facilities in this apartment (house) (go to C7)
3. No
plumbing facilities in this apartment (house) (go to C7)
(VOL) DK (go to C7)
(VOL) RF (go to C7)
C5. Are these facilities for the exclusive use of this household or are they also for use by another household?
1. For the
exclusive use of this household
2. Also for use by another
household
(VOL) DK
(VOL) RF
C7. Does this apartment (house) have complete kitchen facilities? [INTERVIEWER: Show flashcard C7]
[IF NEEDED: Complete kitchen facilities include a sink with piped water, a range or cookstove, and a refrigerator.]
1. Yes has
complete kitchen facilities
2. No, has some but not all
facilities in this apartment (house) (SKIP TO C9)
3. No kitchen
facilities in this apartment (house) but facilities available in
building (SKIP TO C15)
4. No kitchen facilities in building
(SKIP TO C15)
(VOL) DK
(VOL) RF
C8. [ASK IF C7 = 1] Are these facilities for the exclusive use of this household or are they also for use by another household?
5. For the
exclusive use of this household
6. Also for the use of another
household
(VOL) DK
(VOL) RF
C9. [ASK IF C7 = 1 OR 2] Are all the kitchen facilities in your apartment functioning?
1. Yes, all are
functioning
2. No, one or more is not working at all
(VOL) DK
(VOL) RF
C15. What would you say is the age of most of your kitchen appliances?
1. Less than a
year
2. One year or more but less than 5 years
3. 5 or more
years but less than 20 years
4. 20 or more years
(VOL) DK
(VOL) RF
[for C15]
How easy or difficulty was it to come up with your answer to this
question?
[for C15]
C11. Does your [house/apartment/manufactured/mobile home] have a dishwasher in working order?
1. Yes
2.
No
DK/RF
C12. Does your [house/apartment/manufactured/mobile home] have a washing machine in working order? [IF NEEDED: Is that in your apartment or in your building?]
1. Yes, in my
apartment
2. Yes, in my building
3. No
DK/RF
C13. (Does your [house/apartment/manufactured/mobile home] have) a clothes dryer in working order? [IF NEEDED: Is that in your apartment or in your building?]
1. Yes, in my
apartment (go to C14)
2. Yes, in my building (go to C16)
3.
No (go to C16)
DK/RF (go to C16)
C14. Do you have a combination washer/dryer?
1. Yes
2.
No
DK/RF
C16. Do you have a working carbon monoxide detector inside [your/the/that] [house/apartment/manufactured/mobile home]?
1. Yes
2.
No
DK/RF
N8. Does your [house/apartment] have a functioning buzzer that allows you to let guests into the building?
Interviewer Notes: A phone/intercom/virtual doorman counts as a buzzer
1. Yes, my buzzer
allows me to let guests in the building
2. No, my buzzer is not
functioning and/or does not allow me to let guests in the building
3.
No, I do not have a buzzer
(VOL) DK
(VOL) RF
Probe here before moving on the next module.
HOUSEHOLD ROSTER
In this next section, we’re going to ask about the people who live here. These first questions will help the computer know what questions I will ask you later on, how to phrase some of those questions, and what questions to skip.
A42. How many people live here?
_________
(VOL) DK
(VOL) RF
A1. What is the first name or initial of each person who lives here, starting with yourself?
We don’t need full names. We just need to have some way to refer to them when we ask some follow-up questions.
[Interviewer instruction: After respondent stops listing people, ask “Anyone else?”]
[INTERVIEWER: You can use the optional looping sheet here.]
____________ ____________
(VOL) DK
(VOL) RF
A3. What is [PERSON]’s relationship to you? [INTERVIEWER: Show flashcard A3]
[INTERVIEWER: You can use the optional looping sheet here.]
1.
Husband/wife
2. Son/daughter (own, adopted, step, foster
child)
3. Brother/sister (stepbrother/sister)
4.
Father/mother
5. Father-in-law/mother-in-law
6.
Grandchild
7. Grandparent
8. Other relative (cousin,
nephew, etc)
9. Roomer/boarder
10. Unmarried partner
11.
Housemate/roommate
12. Other non-relative
(VOL) DK
(VOL) RF
[LOOP A3 to collect relationship for each person in the household to
respondent]
[for A3]
[If not already clear] Are there people who are related to each
other but not to [you/reference person]?
A43. What pronoun would you like us to use when we ask follow-up questions about (person)? (If needed: Pronouns are words used to refer to people, like he, she, and they.)
[INTERVIEWER: You can use the optional looping sheet here.]
1. He/His
2.
She/Her
3. They/Them
4. Just use Person's name instead of
pronoun
(VOL) DK
(VOL) RF
[LOOP A43 for each person in the household]
[for A43]
Interviewer: Note if “pronoun” definition needs to
be read.
[IF DEFINITION NOT READ] What does the word “pronoun”
mean to you?
Probe here before moving on the next module.
RESIDENTIAL HISTORY (renters)
M43. What is the length of the lease on this apartment (house); that is, the total time from when the lease began until it will expire? [INTERVIEWER: Show flashcard M43]
1. Less than 1
year (go to M44)
2. 1 year (go to M44)
3. More that 1 but
less than 2 years (go to M44)
4. 2 years (go to M44)
5.
Other (go to M5)
6. My lease expired but I am still living here
(go to M5)
7. No lease (go to M5)
(VOL) DK
(VOL) RF
M44. What year did the lease originate?
_________
(VOL) DK
(VOL) RF
M45. (Ask only if the lease originated within the last 2 years) What month did the lease originate?
_________
(VOL) DK
(VOL) RF
RESIDENTIAL HISTORY
M5. Now, I’m going to ask about where you lived before.
Before moving into this [house/apartment] were you living in another [house/apartment] or were you homeless or in a temporary housing situation?
1. Another house
[apartment] (go to M4)
2. Homeless or temporary housing
situation (go to M6)
3. I have always lived in my current
address (go to M34)
(VOL) DK
(VOL) RF
M6. Were you living in a shelter, temporary residence, or on the street?
1. Shelter (go to
M34)
2. Temporary residence (go to M34)
3. On the street
(go to M34)
4. Other (go to M34)
(VOL) DK
(VOL) RF
[for M5, M6]
Tell me more about your answer
[FOR RESPONDENTS REPORTING “TEMPORARY HOUSING SITUATION”]
What does “temporary” mean to you in this question?
M4. [if moved in the last 2 years] How many times have you moved in the past five years?
________
(VOL) DK
(VOL) RF
M7. We are asking about the place you lived because it helps us know a little more about the neighborhood and the city services that were accessible there.
What was the address of the last place you lived?
__________________________________________________
(VOL) DK
(VOL) RF
M8. [if won’t provide address] What was the intersection of the last place you lived?
Street 1:
_________________
Street 2: _________________
(VOL) DK
(VOL) RF
M9. What was the zip code of the last place you lived?
____________
(VOL) DK
(VOL) RF
M11. Which of the people that live with you now lived in your last home?
[Person
1]
[Person 2]
[Person 3]
[Person 4]
[Person
5]
[Person 6]
None
(VOL) DK
(VOL) RF
M12. [if anyone did not live at last home] Just to confirm, the following people did not live with you in your last home? [Fill based on response to M11]
[Person X]
[Person X]
[Person X]
1. Yes
2. No
(VOL) DK
(VOL) RF
M13. [ASK IF M5 = 1. Else skip to probes.] We'd like you to think about all the people that lived with you in your last home. Who else lived at your last home at the time you left?
For each person, please give me their first name or initials so we can keep track of them as we go.
_____________________[Interviewer instruction: After respondent stops listing people, ask “Anyone else?”] (VOL) DK
(VOL) RF
M14. [if people lived at previous home] We are interested in learning more about the people that lived with you at the time and their relationship to you. What was [Person]'s relationship to you? [INTERVIEWER: Show flashcard M14]
[INTERVIEWER: You can use the optional looping sheet here.]
1.
Husband/wife
2. Son/daughter (own, adopted, step, foster
child)
3. Brother/sister (stepbrother/sister)
4.
Father/mother
5. Father-in-law/mother-in-law
6.
Grandchild
7. Grandparent
8. Other relative (cousin,
nephew, etc)
9. Roomer/boarder
10. Unmarried partner
11.
Housemate/roommate
12. Other non-relative
(VOL) DK
(VOL) RF
[for M14]
Were there any categories missing from this list that you were
looking for?
Is there anything else you’d like to tell me about the
categories on this list?
[If not already clear], can you tell me a little bit more about the
relationships between the people who live here?
Are there people who are related to each other but not to
[you/reference person]?
[loop M14 for each other person that lived at previous home]
M15. If you had not moved out of your last address, could you have lived there for another year?
1.
Yes
2. No
(VOL) DK
(VOL) RF
[for M15]
In your own words, what is this question asking?
Tell me more about your answer.
M18. [if renter] In your last home, did the landlord ever start an eviction proceeding against the people that lived there?
1. Yes (go to
M19)
2. No (go to M21)
(VOL) DK (go to M21)
(VOL) RF (go to M21)
M19. Did it result in you being evicted, settling the court case by leaving, or taking a payment for leaving?
1. Evicted
2.
Settled by leaving
3. Took payment for leaving
4. Other
(VOL) DK
[for M18, M19]
Tell me more about your answer.
Probe here before moving on the next module.
[Half of owners get housing quality/compare current & last home/housing search and half get income/debt/assets.]
INCOME
[General Probes]
Do you receive any other types of income that you haven’t had
a chance to tell us about yet?
In the questions that I just asked you about income, was there any
question that was particularly hard to answer?
Were there any questions you did not know the answer to?
Would you have been ok with us following up on these questions with
[NAME OF OTHER HOUSEHOLD MEMBER] directly?
Do not include (your/NAME’s) coop as a business.
1 Yes (go to
E15)
2 No (go to E17)
(VOL) DK
(VOL) RF
E15. Is the business incorporated, such as an LLC or something similar?
1 Yes (go to
E16)
2 No (go to E17)
(VOL) DK
(VOL) RF
E16. [Are you/IsNAME] also an employee of that business?
1
Yes
2 No
(VOL) DK
(VOL) RF
E17. In the last 12 months, did [you/NAME] receive income from any of the following sources? [INTERVIEWER: Show flashcard E17.]
1 Wages, salary,
tips, bonuses, or commissions
2 income from self-employment such
as a free-lancer or contractor, net real estate income including
short-term rental of part or all of your apartment/home, or income
from a business that is not incorporated
3 Disability benefits
including SSI, SSDI, or a disability pension
4 Retirement income
including Social Security or
5 Survivor benefits for [person] or
[person] on behalf of others
6 Regular payments from dividends,
annuities, stipends, estates, trusts, or royalties
7 Child
support, alimony, or similar
8 Unemployment
None of the above
(VOL) DK
(VOL) RF
[IF R reported having an incorporated business at E15, probe on E17]
You mentioned that [your/NAME’s] business is incorporated or
an LLC. Did you include distributions from [your/NAME’s]
business when I asked [you/NAME] if you had income from the
following sources? [INTERVIEWER: Show flashcard E18.]
If yes: Where did you report that type of income (the
distributions)?
E18. In the last 12 months, did [you/NAME] have investments that earned any interest?
1
Yes
2 No
(VOL) DK
(VOL) RF
E19. In the last 12 months, did [you/NAME] sell any assets at a profit of $10,000 or more?
1
Yes
2 No
(VOL) DK
(VOL) RF
E20. In the last 12 months, did [you/NAME] receive any one-time lump sum payments, such as an inheritance, settlement of a lawsuit, or buyout from a landlord?
1
Yes
2 No
(VOL) DK
(VOL) RF
[INTERVIEWER: Use tally sheet to record income for questions with a check mark.]
E21. [if
E17 = 1] In the last 12 months, how much did [you/NAME] earn from
wages, salary, tips, bonuses, and commissions?
$_______________________
(VOL) DK
(VOL) RF
E22. [if
E17 = 2] In the last 12 months, how much did [you/NAME] earn from
income from self-employment such as a free-lance or contractor, net
real estate income including short-term rental of part or all of your
apartment/home, and income from a business that is not incorporated?
$_______________________
(VOL) DK
(VOL) RF
E25. [if
E17 = 3] In the last 12 months, how much did [you/NAME] receive
from disability benefits including SSI, SSDI, or a disability
pension?
$_______________________
(VOL) DK
(VOL) RF
E23. [if
E17 = 4] In the last 12 months, how much did [you/NAME] receive
from retirement income including Social Security, pensions, any other
payments from retirement funds including a 401K, IRA, KEOGH accounts
and similar?
$_______________________
(VOL) DK
(VOL) RF
E24. [if
E17 = 5] In the last 12 months, how much did [you/NAME] receive or
receive on behalf of anyone else who is living with your from
survivor benefits such as Social Security, SSDI, a pension or
similar?
$_______________________
(VOL) DK
(VOL) RF
E26. [if
E17 = 6] In the last 12 months, how much did [you/NAME] receive
from regular payments from dividends, annuities, stipends, estates,
trusts, and royalties? If [you/NAME] received multiple kinds or if we
should calculate the last 12 months together, I can help!
$_______________________
(VOL) DK
(VOL) RF
E27. [if
E17 = 7] In the last 12 months, how much did [you/NAME] receive
from child support, alimony, and similar payments? (This is the
amount [person] actually received, not the amount that was due.) If
[you/NAME] received multiple kinds or if we should calculate the last
12 months together, I can help!
$_______________________
(VOL) DK
(VOL) RF
E28. [if
E17 = 8] In the last 12 months, how much did [you/NAME] receive
from unemployment insurance?
$_______________________
(VOL) DK
(VOL) RF
E29. [if
E18=1] In the last 12 months, you indicated that [you/NAME] has
investments that earned income. How much total interest did
[you/NAME]earn? [This includes interest that was rolled over or
reinvested in addition to what was paid out.]
$_______________________
(VOL) DK
(VOL) RF
E31. [if
E20=1] In the last 12 months, you indicated that [person] received
a one-time lump sum payment. About how much did [you/NAME] receive in
the last 12 months? [If more than one, please combine]
$_______________________
(VOL) DK
(VOL) RF
E36. It seems like [you/NAME] made [Calculate total income for person using tally sheet] in income last year. Does that seem right?
1. Yes
2. No
(VOL) DK
(VOL) RF
[loop back to E14 for all adults in HH. You can use the tally sheet
here. Then go to F3]
E37. It seems like the combined income for the people who live here was [Calculate total household income using tally sheet] last year. Does that seem right?
1. Yes
2. No
(VOL) DK
(VOL) RF
[For E37]
Do people in your household typically combine any of their income
together in order to pay common expenses? Could you tell me a bit
about how that works in your household)?
F3. Have you set aside emergency or rainy day funds that would cover your expenses for 3 months, in case of sickness, job loss, economic downturn, or other emergencies?
1.
Yes
2. No
(VOL) DK
(VOL) RF
In this section we asked you about the income and payments that
everyone in the household receive. Can you tell me more about how
you know about the income that each person living with you receives?
IF NEEDED: What kind of things helped you provide your answers? How
confident are you about these answers?
IF NEEDED IN MULTIPERSON HOUSEHOLD BECAUSE YOU DID NOT HAVE TIME TO
COLLECT INCOME FOR EVERYONE: We asked about your income [and
______’s income]. What if we had asked about the income for
the other people who live in your household? Would you have had
trouble answering for any of your other household members? Can you
tell me more about that?
Probe here before moving on the next module.
[Half of owners get housing quality/compare current & last home/housing search and half get income/debt/assets.]
COMPARE LAST AND CURRENT HOMES
M20. For the next set of questions, we would like to ask how your previous home compared with your current home. For each question, please tell me which was better, your previous or your current home.
M21. Which home cost less? [INTERVIEWER: Show flashcard M21]
1. Current
home
2. Previous home
3. About the same
(VOL) DK
(VOL) RF
M22. Which home was more affordable to you during your time there?
1. Current
home
2. Previous home
3. About the same
(VOL) DK
(VOL) RF
M23. In which home were you better able to remain safely and securely?
1. Current
home
2. Previous home
3. About the same
(VOL) DK
(VOL) RF
M24. Which apartment [house] was in better physical condition?
1. Current
home
2. Previous home
3. About the same
(VOL) DK
(VOL) RF
M25. Which apartment [house] was bigger?
1. Current
home
2. Previous home
3. About the same
(VOL) DK
(VOL) RF
M26. Which apartment [house] had better amenities?
1. Current
home
2. Previous home
3. About the same
(VOL) DK
(VOL) RF
[For M26]
How did you come up with your answer to this question?
What does amenities mean to you in this question
M27. Now we're going to ask about how your previous building compared with your current building.
Which building was in better physical condition? [INTERVIEWER: Show flashcard M27-M28]
1. Current
home
2. Previous home
3. About the same
(VOL) DK
(VOL) RF
M28. Which building had better amenities? [INTERVIEWER: Show flashcard M27-M28]
1. Current
home
2. Previous home
3. About the same
(VOL) DK
(VOL) RF
M29. Now we'd like to ask you some questions about how your previous neighborhood compared with your current neighborhood.
Which neighborhood had better amenities? [INTERVIEWER: Show flashcard M29-M31]
1. Current
neighborhood
2. Previous neighborhood
3. About the same
(VOL) DK
(VOL) RF
M30. Which neighborhood was safer? [INTERVIEWER: Show flashcard M29-M31]
1. Current
neighborhood
2. Previous neighborhood
3. About the same
(VOL) DK
(VOL) RF
M31. Which neighborhood had better schools? [INTERVIEWER: Show flashcard M29-M31]
1. Current
neighborhood
2. Previous neighborhood
3. About the same
(VOL) DK
(VOL) RF
M32. At which home did it take you longer to get to work?
1. Current
home
2. Previous home
3. About the same
4. I do not
work
(VOL) DK
(VOL) RF
M33. Which home was closer to family and friends?
1. Current
home
2. Previous home
3. About the same
Probe here before moving on the next module.
[Half of owners get housing quality/compare current & last home/housing search and half get income/debt/assets.]
HOUSING SEARCH
A36. Do you have any pets?
1. Yes (go to
A37)
2. No (go to M34)
(VOL) DK (go to M34)
(VOL) RF (go to M34)
A37. What type of pet(s) do you have?
Dog
Cat
Service animal
Other (Please Specify) __________
(VOL) DK
(VOL) RF
A37.1. If you were to move, would your pet(s) move with you?
1.
Yes
2. No
(VOL) DK
(VOL) RF
M34. Are you planning to move in the next 2 years?
1. Yes (go to
M35)
2. No (go to M38)
(VOL) DK (go to M38)
(VOL) RF (go to M38)
M35. Of the things on this list, which three are the most important to you when choosing your next home? [INTERVIEWER: Show flashcard M35]
1. Cost of the
apartment [house]
2. What I am able to pay at this time
3.
Ability to remain in the home safely and securely
4. Physical
condition of the apartment [house]
5. Size of the apartment
[house]
6. Apartment amenities (dishwasher, laundry, balcony,
etc)
7. Physical condition of the building
8. Building
amenities (elevator, laundry, gym, etc)
9. Neighborhood
amenities (parks, museums, stores, etc)
10. Neighborhood
safety
11. The time it takes to get to work
12. School
quality
13. Proximity of family and friends
(VOL) DK
(VOL) RF
[For M35]
[Interviewer: Show the list.] Tell me more about your answer.
M37. When are you planning to move? [INTERVIEWER: Show flashcard M37]
1. Within the
next month
2. More than a month, but in the next six months
3.
More than six months, but in the next year
4. More than a year,
but in the next two years
(VOL) DK
(VOL) RF
M36. If you could, would you prefer to move within your current neighborhood or move to a different neighborhood?
1. Stay in my
neighborhood
2. Move to another neighborhood
3. I'm fine
with either
(VOL) DK
(VOL) RF
M38. On a scale of 1 to 10, how would you rate your [apartment/house] as a place to live?
10 is best, 1 is worst ____________
(VOL) DK
(VOL) RF
[For M38]
What were you thinking about when you answered this question?
M39. How would you rate your neighborhood on a scale of 1-10?
10 is best, 1 is worst ____________
(VOL) DK
(VOL) RF
Probe here before moving on the next module.
HOUSING COSTS (renters)
B47. Do the people who live in this (apartment/house) pay the total amount of rent owed to the landlord each month or does another person or program pay any or all of the rent? [INTERVIEWER: Show flashcard B47]
1.The people who
live here pay the full rent (Skip to B52)
2. Another person pays
part or all of the rent (Skip to B50)
3. Another program pays
part or all of the rent (Go to B48)
4. Both another person and a
program pay part or all of the rent (Go to B48)
5. The landlord
is not owed rent for this apartment (Skip to next module, Utilities)
(VOL) DK (Skip to B52)
(VOL) RF (Skip to B52)
[For B47]
Tell me more about your answer.
How easy or difficult was it to answer this question
B48. Which types of rental assistance paid some or all of the rent owed last month? Please reference Flashcard. Check all that apply [INTERVIEWER: Show flashcard B48]
Interviewer Note: Exclude housing programs that offer a lower rent instead of supplementing rent. Exclude any SNA voucher.
1. Section 8/Housing
Choice Voucher
2. Shelter Allowance/City FEPS
3.
SCRIE/DRIE
4. Other assistance that pays part of my rent
(VOL)
DK
[For B48]
Tell me more about your answer.
Did you use any other types of assistance to pay rent owed last
month that we did not mention?
B49. What was the total contribution from rental assistance last month?
$______
(VOL) DK
(VOL) RF
B50. [ASK IF B47 = 2 or 4] Which of the following is covered all or part of your rent last month? Check all that apply [INTERVIEWER: Show flashcard B50]
1. A family
member or another person
2. An employer of someone in the
household
3. Other
(VOL) DK
[For B50]
Tell me more about your answer
B51. [ASK IF B47 = 2 or 4] What was the total contribution from these outside sources last month?
$______
(VOL) DK
(VOL) RF
B52. What was the total monthly rent owed to the landlord last month?
1. Dollar
Value_______/month
2. Dollar Value_______/week
(VOL) DK
(VOL) RF
B57. [Ask if program and person contributions = the total amount owed to landlord] Last month, did you or anyone else who lives here pay any additional money to your landlord?
Yes
No
(VOL) DK
[IF YES TO B57]
Tell me more about your answer
B53. [INTERVIEWER: Fill with “you” first. Fill with “NAME” for other household members when you loop through this question again.] How much did (you personally/NAME) pay toward the rent last month?
1. ______
dollars
2. (I/They) give different amount each month
3.
Joint/Shared resources
(VOL) DK
(VOL) RF
[LOOP THROUGH B53 FOR EACH HOUSEHOLD MEMBER.You can use the optional
looping sheet here.]
.]
B55. [Ask only if B47=/2/3/4, respondent answered "Don't Know" to B53, or rents/contributions do not add up to B52 (if renters contributions do not add up to amount owed to the landlord)] How much did your household pay toward rent last month ? (This includes you and anyone else who lives with you now)
$______
(VOL) DK
(VOL) RF
B58. [Ask only if B52 does not equal the sum contributed by all people and programs] The amount paid doesn’t seem to be the same as what you said was owed to the landlord. Did you pay (less/more) than was owed last month?
Yes (go to
M16)
No (go to B47)
(VOL) DK (go to M16)
[For B58]
Tell me more about your answer
M16. Since moving to this address, has the landlord ever started an eviction proceeding against any of the people who live here? This includes giving you a warrant of eviction or having a notice of eviction delivered by a Court Marshal.
1. Yes (go to
M17)
2. No (skip to probes)
(VOL) DK
[IF YES TO M16]
Tell me more about your answer
[IF M16 = Yes]
M17. Did the eviction proceeding happen within the last two years?
1.
Yes
2. No
(VOL) DK
(VOL) RF
Probe here before moving on the next module.
PUBLIC BENEFITS AND COVERAGE
P1. Last month, did you or anyone else who lives here receive assistance or payments from any of the following? [INTERVIEWER: Show flashcard P1]
Check all that apply
Interviewer note: We will ask separately about any other help you get for housing costs.
1. Supplemental
Nutrition Assistance Program (SNAP)
2. Temporary Assistance for
Needy Families (TANF)
3. Women, Infants and Children (WIC)
(VOL) DK
(VOL) RF
P1.5. Last month, did you or anyone else who lives here receive any assistance or payment from SNA (Safety Net Assistance)?
1.
Yes
2. No
(VOL) DK
(VOL) RF
P1.8. Last month, did you or anyone else who lives here receive assistance or payment from another public benefit or welfare program?
1. Yes (go to
P2)
2. No (go to P3)
(VOL) DK (go to P3)
(VOL) RF (go to P3)
P2. What was the other public benefit or welfare program?
Specify_______
(VOL) DK
(VOL) RF
P3. [Ask only if P1 = "SNAP"] Last month, how much did you and the other people who live here receive in SNAP benefits?
$ ____________
(VOL) DK
(VOL) RF
P4. [Ask only if P1 = "SNAP"] In the last 12 months, how many months did you and the other people who live here receive SNAP benefits?
____________ months
(VOL) DK
(VOL) RF
P5. [Ask only if P1 = "TANF"] Last month, how much did you and the other people who live here receive in TANF benefits?
$ ____________
(VOL) DK
(VOL) RF
P6. [Ask only if P1 = "TANF"] In the last 12 months, how many months did you and the other people who live here receive TANF benefits?
____________ months
(VOL) DK
(VOL) RF
P14. [Ask only if P1 = "WIC"] Last month, how much did you and the other people who live here receive in WIC benefits?
$ ____________
(VOL) DK
(VOL) RF
P15. [Ask only if P1 = "WIC"] In the last 12 months, how many months did you and the other people who live here receive WIC benefits?
____________ months
(VOL) DK
(VOL) RF
P7. (Ask only if P1.5 = Yes)Last month, were these SNA benefits sent to you or someone else who lives here or to another person or entity?
1. SNA benefits
are sent to the people who live here
2. SNA benefits are sent to
the landlord
3. SNA benefits are sent to the utility company
(VOL) DK
(VOL) RF
P8. [Ask only if P7=1] Last month, how much did you and the other people who live here receive in SNA benefits?
$ ____________
(VOL) DK
(VOL) RF
P10. [Ask only if P7=1] In the last 12 months, how many months did you and the other people who live here receive SNA benefits?
____________ months
(VOL) DK
(VOL) RF
P9. [Ask only if P7=2] Last month, what is the total value of the SNA benefit sent to the landlord?
$ ____________
(VOL) DK
(VOL) RF
P13. [Ask only if P7=2] For how many of the last 12 months were the SNA benefits a check or voucher that went to the landlord?
____________ months
(VOL) DK
(VOL) RF
P11. [if P1.8 = YES] Last month, how much did you and the other people who live here receive from [Other source fill]?
$ ____________
(VOL) DK
(VOL) RF
P12. (Ask only if P1.8=Yes) In the last 12 months, how many months did you and the other people who live here receive [Other source fill]?
____________ months
(VOL) DK
(VOL) RF
NOTE AND PROBE DURING SIGNS OF DIFFICULTY ANSWERING THE QUESTIONS
(E.G., HESITATION, DON’T KNOW RESPONSES, QUALIFIED RESPONSES
Probe here before moving on the next module.
[Half of owners get housing quality/compare current & last home/housing search and half get income/debt/assets.]
DEBT
General Probe:
Do you have any major costs on a regular basis that we didn’t
capture?
F18. Please tell me all of the types of debt you currently have from Response Card F18:
1. Student Loan
2. Car Loans
3. Loans from relatives and friends
4.
Credit Card
5. Medical Bills
6. Legal Bills
7. Other
(VOL) DK
(VOL) RF
F46. [if F18 = 7] What were those other debts?
Specify _____________
(VOL) DK
(VOL) RF
[INTERVIEWER: Use tally sheet to record income for questions with a check mark.]
F26. [if
F18 = 1] If you added up all student loans, about how much would
they amount to right now?
• INCLUDE unpaid balance(s), or student loans that are outstanding
$ ______________ [between 1 – 9,999,997]
(VOL) DK
(VOL) RF
[For F26]
How easy or difficult was it to come up with your answer?
F27. Would they amount to $25,000 or more?
Yes (go to
F28)
No (go to F29)
DK/RF (go to F76)
F28. (Would they amount to) $50,000 or more?
Yes (go to
F30)
No (go to F76)
DK/RF (go to F76)
F29. (Would they amount to) $10,000 or more?
Yes (go to
F76)
No (go to F76)
DK/RF (go to F76)
F30. (Would they amount to) $75,000 or more?
Yes (go to
F76)
No (go to F76)
DK/RF (go to F76)
F76. [IF
F18 = 2] If you added up all the car loans, about how much would
they amount to right now?
$ ______________ [between 1 – 9,999,997]
[For F76]
How easy or difficult was it to come up with your answer?
F77. Would they amount to $4,000 or more?
Yes (go to
F78)
No (go to F79)
DK/RF (go to F41)
F78. (Would they amount to) $10,000 or more?
Yes (go to
F80)
No (go to F41)
DK/RF (go to F41)
F79. (Would they amount to) $1,000 or more?
Yes (go to
F41)
No (go to F41)
DK/RF (go to F41)
F80. (Would they amount to) $20,000 or more?
Yes
No
DK/RF
F41. [IF
F18 = 3] If you added up all loans from relatives and friends,
about how much would they amount to right now?
• INCLUDE unpaid balance(s), or loans from relatives that are outstanding
$ ______________ [between 1 – 9,999,997]
(VOL) DK
(VOL) RF
[if no exact amount given to F41, go to F42. If exact amount given, go to F20]
[For F41]
How easy or difficult was it to come up with your answer?
F42. Would they amount to $4,000 or more?
Yes (go to
F43)
No (go to F45)
DK/RF (go to F20)
F43. (Would they amount to) $10,000 or more?
Yes (go to
F44)
No (go to F20)
DK/RF (go to F20)
F44. (Would they amount to) $1,000 or more?
Yes (go to
F20)
No (go to F20)
DK/RF (go to F20)
F45. (Would they amount to) $20,000 or more?
Yes
No
DK/RF
(go to F20)
F20. [IF
F18 = 4] If you added up all credit card and store card debts,
about how much would they amount to right now? (Please do not count
any new debt that will be paid off this month.)
• INCLUDE unpaid balance(s) only, or credit card and store card debts that are outstanding
$ ______________ [between 1 – 9,999,997]
[For F20]
How easy or difficult was it to come up with your answer?
F21. Would they amount to $5,000 or more?
Yes (go to
F22)
No (go to F24)
DK/RF (go to F31)
F22. (Would they amount to) $10,000 or more?
Yes (go to
F23)
No (go to F31)
DK/RF (go to F31)
F23. (Would they amount to) $1,000 or more?
Yes (go to
F31)
No (go to F31)
DK/RF (go to F31)
F24. (Would they amount to) $15,000 or more?
Yes
No
DK/RF
F31. [IF
F18 = 5] If you added up all medical bills, about how much would
they amount to right now?
• INCLUDE unpaid balance(s), or medical bills that are outstanding
$ ______________ [between 1 – 9,999,997]
[For F31]
How easy or difficult was it to come up with your answer?
F32. Would they amount to $3,000 or more?
Yes (go to
F33)
No (go to F35)
DK/RF (go to F36)
F33. (Would they amount to) $10,000 or more?
Yes (go to
F34)
No (go to F36)
DK/RF (go to F36)
F34. (Would they amount to) $1,000 or more?
Yes (go to
F36)
No (go to F36)
DK/RF (go to F36)
F35. (Would they amount to) $25,000 or more?
Yes
No
DK/RF
F36. [IF
F18 = 6] If you added up all legal bills, about how much would
they amount to right now?
• INCLUDE unpaid balance(s), or legal bills that are outstanding
$ ______________ [between 1 – 9,999,997]
(VOL) DK
(VOL) RF
[For F36]
How easy or difficult was it to come up with your answer?
F37. Would they amount to $3,000 or more?
Yes (go to
F38)
No (go to F39)
DK/RF (go to F47)
F38. (Would they amount to) $8,000 or more?
Yes (go to
F40)
No (go to F47)
DK/RF (go to F47)
F39. (Would they amount to) $1,000 or more?
Yes (go to
F47)
No (go to F47)
DK/RF (go to F47)
F40. (Would they amount to) $20,000 or more?
Yes
No
DK/RF
F47. [IF
F18 = 7] If you added up all [other debts], about how much would
they amount to right now?
• INCLUDE unpaid balance(s), or other debts that are outstanding
$ ______________ [between 1 – 9,999,997]
(VOL) DK
(VOL) RF
[For F47]
How easy or difficult was it to come up with your answer?
F48. Would they amount to $4,000 or more?
Yes (go to
F49)
No (go to F50)
DK/RF (go to F51)
F49. (Would they amount to) $10,000 or more?
Yes (go to
F50.1)
No (go to F51)
DK/RF (go to F51)
F50. (Would they amount to) $1,000 or more?
Yes (go to
F51)
No (go to F51)
DK/RF (go to F51)
F50.1. (Would they amount to) $20,000 or more?
Yes
No
DK/RF
F51. It seems like you have [Calculate total debt for person using tally sheet] in debt, does that seem right?
Yes
No,
(Please specify) _________________
(VOL) DK
(VOL) RF
F52. Altogether, is this more or less debt than you had a year ago?
1. More
2.
Less
3. About the same
(VOL) DK
(VOL) RF
F53. Altogether, is this more or less debt than you had five years ago?
1. More
2.
Less
3. About the same
(VOL) DK
(VOL) RF
Probe here before moving on the next module.
[Half of owners get housing quality/compare current & last home/housing search and half get income/debt/assets.]
ASSETS
F54. Please tell me all of the assets that you have not already named from Response Card F54:
Checking account
Savings account
Equity in a business
Car
Property other than your own home
Retirement plan
Educational savings account
Other Investments
Anything else of value more than $5,000
None
(VOL) DK
-
[For F54]
Tell me more about your answer .
How easy or difficult was it to come up with your answer?
Is there anything missing from this list, like another kind of asset?
(VOL) RF
F55. Thinking about all of those assets, would you say that their current value is $10,000 or more?
Yes
No
About the same
(VOL) DK
(VOL) RF
[IF F55 = “Yes” ASK F56. ELSE TO PROBES BEFORE ROSTER PART 1]
F56. Thinking about all of those assets, would you say that their current value is $25,000 or more?
Yes
No
About the same
(VOL) DK
(VOL) RF
[IF F56 = “Yes” ASK F57. ELSE TO PROBES BEFORE ROSTER PART 1]
F57. Thinking about all of those assets, would you say that their value is [Total Debt from F51 – see Tally Sheet] or more?
Yes
No
About the same
(VOL) DK
(VOL) RF
[IF F57 = “Yes” AND INCOME =/= “0” ASK F58. ELSE TO PROBES BEFORE ROSTER PART 1]
F58. Thinking about all of those assets, would you say that their value is [Annual Income from E36 for respondent – see Tally Sheet] or more?
Yes
No
About the same
(VOL) DK
(VOL) RF
Probe here before moving on the next module.
SOGI PATH A
For some questions, I will show you a card that has the answer options written down. When you give me your answer, you can tell me the answer or the number next to your answer.
[Start with respondent. Note whether answer or number is given for A10-A12]
A10. Which of the following best represents how you think of yourself? [IF PROXY] To the best of your knowledge, which of the following best represents how [NAME] thinks of themselves? [INTERVIEWER: Show flashcard A10]
1. Gay or lesbian
2. Straight; that is, not gay, lesbian, or bisexual
3. Bisexual
4. Something else
(VOL) DK
(VOL) RF
[For A10]
Tell me more about your answer for yourself.
Are there other options not listed that better describe you? For
what reason?
.[IFA10= DK, PROBE] How easy or difficult was it to answer this
question? Are there any words in this question that some people
might find confusing?
[IF R GAVE PROXY RESPONSE FOR OTHER HH MEMBERS] How easy or
difficult was it to answer for the other people living with you?
Can you tell me more about that?
How comfortable were you answering for the other people living with
you? Can you tell me more about that?
I’m interested in trying out another way to ask about this
topic. [INTERVIEWER SHOW A23 FROM SOGI PATH B.] How would you
answer this question?
[IF ANSWER TO A10 DIFFERENT FROM A23, PROBE] I noticed you answered
a little bit differently this time. Can you tell me more about how
you came up with the answer to this question?
Which version was easier to understand? If respondent says both
are the same: Do you prefer one of these versions over the
other? [INTERVIEWER SHOW A10 AND A23 IF NEEDED?
A11. [IF RESPONDENT READ: Was your sex recorded as male, female, or intersex at birth? / IF PROXY READ: To the best of your knowledge, was [NAME]'s sex recorded as male, female, or intersex at birth?
1. Male
2. Female
3. Intersex
(VOL) DK
(VOL) RF
[For A11]
Tell me more about your answer for yourself.
What does “intersex” mean to you in this question?
IFA11= DK, PROBE] How easy or difficult was it to answer this
question?
[IF R GAVE PROXY RESPONSE FOR OTHER HH MEMBERS] How easy or
difficult was it to answer for the other people living with you?
Can you tell me more about that?
How comfortable were you answering for the other people living with
you? Can you tell me more about that?
I’m interested in trying out another way to ask about this
topic. [INTERVIEWER SHOW A15 FROM SOGI PATH B.] How would you
answer this question?
[IF ANSWER TO A11 DIFFERENT FROM A15, PROBE] I noticed you
answered a little bit differently this time. Can you tell me more
about how you came up with the answer to this question?
Which version was easier to understand? If respondent says both
are the same: Do you prefer one of these versions over the
other? [INTERVIEWER SHOW A11 AND A15 IF NEEDED]
A12. [IF RESPONDENT READ: Do you describe yourself as male, female, or transgender?/ IF PROXY READ: To the best of your knowledge, does [NAME] describe themselves as male, female, or transgender?
1. Male
2. Female
3. Transgender
(VOL) DK
(VOL) RF
[Loop A10-A12 for all person in HH 15+. You can use the optional
looping sheet here.]
[For A12]
What does “transgender” mean to you in this question?
If appropriate: Are there other words you would use to describe
yourself besides the ones I mentioned?
[IFA12= DK, PROBE] How easy or difficult was it to answer this
question?
[IF R GAVE PROXY RESPONSE FOR OTHER HH MEMBERS] How easy or
difficult was it to answer for the other people living with you?
Can you tell me more about that?
How comfortable were you answering for the other people living with
you? Can you tell me more about that?
I’m interested in trying out another way to ask about this
topic. [INTERVIEWER SHOW A13 FROM SOGI PATH B.] How would you
answer this question?
[IF ANSWER TO A12 DIFFERENT FROM A13, PROBE] I noticed you answered
a little bit differently this time. Can you tell me more about how
you came up with the answer to this question?
Which version was easier to understand? If respondent says both
are the same: Do you prefer one of these versions over the
other? [INTERVIEWER SHOW A12 AND A13 IF NEEDED]
Probe here before moving on the next module.
SOGI PATH B
For some questions, I will show you a card that has the answer options written down. When you give me your answer, you can tell me the answer or the number next to your answer.
[Interviewer: Note whether answer or number is given for A13, A15, A23.]
A13. I want to ask you about your gender identity and your sex assigned at birth. Gender identity refers to how you identify yourself, which may or may not be the same as the sex you were assigned at birth. How do you currently identify your gender? Do you identify as... [INTERVIEWER: Show flashcard A13]
Interviewer: Read and allow for multiple responses but do not probe
1. a man, SKIP TO A15
2. a woman, SKIP TO A15
3. a transgender man (TRANS MAN, TRANS MASCULINE, TRANS FEMALE-TO-MALE, MAN OF TRANSGENDER EXPERIENCE), SKIP TO A15
4. a transgender woman (TRANS WOMAN, TRANS FEMINIME, TRANS MALE-TO-FEMALE, WOMAN OF TRANSGENDER EXPERIENCE), SKIP TO A15
5. a non-binary person (GENDERQUEER PERSON, GENDER NONCONFORMING PERSON, TWO-SPIRIT, NEITHER WOMAN OR MAN), or SKIP TO A15
6. or, a gender not mentioned?
(VOL) DK SKIP TO A15
(VOL) RF SKIP TO A15
[For A13]
Tell me more about your answer for yourself.
.[IFA13= DK, PROBE] How easy or difficult was it to answer this
question? Are there any words in this question that some people
might find confusing?
[IF R GAVE PROXY RESPONSE FOR OTHER HH MEMBERS] How easy or
difficult was it to answer for the other people living with you?
Can you tell me more about that?
How comfortable were you answering for the other people living with
you? Can you tell me more about that?
I’m interested in trying out another way to ask about this
topic. [INTERVIEWER SHOW A12 FROM SOGI PATH A.] How would you
answer this question?
[IF ANSWER TO A12 DIFFERENT FROM A13, PROBE] I noticed you answered
a little bit differently this time. Can you tell me more about how
you came up with the answer to this question?
Which version was easier to understand? If respondent says both
are the same: Do you prefer one of these versions over the
other? [INTERVIEWER SHOW A12 AND A13 IF NEEDED?
[ASK IF A13 = 6 a gender not mentioned. ELSE SKIP TO A15.]
A14. How do you identify your gender?
(Specify)
(VOL) DK
(VOL) RF
A15. What was your sex assigned at birth? Male or female?
[INTERVIEWER: If respondent says “Don’t Know,” probe: When you were born, were you labeled as a boy or a girl?]
[INTERVIEWER: If the respondent says they were born with intersex traits, probe: What was the sex listed on your original birth certificate? Male or female?]
1. Male
2. Female
(VOL) DK
(VOL) RF
[For A15]
Tell me more about your answer for yourself.
IFA15= DK, PROBE] How easy or difficult was it to answer this
question?
[IF R GAVE PROXY RESPONSE FOR OTHER HH MEMBERS] How easy or
difficult was it to answer for the other people living with you?
Can you tell me more about that?
How comfortable were you answering for the other people living with
you? Can you tell me more about that?
I’m interested in trying out another way to ask about this
topic. [INTERVIEWER SHOW A11 FROM SOGI PATH A.] How would you
answer this question?
[IF ANSWER TO A11 DIFFERENT FROM A15, PROBE] I noticed you answered
a little bit differently this time. Can you tell me more about how
you came up with the answer to this question?
Which version was easier to understand? If respondent says both
are the same: Do you prefer one of these versions over the
other? [INTERVIEWER SHOW A11 AND A15 IF NEEDED]
[IF A13 = MAN and A15 = WOMAN, OR IF A13 = WOMAN AND A15 = MAN, ASK A16. ELSE GO TO SKIP BEFORE A18.]
A16. To confirm, you identify as [A13 FILL] and your sex assigned at birth was [A15 FILL], correct?
1 YES; RESPONDENT HAS A GENDER IDENTITY DIFFERENT THAN THEIR SEX AT BIRTH GO TO SKIP BEFORE A18.
2 NO
(VOL) DK SKIP TO A18.
(VOL) RF SKIP TO A18.
[IF A16 = “No” ASK A17. ELSE GO TO SKIP BEFORE A18.]
A17. We have your identity as [A13 FILL] and your sex assigned at birth as [A15 FILL]. Should we update your identity or your assigned sex at birth?
1 UPDATE IDENTITY [A13 UPDATE TO EQUAL A15] SKIP TO A23
2 UPDATE ASSIGNED SEX AT BIRTH [A15 UPDATE TO EQUAL A13] SKIP TO A23
(VOL) DK SKIP TO A23
(VOL) RF SKIP TO A23
[IF A13 = “Don’t Know” ASK A18. ELSE GO TO SKIP BEFORE A19]
A18. Are you exploring your gender identity and are not sure how you identify yet, do you not understand the question, or do you identify as [A15 FILL]?
1 You are exploring your gender identity and not sure how you identify yet,
2 You do not understand the question,
3 You identify as [A15 fill]
(VOL) DK
[IF A18 ASKED]
Tell me more about your answer for yourself.
[IF A13 = TRANSGENDER MAN AND A15 = MALE ASK A19. ELSE GO TO SKIP BEFORE A21.]
A19. Transgender men are often persons who identify as men and were assigned female sex at birth. To confirm, you identify as a transgender man and were assigned male sex at birth?
1 YES: RESPONDENT IDENTIFIES AS TRANSGENDER MAN AND WAS ASSIGNED MALE SEX AT BIRTH GO TO SKIP BEFORE A21.
2 NO
(VOL) DK GO TO SKIP BEFORE A21.
(VOL) RF GO TO SKIP BEFORE A21.
[IF A19 ASKED]
Tell me more about your answer for yourself.
[IF A19 = “No” ASK A20. ELSE GO TO SKIP BEFORE A21.]
A20. Do you identify as a transgender man and were assigned female sex at birth, do you identify as a woman or transgender woman and were assigned male sex at birth, or do you identify as a man and were assigned male sex at birth?
1 Identify as a transgender man and were assigned female sex at birth
2 Identify as a woman or transgender woman and were assigned male sex at birth
3 Identify as a man and were assigned male sex at birth
(VOL) DK
[IF A20 ASKED]
Tell me more about your answer for yourself.
[IF A13 = TRANSGENDER WOMAN & A15 = FEMALE ASK A21. ELSE GO TO A23.]
A21. Transgender women are often persons who identify as women and were assigned male sex at birth. To confirm, you identify as a transgender woman and were assigned female sex at birth?
1 YES: RESPONDENT IDENTIFIES AS A TRANSGENDER WOMAN AND WAS ASSIGNED FEMALE SEX AT BIRTH GO TO A23
2 NO
(VOL) DK GO TO A23
[IF A21 ASKED]
Tell me more about your answer for yourself.
[IF A21 = “No” ASK A22. ELSE SKIP TO A23.]
A22. Do you identify as a transgender woman and were assigned male sex at birth, do you identify as a man or transgender man and were assigned female sex at birth, or do you identify as a woman and were assigned female sex at birth? [INTERVIEWER: Show flashcard A22]
1 Identify as a transgender man and were assigned female sex at birth
2 Identify as a woman or transgender woman and were assigned male sex at birth
3 Identify as a man and were assigned male sex at birth
[IF A22 ASKED]
Tell me more about your answer for yourself.
(VOL) RF
A23. Now I'll read a list of terms people sometimes use to describe themselves:
[INTERVIEWER: Show flashcard A23]
[IF A13= MAN/TRANSGENDER WOMAN/NON-BINARY PERSON READ: Are you gay, straight - that is not gay, bisexual, or something else?]
[IF A13 = WOMAN/TRANSGENDER MAN/GENDER NOT MENTIONED/DK/RF READ: Are you lesbian or gay, straight - that is not lesbian or gay, bisexual, or something else?]
[IF Q8.2 = 7 OR 9 - READ] Are you gay, straight - that is not gay or lesbian, bisexual, or something else?]
1 Gay [A13= WOMAN/TRANSGENDER MAN/GENDER NOT MENTIONED/DK/RF READ: or lesbian]
2 Straight, that is not gay
3 Bisexual, or
4 Something else
7 DON’T KNOW/NOT SURE
[For A23]
Tell me more about your answer for yourself.
[IFA23= DK, PROBE] How easy or difficult was it to answer this
question? Are there any words in this question that some people
might find confusing?
Are there other options not listed that better describe you? For
what reason?
[IF R GAVE PROXY RESPONSE FOR OTHER HH MEMBERS] How easy or
difficult was it to answer for the other people living with you?
Can you tell me more about that?
How comfortable were you answering for the other people living with
you? Can you tell me more about that?
I’m interested in trying out another way to ask about this
topic. [INTERVIEWER SHOW A10 FROM SOGI PATH A.] How would you
answer this question?
[IF ANSWER TO A10 DIFFERENT FROM A23, PROBE] I noticed you answered
a little bit differently this time. Can you tell me more about how
you came up with the answer to this question?
Which version was easier to understand? If respondent says both
are the same: Do you prefer one of these versions over the
other? [INTERVIEWER SHOW A10 AND A23 IF NEEDED?
[IF A23 = 7 ASK A24.]
A24. Do you not understand the words, are you not sure yet, or do you mean something else?
1 Don’t understand the words
2 Not sure yet, or
3 Something else
7 DON’T KNOW/NOT SURE
[IF A23 = SOMETHING ELSE OR A24 = SOMETHING ELSE ASK A25.].
A25. What do you mean by something else?
(SPECIFY)____________
(VOL) DK
(VOL) RF
[Loop A13-A25 for all person in HH 15+. You can use the optional
looping sheet here.]
Probe here before moving on the next module.
CLOSETOUT AND PHONES
I21. Is there a landline telephone in this [apartment/house]? Do not count cellular phones, or any phone line that is used only for a computer or fax machine.
1. Yes
2. No
(VOL) DK
(VOL) RF
I22. How many adults (age 18 and over) in this household have a cell phone for personal use? (If an individual shares a cell phone, count the adult if he or she has it for at least one-third of the time.)
1. ____Persons
2. None
(VOL) DK
(VOL) RF
General Probe
Is there anything else you’d like to tell me that we haven’t
had a chance to discuss yet?
Probe here before moving on the next module.
|
|
Those were all of my questions. I appreciate you taking the time to speak with me. Your answers were very helpful. Now I’m going to turn the tape recorder off. [TURN OFF TAPE RECORDER. HAND RESPONDENT INCENTIVE].
This is the payment to thank you for your time today. Please open the envelope and double check that the payment for $40 is all there, and then please fill out this receipt. [HAVE RESPONDENT PUT THEIR NAME, ADDRESS, SIGNATURE, AND DATE ON VOUCHER FORM.]
Thank you!
Maintenance Deficiencies for C45.1 & 41 – C44
C24. A breakdown in your heating equipment
C26. A need to use additional sources of heat
C29. Seeing signs of mice or rats
C36. Broken plaster or peeling paint
C32. Cracks or holes in the interior walls or ceiling
C34. Holes in the floors
C6. Toilets not working
C38. Water leaking into your apartment/house
Income Calculations
|
Q # |
P1 |
P2 |
P3 |
P4 |
P5 |
P6 |
Income |
E21 |
|
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|
E22 |
|
|
|
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|
|
|
E25 |
|
|
|
|
|
|
|
E23 |
|
|
|
|
|
|
|
E24 |
|
|
|
|
|
|
|
E26 |
|
|
|
|
|
|
|
E27 |
|
|
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|
E28 |
|
|
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E29 |
|
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|
|
E31 |
|
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|
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|
|
E36 Total |
|
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|
|
E37 Grand total |
|
||||||
Debt Calculations
|
F26 |
F76 |
F41 |
F20 |
F31 |
F36 |
F47 |
F51 Total |
Respondent Debt |
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Rodney Terry (CENSUS/CBSM FED) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-16 |
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