Appendix A: Survey protocol
Introduction
This is a survey for the US Bureau of Labor Statistics. This voluntary study is being collected by the Bureau of Labor Statistics under OMB No. 1220-0141. This survey will take approximately 20 minutes to complete. Your participation is voluntary and you have the right to stop at any time.
We are looking for information about how respondents answer our surveys. Please take your time as you answer these questions. The information you provide will contribute to valuable research at the BLS, one of the leading Federal statistical agencies.
This survey is being administered by Qualtrics and resides on a server outside of the BLS Domain. The BLS cannot guarantee the protection of survey responses and advises against the inclusion of sensitive personal information in any response. By proceeding with this study, you give your consent to participate in this study.
<page break>
First we have some questions about your household.
How many people, 15 years old or older, are living or staying with you, including yourself?
1 (just yourself)
2 people
3 people
4 people
5 people
6 or more people
Please enter the initials (first, middle, and last) of each of the people who are living or staying with you.
<insert appropriate number of text boxes based on response to Q1>
<page break>
(skip if only 1 person living in the household) You indicated that [TEXT FILL] other [person/people] are living or staying with you. In the space(s) below, please indicate how you are related to [that/each] person.
[TEXT FILL initials of Person 1]
[TEXT FILL initials of Person 2]
….and so forth as appropriate.
<Dropdown menu with the following selections for each person>
Opposite sex spouse (husband/wife)
Opposite sex unmarried partner
Same sex spouse (husband/wife)
Same sex unmarried partner
Child
Grandchild
Parent
Brother/ sister
Other relative (aunt, uncle, cousin, in law)
Foster child
Housemate/roommate
Roomer/boarder
Other nonrelative
<page break>
What is your sex?
Male
Female
Don’t know
Prefer not to say
Was your sex recorded as male or female at birth?
Male
Female
Don’t know
Prefer not to say
Do you describe yourself as male, female, or transgender?
Male
Female
Transgender
Don’t know
Prefer not to say
Which of the following best represents how you think of yourself?
Gay or Lesbian
Straight, that is not gay, lesbian, or bisexual
Bisexual
Something else
Don’t know
Prefer not to say
<page break>
[This section will randomly select 3 of the household members entered into the roster]
You indicated that Person 1, your [TEXT FILL PERSON 1’s RELATION], is living or staying with you. What is their sex?
Male
Female
Don’t know
Prefer not to say
Was their sex recorded as male or female at birth?
Male
Female
Don’t know
Prefer not to say
Do they describe themselves as male, female, or transgender?
Male
Female
Transgender
Don’t know
Prefer not to say
Which of the following best represents how they think of themselves?
Gay or Lesbian
Straight, that is not gay, lesbian, or bisexual
Bisexual
Something else
Don’t know
Prefer not to say
<REPEAT LOOP FOR THE NUMBER OF PEOPLE IN THE HOUSEHOLD, UP TO 3>
<page break>
What is your current marital status?
Married
Widowed
Divorced
Separated
Never married
Don’t know
Prefer not to say
What is your age?
_____
Prefer not to say
Are you of Hispanic, Latino or Spanish origin?
Yes
No
Don’t know
Prefer not to say
What is your race?
White
Black or African American
American Indian or Alaska Native
Asian
Other
Don’t know
Prefer not to say
What is the highest level of education you’ve completed?
Less than high school
High school diploma or GED
Some college
Associate degree
Bachelor’s degree
Graduate school degree
Prefer not to say
Are you currently employed:
Full time (go to 7)
Part time (go to 7)
Unemployed (go to next page)
Student (go to next page)
Retired (go to next page)
Other, specify (go to 7)
Prefer not to say (go to 7)
What is your occupation?
Administrator, manager
Teacher
Professional
Administrative support, including clerical
Sales
Technician
Protective Services
Other service
Machine or transportation operator
Construction worker, mechanic
Farming
Forestry, fishing or grounds keeping
Armed Forces
Other, specify:______
Don’t know
Prefer not to say
What is your job title? ____
Don’t know
Prefer not to say
<page break>
What is your annual income? ____
Don’t know
Prefer not to say
[If 1 is blank], In which of these ranges does your annual income fall?
Less than $25,000
$25,000 - $50,000
$50,001 – $75,000
$75,001 - $100,000
More than $100,000
Don’t know
Prefer not to say
What is your annual household income? ____
Don’t know
Prefer not to say
[If 3 is blank] In which of these ranges does your annual household income fall?
Less than $25,000
$25,000 - $50,000
$50,001 – $75,000
$75,001 - $100,000
More than $100,000
Don’t know
Prefer not to say
<page break>
Because of a physical, mental, or emotional condition, do you or anyone in your household have serious difficulty concentrating, remembering, or making decisions?
Yes
No
Don’t know
Prefer not to say
Do you have difficulty dressing or bathing?
Yes
No
Don’t know
Prefer not to say
Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping?
Yes
No
Don’t know
Prefer not to say
<page break>
In the survey we’re looking at, we ask one person to answer a set of questions for everyone in the household. Now we’d like to get your feedback on some of the questions you answered, and what it would be like to answer these questions about other household members 15 years old or older.
Thanks for answering the questions so far. Now we’d like to get your feedback on some of them, to understand how well they worked and what your reactions are. Please answer the next set of questions as completely as possible, as that will give us the most information to understand your experience.
For background, we’re testing a survey where one person answers the same set of questions for everyone in their household.
Did any of the questions stand out to you for any reason? Please explain the reasons they stood out to you.
<page break>
One of the questions asked:
“Was your sex recorded as male or female at birth?”
In your own words, what is this question asking? ____
What was your reaction to this question? ____
How easy or difficult was it to answer this question about yourself?
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Please explain (optional): ______
How easy or difficult was it to answer this question for [TEXT FILL PERSON 1]? <repeat question for up to 3 household members>
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Please explain (optional): ______
How confident are you about your response to this question for [TEXT FILL PERSON 1]? <repeat question for up to 3 household members>
Not at all confident
A little confident
Moderately confident
Very confident
Completely confident
Please explain (optional): ______
If someone in your household was answering this question about you, how confident are you that they would give the correct answer?
Not at all confident
A little confident
Moderately confident
Very confident
Completely confident
It depends (please explain): ______________
If other members of your household were nearby and could listen to your answer, how comfortable would you feel answering this question about yourself?
Not at all comfortable
A little comfortable
Moderately comfortable
Very comfortable
Completely comfortable
It depends (please explain): ______________
If other members of your household were nearby and could listen to your answer, how comfortable would you feel answering this question about them?
Not at all comfortable
A little comfortable
Moderately comfortable
Very comfortable
Completely comfortable
It depends (please explain): ______________
<page break>
We have another question we’d like your feedback on. It asked:
“Do you describe yourself as male, female, or transgender?”
In your own words, what is this question asking?
What does “transgender” mean to you?
How easy or difficult was it to answer this question about yourself?
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Please explain (optional): ______
How easy or difficult was it to answer this question for [TEXT FILL PERSON 1]? <repeat question for up to 3 household members>
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Please explain (optional): ______
How confident are you about your response to this question for [TEXT FILL PERSON 1]? <repeat question for up to 3 household members>
Not at all confident
A little confident
Moderately confident
Very confident
Completely confident
Please explain (optional): ______
If someone in your household was answering this question about you, how confident are you that they would give the correct answer?
Not at all confident
A little confident
Moderately confident
Very confident
Completely confident
It depends (please explain): ______________
Please explain (optional): ______
If other members of your household were nearby and could listen to your answer, how comfortable would you feel answering this question about yourself?
Not at all comfortable
A little comfortable
Moderately comfortable
Very comfortable
Completely comfortable
It depends (please explain): ______________
Please explain (optional): ______
If other members of your household were nearby and could listen to your answer, how comfortable would you feel answering this question about them?
Not at all comfortable
A little comfortable
Moderately comfortable
Very comfortable
Completely comfortable
It depends (please explain): ______________
Please explain (optional): ______
<page break>
We have another question we’d like your feedback on. It asked:
“Which of the following best represents how you think of yourself?”
Gay or Lesbian
Straight, that is not gay, lesion, or bisexual
Something else
Don’t know
Prefer not to say
What was your overall reaction to this question? ____
In your own words, what is this question asking? ____
How easy or difficult was it to answer this question about yourself?
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Please explain (optional): ______
How easy or difficult was it to answer this question about [TEXT FILL PERSON 1]? <repeat question for up to 3 household members>
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Please explain (optional): ______
How confident are you about your response to this question about [TEXT FILL PERSON 1]? <repeat question for up to 3 household members>
Not at all confident
A little confident
Moderately confident
Very confident
Completely confident
Please explain (optional): ______
If someone in your household was answering this question about you, how confident are you that they would give the correct answer?
Not at all confident
A little confident
Moderately confident
Very confident
Completely confident
It depends (please explain): ______________
Please explain (optional): ______
If other members of your household were nearby and could listen to your answer, how comfortable would you feel answering this question about yourself?
Not at all comfortable
A little comfortable
Moderately comfortable
Very comfortable
Completely comfortable
It depends (please explain): ______________
Please explain (optional): ______
If other members of your household were nearby and could listen to your answer, how comfortable would you feel answering this question about them?
Not at all comfortable
A little comfortable
Moderately comfortable
Very comfortable
Completely comfortable
It depends (please explain): ______________
Please explain (optional): ______
<page break>
We are thinking about asking questions about sexual orientation and gender identity in a national government survey about employment.
By sexual orientation, we mean the question that asked if you were gay or lesbian, straight or something else. By gender identity, we mean the questions that asked if you were male, female or transgender.
These questions are not currently asked on our employment survey, so we’re looking for feedback on the idea of adding them.
What are your reactions to this idea?
Why do you think the government is interested in asking people about sexual orientation and gender identity in a survey about employment?
How negative or positive would you feel if you were asked to provide information about your sexual orientation and gender identity in a government survey about employment?
Very negative
Negative
Neither negative nor positive
Positive
Very positive
Please explain (optional): ______
How negative or positive would others in your household feel if they were asked provide information about your sexual orientation and gender identity in a government survey about employment?
Very negative
Negative
Neither negative nor positive
Positive
Very positive
Don’t know
Please explain (optional): ______
How negative or positive would you feel if you were asked to provide information about the sexual orientation and gender identity of everyone else in your household 15 years old or older?
Very negative
Negative
Neither negative nor positive
Positive
Very positive
Please explain (optional): ______
How likely would you be to participate in a government survey in the future that asked you to provide information about the sexual orientation and gender identity of everyone else in your household 15 years old or older?
Not at all likely
A little likely
Moderately likely
Very likely
Extremely likely
Please explain (optional): ______
Do you have anything else you would like to tell us about the collection of information about sexual orientation and gender identity?
Page
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Kincaid, Nora - BLS |
File Modified | 0000-00-00 |
File Created | 2021-01-22 |