Appendix B. Question-by-question justification for baseline survey

Appendix B. Question-by-question justification for baseline survey.docx

OPRE Evaluation: Next Generation of Enhanced Employment Strategies Project [Impact, Descriptive, and Cost Studies]

Appendix B. Question-by-question justification for baseline survey

OMB: 0970-0545

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Appendix B. Question-by-question justification for baseline survey



This document provides the sources and justifications for each question on the Baseline Survey (Instrument 1).

Item

Question text

Source

Justification

SECTION B: DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS

B01

Are you Hispanic, Latino/a, or Spanish origin?

1. No, not of Hispanic, Latino/a, or Spanish origin

2. Yes, Mexican, Mexican American, Chicano/a

3. Yes, Puerto Rican

4. Yes, Cuban

5. Yes, Another Hispanic, Latino/a, or Spanish origin

Adapted from Building Evidence on Employment Strategies (BEES)
(OMB No. 0970-0537)

These items measure demographic and socioeconomic characteristics. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, 3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

B02

What is your race?
1. AMERICAN INDIAN OR ALASKA NATIVE
2. ASIAN
3. BLACK OR AFRICAN AMERICAN
4. NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER
5. WHITE
99. OTHER (SPECIFY)

Adapted from BEES
(OMB No. 0970-0537)

B03

What is the primary language spoken in your home? Is it…
1. English,
2. Spanish, or
99. Some other language?

BEES
(OMB No. 0970-0537)

B04

Are you currently in high school?

New;
Developed by Mathematica

B05

What is the highest degree or year of school that you have attained?
1. LESS THAN A HIGH SCHOOL DIPLOMA
2. GED or GENERAL EDUCATION DEVELOPMENT
3. REGULAR HIGH SCHOOL DIPLOMA (NOT A GED)
4. SOME COLLEGE
5. A TWO-YEAR DEGREE (ASSOCIATE’S DEGREE)
6. A FOUR-YEAR DEGREE (BACHELOR’S DEGREE)
7. A GRADUATE OR PROFESSIONAL DEGREE OR HIGHER

Adapted from BEES
(OMB No. 0970-0537)

B06

What is your current marital status—are you now married, separated, divorced, widowed, or have you never been married?

Adapted from BEES
(OMB No. 0970-0537)

B07

Do you have a spouse or partner who lives in your household?

BEES
(OMB No. 0970-0537)

B07a

How many children under the age of 18 are in your household?

BEES
(OMB No. 0970-0537)


B07b

How many adults age 18 or older, including yourself, are in your household?

BEES
(OMB No. 0970-0537)

B08

Do you currently care for someone in your household with a disability?

Subsidized and Transitional Employment Demonstration (STED)
(OMB No. 0970-0413)

B09

Which of the following best describes your housing during the past month?
1. own your own home or apartment,
2. rent your home or apartment,
3. homeless or live in emergency or temporary housing, such as a shelter,
4. live in a halfway house, sober house, or other transitional housing,
5. live in a group home
6. live with friends or relatives and pay rent to them
7. live with friends or relatives and not pay rent to them, or
99. some other arrangement? (SPECIFY: __________)

Adapted from BEES
(OMB No. 0970-0537)

B09a

Which of the following best describes your housing during the past month?
1. live with a parent or guardian,
2. rent your home or apartment,
3. homeless or live in emergency or temporary housing, such as a shelter,
4. live in a halfway house, sober house, or other transitional housing,
5. live in a group home
6. live with friends or relatives and pay rent to them
7. live with friends or relatives and not pay rent to them, or
99. some other arrangement? (SPECIFY: __________)

Adapted from BEES
(OMB No. 0970-0537)

B10

Have you been homeless at any time in the last three months?

Adapted from Rural Welfare to Work
(OMB No. 0970-0246)

B10a

If you add up all the days you have been homeless in the last three months, about how many days have you been homeless? Your best guess is fine.

Adapted from HUD's Point-In-Time Survey

B11

Are you currently receiving child support?

STED
(OMB No. 0970-0413)


B12

Are you currently expected to pay child support?

STED
(OMB No. 0970-0413)

B13

During the past year, did you or anyone in your household receive income or assistance from any of the following sources?
1. Disability benefits from the Social Security Administration. These are also called Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)
2. Temporary Assistance for Needy Families (TANF) or [STATE SPECIFIC TANF NAME]
3. Unemployment Insurance
4. Worker’s Compensation
5. Short-term disability
6. Food Stamps/Supplemental Nutrition Assistance Program (SNAP)/ [STATE-SPECIFIC PROGRAM]
7. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
8. Housing Choice Voucher, also known as Section 8 or Public Housing
9. Veterans Benefits
10. Medicaid or [STATE SPECIFIC MEDICAID] or Children’s Health Insurance Program (CHIP)
0. NONE OF THE ABOVE

Adapted from BEES
(OMB No. 0970-0537)

B14

For these next questions, please consider only yourself, not anyone else in your household. Have you received a check or electronic payment from the Social Security Administration because of a disability in the past year as an adult?

Adapted from BEES
(OMB No. 0970-0537)

These items measure demographic and socioeconomic characteristics. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, 3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, (5) support analysis of the mediating factors driving program impacts, and (6) determine the target population of interest to the Social Security Administration (namely, individuals who are not currently receiving SSI or awaiting a pending claim).

B15

Are you currently receiving checks or electronic payments from the Social Security Administration because of a disability?

Adapted from BEES
(OMB No. 0970-0537)

B16

As an adult, in the past five years, have you applied to the Social Security Administration to receive checks or electronic payments because of a disability?

New;
Developed by Mathematica

B17

Are you currently awaiting a decision by the Social Security Administration on a pending disability application?

Adapted from BEES
(OMB No. 0970-0537)

B18

If you had an emergency, would you be able to count on someone to help you?

Adapted from Building Strong Families Evaluation (BSF)
(OMB No. 0970-0304)

These items measure social supports for economic well-being. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

B19

Is there someone you could turn to if you suddenly needed to borrow $100?

Adapted from BSF
(OMB No. 0970-0304)

SECTION C: EMPLOYMENT STATUS AND CHALLENGES

C0

Have you ever worked for pay?

New;
Developed by Mathematica

These items measure baseline employment status. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

C01

Are you currently working for pay?

BEES
(OMB No. 0970-0537)

C02

In total, how many months did you work for pay during the past year (including current job)?

BEES
(OMB No. 0970-0537)

C03

In what month and year did you last work for pay?

Adapted from Parents and Children Together Evaluation (PACT)
(OMB No. 0970-0403)

C03a

How much [do/did] you get paid before taxes and deductions, at your [current/most recent] job?

Evaluation of Employment Coaching for TANF and Other Related Populations (Coaching)
(OMB No. 0970-0506)

C04-C04a

How many hours per week, including regular overtime hours, did you usually work on your [current/most recent] job? Your best estimate is fine.

Adapted from BEES
(OMB No. 0970-0537)

C05

Does a physical, mental, or emotional condition limit the kind or amount of work you can do?

Adapted from BEES
(OMB No. 0970-0537)

These items measure baseline barriers to employment. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

C06a

Please indicate if each of the following has made it not at all hard, a little hard, somewhat hard, very hard, or extremely hard for you to work or pursue education or training in the past 3 months. NOT HAVING RELIABLE TRANSPORTATION

Adapted from Child Support Noncustodial Parent Employment Demonstration (CSPED)
(OMB No. 0970-0439)

C06b

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. NOT HAVING DRIVER’S LICENSE OR A VALID DRIVER’S LICENSE

Adapted from CSPED
(OMB No. 0970-0439)

C06c

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. NOT HAVING STABLE HOUSING

Adapted from CSPED
(OMB No. 0970-0439)

C06d

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. A PREGNANCY OR A RECENT CHILDBIRTH

Adapted from Rural Welfare to Work
(OMB No. 0970-0246)

C06e

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. NOT HAVING GOOD ENOUGH CARE FOR A CHILD OR SOMEONE ELSE IN YOUR HOUSEHOLD WHO NEEDS CARE

Adapted from CSPED
(OMB No. 0970-0439)

C06f

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. NOT HAVING RIGHT CLOTHES OR TOOLS FOR WORK

Adapted from CSPED
(OMB No. 0970-0439)

C06g

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. NOT HAVING RIGHT SKILLS OR EDUCATION

Adapted from CSPED
(OMB No. 0970-0439)

C06h

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. HAVING DIFFICULTY SPEAKING OR READING ENGLISH

Adapted from CSPED
(OMB No. 0970-0439)

C06i

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. HAVING DIFFICULTY COMPLETING JOB APPLICATIONS ON MY OWN

Adapted from CSPED
(OMB No. 0970-0439)

C06j

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. HAVING A CRIMINAL RECORD

Adapted from CSPED
(OMB No. 0970-0439)

C06k

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. HAVING PROBLEMS WITH ALCOHOL OR DRUGS

Adapted from CSPED
(OMB No. 0970-0439)

C06l

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. HAVING A GAP IN EMPLOYMENT

New;
Developed by Mathematica

C06m

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. LACK OF SUPPORT OR RESISTANCE FROM FRIENDS OR RELATIVES RELATED TO FINDING A JOB OR WORKING

Adapted from Rural Welfare to Work
(OMB No. 0970-0246)

C06n

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. EXPERIENCING ABUSE BY A SPOUSE OR PARTNER

Adapted from Rural Welfare to Work
(OMB No. 0970-0246)

C06o

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. A LEARNING DISABILITY

Adapted from Rural Welfare to Work
(OMB No. 0970-0246)

C06p

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. NOT FINDING THE RIGHT KIND OF DISABILITY-RELATED SUPPORTS OR ACCOMMODATIONS

New;
Developed by Mathematica

C06q

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. LOSING BENEFITS YOU NEED SUCH AS SOCIAL SECURITY, DISABILITY INSURANCE, WORKERS' COMPENSATION, OR MEDICAID IF YOU TOOK A JOB OR WORKED MORE HOURS

New;
Developed by Mathematica

C06r

Please indicate if each of the following has made it not at all hard, slightly hard, moderately hard, or very hard for you to work or pursue education or training in the past 3 months. OTHER SPECIFY

Adapted from Rural Welfare to Work
(OMB No. 0970-0246)

C07a

I set long-term employment goals that I hope to achieve within a year, such as finding a job, finding a better job, getting promoted, or enrolling in further education.
1. STRONGLY DISAGREE
2. DISAGREE
3. AGREE
4. STRONGLY AGREE

Goal Setting Questionnaire, adapted from Coaching
(OMB No. 0970-0506)

These items measure goal setting and goal pursuit in the context of employment. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

C07b

I set specific short-term goals that will allow me to achieve my long-term employment goals.
1. STRONGLY DISAGREE
2. DISAGREE
3. AGREE
4. STRONGLY AGREE

Goal Setting Questionnaire, adapted from Coaching
(OMB No. 0970-0506)

C07c

I think I should work on finding a job or a better job.
1. STRONGLY DISAGREE
2. DISAGREE
3. AGREE
4. STRONGLY AGREE

LASER Questionnaire, adapted from Coaching
(OMB No. 0970-0506)

C07d

I think there is nothing I can do being out of work right now.
1. STRONGLY DISAGREE
2. DISAGREE
3. AGREE
4. STRONGLY AGREE

LASER Questionnaire, adapted from Coaching
(OMB No. 0970-0506)

C08

Have you ever been arrested?

Adapted from BEES
(OMB No. 0970-0537)

These items measure past involvement with the criminal justice system. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

C09

Have you ever been convicted of a crime?

BEES
(OMB No. 0970-0537)

C10

Are you currently on parole or probation?

BEES
(OMB No. 0970-0537)

C11

Have you ever been incarcerated in a juvenile or adult facility, such as a detention center, jail, or prison?

Adapted from BEES
(OMB No. 0970-0537)

C12

What is the total amount of time you have spent in incarceration?

New
Developed by Mathematica

SECTION D: PHYSICAL AND MENTAL HEALTH

D01-D09

SF-12v2 Questionnaire

SF-12 Instrument


Also used on BEES
(OMB No. 0970-0537)

This questionnaire measures functional health status. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

D10

Are you deaf or do you have serious difficulty hearing?

American Community Survey (ACS) disability questions


Also used on BEES
(OMB No. 0970-0537)

These items measure disability. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

D11

Are you blind or do you have serious difficulty seeing even when wearing glasses?

ACS disability questions


Also used on BEES
(OMB No. 0970-0537)

D12

Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?

ACS disability questions


Also used on BEES
(OMB No. 0970-0537)

D13

Do you have serious difficulty walking or climbing stairs?

ACS disability questions


Also used on BEES
(OMB No. 0970-0537)

D14

Do you have difficulty dressing or bathing?

ACS disability questions


Also used on BEES
(OMB No. 0970-0537)

D15

Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping?

ACS disability questions


Also used on BEES
(OMB No. 0970-0537)

D16

Have you ever been treated for any mental health condition?

New
Developed by Mathematica

These items measure physical and mental health status. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

D17

What physical, mental, or emotional condition is the main reason you are limited?

Adapted from National Beneficiary Survey (NBS)
(OMB No. 0960-0800)

D18a

During the last 30 days about how often did you feel so depressed that nothing could cheer you up?
0. NONE OF THE TIME
1. A LITTLE OF THE TIME
2. SOME OF THE TIME
3. MOST OF THE TIME
4. ALL THE TIME

K-6 Distress Scale


Also used on BEES
(OMB No. 0970-0537)

This questionnaire assesses mental health and distress. We will use these items to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

D18b

During the last 30 days about how often did you feel hopeless?
0. NONE OF THE TIME
1. A LITTLE OF THE TIME
2. SOME OF THE TIME
3. MOST OF THE TIME
4. ALL THE TIME

K-6 Distress Scale


Also used on BEES
(OMB No. 0970-0537)

D18c

During the last 30 days about how often did you feel restless or fidgety?
0. NONE OF THE TIME
1. A LITTLE OF THE TIME
2. SOME OF THE TIME
3. MOST OF THE TIME
4. ALL THE TIME

K-6 Distress Scale


Also used on BEES
(OMB No. 0970-0537)

D18d

During the last 30 days about how often did you feel that everything was an effort?
0. NONE OF THE TIME
1. A LITTLE OF THE TIME
2. SOME OF THE TIME
3. MOST OF THE TIME
4. ALL THE TIME

K-6 Distress Scale


Also used on BEES
(OMB No. 0970-0537)

D18e

During the last 30 days about how often did you feel worthless?
0. NONE OF THE TIME
1. A LITTLE OF THE TIME
2. SOME OF THE TIME
3. MOST OF THE TIME
4. ALL THE TIME

K-6 Distress Scale


Also used on BEES
(OMB No. 0970-0537)

D18f

During the last 30 days about how often did you feel nervous?
0. NONE OF THE TIME
1. A LITTLE OF THE TIME
2. SOME OF THE TIME
3. MOST OF THE TIME
4. ALL THE TIME

K-6 Distress Scale


Also used on BEES
(OMB No. 0970-0537)

D19-D21

AUDIT-C questionnaire

AUDIT-C Questionnaire

This questionnaire measures alcohol dependency. We will use the items to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

D22-D31

DAST-10 questionnaire

DAST-10 Questionnaire

This questionnaire measures drug dependency. We will use the items to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.

D32

The next question asks about using prescription pain relievers in any way a doctor did not direct you to use them.
When you answer this question, please think only about your use of the drug in any way a doctor did not direct you to use it, including:
• Using it without a prescription of your own
• Using it in greater amounts, more often, or longer than you were told to take it
• Using it in any other way a doctor did not direct you to use it
Are you currently taking a prescription painkiller (such as OxyContin, Percocet, or Vicodin) without a prescription or in any way not directed by a doctor?

Adapted from BEES
(OMB No. 0970-0537)

This item measures opioid use. We will use it to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts.



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