N ote: Questionnaire is a working draft and questions may be added, removed, or edited
2020 Census Experience Follow-up Survey
Hi, my name is XXXX and I am calling on behalf of the U.S. Census Bureau. If no respondent name available, skip to Q2.
Have I reached [RESPONDENT NAME]?
Yes – Continue to Q2
No
Is [RESPONDENT NAME] available?
Available – Reintroduce yourself and continue to Q2
Not available – Skip to Q3
The Census Bureau is conducting a survey to learn more about people’s experiences with the 2020 Census. Did you personally complete the 2020 Census for [FILL ADDRESS]? They could have responded online, on paper, by phone, or in-person.
Yes – Skip to Section 1
No
Don’t know – Continue to Q3
Do you know who did respond to the 2020 Census?
Yes – May I speak with them now?
Available – Reintroduce yourself and re-read Q2
Not Available – Continue to Q3
No, don’t know – Continue to Q3
No, no one in household completed census – End interview
Were you living or staying at this address on April 1, 2020?
Yes
What is your name? – Record and skip to Section 1 Q5 Special Intro
No – End interview
I have some questions to ask you about the 2020 Census. Answers from this survey will help the Census Bureau plan for the next census in 2030.
I am required by law to tell you that this survey is authorized by Title 13, Sections 141, 193, and 221 of the United States Code. The average interview takes about 20 minutes and your cooperation is very important. The Census Bureau is required by law to keep your information confidential. The Census Bureau is not permitted to publicly release your responses in a way that could identify this household. Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data.
Did you respond to the 2020 Census online, on paper, on the telephone, or in-person?
Online
On paper
On the telephone
In-person
Don’t Know
Refused
Q5 Special Intro: Even though you may not have completed the 2020 Census for this address, we’d still like to talk to you about the census. Answers from this survey will help plan for the next census in 2030.
I am required by law to tell you that this survey is authorized by Title 13, Sections 141, 193, and 221 of the United States Code. The average interview takes about 20 minutes and your cooperation is very important. The Census Bureau is required by law to keep your information confidential. The Census Bureau is not permitted to publicly release your responses in a way that could identify this household. Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data. Skip to Q5
Q5 All Others: We’d like to know how you feel about each of the following census questions. How sensitive do you consider each of these census questions to be- extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?
The first question is whether the home is owned or rented [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
How about the number of people in your household? [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
What about your name? [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
[SKIP IF ONLY 1 PERSON IN HOUSEHOLD] Names of household members [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
Your date of birth [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
[SKIP IF ONLY 1 PERSON IN HOUSEHOLD] Your household members’ dates of birth [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
Your Hispanic, Latino, or Spanish origin [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
[SKIP IF ONLY 1 PERSON IN HOUSEHOLD] Hispanic, Latino, or Spanish origin of household members [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
Your race [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
Not too sensitive
Not at all sensitive
Don’t Know
Refused
[SKIP IF ONLY 1 PERSON IN HOUSEHOLD] Race of household members [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
[SKIP IF RESPONDENT IS PERSON 1] How you are related to ([PERSON 1]/the householder) [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
[SKIP IF ONLY 1 PERSON IN HOUSEHOLD] How household members are related to ([PERSON 1]/the householder) [If needed: Is that extremely sensitive, very sensitive, somewhat sensitive, a little sensitive, or not at all sensitive?]
Extremely sensitive
Very sensitive
Somewhat sensitive
A little sensitive
Not at all sensitive
Don’t Know
Refused
Now, thinking about the 2020 Census in general.
How important do you think it is for the Census Bureau to ask the questions they do on the census form? Is it extremely important, very important, somewhat important, a little important, or not at all important?
Extremely important
Very important
Somewhat important
A little important
Not at all important
Don’t Know
Refused
Do you believe that answering and submitting your census form could benefit you?
Yes
No
Don’t Know
Refused
What about your community? [If needed: Do you believe that answering and submitting your census form could benefit your community?]
Yes
No
Don’t Know
Refused
Do you believe that answering and submitting your census form could harm you?
Yes
No
Don’t Know
Refused
What about your community? [If needed: Do you believe that answering and submitting your census form could harm your community?]
Yes
No
Don’t Know
Refused
Now, I’d like to ask about your opinions on privacy.
In general, how worried would you say you are about your personal privacy? Would you say extremely worried, very worried, somewhat worried, a little very worried, or not at all worried?
Extremely worried
Very worried
Somewhat worried
A little worried
Not at all worried
Don’t Know
Refused
I am going to read three statements. Please tell me whether you strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, or strongly disagree with the following statements.
People’s rights to privacy are well protected. [If needed: Do you strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, or strongly disagree?]
Strongly agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Strongly disagree
Don’t Know
Refused
People have lost all control over how personal information about them is used. [If needed: Do you strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, or strongly disagree?]
Strongly agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Strongly disagree
Don’t Know
Refused
The government knows more about me than it needs to. [If needed: Do you strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, or strongly disagree?]
Strongly agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Strongly disagree
Don’t Know
Refused
Business and private industry have too much information about me. [If needed: Do you strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, or strongly disagree?]
Strongly agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Strongly disagree
Don’t Know
Refused
Which poses a greater risk to your privacy—businesses and private industry, or the government?
Businesses and private industry
The government
How often do you refuse to answer specific questions or an entire survey because of privacy concerns—would you say very often, sometimes, rarely, or never?
Very often
Sometimes
Rarely
Never
Have you ever given a wrong answer to a question on a survey because of privacy concerns?
Yes
No
Don’t Know
Refused
Thinking now about your use of the internet…
Overall, how often do you use the internet – several times a day, once a day, at least once a week, or less often?
Several times a day
Once a day
At least once a week
Less often
Don’t Know
Refused
In general, how concerned are you about your privacy while you are using the internet-- are you extremely concerned, very concerned, somewhat concerned, a little concerned, or not concerned at all?
Extremely concerned
Very concerned
Somewhat concerned
A little concerned
Not at all concerned
Don’t Know
Refused
Do you feel as though you already do enough to protect the privacy of your personal information online, or do you feel as though you would like to do more?
I already do enough
I would like to do more
Don’t Know
Refused
IF RESPONDED THROUGH MODE OTHER THAN INTERNET: Thinking now about the 2020 Census again, were you aware that you could answer the census online?
Yes – Continue to Q36
No – Skip to Q38
Don’t Know – Skip to Q38
Refused – Skip to Q38
IF YES TO Q31 OR RESPONDED BY INTERNET: Did the option of responding online to the 2020 Census raise any concerns for you?
Yes – Continue to Q37
No – Skip to Q38
Don’t Know – Skip to Q38
Refused – Skip to Q38
What concerns did you have about responding to the 2020 Census online? (Open-ended)
Verbatim text response: _______________________
Don’t Know
Refused
Do you think the Census Bureau does a good job of providing information to the public about how it protects people's privacy?
Yes
No
Don’t Know
Refused
Do you think the Census Bureau does a good job of providing information to the public about how it keeps data confidential? [If needed: Do you think the Census Bureau does a good job of providing information to the public about how it keeps data confidential?]
Yes
No
Don’t Know
Refused
Do you think the Census Bureau does a good job of providing information to the public about how census responses are used? [If needed: Do you think the Census Bureau does a good job of providing information to the public about how it produces statistics?]
Yes
No
Don’t Know
Refused
Next, a question about the U.S. government as a whole. Do you think federal government agencies share a single central database of the name, address and date of birth of U.S. residents?
Yes
No
Don’t Know
Refused
How concerned are you, if at all, that the Census Bureau will not keep answers to the 2020 Census confidential—are you extremely concerned, very concerned, somewhat concerned, a little concerned, or not at all concerned?
Extremely concerned
Very concerned
Somewhat concerned
A little concerned
Not at all concerned
Don’t Know
Refused
How concerned are you, if at all, that the answers you provide to the 2020 Census will be used against you—are you extremely concerned, very concerned, somewhat concerned, a little concerned, or not at all concerned?
Extremely concerned
Very concerned
Somewhat concerned
A little concerned
Not at all concerned
Don’t Know
Refused
How concerned are you, if at all, that an unauthorized person or hacker might gain access to 2020 Census responses—are you extremely concerned, very concerned, somewhat concerned, a little concerned, or not at all concerned?
Extremely concerned
Very concerned
Somewhat concerned
A little concerned
Not at all concerned
Don’t Know
Refused
Are you concerned that other government agencies could obtain your answers to the 2020 Census?
Yes
No
Don’t Know
Refused
Which of the following statements comes closest to your opinion?
I am willing to share information about me and my household with some government agencies (like the Census Bureau) so the government can produce more useful data and statistics, even if it means having less control over that information.
I would rather keep information about me and my household private even if it means the data and statistics produced by the government are less useful.
I agree equally with both
I don't agree with either
Don’t Know
Refused
The Census Bureau plans to protect your privacy in the 2020 Census by using a technique called differential privacy. Have you heard about differential privacy or have you not heard about differential privacy?
Yes, I have heard about differential privacy
No, I have not heard about differential privacy
Don’t Know
Refused
For the next census in 2030, one proposal is to do away with Census forms entirely. No one would be asked to fill out a form. Instead, the Census Bureau would count the entire population by getting information from other government agencies. Would you be in favor or oppose the Census Bureau getting everyone's information from the records of other government agencies?
Strongly in favor of it
Somewhat in favor of it
Neither in favor nor against it
Somewhat against it
Strongly against it
Don’t Know
Refused
I'm going to read you three different types of information and ask you if you would be strongly in favor of the Census Bureau getting that information from other government agencies, somewhat in favor of it, neither in favor nor against it, somewhat against it, or strongly against it.
Whether your address was occupied or vacant on a particular date [If needed: Would you be strongly in favor, somewhat in favor of it, neither in favor nor against it, somewhat against it, or strongly against it?]
Strongly in favor of it
Somewhat in favor of it
Neither in favor nor against it
Somewhat against it
Strongly against it
Don’t Know
Refused
Whether your home is owned or rented [If needed: Would you be strongly in favor, somewhat in favor of it, neither in favor nor against it, somewhat against it, or strongly against it?]
Strongly in favor of it
Somewhat in favor of it
Neither in favor nor against it
Somewhat against it
Strongly against it
Don’t Know
Refused
Your contact information, like phone numbers and email addresses [If needed: Would you be strongly in favor, somewhat in favor of it, neither in favor nor against it, somewhat against it, or strongly against it?]
Strongly in favor of it
Somewhat in favor of it
Neither in favor nor against it
Somewhat against it
Strongly against it
Don’t Know
Refused
If you have to choose, for the next census in 2030, would you prefer that the Census gets your household’s information from other government agencies or would you prefer that the Census Bureau send an interviewer to your home to ask for it?
Get information from other government agencies
Get information from interviewer at home
Don't know
Refused
For you PERSONALLY, if you did not respond to your census form for the next census in 2030, would you rather the Census Bureau get your information from your neighbors or from other government agencies?
Get information from their neighbors
Get information from other government agencies
Don't know
Refused
We are almost done with the survey.
The population count, the crime rate, and the unemployment rate are examples of statistics produced by the federal government. Have you ever used federal statistics for study or work?
Yes
No
Don’t Know
Refused
Personally, how much trust do you have in the federal statistics in the United States? Would you say that you tend to trust federal statistics or tend not to trust them?
Tend to trust
Tend not to trust
Don’t Know
Refused
Please tell me whether you strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, or strongly disagree with the following statement: Policy makers need federal statistics to make good decisions about things like federal funding.
Strongly agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Strongly disagree
Don’t Know
Refused
Now I’m going to read you a list of institutions in American society. Please tell me how much confidence you, yourself, have in each one – a great deal, quite a lot, some or very little? Randomly rotate order.
Newspapers
A great deal
Quite a lot
Some
Very little
Don’t Know
Refused
The military
A great deal
Quite a lot
Some
Very little
Don’t Know
Refused
Federal statistical agencies, such as the Census Bureau
A great deal
Quite a lot
Some
Very little
Don’t Know
Refused
Congress
A great deal
Quite a lot
Some
Very little
Don’t Know
Refused
Universities
A great deal
Quite a lot
Some
Very little
Don’t Know
Refused
I have just a few more basic questions before we are finished.
IF RESPONDENT IS SOMEONE OTHER THAN PERSON 1, ASK THE FOLLOWING QUESTIONS. OTHERWISE, SKIP TO EDUCATION Q66.
What is your sex?
Male
Female
Don’t Know
Refused
What is your age? (Open-ended)
XX-XXX: ________________
Don’t Know
Refused
Are you of Hispanic, Latino, or Spanish origin?
Yes
No
What is your race?
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Some other race
What is the highest level of school you have completed or the highest degree you have received?
Less than high school
Completed high school
Some college, no degree
Associate's degree (AA/AS)
Bachelor's degree (BA/BS)
Post-Bachelor's Degree
Don’t Know
Refused
What is your marital status?
Now married
Widowed
Divorced
Separated
Never married
Don’t Know
Refused
What is your total ANNUAL household income, before taxes? Please include income from wages and salaries, remittances from family members living elsewhere, farming, and all other sources.
Under $720
$720 to $5,999
$6,000 to $11,999
$12,000 to $23,999
$24,000 to $35,999
$36,000 to $47,999
$48,000 to $59,999
$60,000 to $89,999
$90,000 to $119,999
$120,000 to $179,999
$180,000 to $239,999
$240,000 and over
Don’t Know – Continue to Q64
Refused – Continue to Q64
If DK/REF previous question: Is your total ANNUAL household income before taxes $48,000 or more, or is it less than $48,000?
Less than $48,000
More than $48,000
Don’t Know
Refused
Do you think of yourself as one, lesbian or gay; two, straight, that is not lesbian or gay; three, bisexual; or four, something else?
Lesbian or gay
Straight, that is not lesbian or gay
Bisexual
Something else
Don’t Know
Refused
Thank you very much for your time today. Your answers will help us plan for the next census in 2030.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Jessica Holzberg (CENSUS/CBSM FED) |
File Modified | 0000-00-00 |
File Created | 2021-01-15 |