0920-0822 Nisvs - Web-based Cognitive Testing Instrument, Round 1

The National Intimate Partner and Sexual Violence Survey (NISVS)

Att E. NISVS Web-Based Cognitive Testing Instrument

National Intimate Partner and Sexual Violence Survey (NISVS) - Developmental Testing

OMB: 0920-0822

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0822 can be found here:

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Attachment E:

National Intimate Partner and Sexual Violence Survey (NISVS) 4.0

WEB INSTRUMENT FOR COGNITIVE TESTING, ROUND 1

Notes for Draft

1. Unless otherwise noted, there will be one question per screen.

2. Screens that have multiple questions (e.g., grids) are noted in the instructions prior the question.

3. Each screen will include links to ‘resources’ (help lines) and study contact information.

4. All of the victimization sections are intended to document up to 10 perpetrators. To save space on this draft, the different sections only carry out the pattern for 3-5 perpetrators.

5. Once a victimization is reported, the screen will include a reference to the particular victimization being reported. The text for this is indicated by the instruction “BURN LINE”.

6. Words in uppercase are skip instructions, programming instructions for programmers, or general notes for readers of the document. Programming notes are also in boxes to distinguish from skip instructions and notes. Words in bold are displayed on screen for respondents to see. Question numbers are in brackets “[ ]”.

7. The respondent selection method assumes an experiment with two different methods. The ‘youngest male, oldest female’ (YMOF) and the Rizzo-Brick-Park (RBP) Method. The YMOF will be used to directly select an individual in the letter sent to the household. For this method, the household will be asked to select the respondent before they sign onto the computer. For the RBP method, the respondent will be selected once signing onto the computer.

8. Respondents will be allowed to skip any question, except for items that are considered critical. When a critical item is skipped, the next screen will display the question again with a message in red: “You haven’t answered the question yet. If possible, please provide an answer to this question as this is one of the key questions in this study. Your answer will help CDC understand more about this topic.”

9. The following abbreviations are used within the instrument: BLANK is for when an item is skipped without respondents providing an answer, DK is for “I truly don’t know”, REF is for “I’d rather not answer”, MTP is Made to Penetrate, and PTSD is Posttraumatic Stress Disorder.

10. This survey will be administered both in English and in Spanish (following translation).

Table of Contents

Section	Description	Pages
CF	Screener	3
HC	Health Characteristics	11
ST	Stalking	16
SC	Sexual Harassment, Unwanted Touching	36
SC	Coerced Sex	44
AD	Completed Alcohol/Drug-Facilitated Rape and Made to Penetrate	51
FC	Unwanted Sex Due to Threats of Harm/Physical Force	70
FA	Attempted Physically Forced Sex	87
OT	Sexual Violence: Outcomes of Rape and Made to Penetrate	101
PA	Psychological Aggression	103
PV	Physical Violence	107
CQ	Consequences and Follow-up	111
IC	Debriefing Questions	118

GENERAL NOTES TO PROGRAMMER: DISPLAY ONE QUESTION PER SCREEN UNLESS SPECIFIED OTHERWISE.

SCREENER

[CF_INTRO] Thank you for participating in this important research study on health and injuries for the Centers for Disease Control and Prevention, the CDC. In addition to preventing diseases, the CDC also focuses on a range of health topics, including injuries. Your household has been chosen randomly to represent thousands of others in the country. Here are a few questions about your household and whether there is an adult in your household who is eligible to participate. You will receive a check for $10/$20 for completing this short survey.

[NUM_ADULTS]

PROGRAMMER NOTE:

-IF R ENTERED ANY NUMBER OUTSIDE 0 TO 10, SHOW THE QUESTION AGAIN AND DISPLAY A MESSAGE IN RED BELOW THE QUESTION: “Please enter a number from 0 to 10. If there are more than 10 people aged 18 or more, enter 10.”

-IF R GOES TO NEXT SCREEN WITHOUT ENTERING A NUMBER, BRING RESPONDENTS BACK TO THE QUESTION AND DISPLAY A MESSAGE IN RED SAYING: “We need to know the number of people living in your household in order to determine the eligibility of an adult in your household. Please provide an answer.”)

Including yourself, how many members of your household are 18 years of age or older? Please enter a number from 0 to 10. If there are more than 10 people aged 18 or more, enter 10.

__________

IF NUM_ADULTS=0, ASK CF6SELF. ELSE GO TO CF7_1.

[CF6SELF] Did you include yourself when you said that no one is 18 years old?

Yes 1

No 2

IF CF6SELF=1, GO TO CF6_1. ELSE GO TO NUM_ADULTS.

[CF6_1] We are only interviewing adults age 18 or older, so those are all the questions we have for you. Thank you for your time.

END INTERVIEW; SCREEN OUT, INELIGIBLE AGE.

IF YMOF VERSION CONTINUE. ELSE GO TO CF7_1

IF YOUNGEST MALE VERSION:

We would like the youngest male or the only male, at least 18 years old, to complete this questionnaire.

If there are no male adults in your household, please ask the youngest female or only female, age 18 or older, to complete this questionnaire.

If you are that person, please continue. Otherwise could you ask that person to complete the rest of the survey?

IF YOUNGEST FEMALE VERSION:

Please ask the youngest female or the only female, at least 18 years old, to complete this questionnaire.

If there are no female adults in your household, please ask the youngest male or only male, age 18 or older, to complete this questionnaire.

If you are that person, please continue. Otherwise could you ask that person to complete the rest of the survey?

IF OLDEST MALE VERSION:

Please ask the oldest male or the only male, at least 18 years old, to complete this questionnaire.

If there are no male adults in your household, please ask the oldest female or only female, age 18 or older, to complete this questionnaire.

If you are that person, please continue. Otherwise could you ask that person to complete the rest of the survey?

IF OLDEST FEMALE VERSION:

Please ask the oldest female or the only female, at least 18 years old, to complete this questionnaire.

If there are no female adults in your household, please ask the oldest male or only male, age 18 or older, to complete this questionnaire.

If you are that person, please continue. Otherwise could you ask that person to complete the rest of the survey?

[CF7_1] These next questions are about you and the other members of the household who are at least 18 years old.

How old are you?

__________

[CF7_2] Would you currently describe yourself as….?

Male 1

Female 2

Transgender 3

[CF7_3] DURING THE PAST THREE MONTHS, that is since [fill1: (date 91 days before today's date)], Did any person 18 years an older in this household] have an injury where any part of the body was hurt, for example, with a [(random set of injury examples)]?

Yes 1

No 2

[CF7_4] Does a physical, mental, or emotional problem NOW keep any person 18 years and older in this household from working at a job or business?

Yes 1

No 2

[CF7_5] Has any person 18 years and older in this household been hospitalized OVERNIGHT in the past 12 months? Do not include an overnight stay in the emergency room.

Yes 1

No 2

PROGRAMMER NOTE:

-DISPLAY CF7_6a TO CF7_6e ON ONE SCREEN IN A GRID

[CF7_6] The following questions are to classify your household.

Do you or any member of this household have access to the Internet using a –

Yes No

a. cellular data plan for a smartphone or other mobile
device? 1 2

b. broadband (high speed) Internet service such as
cable, fiber optic, or DSL service installed in this
household? 1 2

c. satellite Internet service installed in this household? 1 2

d. dial-up Internet service installed in this household? 1 2

e. some other service? 1 2

[CF7_7] Is this house, apartment, or mobile home

1. Owned by you or someone in this household with a mortgage or loan? Include home equity loans.

2. Owned by you or someone in this household free and clear (without a mortgage or loan)?

3. Rented?

4. Occupied without payment of rent?

IF SAMPLE DESIGNATED FOR YMOF SELECTION, GO TO CF12b.

IF SAMPLE DESIGNATED FOR RBP SELECTION, CHECK NUM_ADULTS

IF NUM_ADULTS=1, GO TO CF12b.

ELSE IF NUM_ADULTS=2, RANDOMLY SELECT ONE ADULT RESPONDENT AND ASK CFSELECT.

ELSE IF NUM_ADULTS>=3, GO TO SKIP INSTRUCTION BEFORE CFSELECT2.

[CFSELECT] The computer will randomly select one adult from your household to participate in the rest of this study.

The person in your household that is selected for this study is {FILL: “you” (IF “R” SELECTED)/“the other household adult” (IF “R” NOT SELECTED)}.

IF R SELECTED, GO TO CF12b. ELSE IF R NOT SELECTED, GO TO CF11_FIRST.

IF NUM_ADULTS > 3, TEST WHETHER RESPONDENT IS SELECTED. IF RESPONDENT IS SELECTED CONTINUE. ELSE GO TO CF9.

[CFSELECT2] The computer will randomly select one adult from your household to participate in this study.

The person in your household that is selected for this study is you.

GO TO CF12b.

[CF9] The computer will randomly select one adult from your household to participate in this study. To do this, we need to collect the age and gender of each person 18 years and older in the household. Besides yourself, please provide the age and gender of each person. Please start with you the oldest and move to the youngest.

[HH_ROSTER2] Not including yourself, how old is the oldest person at least 18 years old?

__________

Is the oldest person….?

Male 1

Female 2

Transgender 3

[HH_ROSTER3] How old is the 2^nd oldest person at least 18 years old?

__________

Is the 2^nd oldest person….?

Male 1

Female 2

Transgender 3

IF NUM_ADULTS>=4, ASK HH_ROSTER4; ELSE GO TO SKP INSTRUCTION BEFORE HH_ROSTER5.

[HH_ROSTER4] How old is the 3^rd oldest person at least 18 years old?

__________

Is the 3^rd oldest person….?

Male 1

Female 2

Transgender 3

IF NUM_ADULTS>=5, ASK HH_ROSTER5; ELSE GO TO SKP INSTRUCTION BEFORE HH_ROSTER6.

[HH_ROSTER5] How old is the 4^th oldest person at least 18 years old?

__________

Is the 4^th oldest person….?

Male 1

Female 2

Transgender 3

IF NUM_ADULTS>=6, ASK HH_ROSTER6; ELSE GO TO SKP INSTRUCTION BEFORE HH_ROSTER7.

[HH_ROSTER6] How old is the 5^th oldest person at least 18 years old?

__________

Is the 5^th oldest person….?

Male 1

Female 2

Transgender 3

IF NUM_ADULTS>=7, ASK HH_ROSTER7; ELSE GO TO SKP INSTRUCTION BEFORE HH_ROSTER8.

[HH_ROSTER7] How old is the 6^th oldest person at least 18 years old?

__________

Is the 6^th oldest person….?

Male 1

Female 2

Transgender 3

IF NUM_ADULTS>=8, ASK HH_ROSTER8; ELSE GO TO SKP INSTRUCTION BEFORE HH_ROSTER9.

[HH_ROSTER8] How old is the 7^th oldest person at least 18 years old?

__________

Is the 7^th oldest person….?

Male 1

Female 2

Transgender 3

IF NUM_ADULTS>=9, ASK HH_ROSTER9; ELSE GO TO SKP INSTRUCTION BEFORE HH_ROSTER10.

[HH_ROSTER9] How old is the 8^th oldest person at least 18 years old?

__________

Is the 8^th oldest person….?

Male 1

Female 2

Transgender 3

IF NUM_ADULTS>=10, ASK HH_ROSTER10; ELSE GO TO CFSLECT3.

[HH_ROSTER10] How old is the 9^th oldest person at least 18 years old?

__________

Is the 9^th oldest person…?

Male 1

Female 2

Transgender 3

[CFSELECT3] The computer will randomly select one adult from your household to participate in this study.

The person in your household that is selected the (GENDER) who is (AGE).

[CF11_FIRST] Before you ask that person to take the survey, we would like to get (his/her/their) name and contact information in case we need to get in touch with him/her?

First name:

Last name:

Email address:

Cell phone number:

PROGRAMMER NOTE: IF R MOVES FORWARD WITHOUT PROVIDING A NAME, BRING R BACK TO THE SCREEN WITH A MESSAGE IN RED: “We really need that person’s name so that we can get in touch about this important study. Could you provide the first name or first initial?”

IF SCREENER R IS NOT SELECTED FOR THE MAIN INTERVIEW, GO TO CF12a. ELSE GO TO CF12b.

[CF12a] Thank you for completing the screening interview. Please ask the (GENDER) who is (AGE) to log in to the survey using the same information that you used. Let them know that we are conducting a study on health and safety and we would like for them to participate. We will provide them $15/$25 if they complete the survey.

We will send you a check for ($10/$20) as a token of appreciation for completing this screening survey. Please fill in your name and confirm your mailing address below.

First Name:

Last Name:

Your Mailing Address is: [FILL IN MAILING ADDRESS]. Is that correct?

Yes 1

No 2

(Your correct mailing address is: _______________________)

We will be sending you a check in the next week.

Thank you very much for your help!

END SURVEY.

[CF12b] Thank you for providing this information about your household.

We will send you a check for ($10/$20) as a token of appreciation. Before you continue with the rest of the survey, please fill in your name and confirm your mailing address below so we can send you a check.

First Name:

Last Name:

Your Mailing Address is: [FILL IN MAILING ADDRESS]. Is that correct?

Yes 1

No 2

(Your correct mailing address is: _______________________)

We will be sending you a check in the next week.

Please continue on to the rest of the survey.

MAIN STUDY

HEALTH CHARACTERISTICS

[CF_INTRO1b] You have been randomly chosen to participate in an important study conducted by the Centers for Disease Control and Prevention (CDC). Men and women age 18 and older will be asked questions about their health and injuries they may have experienced. Your answers are very important and will be combined with the answers from other people to inform prevention efforts.

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

Participation is voluntary and you can skip any question or stop the survey at any time.

If you complete the survey, as a token of our appreciation we will send you a check for {FILL: $15 / $25 }

No information that could personally identify you will be given to the CDC or anyone else. If you have questions or concerns about participating in the study, you may call the Survey Manager, {NAME}, at ###-###-####. If you have any questions about your rights as a research participant, please contact {CONTRACTOR} Office of Research Protection toll-free at ###-###-####.

[RCMO/RCYR]

PROGRAMMER NOTE:

-TWO DROP-DOWN BOXES WITH ONE FOR BIRTH MONTH (SHOWING OPTIONS FROM 01 TO 12 AND ONE FOR BIRTH YEAR (SHOWING OPTIONS FROM 1909 TO 2001).

First, some questions about you for survey analysis purpose. In what month and year were you born?

IF R IS THE SAME AS SCREENER R AND R PROVIDED SEX, PASS GENDER TO ‘RESPSEX’ AND THEN GO TO CF16. ELSE ASK CF 14.

[CF14] Would you currently describe yourself as….?

Male 1

Female 2

Transgender 3

IF CF14=MALE OR FEMALE, PASS TO ‘RESPSEX’ AND THEN GO TO RC16. ELSE ASK CF15.

[CF15]

PROGRAMMER NOTE: DISPLAY A TEXT FIELD FOR OPTION 3 TO ALLOW PEOPLE TO WRITE IN.

What was your sex assigned to you at birth?

Male 1

Female 2

Other (specify) 3

[RESPEX]

PROGRAMMER NOTE: WEB SYSTEM VARIABLE USED FOR WEB FILL IN DISPLAY. DO NOT SHOW TO RESPONDENTS.

MALE 1

FEMALE 2

[CF16] Do you think of yourself as …

Lesbian or gay 1

Straight, that is, not lesbian or gay 2

Bisexual 3

I think of myself as ___________ 4

[CF17] What is the highest level of education you have completed?

No schooling 1

1^st-8^th grade 2

Some high school 3

High school graduate/GED 4

Technical or vocational school
(Attended/graduated) 5

Some college 6

Associates (2-year) degree 7

Bachelor’s (4-year) degree 8

Postgraduate degree (Master’s Degree, Doctorate Degree, M.D. J.D.) 9

[CF18] Are you of Hispanic or {FILL: “Latina” (FEMALE) / “Latino” {MALE)} origin?

Yes 1

No 2

[CF19]

PROGRAMMER:

-CHECK BOXES TO ALLOW R TO SELECT MORE THAN ONE.

-PROVIDE A TEXT FIELD THAT TAKES UP TO 40 CHARACTERS FOR ‘OTHER (PLEASE SPECIFY)’ OPTION.

What is your race? You may identify more than one category.

White 1

Black or African American 2

Asian 3

Native Hawaiian or Pacific Islander 4

American Indian or Alaska Native 5

Other (Please specify ______) 6

[CF20] Are you now…?

Married 1

Divorced 2

Separated 3

Widowed 4

Not married but living with a partner 5

Never married 6

IF CF19=4 (NATIVE AMERICAN/ALASKA NATIVE), SKIP TO CF22. ELSE GO TO CF21.

[CF21] Were you born in the United States, including U.S. territories and U.S. military bases?

Yes 1

No 2

IF CF21=NO, ASK CF21A. ELSE GO TO CF22.

[CF21A]

PROGRAMMER:

-IF NUMBER ENTERED HERE IS MORE THAN RESPONDENT AGE, BRING R BACK TO QUESTION, SHOWING MESSAGE UNDER QUESTION IN RED: “You entered a number larger than your age. Please check your answer”

How many years have you lived in the United States?

If it is less than 1 year, enter 0.

________ YEARS

[CF22] What was the total income from ALL household members during <fill previous year>, before taxes?

Include income from all sources such as work, investments, child support, and public assistance.

If you are a student, you should NOT include your parents income.

Less than $10,000 1

$10,000 to Less than $15,000 2

$15,000 to Less than $20,000 3

$20,000 to Less than $25,000 4

$25,000 to Less than $35,000 5

$35,000 to Less than $50,000 6

$50,000 to Less than $75,000 7

S75,000 or more 8

PROGRAMMER NOTE: PLACE HC01-HC03 IN A GRID.

[HC01] The following questions are about health conditions that you may have. Remember, you don’t have to answer any question that you don’t want to.

Do you have …

… frequent headaches?

Yes 1

No 2

[HC02] … chronic pain?

Yes 1

No 2

[HC03] … difficulty sleeping?

Yes 1

No 2

PROGRAMMER NOTE: PLACE HC04-HC06 IN A GRID.

[HC04] Have you ever been told by a doctor, nurse, or other health professional that you had …

… Asthma?

Yes 1

No 2

[HC05] … Irritable Bowel Syndrome or IBS?

Yes 1

No 2

[HC06] …any type of depression?

Yes 1

No 2

[HC07] Have you ever, even once, taken any prescription pain medicine (like OxyContin, Vicodin, Lortab, or Percocet) without a prescription or differently than how a doctor told you to use it?

Yes 1

No 2

[HC08] Have you ever attempted suicide?

Yes 1

No 2

STALKING

[V_INTRO]

PROGRAMMER NOTE: SHOW V_INTRO ON ONE SCREEN.

The next set of questions asks about experiences that can directly impact your health or may have resulted in injury. The questions ask about physical injuries, harassing behaviors, and unwanted sexual activity.

Remember, you don’t have to answer any question that you don’t want to. We suggest that you be in a private setting during the remainder of the survey. If, at any time, you do not feel physically or emotionally safe, you can just quit the survey by closing the browser. You can come back to the survey whenever you want.

[ST_INTRO]

PROGRAMMER NOTE: SHOW ST_INTRO ON ONE SCREEN.

First are some detailed questions about times in your life when someone may have ever given you unwanted attention by repeatedly contacting you, following you, or harassing you. When answering, please think about anyone who may have done these things to you; for example, a romantic or sexual partners, a family member, a friend, a teacher, a supervisor or a co-worker, a neighbor, someone your just met, or a stranger.

Please DO NOT include someone following or contacting you as part of their job, such as bill collectors or sales people.

PROGRAMMER NOTE: PLACE ST01-ST02 IN A GRID.

[ST01] Has anyone ever …

… followed you around, watched, or spied on you when you did not want them to?

Yes 1

No 2

[ST02] … approached you or showed up in places, such as your home, work, or school when you did not want them to?

Yes 1

No 2

PROGRAMMER NOTE: PLACE ST03-ST04 IN A GRID.

[ST03] Has anyone ever …

… used technology, such as hidden cameras, computer software, apps, or GPS (Global Positioning System) to monitor or track your location without your permission? This includes GPS used in a phone or in social media, such as Facebook. (We are talking about times when you knew or you thought someone was using GPS technology to monitor you.)

Yes 1

No 2

[ST04] … sneaked onto your property, such as your home or car, and did things to scare you by letting you know they had been there?

Yes 1

No 2

PROGRAMMER NOTE: PLACE ST05-ST07 IN A GRID.

[ST05] Has anyone ever …

… made unwanted phone calls, sent emails, voice, or text messages?

Yes 1

No 2

[ST06] … sent you unwanted messages through social media, such as Facebook, Instagram, and chat rooms?

Yes 1

No 2

[ST07] … sent you cards, letters, flowers, or presents when they knew you didn’t want them to?

Yes 1

No 2

IF R DIDN’T ANSWER “YES” TO ANY OF ST01 TO ST07, SKIP TO SC_INTRO01. ELSE GO TO ST08.

[ST08]

PROGRAMMER NOTE:

DISPLAY A DROP-DOWN BOX SHOWING NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE PEOPLE.

You answered earlier that someone had

-(IF ST01>0: followed you around and watched you)

-(IF ST02>0: approached you or showed up in places)

-(IF ST03>0: used technology to monitor or track your location)

-(IF ST04>0: sneaked onto your property)

-(IF ST05>0: made unwanted phone calls, emails, text messages)

-(IF ST06>0: sent unwanted messages through social media)

-(IF ST07>0: left unwanted presents).

How many people did any of these things to you on more than one occasion?

__________

IF R ANSWERED AT LEAST TWO “YES” ANSWERS TO ST01 TO ST07, GO TO SKIP INSTRUCTIONS BEFORE ST09A.

ELSE IF R ANSWERED “YES” ONCE TO ST01 TO ST07 AND ST08>=1, GO TO SKIP INSTRUCTION BEFORE ST09A.

ELSE SKIP TO SC_INTRO01.

ONLY ONE PERSON WHO FOLLOWED/CONTACTED/HARASSED R ON MORE THAN ONE OCCASION.

IF ST08=1, ASK ST09A AND ST10A. ELSE GO TO SKIP INSTRUCTION BEFORE ST09.

[ST09A] Now, thinking ONLY about that person who followed, contacted or harassed you on more than one occasion, did he/she ever make you feel fearful, threatened, or concerned for your safety or the safety of others?

Yes 1

No 2

[ST10A] Still thinking about that person who followed, contacted or harassed you on more than one occasion, did he/she ever made threats to physically harm you?

Please include ALL people who made threats to physically harm you EVEN IF you did not take the threat seriously or did not feel fearful, threatened, or concerned for your safety or the safety of others.

Yes 1

No 2

IF ST09A=NO AND ST10A=NO, GO TO SC_INTRO1.

ELSE:

-IF ST09A=YES, THEN CODE ST09=1. ELSE CODE ST09=0.

-IF ST10A=YES, THEN CODE ST10=1. ELSE CODE ST10=0.

-GO TO ST10_REVIEW.

IF ST08>1 OR (ST08=0 AND AT LEAST TWO “YES” ANSWERS TO ST01-ST07), ASK ST09. ELSE GO TO SC_INTRO1.

[ST09]

PROGRAMMER NOTE: DISPLAY A DROP-DOWN BOX SHOWING NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE PEOPLE.

Now, thinking ONLY about the {fill: ST08/IF ST08>1} people who followed, contacted or harassed you on more than one occasion, how many of those people ever made you fearful, threatened, or concerned for your safety or the safety of others?

__________

[ST10]

PROGRAMMER NOTE: DISPLAY A DROP-DOWN BOX SHOWING NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE PEOPLE.

Now, thinking ONLY about the {fill: (ST08)} people who followed contacted or harassed you on more than one occasion, how many of those people ever made threats to physically harm you?

__________

IF ST09=0 AND ST10=0 THEN GO TO NEXT SECTION (SC_INTRO1).

ELSE IF ST09>=1 AND ST10=0 THEN ST10_REVIEW=ST09 AND GO TO ST11_01.

ELSE IF ST09=0 AND ST10>=1 THEN ST10_REVIEW=ST10 AND GO TO ST11_01.

ELSE IF ST09>=1 and ST10>=1, THEN ASK ST10_REVIEW.

[ST10_REVIEW] You said that

-(IF ST09>0: [FILL IN ST09] people made you feel fearful, threatened, or concerned for your safety or the safety of others)

-(IF ST10>0: [FILL IN ST10] people made threats to physically harm you).

In total, how many DIFFERENT people did these things to you?

__________

STALKING: Person 1

IF ST10_REVIEW>=1, ASK ST11_01. ELSE GO TO INSTRUCTION BEFORE ST11_02.

PROGRAMMER NOTE: DISPLAY A BURN LINE (Repeatedly contacted, followed, harassed you: Person 1).

[ST11_01] Only thinking about the 1^st person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Was that person …?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY ST11_01B AND ST11_01C ON ONE SCREEN; DISPLAY BURNLINE (Repeatedly contacted, followed, harassed you: Person 1).

[ST11_01B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_01B=1,2, CODE ST11_INT=1;

IF ST11_01B=1,2,3,4,5 ASK ST11_01C. ELSE GO TO ST11_01E.

[ST11_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON ANSWERS TO ST11_01 AND ST11_01B IN APPENDIX II.

[ST11_01E]

PROGRAMMER NOTE: SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 1).

How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: IF R ENTERED OUT-OF-RANGE VALUE (>110) OR NUMBER OLDER THAN AGE, BRING R BACK TO THE QUESTION AND SHOW THE MESSAGE IN RED:

“You entered a number larger than 110/ your age. Please check your answer.”.

PROGRAMMER NOTE: DISPLAY ST11_01F TO ST11_01G ON ONE SCREEN;

SHOW BURN LINE: Repeatedly contacted, followed, harassed you: Person 1.

[ST11_01F] Still thinking about the 1^st person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Did [FILL: he/she] do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF ST11_01F=YES AND ST11_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK ST11_011G. ELSE GO TO SKIP INSTRUCTION BEFORE ST11_02.

[ST11_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did (this/any of these things) to you in the past 12 months. Is that correct?

Yes 1

No 2

IF ST11_01G=NO OR (ST11_01F=YES AND ST11_01B=SOMEONE ELSE), ASK ST11_01H. ELSE GO TO ST11_02.

[PROGRAMMER NOTE: DISPLAY ST11_01H TO ST11_01I ON ONE SCREEN;

SHOW BURN LINE: Repeatedly contacted, followed, harassed you: Person 1.

[ST11_01H] When [FILL: he/she] did these things to you in the past 12 months, what was [FILL: his/her] relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_01H=INTIMATE RELATIONSHIPS, ASK ST11_01I. ELSE GO TO SKIP INSTRUCTION BEFORE ST11_02.

[ST11_01I]. Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON PERSON1’S SEX.

STALKING: Person 2

IF ST10_REVIEW>1, ASK ST11_02. ELSE GO TO INSTRUCTION BEFORE ST11_03.

PROGRAMMER NOTE: DISPLAY A BURN LINE (Repeatedly contacted, followed, harassed you: Person 2).

[ST11_02] Only thinking about the 2nd person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Was that person …?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY ST11_02B AND ST11_02C ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 2).

[ST11_02B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_02B=1,2,3,4,5, ASK ST11_02C. ELSE GO TO ST11_02D.

[ST11_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF ST11_INT^=1 AND ST11_02B=(INTIMATE RELATIONSHIP), ASK ST11_02D AND ST11_02E.

PROGRAMMER NOTE: DISPLAY ST11_02D AND ST11_02E ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 2).

[ST11_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF ST11_02D=YES, CODE ST11_INT=1 AND ASK ST11_02E. ELSE GO TO ST11_02F.

[ST11_02E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: IF R ENTERED OUT-OF-RANGE VALUE (>110) OR NUMBER OLDER THAN AGE, BRING R BACK TO THE QUESTION AND SHOW THE MESSAGE IN RED:

“You entered a number larger than 110/ your age. Please check your answer”.

PROGRAMMER NOTE: DISPLAY ST11_02F TO ST11_02G ON ONE SCREEN; SHOW BURN LINE: Repeatedly contacted, followed, harassed you: Person 2.

[ST11_02F] Still think about the 2^ndperson who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF ST11_02F=YES AND ST11_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK ST11_02G. ELSE GO TO ST11_02H.

[ST11_02G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF ST11_02G=NO OR (ST11_02F=1 AND ST11_02B=SOMEONE ELSE), ASK ST11_02H. ELSE GO TO ST11_03.

PROGRAMMER NOTE: DISPLAY ST11_02H TO ST11_02I ON ONE SCREEN; SHOW BURN LINE: Repeatedly contacted, followed, harassed you: Person 2.

[ST11_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_02H=INTIMATE RELATIONSHIPS, ASK ST11_02I. ELSE GO TO ST11_03.

[ST11_02I]. Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

STALKING: Person 3

IF ST10_REVIEW>2, ASK ST11_03. ELSE GO TO INSTRUCTION BEFORE ST11_04.

PROGRAMMER NOTE: DISPLAY A BURN LINE (Repeatedly contacted, followed, harassed you: Person 3).

[ST11_03] Only thinking about the 3^rd person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Was that person …?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY ST11_03B AND ST11_03c ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 3).

[ST11_03B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_03b=1,2,3,4,5, ASK ST11_03C. ELSE GO TO ST11_03C.

[ST11_03C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF ST11_INT^=1 AND ST11_03B=(INTIMATE RELATIONSHIP), ASK ST11_03D AND ST11_03E. ELSE GO TO SKIP INSTRUCTIONS BEFORE ST11_03F.

PROGRAMMER NOTE: DISPLAY ST11_03D AND ST11_03E ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 3).

[ST11_03D] Is Person 3 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF ST11_03D=YES, CODE ST11_INT=1 AND ASK ST11_03E. ELSE GO TO ST11_03F.

[ST11_03E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: IF R ENTERED OUT-OF-RANGE VALUE (>110) OR NUMBER OLDER THAN AGE, BRING R BACK TO THE QUESTION AND SHOW THE MESSAGE IN RED: “You entered a number larger than 110/ your age. Please check your answer”.

PROGRAMMER NOTE: DISPLAY ST11_03F TO ST11_03G ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 3).

[ST11_03F] Still thinking about the 3^rd person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF ST11_03F=YES AND ST11_03B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK ST11_03G. ELSE GO TO ST11_03H.

[ST11_03G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF ST11_03G=NO OR (ST11_03F=YES AND ST11_03B=SOMEONE ELSE), ASK ST11_03H. ELSE GO TO ST11_04.

PROGRAMMER NOTE: DISPLAY ST11_03H TO ST11_03I ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 3).

[ST11_03H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_03H=INTIMATE RELATIONSHIPS, ASK ST11_03I. ELSE GO TO ST11_04.

[ST11_03I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

STALKING: Person 4

IF ST10_REVIEW>3, ASK ST11_04. ELSE GO TO INSTRUCTION BEFORE ST11_05.

PROGRAMMER NOTE: DISPLAY A BURN LINE (Repeatedly contacted, followed, harassed you: Person 4).

[ST11_04] Only thinking about the 4^th person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Was that person …?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY ST11_04B AND ST11_04c ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 4).

[ST11_04B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_04b=1,2,3,4,5, ASK ST11_04C. ELSE GO TO ST11_04D.

[ST11_04C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF ST11_INT^=1 AND ST11_04B =INTIMATE RELATIONSHIP ASK ST11_04D AND ST11_04E. ELSE GO TO SKIP INSTRUCTIONS BEFORE ST11_04F.

PROGRAMMER NOTE: DISPLAY ST11_04D AND ST11_04E ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: : Person 4).

[ST11_04D] Is Person 4 the FIRST romantic or sexual partner who ever did any of these things to you?

YES 1

NO 2

IF ST11_04D=YES, CODE ST11_INT=1 AND ASK ST11_04E. ELSE GO TO ST11_04F.

[ST11_04E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY ST11_04F TO ST11_04G ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 4).

[ST11_04F] Still think about the 4^th person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF ST11_04F=YES AND ST11_04B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK ST11_04G. ELSE GO TO ST11_04H.

[ST11_04G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF ST11_04G=NO OR (ST11_04F=YES AND ST11_04B=SOMEONE ELSE), ASK ST11_04H. ELSE GO TO ST11_05.

PROGRAMMER NOTE: DISPLAY ST11_04H TO ST11_04I ON ONE SCREEN;

SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 4).

[ST11_04H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_04H=INTIMATE RELATIONSHIPS, ASK ST11_04I. ELSE GO TO ST11_05.

[ST11_04I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

STALKING: Person 5

IF ST10_REVIEW>4, ASK ST11_05. ELSE GO TO INSTRUCTION BEFORE ST11_06.

PROGRAMMER NOTE: DISPLAY A BURN LINE (Repeatedly contacted, followed, harassed you: Person 5).

[ST11_05] Only thinking about the 5^th person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Was that person …?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY ST11_05B AND ST11_05c ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 5).

[ST11_05B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else 7

IF ST11_05b=1,2,3,4,5, ASK ST11_05C. ELSE GO TO ST11_05D.

[ST11_05C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF ST11_INT^=1 AND ST11_05B=INTIMATE RELATIONSHIP, ASK ST11_05D AND ST11_05E. ELSE GO TO SKIP INSTRUCTIONS BEFORE ST11_05F.

PROGRAMMER NOTE: DISPLAY ST11_05D AND ST11_05E ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 5).

[ST11_05D] Is Person 5 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF ST11_05D=YES, CODE ST11_INT=1 AND ASK ST11_05E. ELSE GO TO ST11_05F.

[ST11_05E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY ST11_05F TO ST11_05G ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 5).

[ST11_05F] Still think about the 5^th person who

followed, contacted, or harassed you on more than one occasion,

AND

[FILL: (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others) (IF ST09>=1 AND ST10>=1: or) (IF ST10>=1: made threats to physically harm you)].

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF ST11_05F=YES AND ST11_05B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK ST11_05G. ELSE GO TO ST11_05H.

[ST11_05G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF ST11_05G=NO OR (ST11_05F=1 AND ST11_05B=SOMEONE ELSE), ASK ST11_05H. ELSE GO TO ST11_06.

PROGRAMMER NOTE: DISPLAY ST11_05H TO ST11_05I ON ONE SCREEN; SHOW BURN LINE (Repeatedly contacted, followed, harassed you: Person 5).

[ST11_05H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF ST11_05H=INTIMATE RELATIONSHIPS, ASK ST11_05I. ELSE GO TO ST11_06.

[ST11_05I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

SEXUAL HARASSMENT, UNWANTED TOUCHING

[SC_INTRO1]

PROGRAMMER NOTE: DISPLAY SC_INTRO1 ON ONE SCREEN.

Next are some detailed questions about times in your life when you may have ever experienced unwanted sexual situations with anyone, including strangers or someone you knew well, or someone you have known for only a short time. These questions are detailed and the language is explicit, which some people may find upsetting. It is important that the questions are asked this way so that you understand what we mean. Your answers will help us learn how often these things happen. You can skip questions you don’t want to answer and you can stop at any time.

PROGRAMMER NOTE: DISPLAY SC01-SC02 ON ONE SCREEN; FOR EACH ITEM, SHOW A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[SC01] These first questions are about unwanted sexual situations, including verbal harassment and unwanted touching.

In your lifetime, how many people in your WORKPLACE made unwanted sexual remarks, sexual jokes, or offensive comments about your body or appearance? Please include people you work with or come into contact with through your job.

__________

IF SC01>=1 THEN ASK SC02. ELSE GO TO SC03.

[SC02] How many people in your WORKPLACE have done this to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}?

__________

PROGRAMMER NOTE: DISPLAY SC03-SC04 ON ONE SCREEN; FOR EACH ITEM, SHOW A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[SC03] While you were in a PUBLIC place, how many people have ever verbally harassed you in a sexual way that made you feel uncomfortable?

__________

IF SC03>=1 THEN ASK SC04. ELSE GO TO PROGRAMMER NOTE BEFORE SC05.

[SC04] How many people have done this to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}?

__________

PROGRAMMER NOTE: DISPLAY SC05 AND 06 ON ONE SCREEN; SHOW A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[SC05] How many people have ever …

… kissed you in a sexual way when you did not want it to happen?

__________

[SC06] … fondled, groped, grabbed, or touched you in a sexual way when you did not want it to happen?

__________

IF SC05=0 AND SC06=0 THEN GO TO NEXT SECTION.

IF SC05>=1 AND SC06=0 THEN SC06_REVIEW=SC05 AND GO TO SC07_01.

IF SC05=0 AND SC06>=1 THEN SC06_REVIEW=SC06 AND GO TO SC07_01.

IF SC05>=1 and SC06>=1, THEN ASK SC06_REVIEW. ELSE GO TO SC07_01.

[SC06_REVIEW]

PROGRAMMER NOTE: SHOW A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

You just answered:

-(IF SC05>0: [FILL IN SC05] people kissed you in a sexual way when you did not want it to happen).

-(IF SC06>0: [FILL IN SC06] people fondled, groped, grabbed, or touched you in a sexual way when you did not want it to happen).

In total, how many DIFFERENT people did any of these things to you?

__________

UNWANTED TOUCHING: Person 1

IF SC06_REVIEW>=1, ASK SC07_01. ELSE GO TO SKIP INSTRUCTION BEFORE SC07_02.

PROGRAMMER NOTE: DISPLAY BURN LINE (Unwanted touching: Person 1) ON THE SAME SCREEN WITH SC07_01; SHOW A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[SC07_01] Think about the first time anyone EVER

-(IF SC05>0: kissed you in a sexual way when you did not want it to happen)

-(IF SC06>0: fondled, groped, grabbed, or touched you in a sexual way when you did not want it to happen),

was the person…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY SC07_01B AND SC07_01C ON ONE SCREEN; SHOW BURN LINE (Unwanted touching: Person 1).

[SC07_01B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF SC07_01B=1,2 CODE SC07_INT=1;

IF SC07_01B=1,2,3,4,5, ASK SC07_01C. ELSE GO TO SC07_01D.

[SC07_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

PROGRAMMER NOTE: SHOW BURN LINE (Unwanted touching: Person 1).

[SC07_01E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY SC07_01F TO SC07_01G ON ONE SCREEN; SHOW BURN LINE (Unwanted touching: Person 1).

[SC07_01F] Still thinking about this person who

[FILL: kissed you in a sexual way (SC05>=1)]
[FILL: or, fondled, groped, grabbed, or touched you in a sexual way (SC06>=1)]

when you did not want them to.

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF SC07_01F=YES AND SC07_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK SC07_01G. ELSE GO TO SC07_01H.

[SC07_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF SC07_01G=NO OR (SC07_01F=YES AND SC07_01B=SOMEONE ELSE), ASK SC07_01H. ELSE GO TO SC07_02.

PROGRAMMER NOTE: DISPLAY SC07_01H TO SC07_01I ON ONE SCREEN;

SHOW BURN LINE (Unwanted touching: Person 1).

[SC07_01H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF SC07_01H=INTIMATE RELATIONSHIPS, ASK SC07_01I. ELSE GO TO SC07_02.

[SC07_01I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

UNWANTED TOUCHING: Person 2

IF SC06_REVIEW>1, ASK SC07_02. ELSE GO TO SKIP INSTRUCTION BEFORE SC07_03.

PROGRAMMER NOTE: DISPLAY BURN LINE (Unwanted touching: Person 2) ON THE SAME SCREEN WITH SC07_02.

[SC07_02] Only thinking about the 2^nd person who

(IF SC05>0: kissed you in a sexual way when you did not want it to happen)
(IF SC06>0: fondled, groped, grabbed, or touched you in a sexual way when you did not want it to happen).

Was the 2^nd person…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY SC07_02B AND SC07_02C ON ONE SCREEN; SHOW BURN LINE (Unwanted touching: Person 2).

[SC07_02B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF SC07_02B=1,2,3,4,5, ASK SC07_02C. ELSE GO TO SC07_02D.

[SC07_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF SC07_INT^=1 AND SC07_02B=INTIMATE RELATIONSHIP, ASK SC07_02D AND SC07_02E. ELSE GO TO SKIP INSTRUCTIONS BEFORE SC07_02G.

PROGRAMMER NOTE: SHOW BURN LINE (Unwanted touching: Person 2); DISPLAY SC07_02D AND SC07_02E ON ONE SCREEN.

[SC07_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF SC07_02D=YES, CODE SC07_INT=1 AND ASK SC07_02E. ELSE GO TO SC07_02F.

[SC07_02E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY SC07_02F TO SC07_02G ON ONE SCREEN; SHOW BURN LINE (Unwanted touching: Person 2).

[SC07_02F] Still thinking about the 2^nd person who

[FILL: kissed you in a sexual way when you did not want it to happen (SC05>=1)]
[FILL: or, fondled, groped, grabbed, or touched you in a sexual way when you did not want it to happen (SC06>=1)],

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF SC07_02F=YES AND SC07_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK SC07_02G. ELSE GO TO SC07_02H.

[SC07_02G] Just to confirm, Person 2 was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF SC07_02G=NO OR SC07_02B=SOMEONE ELSE, ASK SC07_02H. ELSE GO TO SC07_03.

PROGRAMMER NOTE: DISPLAY SC07_02H TO SC07_02I ON ONE SCREEN; SHOW BURN LINE (Unwanted touching: Person 2).

[SC07_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF SC07_02H=INTIMATE RELATIONSHIPS, ASK SC07_02I. ELSE GO TO SC07_03.

[SC07_02I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

COERCED SEX

[SC_INTRO2]

PROGRAMMER NOTE: DISPLAY SC_INTRO2 ON ONE SCREEN.

Sometimes unwanted sex happens after a person is pressured into it, such as through verbal and emotional pressure and other nonphysical kinds of pressure. The following questions are about times in your life when someone may have ever used verbal or other nonphysical pressure to make you have sex when you didn’t want to. This could be anyone, including strangers, someone you knew well, or someone you have known for only a short time.

PROGRAMMER NOTE: DISPLAY SC15-SC17 ON ONE SCREEN; USE DROP-DOWN BOX FOR EACH ITEM WITH THE OPTIONS BEING NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[SC15] How many people have you had vaginal, oral, or anal sex with after they pressured you by doing any of the following….?

Telling you lies, making promises about the future they knew were untrue, threatening to end your relationship, or threatening to spread rumors about you?

__________

[SC16] Wearing you down by repeatedly asking for sex, or showing they were unhappy?

__________

[SC17] Using their influence or authority over you, for example, your boss or your teacher? (We are asking about people other than parents or other family members.)

__________

IF SC15=0 AND SC16=0 AND SC17=0 THEN GO TO NEXT SECTION (AD_INTRO1).

IF SC15>=1 AND SC16=0 AND SC17=0 THEN SC17_REVIEW=SC15 AND GO TO SC18_01.

IF SC15=0 AND SC16>=1 AND SC17=0 THEN SC17_REVIEW=SC16 AND GO TO SC18_01.

IF SC15=0 AND SC16=0 AND SC17>=1 THEN SC17_REVIEW=SC17 AND GO TO SC18_01.

IF SC15>=1 and SC16>=1 AND SC17>=1, THEN ASK SC17_REVIEW. ELSE GO TO SC18_01.

PROGRAMMER NOTE: SHOW A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[SC17_REVIEW] You just answered that you have had vaginal, oral, or anal sex with people after they pressured you-

-(IF SC15>0: [FILL IN SC15] by telling you lies, making promises about the future they knew were untrue, threatening to end your relationship, or threatening to spread rumors about you)

-(IF SC16>0: [FILL IN SC16] by wearing you down by repeatedly asking for sex, or showing they were unhappy)

-(IF SC17>0: [FILL IN SC17] by using their influence or authority over you).

In total, how many DIFFERENT people did any of these things to you?

__________

COERCED SEX: Person 1

IF SC17_REVIEW>=1, ASK SC18_01. ELSE GO TO SKIP INSTRUCTION BEFORE SC18_02.

PROGRAMMER NOTE: DISPLAY BURN LINE (Unwanted sex you were pressured into: Person 1) ON THE SAME SCREEN WITH SC18_01.

[SC18_01] Think about the first time these things happened to you. Was the person…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY SC18_01B AND SC18_01C ON ONE SCREEN; SHOW BURN LINE (Unwanted sex you were pressured into: Person 1).

[SC18_01B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF SC18_01B=1,2, CODE SC18_INT=1;

IF SC18_01B=1,2,3,4,5, ASK SC18_01C. ELSE GO TO SC18_01D.

[SC18_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

PROGRAMMER NOTE: SHOW BURN LINE (Unwanted sex you were pressured into: Person 1).

[SC18_01E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY SC18_01F TO SC18_01G ON ONE SCREEN; SHOW BURN LINE (Unwanted sex you were pressured into: Person 1).

[SC18_01F] Still thinking about this person who pressured you into having vaginal, oral, or anal sex with {him/her} by

-(SC15>0: telling you lies, making promises about the future they knew were untrue, threatening to end your relationship, or threatening to spread rumors about you)

-(SC16>0: wearing you down by repeatedly asking for sex, or showing they were unhappy)

-(SC17>0: using their influence or authority over you).

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF SC18_01F=YES AND SC18_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK SC18_01G. ELSE GO TO SC18_01H.

[SC18_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF SC18_01G=NO OR (SC18_01F=YES AND SC18_01B)=SOMEONE ELSE, ASK SC18_01H. ELSE GO TO SC18_02.

PROGRAMMER NOTE: DISPLAY SC18_01H TO SC18_01I ON ONE SCREEN; SHOW BURN LINE (Unwanted sex you were pressured into: Person 1).

[SC18_01H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF SC18_01H=INTIMATE RELATIONSHIPS, ASK SC18_01I. ELSE GO TO SC18_02.

[SC18_01I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

COERCED SEX: Person 2

IF SC17_REVIEW>1, ASK SC18_02. ELSE GO TO SKIP INSTRUCTION BEFORE SC18_03.

PROGRAMMER NOTE: DISPLAY BURN LINE (Unwanted sex you were pressured into: Person 2) ON THE SAME SCREEN WITH SC18_02.

[SC18_02] Think about the 2^nd person who ever did this/these things to you. Was the 2^nd person…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY SC18_02B AND SC18_02C ON ONE SCREEN; SHOW BURN LINE (Unwanted sex you were pressured into: Person 2).

[SC18_02B] The first time this happened, what was Person 2's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF SC18_02B=1,2,3,4,5 ASK SC18_02C. ELSE GO TO SC18_02D.

[SC18_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF SC18_INT^=1 AND SC18_02B=INTIMATE RELATIONSHIPS, ASK SC18_02D AND SC18_02E. ELSE GO TO S18_02F.

PROGRAMMER NOTE: SHOW BURN LINE (Unwanted sex you were pressured into: Person 2).

[SC18_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF SC18_02D=YES, CODE SC18_INT=1 AND ASK SC18_02E. ELSE GO TO SC18_02F.

[SC18_02E] How old were you the first time Person 2 did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY SC18_012F TO SC18_02G ON ONE SCREEN; SHOW BURN LINE (Unwanted sex you were pressured into: Person 2).

[SC18_02F] Still thinking about Person 2 who pressured you into having vaginal, oral, or anal sex with {him/her}. Did Person 2 do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF SC18_02F=YES AND SC18_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK SC18_02G. ELSE GO TO SC18_02H.

[SC18_02G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF SC18_02G=NO OR (SC18_02F=1 AND SC18_02B=SOMEONE ELSE), ASK SC18_02H. ELSE GO TO SC18_03.

PROGRAMMER NOTE: DISPLAY SC18_012H TO SC18_02I ON ONE SCREEN; SHOW BURN LINE (Unwanted sex you were pressured into: Person 2).

[SC18_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF SC18_02H=INTIMATE RELATIONSHIPS, ASK SC18_02I. ELSE GO TO SC18_03.

[SC18_02I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

PROGRAMMER NOTE: DISPLAY SC23 AND SC24 ON ONE SCREEN IN A GRID.

[SC23] Did you ever get a sexually transmitted disease or other infection when {FILL: “this” (JUST SC17) / “any of these things”} happened? For example, did you get Chlamydia, Gonorrhea, HIV, or some other STD?

Yes 1

No 2

IF RESPSEX=FEMALE, ASK SC24. ELSE GO TO INSTRUCTION BEFORE SC25.

[SC24] Did you ever get pregnant when FILL: “this” (JUST SC17) / “any of these things”} happened?

Yes 1

No 2

COMPLETED ALCOHOL/DRUG-FACILITATED RAPE AND MADE TO PENETRATE

PROGRAMMER NOTE: DISPLAY AD_INTRO ON ONE SCREEN

[AD_INTRO1] This next section is about unwanted sex or sexual contact, that is, sexual contact that you did not consent to and that you did not want to happen.

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

IF RESPSEX=’TRANSGENDER’, ASK AD00. ELSE GO TO SKIP INSTRUCTION BEFORE AD01.

[AD00] The following questions refer to sexual contact and we want to make sure the questions are relevant to you. Would you prefer to be referred to as a male or female?

Male 1

Female 2

PROGRAMMER NOTE:

-IF R LEAVES AD00 BLANK GO TO AD00a.

-ELSE IF AD00=MALE OR FEMALE, PASS VALUE TO ‘RESPSEX’ THEN GO TO INSTRUCTION BEFORE AD01.

[AD00a] We have to know your sex so that we can ask you the relevant questions about sexual contact. If you choose not to answer, we will have to terminate the survey. What would you like to do?

Answer the sex question 1

Terminate the survey 2

IF AD00a=1, GO BACK TO AD00. ELSE IF AD00a=2, GO TO AD00b.

[AD00b] Thank you very much for your time.

END SURVEY.

IF RESPSEX= “FEMALE”, ASK AD01 TO AD04. ELSE SKIP TO AD05.

PROGRAMMER NOTE

-DISPLAY AD01-AD02 ON ONE SCREEN

-USE DROP-DOWN BOX WITH OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE;

-FOR AD01, ALSO DISPLAY A CHECK BOX LABELED “Never drunk, high, drugged, or passed out from alcohol or drugs’ BELOW THE DROP-DOWN BOX.

[AD01] When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many PEOPLE ever did the following when you did not want them to?

Put their mouth on your vagina?

__________

IF AD01=‘NEVER DRUNK, HIGH, DRUGGED, OR PASSED OUT FROM ALCOHOL OR DRUGS’, SKIP TO NEXT SECTION (FC_INTRO1). ELSE ASK AD02.

[AD02] Put their fingers or an object in your vagina or anus?

__________

PROGRAMMER NOTE:

-DISPLAY AD03 AND AD04 ON ONE SCREEN

-USE DROP-DOWN BOX WITH OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[AD03] When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many MALES ever did the following when you did not want them to…?

Put their penis in your vagina?

__________

[AD04] Put their penis in your mouth or anus?

__________

IF RESPSEX= ‘MALE’, ASK AD05 TO AD08. ELSE GO TO AD09.

PROGRAMMER NOTE:

-DISPLAY AD05 AND AD06 ON ONE SCREEN

-USE DROP-DOWN BOX WITH OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

-FOR AD05, ALSO DISPLAY A CHECK BOX LABELED “Never drunk, high, drugged, or passed out from alcohol or drugs’ BELOW THE DROP-DOWN BOX.

[AD05] When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many PEOPLE ever did the following when you did not want them to…?

Put their fingers or an object in your anus?

__________

IF AD05=’NEVER DRUNK, HIGH, DRUGGED, OR PASSED OUT FROM ALCOHOL OR DRUGS, SKIP TO NEXT SECTION (FC_INTRO1). ELSE GO TO AD06.

[AD06] Put their mouth on your penis?

__________

PROGRAMMER NOTE:

-USE DROP-DOWN BOX WITH OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[AD07] When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many FEMALES ever did the following when you did not want them to…

Made you put your penis in their vagina?

__________

PROGRAMMER NOTE: USE DROP-DOWN BOX WITH OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[AD08] When you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs, how many MALES ever did the following when you did not want them to …

Put their penis in your mouth or anus?

__________

PROGRAMMER NOTE: DISPLAY AD09 AND AD10 ON ONE SCREEN.

[AD09] The next two questions are about your exposure to alcohol or drugs. Thinking about the times when {FILL: “this” (ONE BEHAVIOR) / “any of these things”} happened to you when you were unable to consent to sex or stop it from happening …

… do you think you were ever given alcohol without your knowledge?

Yes 1

No 2

[AD10] … do you think you were ever given other drugs without your knowledge?

Yes 1

No 2

FOR FEMALE RESPONDENTS:

IF AD01=0 AND AD02=0 AND AD03=0 AND AD04=0 THEN GO TO NEXT SECTION.

ELSE IF AD01>=1 AND AD02=0 AND AD03=0 AND AD04=0 THEN CODE AD11_REVIEW=AD01 AND GO TO AD11_01.

ELSE IF AD01=0 AND AD02>=1 AND AD03=0 AND AD04=0 THEN CODE AD11_REVIEW=AD02 AND GO TO AD11_01.

ELSE IF AD01=0 AND AD02=0 AND AD03>=1 AND AD04=0 THEN CODE AD11_REVIEW=AD03 AND GO TO AD11_01.

ELSE IF AD01=0 AND AD02=0 AND AD03=0 AND AD04>=1 THEN CODE AD11_REVIEW=AD04 AND GO TO AD11_01.

ELSE GO TO AD11_REVIEW.

IF MALE RESPONDENTS:

IF AD05=0 AND AD08=0 THEN GO TO NEXT SECTION.

ELSE IF AD05=0 AND AD08>=1 THEN CODE AD11_REVIEW=AD08 AND GO TO AD11_01.

ELSE IF AD05>=1 AND AD08=0 THEN CODE AD11_REVIEW=AD05 AND GO TO AD11_01.

ELSE GO TO AD11_REVIEW.

[AD11_REVIEW] (IF FEMALE RESPONDENTS: )

You answered earlier that, when you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs,

-(IF AD01>=1: [FILL: AD01] people put their mouth on your vagina,)

-(IF AD02>=1: [FILL: AD02] people put their fingers or an object in your vagina or anus,)

-(IF AD03>=1: [FILL: AD03] males put their penis in your vagina,)

-(IF AD04>=1: [FILL: AD04] males put their penis in your mouth or anus.)

(IF MALE RESPONDENTS: )

You answered earlier that, when you were unable to consent to sex or stop it from happening because you were too drunk, high, drugged, or passed out from alcohol or drugs,

-(IF AD05>=1: [FILL: AD05] people put their fingers or an object in your anus,)

-(IF AD08>=1: [FILL: AD08] males put their penis in your mouth or anus.)

In total, how many DIFFERENT people did any of these things to you?

__________

ALCOHOL/DRUG FACILITATED SEX: Person 1

IF AD11_REVIEW>=1, ASK AD11_01. ELSE GO TO AD11_02.

IF RESPSEX=FEMALE AND AD01=0 AND AD02=0 AND AD11_REVIEW>=1, CODE AD11_01=MALE, AND GO TO AD11_01B. ELSE ASK AD11_01;

IF RESPSEX=MALE AND AD05=0 AND AD11_REVIEW>=1, CODE AD11_01=MALE AND GO TO AD11_01B. ELSE ASK AD11_01.

[AD11_01]

PROGRAMMER NOTE: DISPLAY BURNLINE (Unwanted sex while drunk, high, drugged, or passed out: Person 1).

Think about the first time anyone EVER:

(IF FEMALE RESPONDENTS:)

-(IF AD01>=1: put their mouth on your vagina,)

-(IF AD02>=1: put their fingers or an object in your vagina or anus,)

-(IF AD03>=1: put his penis in your vagina,)

-(IF AD04>=1: put his penis in your mouth or anus.)

(IF MALE RESPONDENTS:)

-(IF AD05>=1: put their fingers or an object in your anus,)

-(IF AD08>=1: put his penis in your mouth or anus.)

when you were unable to consent to sex or stop it from happening, because you were too drunk, high, drugged, or passed out from alcohol or drugs.

Was this person…?

Male 1

Female 2

PROGRAMMER NOTE:

-DISPLAY AD11_01B AND AD11_01C ON ONE SCREEN;

-SHOW BURN LINE (Unwanted sex while drunk, high, drugged, or passed out: Person 1).

[AD11_01B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF AD11_01B=1,2, CODE AD11_INT=1.

IF AD11_01B=1,2,3,4,5 ASK AD11_01C. ELSE GO TO AD11_01E.

[AD11_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

[AD11_01E]

PROGRAMMER NOTE: SHOW BURN LINE (Unwanted sex while drunk, high, drugged, or passed out: Person 1).

How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: IF R ENTERED OUT-OF-RANGE VALUE (>110) OR NUMBER OLDER THAN AGE, BRING R BACK TO THE QUESTION AND SHOW THE MESSAGE IN RED:

“You entered a number larger than 110/ your age. Please check your answer”.

PROGRAMMER NOTE: DISPLAY AD11_01F TO AD11_01G ON ONE SCREEN]

SHOW BURN LINE (Unwanted sex while drunk, high, drugged, or passed out: Person 1).

[AD11_01F] Still thinking about this person who

(IF FEMALE RESPONDENTS: )

-(IF AD01>=1: put {his/her} mouth on your vagina,)

-(IF AD02>=1: put {his/her}their fingers or an object in your vagina or anus,)

-(IF AD03>=1: put his penis in your vagina,)

-(IF AD04>=1: put his penis in your mouth or anus.)

(IF MALE RESPONDENTS: )

-(IF AD05>=1: put {his/her} fingers or an object in your anus,)

-(IF AD08>=1: his penis in your mouth or anus.)

when you were unable to consent to sex or stop it from happening, because you were too drunk, high, drugged, or passed out from alcohol or drugs.

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF AD11_01F=YES AND AD11_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK AD11_01G. ELSE GO TO AD11_01H.

[AD11_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF AD11_01G=NO OR (AD11_01F=YES AD11_01B=SOMEONE ELSE), ASKAD11_01H. ELSE GO TO AD11_02.

PROGRAMMER NOTE: DISPLAY AD11_01H TO AD11_01I ON ONE SCREEN; SHOW BURN LINE (Unwanted sex while drunk, high, drugged, or passed out: Person 1).

[AD11_01H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF AD11_01H=INTIMATE RELATIONSHIPS, ASK AD11_01I. ELSE GO TO AD11_02.

[AD11_01I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

ALCOHOL/DRUG FACILITATED SEX: Person 2

IF AD11_REVIEW>1, ASK AD11_02. ELSE GO TO AD11_03.

IF RESPSEX=FEMALE AND AD01=0 AND AD02=0 AND AD11_REVIEW>1, CODE AD11_02=MALE AND GO TO AD11_02B. ELSE ASK AD11_02;

IF RESPSEX=MALE AND AD05=0 AND AD11_REVIEW>1, CODE AD11_02=MALE AND GO TO AD11_02B. ELSE ASK AD11_02.

[AD11_02]

PROGRAMMER NOTE: DISPLAY BURNLINE (Unwanted sex while drunk, high, drugged, or passed out: Person 2).

Think about the 2^nd person who did this/any of these things to you. Was Person 2…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY AD11_02B AND AD11_02C ON ONE SCREEN; SHOW BURN LINE (Unwanted sex while drunk, high, drugged, or passed out: Person 2).

[AD11_02B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 3

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 4

A stranger 5

Someone else (Please specify:
) 6

IF AD11_02B=1,2,3,4,5 ASK AD11_02C. ELSE GO TO AD11_02D.

[AD11_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF AD11_INT^=1 AND AD11_02B=INTIMATE RELATIONSHIP, ASK AD11_02D AND AD11_02E. ELSE GO TO AD11_02F.

PROGRAMMER NOTE:

-DISPLAY AD11_02D AND AD11_02E ON ONE SCREEN;

-SHOW BURN LINE (Unwanted sex while drunk, high, drugged, or passed out: Person 2).

[AD11_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF AD11_02D=YES, CODE AD11_INT=1 AND ASK AD11_02E. ELSE GO TO AD11_02F.

[AD11_02E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY AD11_02F TO AD11_02G ON ONE SCREEN; SHOW BURN LINE (Unwanted sex while drunk, high, drugged, or passed out: Person 2).

[AD11_01F] Still thinking about Person 2, did he/she do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF AD11_02F=YES AND AD11_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK AD11_02G. ELSE GO TO AD11_02H.

[AD11_02G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF AD11_02G=NO OR AD11_02B=SOMEONE ELSE, ASKAD11_02H. ELSE GO TO AD11_03.

PROGRAMMER NOTE: DISPLAY AD11_02H TO AD11_02I ON ONE SCREEN; SHOW BURN LINE (Unwanted sex while drunk, high, drugged, or passed out: Person 2).

[AD11_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF AD11_02H=INTIMATE RELATIONSHIPS, ASK AD11_02I. ELSE GO TO AD11_03.

[AD11_02I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF AD11_01F=1 OR AD11_02F=1 OR AD11_03F=1 OR AD11_04F=1 OR AD11_05F=1 OR AD11_06F=1 OR AD11_07F=1 OR AD11_08F=1 OR AD11_09F=1 OR AD11_10F=1, ASK AD18. ELSE GO TO SKIP INSTRUCTIONS BEFORE AD_INTRO2.

[AD18]

[PROGRAMMER NOTE:

-CREATE A VARIABLE AD12_CNT AND MAKE AD12_CNT EQUAL TO THE NUMBER OF YES ANSWERS TO AD11_01F, AD11_02F, AD11_03F, AD11_04F, AD11_05F, AD11_06F, AD11_07F, AD11_08F, AD11_09F, AD11_10F.

-SHOW A TEXT FIELD ALLOWING FOR NUMBERS FROM 1 TO 99.

-SHOW TWO RADIO BUTTONS BELOW THE TEXT FIELD; ONE IS LABELED AS “More than 100 times” AND THE SECOND “Too many to count”.

Think about the {AD12_CNT=1: person / (FILL: AD12_CNT) people} who

(IF FEMALE RESPONDENTS: )

-(IF AD01>=1: put {his/her} mouth on your vagina,)

-(IF AD02>=1: put {his/her}their fingers or an object in your vagina or anus,)

-(IF AD03>=1: put his penis in your vagina,)

-(IF AD04>=1: put his penis in your mouth or anus.)

(IF MALE RESPONDENTS: )

-(IF AD05>=1: put {his/her} fingers or an object in your anus,)

-(IF AD08>=1: his penis in your mouth or anus.)

when you were unable to consent to sex or stop it from happening, because you were too drunk, high, drugged, or passed out from alcohol or drugs in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}.

How many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months?

(“In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.)

__________

MADE TO PENETRATE: ANSWERED BY ONLY MALE RESPONDENTS

IF FEMALE RESPONDENTS, GO TO NEXT SECTION (FC_INTRO1).

IF MALE RESPONDENTS:

-IF AD06=0 AND AD07=0 THEN SKIP TO NEXT SECTION (FC_INTRO1);

-ELSE GO TO SKIP INSTRUCTIONS BEFORE AD_INTRO2.

IF AD11_REVIEW>=1, GO TO AD_INTRO2. ELSE GO TO SKIP INSTRUCTIONS BEFORE AD19_REVIEW.

[AD_INTRO2] The next questions are about some of the other things that have happened to you.

IF AD06=0 AND AD07>=1 THEN AD19_REVIEW=AD07 AND GO TO SKIP INSTRUCTION BEFORE AD19_01;

ELSE IF AD06>=1 AND AD07=0 THEN AD19_REVIEW=AD06 AND GO TO SKIP INSTRUCTION BEFORE AD19_01;

ELSE GO TO AD19_REVIEW.

[AD19_REVIEW] You answered earlier that

-(IF AD06>=1: [FILL IN AD06] people put their mouth on your penis)

-(IF AD07>=1: [FILL IN AD07] females made you put your penis in their vagina)

when you were unable to consent to sex or stop it from happening, because you were too drunk, high, drugged, or passed out from alcohol or drugs.

In total, how many DIFFERENT people did any of these things to you?

__________

ALCOHOL/DRUG FACILITATED MADE TO PENETRATE: Person 1

IF AD19_REVIEW>=1 AND AD06=0, CODE AD19_01=FEMALE AND GO TO AD19_01B.

ELSE IF AD19_REVIEW>=1 AND AD06>0, ASK AD19_01.

ELSE GO TO SKIP INSTRUCTION BEFORE AD19_02.

[AD19_01]

PROGRAMMER NOTE:. DISPLAY BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 1).

Think about the first time anyone EVER

-(IF AD06>=1: put their mouth on your penis,)

-(IF AD07>=1: made you put your penis in their vagina)

when you were unable to consent to sex or stop it from happening, because you were too drunk, high, drugged, or passed out from alcohol or drugs.

The first time these things happened to you, was the person…?

Male 1

Female 2

PROGRAMMER NOTE:

-DISPLAY AD19_01B AND AD19_01C ON ONE SCREEN;

-SHOW BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 1).

[AD19_01B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF AD19_01B=1,2, CODE AD19_INT=1.

IF AD19_01B=1,2,3,4,5 ASK AD19_01C. ELSE GO TO AD19_01E.

[AD19_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

[AD19_01E]

PROGRAMMER NOTE: SHOW BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 1).

How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY AD19_01F TO AD19_01G ON ONE SCREEN; SHOW BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 1).

[AD19_01F] Still thinking about this person. Did {he/she} do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF AD19_01F=YES AND AD19_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK AD19_01G. ELSE GO TO AD19_01H.

[AD19_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF AD19_01G=NO OR (AD19_01F=YES AND AD19_01B=SOMEONE ELSE), ASK AD19_01H. ELSE GO TO AD19_02.

PROGRAMMER NOTE: DISPLAY AD19_01H TO AD19_01I ON ONE SCREEN; SHOW BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 1).

[AD19_01H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually or intimate 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF AD19_01H=INTIMATE RELATIONSHIPS, ASK AD19_01I. ELSE GO TO AD19_02.

[AD19_01I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

ALCOHOL/DRUG FACILITATED MADE TO PENETRATE: Person 2

IF AD19_REVIEW>1 AND AD06=0, CODE AD19_02=FEMALE AND GO TO AD19_02B. ELSE IF AD19_REVIEW>1 AND AD06>0, ASK AD19_02. ELSE GO TO AD19_03.

[AD19_02]

PROGRAMMER NOTE: DISPLAY BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 12).

Was the 2^nd person who did this/any of these to you…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY AD19_02B AND AD19_02C ON ONE SCREEN; SHOW BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 2).

[AD19_02B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF AD19_02B=1,2,3,4,5 ASK AD19_02C. ELSE GO TO AD19_02D.

[AD19_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF AD19_INT^=1 AND AD19_02B=INTIMATE RELATIONSHIP, ASK AD19_02D AND AD19_02E.

PROGRAMMER NOTE: DISPLAY AD19_01D AND AD19_02E ON ONE SCREEN; SHOW BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 2).

[AD19_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF AD19_02D=YES, CODE AD19_INT=1 AND ASK AD19_02E. ELSE GO TO AD19_02F.

AD19_02E How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY AD19_02F TO AD19_02G ON ONE SCREEN; SHOW BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 2).

[AD19_02F] Did Person 2 do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF AD19_02F=YES AND AD19_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK AD19_02G. ELSE GO TO AD19_02H.

[AD19_02G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF AD19_02G=NO OR (AD19_02F=YES AND AD19_02B=SOMEONE ELSE), ASK AD19_02H. ELSE GO TO AD19_03.

PROGRAMMER NOTE: DISPLAY AD19_02H TO AD19_02I ON ONE SCREEN; SHOW BURN LINE (Made to penetrate while drunk, high, drugged, or passed out: Person 2).

[AD19_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF AD19_02H=INTIMATE RELATIONSHIPS, ASK AD19_02I. ELSE GO TO AD19_03.

[AD19_02I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF AD19_01F=1 OR AD19_02F=1 OR AD19_03F=1 OR AD19_04F=1 OR AD19_05F=1 OR AD19_06F=1 OR AD19_07F=1 OR AD19_08F=1 OR AD19_09F=1 OR AD19_10F=1, ASK AD26. ELSE GO TO FC_INTRO1.

[AD26]

PROGRAMMER NOTE:

-CREATE A VARIABLE AD19_CNT AND MAKE AD19_CNT EQUAL TO THE NUMBER OF YES ANSWERS TO AD19_01F, AD19_02F, AD19_03F, AD19_04F, AD19_05F, AD19_06F, AD19_07F, AD19_08F, AD19_09F, AD19_10F.

-SHOW A TEXT FIELD ALLOWING FOR NUMBERS FROM 1 TO 99.

-SHOW TWO RADIO BUTTONS BELOW THE TEXT FIELD; ONE IS LABELED AS “More than 100 times” AND THE SECOND “Too many to count”.

Think about the {(IF AD19_CNT=1: person)/(FILL: AD19_CNT) people} who

-(IF AD06>=1: put their mouth on your penis,)

-(IF AD07>=1: made you put your penis in their vagina)

when you were unable to consent to sex or stop it from happening, because you were too drunk, high, drugged, or passed out from alcohol or drugs in the past 12 months, that is, since {FILL: DATE 12 MONTHS AGO}.

How many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months?

(“In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months).

__________

UNWANTED SEX DUE TO THREATS OF HARM/PHYSICAL FORCE

[FC_INTRO1]

PROGRAMMER NOTE: DISPLAY FC_INTRO1 ON ONE SCREEN.

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

IF RESPSEX=FEMALE, ASK FC01 TO FC04. ELSE GO TO SKIP INSTRUCTIONS BEFORE FC05.

PROGRAMMER NOTE: DISPLAY FC01 AND FC02 ON ONE SCREEN; USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[FC01] How many PEOPLE have ever used physical force or threats of physical harm to …

….put their mouth on your vagina?

(Examples of physical force are being pinned or held down, using violence or threats of violence, or not physically stopping after you said no.)

__________

[FC02] … put their fingers or an object in your vagina or anus?

__________

PROGRAMMER NOTE: DISPLAY FC01 AND FC02 ON ONE SCREEN; USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

[FC03] How many MALES have ever used physical force or threats of physical harm to …

… put their penis in your vagina?

(Examples of physical force are being pinned or held down, using violence or threats of violence, or not physically stopping after you said no.)

__________

[FC04] … put their penis in your mouth or anus?

__________

IF RESPSEX=MALE, ASK FC51 TO FC06. ELSE GO TO SKIP INSTRUCTIONS BEFORE FC05.

PROGRAMMER NOTE: DISPLAY FC05 TO FC08 ON ONE SCREEN; USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE DROP-DOWN BOX.

[FC05] How many PEOPLE have ever used physical force or threats of physical harm to …

… put their fingers or an object in your anus?

(Examples of physical force are being pinned or held down, using violence or threats of violence, or not physically stopping after you said no.)

__________

[FC06] … put their mouth on your penis?

__________

PROGRAMMER NOTE: DISPLAY FC05 TO FC08 ON ONE SCREEN; USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

[FC07] How many FEMALES have ever used physical force or threats of physical harm to make you put your penis in their vagina?

(Examples of physical force are being pinned or held down, using violence or threats of violence, or not physically stopping after you said no.)

__________

[FC08] How many MALES have ever used physical force or threats of physical harm to put their penis in your mouth or anus?

__________

IF FEMALE RESPONDENTS:

IF FC01=0 AND FC02=0 AND FC03=0 AND FC04=0 THEN GO TO NEXT SECTION.

ELSE IF FC01>=1 AND FC02=0 AND FC03=0 AND FC04=0 THEN CODE FC09_REVIEW=FC01 AND GO TO FC09_01.

ELSE IF FC01=0 AND FC02>=1 AND FC03=0 AND FC04=0 THEN CODE FC09_REVIEW=FC02 AND GO TO FC09_01.

ELSE IF FC01=0 AND FC02=0 AND FC03>=1 AND FC04=0 THEN CODE FC09_REVIEW=FC03 AND GO TO FC09_01.

ELSE IF FC01=0 AND FC02=0 AND FC03=0 AND FC04>=1 THEN CODE FC09_REVIEW=FC04 AND GO TO FC09_01.

ELSE GO TO FC09_REVIEW.

IF MALE RESPONDENTS:

IF FC05=0 AND FC08=0 THEN GO TO NEXT SECTION.

ELSE IF FC05=0 AND FC08>=1 THEN CODE FC09_REVIEW=FC08 AND GO TO FC09_01.

ELSE IF FC05>=1 AND FC08=0 THEN CODE FC09_REVIEW=FC05 AND GO TO FC09_01.

ELSE GO TO FC09_REVIEW.

[FC09_REVIEW]

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

(IF FEMALE RESPONDENTS: )

You answered earlier that, using physical force or threats of harm…

-(IF FC01>=1: [FILL: FC01] people put their mouth on your vagina)

-(IF FC02>=1: [FILL: FC02] people put their fingers or an object in your vagina or anus)

-(IF FC03>=1: [FILL: FC03] males put their penis in your vagina)

-(IF FC04>=1: [FILL: FC04] males put their penis in your mouth or anus)

(IF MALE RESPONDENTS: )

You answered earlier that,

-(IF FC05>=1: [FILL: FC05] people put their fingers or an object in your anus)

-(IF FC06>=1: [FILL: FC08] males put their penis in your mouth or anus).

In total, how many DIFFERENT people did any of these things to you?

__________

UNWANTED SEX BY FORCE: Person 1

IF FC09_REVIEW>=1 AND (RESPSEX=FEMALE AND FC01=0 AND FC02=0), CODE FC09_01=MALE AND GO TO FC09_01B.

ELSE IF FC09_REVIEW>=1 AND (RESPSEX=MALE AND FC05=0), CODE FC09_01=FEMALE AND GO TO FC09_01B.

ELSE IF FC09_REVIEW>=1 GO TO FC09_01.

ELSE GO TO SKIP INSTRUCTIONS BEFORE FC09_02.

PROGRAMMER NOTE: DISPLAY BURNLINE (Unwanted sex by force: Person 1).

[FC09_01] Think about the first time anyone EVER

(IF FEMALE RESPONDENTS: )

-(IF FC01>=1: put their mouth on your vagina)

-(IF FC02>=1: put their fingers or an object in your vagina or anus)

-(IF FC03>=1: put their penis in your vagina)

-(IF FC04>=1: [put their penis in your mouth or anus)

(IF MALE RESPONDENTS: )

-(IF FC05>=1: put their fingers or an object in your anus)

-(IF FC06>=1: put their penis in your mouth or anus).

using physical force or threats of harm.

The first time these things happened to you, was this person…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY FC09_01B AND FC09_01C ON ONE SCREEN; SHOW BURN LINE (Unwanted sex by force: Person 1).

[FC09_01B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FC09_01B=1,2,CODE FC09_INT=1.

IF FC09_01B=1,2,3,4,5 ASK FC09_01C. ELSE GO TO FC09_01E.

[FC09_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

PROGRAMMER NOTE: SHOW BURN LINE (Unwanted sex by force: Person 1).

[FC09_01E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE:

-DISPLAY FC09_01F TO FC09_01G ON ONE SCREEN;

-SHOW BURN LINE (Unwanted sex by force: Person 1).

[FC09_01F] Still thinking about this person who

(IF FEMALE RESPONDENTS: )

-(IF FC01>=1: put {his/her} mouth on your vagina)

-(IF FC02>=1: put {his/her} fingers or an object in your vagina or anus)

-(IF FC03>=1: put his penis in your vagina)

-(IF FC04>=1: put his penis in your mouth or anus)

(IF MALE RESPONDENTS: )

-(IF FC05>=1: put {his/her? fingers or an object in your anus)

-(IF FC06>=1: put his penis in your mouth or anus).

………..using physical force or threats of harm.

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF FC09_01F=YES AND FC09_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK FC09_01G. ELSE GO TO FC09_01H.

[FC09_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF FC09_01G=NO OR (FC09_01F=YES AND FC09_01B=SOMEONE ELSE), ASK FC09_01H. ELSE GO TO FC09_02.

PROGRAMMER NOTE:

-DISPLAY FC09_01H TO FC09_01I ON ONE SCREEN;

-SHOW BURN LINE (Unwanted sex by force: Person 1).

[FC09_01H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FC09_01H=INTIMATE RELATIONSHIPS, ASK FC09_01I. ELSE GO TO FC09_02.

[FC09_01I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

UNWANTED SEX BY FORCE: Person 2

IF FC09_REVIEW>1 AND (RESPSEX=FEMALE AND FC01=0 AND FC02=0), CODE FC09_02=MALE AND GO TO FC09_02B.

ELSE IF FC09_REVIEW>1 AND (RESPSEX=MALE AND FC05=0), CODE FC09_02=FEMALE AND GO TO FC09_02B.

ELSE IF FC09_REVIEW>1 ASK FC09_02.

ELSE GO TO SKIP INSTRUCTION BEFORE FC09_03.

PROGRAMMER NOTE: DISPLAY BURNLINE (Unwanted sex by force: Person 2).

[FC09_02] Think about the 2^nd person who did this/any of these things to you. Was Person 2…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY FC09_02B AND FC09_02C ON ONE SCREEN; SHOW BURN LINE (Unwanted sex by force: Person 2).

[FC09_02B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FC09_02B=1,2,3,4,5 ASK FC09_02C. ELSE GO TO FC09_02D.

[FC09_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF FC09_INT^=1 AND FC09_02B=INTIMATE RELATIONSHIP, ASK FC09_02D AND FC09_02E. ELSE GO TO FC09_02F.

PROGRAMMER NOTE: DISPLAY FC09_02D AND FC09_02E ON ONE SCREEN; SHOW BURN LINE (Unwanted sex by force: Person 2).

[FC09_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF FC09_02D=YES, CODE FC09_INT=1 AND ASK FC09_02E. ELSE GO TO FC09_02F.

[FC09_02E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE:

-DISPLAY FC09_02F TO FC09_02G ON ONE SCREEN;

-SHOW BURN LINE (Unwanted sex by force: Person 2).

[FC09_01F] Still thinking about Person 2, did he/she do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF FC09_02F=YES AND FC09_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK FC09_02G. ELSE GO TO FC09_02H.

[FC09_02G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF FC09_02G=NO OR (FC09_02=YES AND FC09_02B=SOMEONE ELSE), ASK FC09_02H. ELSE GO TO FC09_03.

PROGRAMMER NOTE:

-DISPLAY FC09_02H TO FC09_02I ON ONE SCREEN;

-SHOW BURN LINE (Unwanted sex by force: Person 2).

[FC09_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually or intimate 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FC09_02H=INTIMATE RELATIONSHIPS, ASK FC09_02I. ELSE GO TO FC09_03.

[FC09_02I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF FC09_01F=1 OR FC09_02F=1 OR FC09_03F=1 OR FC09_04F=1 OR FC09_05F=1 OR FC09_06F=1 OR FC09_07F=1 OR FC09_08F=1 OR FC09_09F=1 OR FC09_10F=1, ASK FC16. ELSE GO TO SKIP INSTRUCTIONS BEFORE FC_INTRO2.

[FC16]

PROGRAMMER NOTE:

-CREATE A VARIABLE FC09_CNT AND MAKE FC09_CNT EQUAL TO THE NUMBER OF YES ANSWERS TO FC09_01F, FC09_02F, FC09_03F, FC09_04F, FC09_05F, FC09_06F, FC09_07F, FC09_08F, FC09_09F, FC09_10F

-SHOW A TEXT FIELD ALLOWING FOR NUMBERS FROM 1 TO 99.

-SHOW TWO RADIO BUTTONS BELOW THE TEXT FIELD; ONE IS LABELED AS “More than 100 times” AND THE SECOND “Too many to count”.

Think about the {(IF FC09_CNT=1: person) / (FILL: FC09_CNT) people} who

(IF FEMALE RESPONDENTS:)

-(IF FC01>=1: put {his/her} mouth on your vagina)

-(IF FC02>=1: put {his/her} fingers or an object in your vagina or anus)

-(IF FC03>=1: put his penis in your vagina)

-(IF FC04>=1: put his penis in your mouth or anus)

(IF MALE RESPONDENTS:)

-(IF FC05>=1: put {his/her} fingers or an object in your anus)

-(IF FC06>=1: put his penis in your mouth or anus)

using physical force or threats of harm in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}.

How many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months?

(“In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.)

__________

IF RESPSEX=FEMALE, GO TO NEXT SECTION (FA_INTRO1).

IF REPSEX= MALE AND:

-IF FC06=0 AND FC07=0 THEN SKIP TO NEXT SECTION (FA_INTRO1);

ELSE GO TO SKIP INSTRUCTION BEFORE FC_INTRO2.

IF (FC06>=1 AND FC07>=1) AND FC09_REVIEW>=1 THEN GO TO FC_INTRO2. ELSE GO TO INSTRUCTION BEFORE FC17_REVIEW.

MADE TO PENETRATE BY FORCE: ANSWERED ONLY BY MALES

[FC_INTRO2] The next questions are about some of the other things that have happened to you.

IF FC06=0 AND FC07>=1 THEN FC17_REVIEW=FC07 AND GO TO SKIP INSTRUCTION BEFORE FC17_01;

ELSE IF FC06>=1 AND FC07=0 THEN FC17_REVIEW=FC06 AND GO TO SKIP INSTRUCTION BEFORE FC17_01;

ELSE GO TO FC17_REVIEW.

[FC17_REVIEW]

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

You answered earlier that

-[FILL IN FC06] people put their mouth on your penis,

-[FILL IN FC07] females made you put your penis in their vagina

…….using physical force or threats of harm.

In total, how many DIFFERENT people did any of these things to you?

________

MADE TO PENETRATE BY FORCE: Person 1

IF FC17_REVIEW>=1 AND FC06=0, CODE FC17_01=FEMALE AND GO TO FC17_01B.

ELSE IF FC17_REVIEW>=1 AND FC07>=1 THEN ASK FC17_01.

ELSE GO TO SKIP INSTRUCTIONS BEFORE FC17_02.

[FC17_01]

PROGRAMMER NOTE: DISPLAY BURN LINE (Made to penetrate by force: Person 1).

Think about the first time anyone EVER

-(IF FC06>=1: put their mouth on your penis)

-(IF FC07>=1: made you put your penis in their vagina)

using physical force or threats of harm.

The first time these things happened to you, was the person…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY FC17_01B AND FC17_01C ON ONE SCREEN; SHOW BURN LINE (Made to penetrate by force: Person 1).

[FC17_01B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FC17_01B=1,2, CODE FC17_INT=1.

IF FC17_01B=1,2,3,4,5 ASK FC17_01C. ELSE GO TO FC17_01E.

[FC17_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

PROGRAMMER NOTE: SHOW BURN LINE (Made to penetrate by force: Person 1).

[FC17_01E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY FC17_01F TO FC17_01G ON ONE SCREEN; SHOW BURN LINE (Made to penetrate by force: Person 1).

[FC17_01F] Still thinking about this person. Did {he/she}

-(IF FC06>=1: put their mouth on your penis)

-(IF FC07>=1: made you put your penis in their vagina)

using physical force or threats of harm within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF FC17_01F=YES AND FC17_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK FC17_01G. ELSE GO TO FC17_01H.

[FC17_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF FC17_01G=NO OR (FC17_01F=YES AND FC17_01B=SOMEONE ELSE), ASK FC17_01H. ELSE GO TO FC17_02.

PROGRAMMER NOTE: DISPLAY FC17_01H TO FC17_01I ON ONE SCREEN; SHOW BURN LINE (Made to penetrate by force: Person 1).

[FC17_01H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FC17_01H=INTIMATE RELATIONSHIPS, ASK FC17_01I. ELSE GO TO FC17_02.

[FC17_01I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

MADE TO PENETRATE BY FORCE: Person 2

IF FC17_REVIEW>1 AND FC05=0, CODE FC17_02=FEMALE AND GO TO FC17_02B.

ELSE IF FC17_REVIEW>1, ASK FC17_02.

ELSE GO TO SKIP INSTRUCTIONS BEFORE FC17_03.

PROGRAMMER NOTE: DISPLAY BURN LINE (Made to penetrate by force: Person 2).

[FC17_02] Was the 2^nd person who did this/any of these to you…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY FC17_02B AND FC17_02C ON ONE SCREEN; SHOW BURN LINE (Made to penetrate by force: Person 2).

[FC17_02B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FC17_02B=1,2,3,4,5 ASK FC17_02C. ELSE GO TO FC17_02D.

[FC17_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF FC17_INT^=1 AND FC17_02B=INTIMATE RELATIONSHIP, ASK FC17_02D AND FC17_02E.

PROGRAMMER NOTE: DISPLAY FC17_01D AND FC17_02E ON ONE SCREEN; SHOW BURN LINE (Made to penetrate by force: Person 2).

[FC17_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF FC17_02D=YES, CODE FC17_INT=1 AND ASK FC17_02E. ELSE GO TO FC17_02F.

[FC17_02E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY FC17_02F TO FC17_02G ON ONE SCREEN; SHOW BURN LINE (Made to penetrate by force: Person 2).

[FC17_02F] Did Person 2 do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF FC17_02F=YES AND FC17_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK FC17_02G. ELSE GO TO FC17_02H.

[FC17_02G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF FC17_02G=NO OR (FC17_02F=YES AND FC17_02B=SOMEONE ELSE), ASK FC17_02H. ELSE GO TO FC17_03.

PROGRAMMER NOTE: DISPLAY FC17_02H TO FC17_02I ON ONE SCREEN; SHOW BURN LINE (Made to penetrate by force: Person 2).

[FC17_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FC17_02H=INTIMATE RELATIONSHIPS, ASK FC17_02I. ELSE GO TO FC17_03.

[FC17_02I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF FC17_01F=1 OR FC17_02F=1 OR FC17_03F=1 OR FC17_04F=1 OR FC17_05F=1 OR FC17_06F=1 OR FC17_07F=1 OR FC17_08F=1 OR FC17_09F=1 OR FC17_10F=1, ASK FC24. ELSE GO TO SKIP INSTRUCTIONS BEFORE FA_INTRO1.

[FC24]

PROGRAMMER NOTE:

-CREATE A VARIABLE FC17_CNT AND MAKE FC17_CNT EQUAL TO THE NUMBER OF YES ANSWERS TO FC17_01F, FC17_02F, FC17_03F, FC17_04F, FC17_05F, FC17_06F, FC17_07F, FC17_08F, FC17_09F, FC17_10F

-SHOW A TEXT FIELD ALLOWING FOR NUMBERS FROM 1 TO 99.

-SHOW TWO RADIO BUTTONS BELOW THE TEXT FIELD; ONE IS LABELED AS “More than 100 times” AND THE SECOND “Too many to count”]

Think about {(IF FC17_CNT=0: person)/(FILL: FC17_CNT) people)} who

-(IF FC06>=1: put their mouth on your penis)

-(IF FC07>=1: made you put your penis in their vagina)

using physical force or threats of harm in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}.

How many times in total did {FILL: “this (ONE BEHAVIOR)/ “these things”} happen to you in the past 12 months?

(“In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.)

__________

ATTEMPTED PHYSICALLY FORCED SEX

PROGRAMMER NOTE: DISPLAY FA_INTRO1 ON ONE SCREEN.

[FA_INTRO1] The next set of questions are about times in your life when someone ever ATTEMPTED to have sex or sexual contact with you by using physical force or threats of harm but sex did NOT happen. Examples of physical force are being pinned or held down, using violence or threats of violence, or not physically stopping after you said no. To be clear, we are now asking only about times when sex was unwanted and you did not give consent, and sex did not happen.

IF RESPSEX=FEMALE, ASK FA01. ELSE GO TO SKIP INSTRUCTIONS BEFORE FA02.

[FA01]

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

How many MALES have ever used physical force or threats of physical harm to TRY to put their penis in your vagina, mouth, or anus, but it did not happen?

__________

IF RESPSEX=MALE, ASK FA02 TO FA04. ELSE GO TO SKIP INSTRUCTIONS BEFORE FA05_01.

[FA02]

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

How many PEOPLE have ever used physical force or threats of physical harm to TRY to put their mouth on your penis, but it did not happen?

__________

[FA03]

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

How many FEMALES have ever used physical force or threats of physical harm to TRY to make you put your penis in their vagina, but it did not happen?

__________

[FA04]

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

How many MALES have ever used physical force or threats of physical harm to TRY to put their penis in your mouth or anus, but it did not happen?

__________

IF FEMALE RESPONDENTS:

IF FA01=0, SKIP TO NEXT SECTION (OT_INTRO1). ELSE GO TO FA05_01.

IF MALE RESPONDENTS:

IF FA02=0 AND FA03=0 AND FA04=0, SKIP TO NEXT SECTION (OT_INTRO1);

ELSE IF FA04>=1 THEN GO TO FA05_1;

ELSE IF FA04=0 AND (FA02>=1 OR FA03>=1, GO TO SKIP INSTRUCTIONS BEFORE FA_INRO2.

IF FA01>=1 OR FA04>=1, CODE FA05_01=MALE AND ASK FA05_01B. ELSE GO TO SKIP INSTRUCTIONS BEFORE FA05_02.

SEX BY FORCE: Person 1

[FA05_01]

PROGRAMMER: CODE THIS TO MALE AND DO NOT SHOW THE ITEM TO RESPONDENTS.

Was this person…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY FA05_01B AND FA05_01C ON ONE SCREEN; SHOW BURN LINE (Attempted Unwanted Sex By Force: Person 1).

[FA05_01B] (IF FEMALE RESPONDENTS: Think about the first time anyone EVER tried to put their penis in your vagina, mouth or anus using physical force or threats of harm, but sex DID NOT happen.)

(IF MALE RESPONDENTS: Think about the first time anyone EVER tried to put their penis in your mouth or anus using physical force or threats of harm, but sex DID NOT happen. )

The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FA05_01B=1,2,CODE FA05_INT=1.

IF FA05_01B=1,2,3,4,5 ASK FA05_01C. ELSE GO TO FA05_01E.

[FA05_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

PROGRAMMER NOTE: SHOW BURN LINE (Attempted Unwanted Sex By Force: Person 1).

[AD11_01E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY FA05_01F TO FA05_01G ON ONE SCREEN; SHOW BURN LINE (Attempted Unwanted Sex By Force: Person 1).

[FA05_01F] Still thinking about this person who

(FOR FEMALE RESPONDENTS: tried to put their penis in your vagina, mouth, or anus)

(FOR MALE RESPONDENTS: tried to put their penis in your mouth or anus)

using physical force or threats of harm, but sex DID NOT happen.

Did this person do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

YES 1

NO 2

IF FA05_01F=YES AND FA05_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK FA05_01G. ELSE GO TO FA05_01H.

[FA05_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

YES 1

NO 2

IF FA05_01G=NO OR (FA05_01F=YES AND FA05_01B=SOMEONE ELSE), ASK FA05_01H. ELSE GO TO FA05_02.

PROGRAMMER NOTE: DISPLAY FA05_01H TO FA05_01I ON ONE SCREEN; SHOW BURN LINE (Attempted Unwanted Sex By Force: Person 1).

[FA05_01H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FA05_01H=INTIMATE RELATIONSHIPS, ASK FA05_01I. ELSE GO TO FA05_02.

[FA05_01I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

SEX BY FORCE: Person 2

IF FA01_>1 OR FA04>1, CODE FA05_02 AS MALE AND GO TO FA05_02B. ELSE GO TO SKIP INSTRUCTIONS BEFORE FA05_03.

PROGRAMMER NOTE: DO NOT SHOW FA05_02.

[FA05_02] Think about the 2^nd person who did this/any of these things to you. Was Person 2…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY FA05_02B AND FA05_02C ON ONE SCREEN; SHOW BURN LINE (Attempted Unwanted Sex by Force: Person 2).

[FA05_02B.] Think about the 2^nd person who did this to you. The first time this happened, what was Person 2's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor,
police officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FA05_02B=1,2,3,4,5 ASK FA05_02C. ELSE GO TO FA05_02D.

[FA05_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF FA05_INT^=1 AND FA05_02B=INTIMATE RELATIONSHIP, ASK FA05_02D AND FA05_02E. ELSE GO TO FA05_02F.

PROGRAMMER NOTE: DISPLAY FA05_02D AND FA05_02E ON ONE SCREEN; SHOW BURN LINE (Attempted Unwanted Sex by Force: Person 2).

[FA05_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF FA05_02D=YES, CODE FA05_INT=1 AND ASK FA05_02E. ELSE GO TO FA05_02F.

[FA05_02E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY FA05_01F AND FA05_01G ON ONE SCREEN; SHOW BURN LINE (Attempted Unwanted Sex by Force: Person 2).

[FA05_01F] Still thinking about Person 2, did he/she do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF FA05_02F=YES AND FA05_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK FA05_02G. ELSE GO TO FA05_02H.

[FA05_02G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY FA05_01H AND FA05_01I ON ONE SCREEN; SHOW BURN LINE (Attempted Unwanted Sex by Force: Person 2).

IF FA05_02G=NO OR (FA05_02F=YES AND FA05_02B=SOMEONE ELSE), ASK FA05_02H. ELSE GO TO FA05_03.

[FA05_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FA05_02H=INTIMATE RELATIONSHIPS, ASK FA05_02I. ELSE GO TO FA05_03.

[FA05_02I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF FA05_01F=1 OR FA05_02F=1 OR FA05_03F=1 OR FA05_04F=1 OR FA05_05F=1 OR FA05_06F=1 OR FA05_07F=1 OR FA05_08F=1 OR FA05_09F=1 OR FA05_10F=1, ASK FA12. ELSE GO TO SKIP INSTRUCTIONS BEFORE FA_INTRO2.

FA12

PROGRAMMER NOTE:

-CREATE A VARIABLE FA05_CNT AND MAKE FA05_CNT EQUAL TO THE NUMBER OF YES ANSWERS TO FA05_01F, FA05_02F, FA05_03F, FA05_04F, FA05_05F, FA05_06F, FA05_07F, FA05_08F, FA05_09F, FA05_10F

-SHOW A TEXT FIELD ALLOWING FOR NUMBERS FROM 1 TO 99.

-SHOW TWO RADIO BUTTONS BELOW THE TEXT FIELD; ONE IS LABELED AS “More than 100 times” AND THE SECOND “Too many to count”.

Think about the {(IF FA05_CNT=1: person) / (FILL: FA05_CNT people)} who did {FILL: “this” (one behavior)/”these things”} to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}.

How many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months?

(“In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.)

__________

MADE TO PENETRATE BY FORCE: ANSWERED ONLY BY MALE RESPONDENTS

IF FEMALE RESPONDENTS, GO TO NEXT SECTION (OT_INTRO1).

IF MALE RESPONDENTS:

IF FA02=0 AND FA03=0 THEN SKIP TO NEXT SECTION (OT_INTRO1);

ELSE IF FA02=0 AND FA03>=1 THEN FA13_REVIEW=FA03. GO TO SKIP INSTRUCTION BEFORE FA13_01;

ELSE IF FA02>=1 AND FA03=0 THEN FA13_REVIEW=FA02. GO TO SKIP INSTRUCTION BEFORE FA13_01;

ELSE IF FA02>=1 AND FA03>=1 THEN GO TO FA13_REVIEW.

[FA13_REVIEW]

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

You answered earlier that

-(IF FA02>=1: [FILL IN FA02] people tried to put their mouth on your penis, )

-(IF FA03>=1: [FILL IN FA03] females tried to make you put your penis in their vagina,)

but it didn’t happen.

In total, how many DIFFERENT people did any of these things to you?

__________

MTP BY FORCE: Person 1

IF FA13_REVIEW>=1 AND FA02=0 THEN CODE FA13_01=FEMALE AND GO TO FA13_01B.

ELSE IF FA13_REVIEW>=1 AND FA02>0, ASK FA13_01.

ELSE GO TO FA13_02.

PROGRAMMER NOTE: DISPLAY BURN LINE (Attempted made to penetrate: Person 1).

[FA13_01] Think about the first time anyone ever

-(IF FA02>=1: tried to put their mouth on your penis)

-(IF FA03>=1: tried to make you put your penis in their vagina) but it didn’t happen.

The first time these things happened to you, was the person…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY FA13_01B AND FA13_01C ON ONE SCREEN; SHOW BURN LINE (Attempted made to penetrate: Person 1).

[FA13_01B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FA13_01B=1,2, CODE FA13_INT=1.

IF FA13_01B=1,2,3,4,5 ASK FA13_01C. ELSE GO TO FA13_01E.

[FA13_01C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

PROGRAMMER NOTE: SHOW BURN LINE (Attempted made to penetrate: Person 1).

[FA13_01E] How old were you the first time this person did any of these things to you?

PROGRAMMER NOTE: DISPLAY FA13_01F AND FA13_01G ON ONE SCREEN; SHOW BURN LINE (Attempted made to penetrate: Person 1).

[FA13_01F] Still thinking about this person. Did {he/she} do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF FA13_01F=YES AND FA13_01B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK FA13_01G. ELSE GO TO FA13_01H.

[FA13_01G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF FA13_01G=NO OR (FA13_01F=YES AND FA13_01B=SOMEONE ELSE), ASK FA13_01H. ELSE GO TO FA13_02.

PROGRAMMER NOTE: DISPLAY FA13_01H AND FA13_01I ON ONE SCREEN; SHOW BURN LINE (Attempted made to penetrate: Person 1).

[FA13_01H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FA13_01H=INTIMATE RELATIONSHIPS, ASK FA13_01I. ELSE GO TO FA13_02.

[FA13_01I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

MTP BY FORCE: Person 2

IF FA13_REVIEW>1 AND FA02=0, CODE FA13_02 AS FEMALE AND GO TO FA13_02B.

ELSE IF FA13_REVIE>1 AND FA02>0, ASK FA13_02.

ELSE GO TO SKIP INSTRUCTIONS BEFORE FA13_03.

PROGRAMMER NOTE:. DISPLAY BURN LINE (Attempted made to penetrate: Person 2).

[FA13_02] Was the 2^nd person who did this/any of these to you…?

Male 1

Female 2

PROGRAMMER NOTE: DISPLAY FA13_02B AND FA13_02C ON ONE SCREEN; SHOW BURN LINE (Attempted made to penetrate: Person 2).

[FA13_02B] The first time this happened, what was that person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

A family member/relative 3

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FA13_02B=1,2,3,4,5 ASK FA13_02C. ELSE GO TO FA13_02D.

[FA13_02C] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF FA13_INT^=1 AND FA13_02B=INTIMATE RELATIONSHIP, ASK FA13_02D AND FA13_02E.

PROGRAMMER NOTE: DISPLAY FA13_02D AND FA13_02E ON ONE SCREEN; SHOW Attempted made to penetrate: Person 2).

[FA13_02D] Is Person 2 the FIRST romantic or sexual partner who ever did any of these things to you?

Yes 1

No 2

IF FA13_02D=YES, CODE FA13_INT=1 AND ASK FA13_02E. ELSE GO TO FA13_02F.

[FA13_02E] How old were you the first time this person did any of these things to you?

__________

PROGRAMMER NOTE: DISPLAY FA13_02F AND FA13_02G ON ONE SCREEN; SHOW BURN LINE (Attempted made to penetrate: Person 2).

[FA13_02F] Did Person 2 do [this/any of these things] within the past 12 months, that is since [FILL: DATE 12 MONTHS AGO]?

Yes 1

No 2

IF FA13_02F=YES AND FA13_02B IS NOT (FAMILY MEMBER/RELATIVE OR SOMEONE ELSE), ASK FA13_02G. ELSE GO TO FA13_02H.

[FA13_02G] Just to confirm, this person was still [FILL RELATIONSHIP] when [FILL: he/she] did [this/any of these things] to you in the past 12 months. Is that correct?

Yes 1

No 2

IF FA13_02G=NO OR (FA13_02F=YES AND FA13_02B=SOMEONE ELSE), ASK FA13_02H. ELSE GO TO FA13_03.

PROGRAMMER NOTE: DISPLAY FA13_02H AND FA13_02I ON ONE SCREEN; SHOW BURN LINE (Attempted made to penetrate: Person 2)]

[FA13_02H] When he/she did these things to you in the past 12 months, what was his/her relationship to you?

Someone I was involved romantically
or sexually with at the time 1

Someone I previously had been
involved romantically or sexually 2

A friend/neighbor/acquaintance 4

A person of authority (e.g., boss,
supervisor, teacher, doctor, police
officer, etc.) 5

A stranger 6

Someone else (Please specify:
) 7

IF FA13_02H=INTIMATE RELATIONSHIPS, ASK FA13_02I. ELSE GO TO FA13_03.

[FA12_02I] Specifically, was this person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF FA13_01F=1 OR FA13_02F=1 OR FA13_03F=1 OR FA13_04F=1 OR FA13_05F=1 OR FA13_06F=1 OR FA13_07F=1 OR FA13_08F=1 OR FA13_09F=1 OR FA13_10F=1, ASK FA20. ELSE GO TO SKIP INSTRUCTIONS BEFORE OT_INTRO1.

[FA20]

PROGRAMMER NOTE:

-CREATE A VARIABLE FA13_CNT AND MAKE FA13_CNT EQUAL TO THE NUMBER OF YES ANSWERS TO FA13_01F, FA13_02F, FA13_03F, FA13_04F, FA13_05F, FA13_06F, FA13_07F, FA13_08F, FA13_09F, FA13_10F

-SHOW A TEXT FIELD ALLOWING FOR NUMBERS FROM 1 TO 99.

-SHOW TWO RADIO BUTTONS BELOW THE TEXT FIELD; ONE IS LABELED AS “More than 100 times” AND THE SECOND “Too many to count”.

Think about the {(IF FA13_CNT=1: person) / (FILL: FA13_CNT people)} who did {FILL: “this” (one behavior)/”these things”} to you in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}.

How many times in total did {FILL: “this” (ONE BEHAVIOR) / “these things”} happen to you in the past 12 months?

(“In total” refers to your combined experiences across all of the people who did {FILL: “this” (ONE BEHAVIOR) / “these things”} to you in the past 12 months.)

[IF FEMALE RESPONDENTS:

IF FC01=0 AND FC02=0 AND FC03=0 AND FC04=0 AND FA01=0 AND AD01=0 AND AD02=0 AND AD03=0 AND AD04=0, SKIP TO NEXT SECTION (PA_INTRO1); ELSE GO TO OT_INTRO1.

IF MALE RESPONDENTS:

IF FC05=0 AND FC06=0 AND FC07=0 AND FC08=0 AND FA02=0 AND FA03=0 AND FA04=0 AND AD05=0 AND AD06=0 AND AD07=0 AND AD08=0, SKIP TO NEXT SECTION (PA_INTRO1). ELSE GO TO OT_INTRO1]

_______________

SEXUAL VIOLENCE: OUTCOMES OF RAPE AND MADE TO PENETRATE

[OT_INTRO1] Next are a few follow-up questions about the times in your life anyone ever

-(IF FC09_REVIEW>=1 OR FC17_REVIEW>=1: made you have sex using physical force or threats of violence)

-(IF FA01>=1 OR FA04>=1 OR FA13_REVIEW>=1: tried to make you have sex using physical force or threats of violence)

-(IF AD11_REVIEW>=1 OR AD19_REVIEW>=1: made you have unwanted sex when you were unable to consent or refuse because you were too drunk, high, drugged, or passed out from alcohol or drugs).

[OT1] Thinking about these experiences in your entire lifetime, when {FILL: “this” (IF JUST ONE BEHAVIOR ENDORSED FROM AD01 – AD04, FC01-FC04,FA01 (FEMALE)/AD05 – AD08, FC05-FC08,FA02-FA04 (MALE), / “any of these things”} happened, did you file a police report?

Yes 1

No 2

[OT2] Were you ever physically injured when {FILL: “this” (IF JUST ONE BEHAVIOR ENDORSED FROM AD01 – AD04,FC01-FC04,FA01 (FEMALE)/AD05 – AD08, FC05-FC08, FA02-FA04 (MALE) / “any of these things”} happened? For example, did you have bruises, {FILL: “vaginal” or (FEMALES)} anal tears, or other internal or external injuries?

Yes 1

No 2

IF RESPSEX=FEMALE AND (AD01>0 OR AD02>0 OR AD03>0 OR AD04>0 OR FC01>0 OR FC02>0 OR FC03>0 OR FC04>0), ASK OT03. ELSE GO TO SKIP INSTRUCTION BEFORE OT04.

IF RESPSEX=MALE AND (AD05>0 OR AD06>0 OR AD07>0 OR AD08>0 OR FC05>0 OR FC06>0 OR FC07>0 OR FC08>0), ASK OT03. ELSE GO TO SKIP INSTRUCTION BEFORE OT04.

[OT03] Did you ever get an STD or other infection when {FILL: “this” (IF JUST ONE BEHAVIOR ENDORSED FROM AD01 – AD04, FC01-FC04 (FEMALE)/AD05 – AD08, FC05-FC08 (MALE) / “any of these things} happened? For example, did you get Chlamydia, Gonorrhea, HIV, or some other STD?

Yes 1

No 2

IF RESPSEX=FEMALE AND (AD03>0 OR FC03>0) ASK OT04. ELSE GO TO OT05.

IF RESPSEX=MALE GO TO OT05.

[OT04] Did you ever get pregnant when {FILL: “this” (IF ONLY AD03 OR FC03 ENDORSED/ “any of these things”} happened?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY OT05 AND OT06 ON ONE SCREEN IN A GRID.

[OT05] Were you ever concerned for your safety?

Yes 1

No 2

[OT06] Were you ever fearful for yourself or someone close to you?

Yes 1

No 2

PSYCHOLOGICAL AGGRESSION

[PA_INTRO1] The next questions ask about experiences you may have had in your life with your romantic or sexual partners. Examples of romantic or sexual partners include: spouses, boyfriends, girlfriends, people you have dated, people you were seeing, or people you hooked up with.

PROGRAMMER NOTE: DISPLAY PA01-PA03 ON ONE SCREEN, USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE .

[PA01] How many of your current or ex partners have EVER ...

… insulted or humiliated you in front of others?

__________

[PA02] … kept you from having your own money?

__________

[PA03] … tried to keep you from seeing or talking to your family or friends?

__________

PROGRAMMER NOTE: DISPLAY PA04-PA06 ON ONE SCREEN, USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[PA04] How many of your current or ex partners have EVER ...

… kept track of you by demanding to know where you were and what you were doing?

[PA05] … made threats to physically harm you?

[PA06] … threatened to hurt themselves or commit suicide because they were upset with you?

PROGRAMMER NOTE: DISPLAY PA07-PA08 ON ONE SCREEN, USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[PA07] How many of your current or ex partners have EVER ...

… made decisions that should have been yours to make?

[PA08] … destroyed something that was important to you?

IF PA01>0 OR PA02>0 OR PA03>0 OR PA04>0 OR PA05>0 OR PA06>0 OR PA07>0 OR PA08>0, ASK P09. ELSE SKIP TO PA_INTRO2.

[PA09] How old were you the first time a current or ex partner

-(IF PA01>=1: insulted or humiliated you in front of others,)

-(IF PA02>=1: kept you from having your own money,)

-(IF PA03>=1: tried to keep you from seeing or talking to your family or friends,)

-(IF PA04>=1: kept track of you by demanding to know where you were and what you were doing,)

-(IF PA05>=1: made threats to physically harm you,)

-(IF PA06>=1: threatened to hurt themselves or commit suicide because they were upset with you,)

-(IF PA07>=1: made decisions that should have been yours to make)

-(IF PA08>=1: destroyed something that was important to you)

__________

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE

[PA10] How many current or ex partners have done {FILL: “this” (JUST ONE OF F01 – F08) / “any of these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}?

__________

IF PA10=0, SKIP TO NEXT SECTION (PV_INTRO1). ELSE ASK PA11.

[PA11] At the time that it was most frequent in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}, how often did a current or ex partner do {FILL: “this” (ONE BEHAVIOR) / “these things”} in the past 12 months?

Once 1

A few times a year 2

Monthly 3

Weekly 4

Daily 5

[PA_INTRO2] The next few questions are related to other experiences you may have had with a current or ex-romantic or sexual partner.

PROGRAMMER NOTE: PLACE PA12-PA14 ON ONE SCREEN; USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

IF RESPSEX=FEMALE, ASK PA12. ELSE GO TO SKIP INSTRUCTIONS BEFORE PA13.

[PA12] How many of your current or ex partners have EVER tried to get you pregnant when you did not want to become pregnant or tried to stop you from using birth control?

__________

IF RESPSEX=MALE, ASK PA13. ELSE GO TO SKIP INSTRUCTIONS BEFORE PA14.

[PA13] How many of your current or ex partners have EVER tried to get pregnant when you didn’t want them to get pregnant or tried to stop you from using birth control?

__________

IF PA12>=1 OR PA13>=1, ASK PA14. ELSE GO TO SKIP INSTRUCTIONS BEFORE PA15.

[PA14] How many current or ex partners have done this to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}?

__________

PROGRAMMER NOTE: PLACE PA15-PA16 ON ONE SCREEN; USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

[PA15] How many of your current or ex partners have EVER refused to use a condom when you wanted them to use one?

__________

IF PA15>0, ASK PA16. ELSE GO TO PV_INTRO1.

[PA16] How many current or ex partners have done this to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}?

__________

PHYSICAL VIOLENCE

PROGRAMMER NOTE: DISPLAY PV_INTRO1, PV01, PV02, PV03 ON ONE SCREEN. USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE FOR PV01 AND PV03.

[PV_INTRO1] The next questions are related to physical acts you may have experienced with your current or ex-romantic or sexual partners.

[PV01] How many of your current or ex partners have ever slapped, pushed, or shoved you?

__________

IF PV01>1, ASK PV02 AND PV03. ELSE GO TO PV04.

[PV02] How old were you the first time a current or ex partner slapped, pushed, or shoved you?

__________

[PV03] How many current or ex partners have slapped, pushed, or shoved you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}?

__________

PROGRAMMER NOTE: IF PV03>PV01, BRING R BACK TO PV03 AND SHOW A WARNING MESSAGE: You entered a number bigger than (FILL PV01).

PROGRAMMER NOTE: DISPLAY PV04-PV06 ON ONE SCREEN, USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE FOR ALL THREE.

[PV04] How many of your current or ex partners have ever …

… hit you with a fist or something hard?

__________

[PV05] … kicked you or stomped on you?

__________

[PV06] … hurt you by pulling your hair?

PROGRAMMER NOTE: DISPLAY PV07-PV08 ON ONE SCREEN, USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE FOR BOTH.

[PV07] How many of your current or ex partners have ever …

… slammed you against something?

__________

[PV08] … tried to hurt you by choking or suffocating you?

PROGRAMMER NOTE: DISPLAY PV09-PV10 ON ONE SCREEN, USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE FOR BOTH.

[PV09] How many of your current or ex partners have ever …

… used a knife on you?

__________

[PV10] … used a gun on you?

__________

IF PV04=0 AND PV05=0 AND PV06=0 AND PV07=0 AND PV08=0 AND PV09=0 AND PV10=1, GO TO SKIP INSTRUCTIONS BEFORE PV13. ELSE ASK PV11.

[PV11] How old were you the first time a current or ex partner

-(IF PV04>0: hit you with a fist or something hard)

-(IF PV05>0: kicked you or stomped on you)

-(IF PV06>0: hurt you by pulling your hair)

-(IF PV07>0: slammed you against something)

-(IF PV08>0: tried to hurt you by choking or suffocating you)

-(IF PV09>0: used a knife on you)

-(IF PV10>0: used a gun on you)

__________

[PA12]

PROGRAMMER NOTE: USE A DROP DOWN BOX WITH THE FOLLOWING OPTIONS: NONE, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 OR MORE.

How many current or ex partners have

-(IF PV04>0: hit you with a fist or something hard)

-(IF PV05>0: kicked you or stomped on you)

-(IF PV06>0: hurt you by pulling your hair)

-(IF PV07>0: slammed you against something)

-(IF PV08>0: tried to hurt you by choking or suffocating you)

-(IF PV09>0: used a knife on you)

-(IF PV10>0: used a gun on you)

in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}?

__________

PROGRAMMER NOTE: IF PV12>SUM(PV04 THROUGH PV10), BRING R BACK TO PV12 AND DISPLAY A WARNING MESSAGE: “You entered a number that is bigger than the number of current or ex partners in life time that ever hurt you.”.

IF PV01=0 AND PV04=0 AND PV05=0 AND PV06=0 AND PV07=0 AND PV08=0 AND PV08=0 AND PV10=0, GO TO NEXT SECTION (CQ_INTRO1). ELSE ASK PV13.

[PV13] Think about {FILL: “the person” (IF SUM OF PV01, PV04 THROUGH PV01=1) / “all of the people”} who

-(IF PV01>0: slapped, pushed, or shoved you)

-(IF PV04>0: hit you with a fist or something hard )

-(IF PV05>0: kicked you or stomped on you )

-(IF PV06>0: hurt you by pulling your hair )

-(IF PV07>0: slammed you against something )

-(IF PV08>0: tried to hurt you by choking or suffocating you)

-(IF PV09>0: used a knife on you)

-(IF PV10>0: used a gun on you)

in your lifetime.

The FIRST time {this/any of these things} happened to you, was that person…?

Male 1

Female 2

[PV13_01B] At the time of the incident, what was the person's relationship to you?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

[PV13_01B] Specifically, was that person…?

PROGRAMMER NOTE: SHOW SUBCATEGORIES AS RESPONSE OPTIONS BASED ON SEX AND BROAD RELATIONSHIP CATEGORY.

IF PV03 = 0 AND PV12 = 0 THEN GO TO NEXT SECTION (CQ_INTRO1). ELSE ASK PV14A.

[PV14A] For the (FILL: “first” (SUM PV03+PV12>1)} current or ex partner who did {FILL: “this” (ONE BEHAVIOR)/ “any of these things”} to you in the past 12 months, was this person male or female?

Male 1

Female 2

[PV14] What was your relationship with the {FILL: “first” (SUM PV03+PV12>1)} current or ex partner who did {FILL: “this” (ONE BEHAVIOR)/ “any of these things”} to you in the past 12 months? That is since {FILL: DATE 12 MONTHS AGO}?

Someone I was involved romantically
or sexually at the time 1

Someone I previously had been
involved romantically or sexually 2

[PV15] At the time that it was most frequent in the past 12 months, that is since {FILL: DATE 12 MONTHS AGO}, how often did a current or ex partner do {FILL: “this” (ONE BEHAVIOR) / “these things”} to you?

Once 1

A few times a year 2

Monthly 3

Weekly 4

Daily 5

CONSEQUENCES AND FOLLOW-UP

IF PV01>=1 OR

SUM OF (PV04 THROUGH PV10)>=1 OR

(ST11_REVIEW>=1 AND ST11_INT=1) OR

(SC06_REVIEW>=1 AND SC07_INT=1) OR

(SC17_REVIEW>=1 AND SC18_INT=1) OR

(AD11_REVIEW>=1 AND AD11_INT=1) OR

(AD19_REVIEW>=1 AND AD19_INT=1) OR

(FC09_REVIEW>=1 AND FC09_INT=1) OR

(FC17_REVIEW>=1 AND FC17_INT=1) OR

((FA01>=1 OR FA04>=1) AND FA05_INT=1) OR

(FA13_REVIEW>=1 AND FA13_INT=1), GO TO CQ_INTRO. ELSE GO TO DEBRIEFING.

[CQ_INTRO] The next questions ask about the consequences of the different experiences that you have shared with us involving a current or ex-romantic or sexual partner.

You said previously that current or ex romantic or sexual partners have:

-(IF ST11_REVIEW>0: followed, contacted, or harassed you on more than one occasion AND) (IF ST09>=1: made you feel fearful, threatened, or concerned for your safety or the safety of others,) (IF ST10>=1: made threats to physically harm you)

-(IF SC05>0: kissed you in a sexual way when you did not want it to happen)

-(IF SC06>0: fondled or touched you when you did not want it to happen)

-(IF SC17_REVIEW>0: verbally pressured you into unwanted sex)

-(IF AD11_REVIEW>0 or AD19_REVIEW>=1: had unwanted sex or sexual contact with you when you were too drunk, high, drugged, or passed out from alcohol or drugs and unable to consent)

-(IF FC09_REVIEW>0 or FC17_REVIEW>0: threatened you with harm or physically forced you to have sex or sexual contact when you didn’t want to)

-(IF FA01>0 OR FA04>0 or FA13_REVIEW>0: attempted to have sex or sexual contact with you by using physical force or threats of harm but sex did NOT Happen)

-(IF PV01>0: slapped, pushed, or shoved you)

-(IF PV04>0: hit you with a fist or something hard )

-(IF PV05>0: kicked you or stomped on you )

-(IF PV06>0: hurt you by pulling your hair )

-(IF PV07>0: slammed you against something )

-(IF PV08>0: tried to hurt you by choking or suffocating you)

-(IF PV09>0: used a knife on you)

-(IF PV10>0: used a gun on you)

PROGRAMMER NOTE: DISPLAY CQ01 AND CQ02 ON ONE SCREEN.

[CQ01] When any of those things happened, were you ever concerned for your safety?

Yes 1

No 2

IF CQ01=YES, ASK CQ02. ELSE GO TO CQ03.

[CQ02] Were you concerned for your safety in the past 12 months?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY CQ03 AND CQ04 ON ONE SCREEN.

[CQ03] When any of those things happened, were you ever fearful for yourself or someone close to you?

Yes 1

No 2

IF CQ03=YES, ASK CQ04. ELSE GO TO CQ05.

[CQ04] Were you fearful in the past 12 months?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY CQ05-CQ08 IN A GRID.

[CQ05] Thinking back to the physical acts, unwanted sexual situations, or repeated unwanted attempts to contact, follow, or harass you by a current or ex romantic or sexual partner …

… did you ever have nightmares?

Yes 1

No 2

[CQ06] … did you ever try hard not to think about or go out of your way to avoid being reminded of the things that were done to you?

Yes 1

No 2

[CQ07] … did you ever feel like you were constantly on guard, watchful, or easily startled?

Yes 1

No 2

[CQ08] … did you ever feel numb or detached from others, your activities, or your surroundings?

Yes 1

No 2

IF CQ05=YES OR CQ06=YES OR CQ07=YES OR CQ08=YES, ASK CQ09. ELSE GO TO CQ10.

[CQ09] You said earlier that you

-(IF CQ05=YES: had nightmares)

-(IF CQ06=YES: tried not to think about things done to you)

-(IF CQ07=YES: felt constantly on guard or easily startled)

-(IF CQ08=YES: felt numb or detached)

because of what a current or ex partner did to you.

Did you ever feel this way in the past 12 months?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY CQ10-CQ15 IN ONE GRID.

[CQ10] Here is a list of possible injuries. Please indicate which of these you have experienced because of the physical acts, unwanted sexual situations, or repeated unwanted attempts to contact, follow, or harass you by a current or ex partner.

Did you ever experience …

… minor bruises or scratches?

Yes 1

No 2

[CQ11] … cuts, major bruises, or black eyes?

Yes 1

No 2

[CQ12] … injury to any ligaments, muscles or tendons?

Yes 1

No 2

[CQ13] … broken bones or teeth?

Yes 1

No 2

[CQ14] … back or neck injury?

Yes 1

No 2

[CQ15] … being knocked out after getting hit, slammed against something or choked?

Yes 1

No 2

[CQ16] A concussion is when a blow to the head caused you to have one or more symptoms such as blurred or double vision, sensitivity to light or noise, headaches, dizziness or balance problems, nausea, being dazed or confused, difficulty remembering, difficulty concentrating, or being knocked out.

Did you ever experience a concussion because of what a current or ex partner did to you?

(Do not include situations where you were hurt accidentally.)

Yes 1

No 2

[CQ17] Did you ever experience mental or emotional harm (for example, anxiety or depression) because of what a current or ex partner did to you?

Yes 1

No 2

IF CQ10=YES OR CQ11=YES OR CQ12=YES OR CQ13=YES OR CQ14=YES OR CQ15=YES OR CQ16=YES, ASK CQ17. ELSE GO TO CQ22.

PROGRAMMER NOTE: DISPLAY CQ18 AND CQ19 ON ONE SCREEN.

[CQ18] Did you ever need medical care because of what a current or ex partner did to you?

Yes 1

No 2

IF CQ18=YES, ASK C19. ELSE GO TO CQ20.

[CQ19] Were you able to get the medical care you needed?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY CQ20 AND CQ21 ON ONE SCREEN.

[CQ20] In the past 12 months were you injured because of the things a current or ex partner did to you?

Yes 1

No 2

IF CQ18=YES AND CQ20=YES, ASK CQ21. ELSE GO TO CQ22.

[CQ22] In the past 12 months did you need medical care for any of these injuries?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY CQ22 TO CQ25 IN A GRID.

[CQ22] Here is a list of services and assistance you might have needed because of what a current or ex-romantic or sexual partner did to you.

Have you ever talked to a crisis hotline operator?

Yes 1

No 2

[CQ23] Did you ever need housing services?

Yes 1

No 2

[CQ24] Did you ever need victim’s advocate services?

Yes 1

No 2

[CQ25] Did you ever need legal services or the advice of an attorney?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY CQ26 TO CQ27 ON ONE SCREEN.

[CQ26] Did you ever file a police report because of the things that a current or ex partner did to you?

Yes 1

No 2

IF CQ26=YES, ASK CQ27. ELSE GO TO CQ28.

[CQ27] In the past 12 months did you file a police report because of the things that a current or ex partner did to you?

Yes 1

No 2

PROGRAMMER NOTE: DISPLAY CQ28 AND CQ29 ON ONE SCREEN; DISPLAY TEXT FIELD TO TAKE WHOLE NUMBER FROM 0 TO 365.

[CQ28] About how many days of work did you ever have to miss when a current or ex partner did these things to you?

__________

IF CQ28>=1, ASK CQ29. ELSE GO TO CQ30.

[CQ29] In the past 12 months how many days of work did you have to miss when a current or ex partner did these things to you?

__________

PROGRAMMER NOTE: DISPLAY CQ30 AND CQ31 ON ONE SCREEN; DISPLAY TEXT FIELD TO TAKE WHOLE NUMBER FROM 0 TO 365.

[CQ30] About how many days of school did you ever have to miss when a current or ex partner did these things to you?

__________

IF CQ30>=1, ASK CQ31. ELSE GO TO DEBRIEFING.

[CQ31] In the past 12 months how many days of school did you have to miss when a current or ex partner did these things to you?

__________

DEBRIEFING QUESTIONS

ITEM COUNT

PROGRAMMER NOTE: RANDOMLY ASSIGN RESPONDENTS INTO TWO GROUPS: GROUP A GET IC1 AND GROUP 2 GET IC2.

[IC1] In the past 12 months, how many of these things happened to you?

_____ COUNT

Had something stolen or taken away from your porch, lawn, or other parts of your property
Had something you carry (such as cell phone, money, wallet etc.) stolen or taken away from you
Went to see a doctor/nurse
Stopped by a police
Had a traffic ticket

[IC2] In the past 12 months, how many of these things happened to you?

_____ COUNT

Had something stolen or taken away from your porch, lawn, or other parts of your property
Had something you carry (such as cell phone, money, wallet, etc.) stolen or taken away from you
Went to see a doctor/nurse
Had unwanted sex or sexual contact
Stopped by a police
Had a traffic ticket

NARRATIVE. Thanks for sharing your experience. To make sure that the survey captures everything needed, would you describe, in your own words, an incident of someone [following you/kissing you in a sexual way/verbally pressuring you into unwanted sex/having sex or sexual contact with you when you were unable to consent/using threats or physical force to have sex or sexual contact with you/ attempting to have sex through threats or physical force)?

____________________________

[DQ_INTRO] Thank you for answering these questions. We appreciate that you were willing to share your personal experiences and answer questions about some very private and sensitive issues in this survey.

The following questions are about your reactions to this survey. Please indicate how strongly you agree or disagree with each statement.

[D1] You experienced intense emotions while completing the survey.

Strongly Disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly Agree 5

[D2] The survey made you think about things you didn’t want to think about.

Strongly Disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly Agree 5

[D3] You believe you have been able to help others by participating in this study.

Strongly Disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly Agree 5

[D5] Now that you know what the survey is about, you would have made the same choice to participate.

Strongly Disagree 1

Disagree 2

Neutral 3

Agree 4

Strongly Agree 5

DEBRIEFING ON ENVIRONMENT

[D6] Where were you when completing the survey?

At home, in a room with all doors
closed 1

At home, in a room with doors, but
at least one door was not closed 2

At home, in a room without any doors 3

On public transportation (e.g., bus,
train) 4

In another public place (specify
) 5

Other setting (specify
) 6

IF D6 = 1, 2, 3, ASK D7. ELSE GO TO D10.

[D7] Was anyone else in the room while you were completing the survey?

Yes 1

No 2

IF D7 = 1, ASK D8 AND D9. ELSE GO TO D10.

[D8] When someone was in the room, was this because…?

The person walked through the area 1

The person was sitting or standing
in the room for less than 5 minutes 2

The person was sitting or standing
in the room for at least 5 minutes 3

[D9] Who else was in the room while you were completing the survey?

Your spouse or partner 1

Some other adult 2

A child/children 3

[D10] Do you think anyone in your household knows what this survey is about?

Yes, someone in my household knows 1

No, no one in my household knows 2

I am not sure if anyone knows 3

[D11] Overall, how burdensome was this survey to you?

Very burdensome 1

Somewhat burdensome 2

A little burdensome 3

Not at all burdensome 4

[D12] How sensitive did you feel the questions asked in this survey were?

Very sensitive 1

Somewhat sensitive 2

A little sensitive 3

Not at all sensitive 4

[D13] Do you feel that the length of this interview was too long, too short, or about right?

Too long 1

Too short 2

About right 3

[D14] How would you rate your understanding of the questions asked in this survey?

Excellent 1

Very good 2

Good 3

Fair 4

Poor 5

[D15] How sure are you that you’ve reported all things happened to you?

Very sure 1

Somewhat sure 2

Somewhat unsure 3

Very unsure 4

[W3] If you have any questions or concerns about participating in the survey, please feel free to call the survey manager, {NAME at 1-###-###-####}. You will hear an option to speak with a project staff member.

Thank you for participating in CDC’s study of health and injuries. We realize that some of the topics covered are quite personal and can be difficult to think and talk about. We appreciate your willingness to be a part of this study and want you to know that we recognize the important contribution you have made. Sometimes when people have participated in a study like this, they realize that they are interested in following up on some of the issues that they have been asked about in the study with someone who is professionally trained to deal with these kinds of issues. We are going to provide you the toll-free numbers of resources that you can use now or in the future if you want to speak further with someone.

You can reach the National Domestic Violence Hotline at 1-800-799-SAFE (7233). You can reach the National Sexual Assault Hotline at 1-800-656-HOPE (4673). You can reach the National Child Abuse Hotline at 1-800-4-A-Child (1-800-422-4453). You can reach the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

That completes the interview. Thank you for your participation. We will send you a check for ($15/$25) as a token of appreciation for completing this survey.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Kresnow-Sedacca, Marcie-jo (CDC/ONDIEH/NCIPC)
File Modified	0000-00-00
File Created	2021-01-16