Download:
pdf |
pdfAttachment C: NIS-4P ACASI Instrument 4-20-2020
National Inmate Survey: Year 4 Prisons
Questionnaire Specifications for Combined Instrument
4/20/20
Attachment C: NIS-4P ACASI Instrument 4-20-2020
Modules Included in the Main and Alternative NIS-4 Prisons Instruments
Module Topic
Interview Set-up
CAPI Demographics
Computer Tutorial
ACASI Demographics
Criminal History
Sexual Identity and Pre-Incarceration Information
Sexual Activity with Inmates
Description of Non-consensual Sexual Acts (NCSAs)
Staff Sexual Misconduct
Determination of Specific Incident for Inmate Incident
Report
Incident Characteristics for Inmate-on-Inmate
Victimization
Determination of Specific Incident for Staff Incident
Report
Incident Characteristics for Staff-on-Inmate
Victimization
Other Victimization While Incarcerated
Pat Downs and Strip Searches
Facility Conditions, Support and Safety
Mental Health
Disability Status
Parental Involvement
Restrictive Housing
Childhood Experiences
Living Area and Activities
Altercations, Fights and Grievances
Work Assignments
Program Participation
Visitors and Outside Contact
Post-Release Plans
Interview Debriefing
Begins on
Page
2
4
7
10
12
16
22
39
41
45
Main
Instrument
(95% of
interviews)
X
X
X
X
X
X
X
X
X
X
Alternative
Instrument
(5% of
interviews)
X
X
X
X
X
X
48
57
X
X
58
67
68
69
73
76
78
82
84
87
92
96
99
102
104
106
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Attachment C: NIS-4P ACASI Instrument 4-20-2020
INTERVIEW SETUP
A1
TYPE OF INTERVIEW:
1
ENGLISH MALE
2
ENGLISH FEMALE
3
SPANISH MALE
4
SPANISH FEMALE
DEFINE CONFIRM_FILL
IF A1 = 1 THEN CONFIRM_FILL = “AN ENGLISH INTERVIEW WITH A MALE INMATE”
IF A1 = 2 THEN CONFIRM_FILL = “AN ENGLISH INTERVIEW WITH A FEMALE
INMATE”
IF A1 = 3 THEN CONFIRM_FILL = “A SPANISH INTERVIEW WITH A MALE INMATE”
IF A1 = 4 THEN CONFIRM_FILL = “A SPANISH INTERVIEW WITH A FEMALE
INMATE”
A1_CONFIRM INTERVIEWER: YOU INDICATED YOU WANT TO ADMINISTER
[CONFIRM_FILL]. IS THIS CORRECT?
1
2
YES
NO
PROGRAMMER: PLEASE ROUTE ‘NO’ RESPONSES BACK TO A1. DK/REF ARE NOT
ALLOWED FOR THIS ITEM.
DEFINE GENDER:
IF A1 = 1 OR 3 THEN GENDER = 1
IF A1 = 2 OR 4 THEN GENDER = 2
OMB INTERVIEWER: IF RESPONDENT ASKS ANY QUESTIONS ABOUT OMB APPROVAL
FOR THIS STUDY, YOU MAY READ THE INFORMATION BELOW. OTHERWISE
TOUCH THE NEXT BUTTON TO GO TO THE NEXT SCREEN.
Notice: Public reporting for this collection of information is estimated to average 35 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to the Director, Bureau of Justice
Statistics, 810 Seventh Street, NW, Washington, DC 20531. An agency may not conduct or
sponsor, and a person is not required to respond to a collection of information unless it displays a
currently valid OMB control number. The OMB control number for this project is XXXX-xxxx.
I1
FACILITY ID
____________________
I2
ENTER YOUR INTERVIEWER ID NUMBER:
__________ [ALLOW 6 DIGITS]
I3
IS THIS INMATE BEING OFFERED AN INCENTIVE?
1
YES
Attachment C: NIS-4P ACASI Instrument 4-20-2020
2
NO
Attachment C: NIS-4P ACASI Instrument 4-20-2020
CAPI DEMOGRAPHICS
A2
In what year were you born?
4-DIGIT YEAR: _________
DK/REF
DEFINE CALCAGE:
CALCAGE = AGE CALCULATED BY SUBTRACTING A2 YEAR FROM CURRENT YEAR.
A3
[IF A2 NE (DK OR REF)] Are you CALCAGE – 1 or CALCAGE?
1
CALCAGE – 1
2
CALCAGE
DK/REF
UPDATE CALCAGE:
IF A3 = 1 THEN CALCAGE = CALCAGE - 1
ELSE CALCAGE = CALCAGE
A4
[IF (A2=DK OR REF) OR A3 = DK OR REF] How old are you?
AGE: ____________
DK/REF
UPDATE CALCAGE:
IF A4 NE BLANK OR DK OR REF THEN CALCAGE = A4
IF A4 = DK THEN CALCAGE = DK
IF A4 = RE THEN CALCAGE = RE
I4
[IF CALCAGE < 18] HAS THIS FACILITY APPROVED PARTICIPATION FOR 16
AND 17-YEAR OLDS?
NOTE: THIS INFORMATION IS INCLUDED IN THE FACILITY LOGISTICS
PLAN.
1
2
A4a
YES
NO
[IF CALCAGE < 16 AND I4 = 1] Thank you for your willingness to participate, but we
cannot interview anyone who is younger than 16 for this study.
[IF CALCAGE < 18 AND 14 = 2] Thank you for your willingness to participate, but we
cannot interview anyone who is younger than 18 for this study.
PRESS NEXT BUTTON TO END INTERVIEW.
Note to Programmers: Route these cases to M20
A4b
[IF A4 = DK/REF] Thank you for your willingness to participate, but we cannot
interview if we don’t know how old you are.
PRESS NEXT BUTTON TO END INTERVIEW.
Note to Programmers: Route these cases to M20
Attachment C: NIS-4P ACASI Instrument 4-20-2020
B1.
How old were you the first time you were arrested or taken into custody for any offense?
AGE: ________________ [RANGE: 6 – CALCAGE]
DK/REF
A5
When were you admitted to this facility?
A5a.
A5b.
A5c.
A6
2-DIGIT MONTH: _________ [RANGE: 1 – 12]
DK/REF
2-DIGIT DAY: ____________ [RANGE: 1 – 31]
DK/REF
4-DIGIT YEAR: ___________ [RANGE: 1915 – current year]
DK/REF
[IF A5a = DK/REF AND A5c NE DK OR REF] What time of year was it? Was it
winter, spring, summer, or fall when you were admitted to this facility?
1
WINTER
2
SPRING
3
SUMMER
4
FALL
DK/REF
DEFINE CALCTIME:
CALCTIME = CALCULATED BY “SUBTRACTING” DATE OF INCARCERATION FROM
DATE OF INTERVIEW AND THEN ROUNDING. (less than 2 months report as days; 2
– 11 months report as months; 12 months or more round to nearest year)
DEFINE DOAFILL1:
If facility admission date is at least 12 months ago then DOAFILL1 = During the past 12 months
If facility admission date is less than 12 months ago then DOAFILL1 = Since you arrived at this
facility
DEFINE DOAFILL2:
If facility admission date is at least 12 months ago then DOAFILL2 = during the past 12 months
If facility admission date is less than 12 months ago then DOAFILL2 = since you arrived at this
facility
A7
[IF CALCTIME NE 0 DAYS] That means you have been here for about [CALCTIME].
Is that correct?
1
2
A8
YES
NO
[IF (A5c=DK OR REF) OR CALCTIME=0 DAYS OR A7 = 2] How long have you been
in this facility?
INTERVIEWER: PROBE THOROUGHLY TO AVOID A DK OR REFUSE
RESPONSE IF AT ALL POSSIBLE.
1
LESS THAN 1 WEEK
2
AT LEAST 1 WEEK BUT LESS THAN 1 MONTH
3
AT LEAST 1 MONTH BUT LESS THAN 2 MONTHS
4
AT LEAST 2 MONTHS BUT LESS THAN 6 MONTHS
5
AT LEAST 6 MONTHS BUT LESS THAN 1 YEAR
6
AT LEAST 1 YEAR BUT LESS THAN 5 YEARS
7
AT LEAST 5 YEARS BUT LESS THAN 10 YEARS
8
10 YEARS OR MORE
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
UPDATE DOAFILL1:
IF A8 = 1 – 5 THEN DOAFILL1 = Since you arrived at this facility
IF A8 = 6 – 8 OR DK OR REF, THEN DOAFILL1 = During the past 12 months
UPDATE DOAFILL2:
IF A8 = 1 – 5 THEN DOAFILL2 = since you arrived at this facility
IF A8 = 6 – 8 OR DK OR REF, THEN DOAFILL2 = during the past 12 months
RANDOMIZATION: PROGRAMMER, PLEASE IMPLEMENT RANDOMIZING ROUTINE
95/5.
A9a.
Did you spend last night in disciplinary or administrative segregation, or solitary confinement?
1
YES
2
NO
DK/REF
A9b.
[IF A9a = 1] How many days have you been in disciplinary or administrative segregation, or
solitary confinement?
1
1 day or less
2
More than 1 day but less than 7 days
3
At least 7 days but less than 14 days
4
At least 14 days but less than 30 days
5
30 days or more
DK/REF
A9c.
[IF A9a = 2 OR DK OR REF] Which of the following best describes the housing unit where you
spent last night?
[IF A9a = 1] Which of the following best describes the housing unit in disciplinary or
administrative segregation, or solitary confinement where you spent last night?
1
An open dorm
2
A dorm with cubicles
3
A unit with cells
4
A unit with rooms
5
An area not originally intended as housing, such as a gym, classroom, or day room
6
NONE OF THESE
DK/REF
A10.
How tall are you?
Feet: ___________
Inches: _____________
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
COMPUTER TUTORIAL
C1
[NO AUDIO REQUIRED] You will complete the rest of this interview on your own
using the computer and headphones. Before you start, we’ll go through a short practice
session together so you can learn how to use this computer to answer the interview
questions. After this introduction, I will move away from the computer and will not be
able to see your answers so that you can take the interview in private.
You do not need the mouse or keyboard to answer questions. You can simply touch the
buttons on the screen using your finger.
MOVE COMPUTER SO RESPONDENT CAN SEE THE SCREEN.
For each question, the answers will appear on the screen, like these yes and no answers.
POINT TO YES AND NO ANSWERS ON SCREEN. When you have the headphones
on you’ll also hear instructions that will help you know where to touch the screen. To
choose an answer you will need to use your finger to touch the button next to for your
answer on the computer screen, like this.
PRESS YES BUTTON.
After you choose your answer, you must touch the NEXT button. TOUCH THE NEXT
BUTTON.
C2
[NO AUDIO REQUIRED] If you want to go back to the previous question, this is the
BACK button. POINT TO BACK BUTTON.
Now I will show you how to use the back button to go back to the previous question and
change the answer to no.
NOW DEMONSTRATE USE OF BACK BUTTON BY PRESSING IT TO GO BACK
TO THE PREVIOUS SCREEN AND CHANGE YOUR ANSWER TO NO. THEN
RETURN TO THIS SCREEN BY PRESSING NEXT.
If you don’t know the answer to the question, touch the button next to DON’T KNOW
[POINT TO DON’T KNOW] and then press NEXT. PRESS DON’T KNOW BUTTON
AND THEN NEXT.
Attachment C: NIS-4P ACASI Instrument 4-20-2020
C3
[NO AUDIO REQUIRED] If you don’t want to answer the question, you can touch the
button next to REFUSE [POINT TO THE REFUSE BUTTON]and then press NEXT to
go to the next question. PRESS REFUSE BUTTON AND THEN NEXT.
C4
[NO AUDIO REQUIRED] If you want the computer to read the question again, you can
press the AUDIO button [POINT TO AUDIO BUTTON].
C5
[NO AUDIO REQUIRED] You can adjust the volume here [DEMONSTRATE
VOLUME ADJUSTMENT, ON THE HEADPHONE CORD]. Or if you want to turn the
volume off you can adjust it on your headphones or take your headphones off.
Please put on your headphones. When you are ready, let me know.
MOVE COMPUTER SO RESPONDENT CAN USE IT. ONCE RESPONDENT HAS
HEADPHONES ON, TOUCH THE NEXT BUTTON SO RESPONDENT CAN BEGIN
PRACTICE SESSION.
PLAY AUDIO FOR ALL FOLLOWING SCREENS
C6
This screen will play while you adjust the volume in your headphones. When you have
adjusted the volume to a level that is comfortable to you, touch the NEXT button to
continue with the practice session.
C7
For the rest of this interview you will control the interview and answer in complete
privacy. You can read the questions on the computer screen and hear them read through
the headphones. Nobody, not even your interviewer will know how you answer the
questions. [IF CALAGE = 16 OR 17] Because you are under 18 I want to remind you
that if you speak to your interviewer about any abuse you have experienced at this facility
the interviewer or his or her supervisor may need to report it to the agency in this state
that investigates abuse.
First, you will learn how to use the system and complete some practice questions.
Touch the NEXT button on your screen.
C8
After you hear the question, you will hear the possible answers. To answer the question,
use your finger to touch the button on the screen next to your answer and then touch the
NEXT button.
Do you like ice cream?
1 Yes
2 No
Don’t Know
Refuse to Answer
C10
For some questions you will enter your answer using a keypad like the one shown below.
Try using the keypad to answer the question below. If you need to change your answer
touch the “X” button in the lower right corner of the keypad to remove what you have
already entered and then put in a new answer. After you answer the question, touch the
NEXT button.
How many meals have you eaten today?
Attachment C: NIS-4P ACASI Instrument 4-20-2020
[RANGE: 0 – 999]
C11
Sometimes there will be more than one question to answer on a screen like the example
shown below. For these questions the answer choices and the REFUSED and DON’T
KNOW buttons are shown to the right of each question. Try answering the questions
below and then touch the NEXT button to go to the next screen.
Has a doctor or other health care provider ever told you that you are allergic to…
C11a. Pollen?
C11b. Dust?
C11c. Mold?
DK/REF
C14
Yes
1
1
1
No
2
2
2
If you have any questions, ask your interviewer now. If not, tell the interviewer you are
ready to begin and he or she will move away from the computer.
Touch the NEXT button when you are ready to begin.
Attachment C: NIS-4P ACASI Instrument 4-20-2020
ACASI DEMOGRAPHICS
A11
Are you of Hispanic, Latino, or Spanish origin?
1
Yes
2
No
DK/REF
A13
Which of these categories describes your race?
You may answer yes to one or more of these categories.
A13a. White?
A13b. Black or African American?
A13c. American Indian or Alaska Native?
A13d. Asian?
A13e. Native Hawaiian or other Pacific Islander?
DK/REF
A16
Yes
1
1
1
1
1
No
2
2
2
2
2
How much do you currently weigh in pounds?
CURRENT WEIGHT: __________________ [RANGE: 50 – 700]
DK/REF
A17
Did you graduate from high school?
1
Yes
2
No
DK/REF
A18
[IF A17 = 1] Did you receive a high school diploma or a GED for finishing high school?
1
A high school Diploma
2
A GED
DK/REF
A19
[If A17 = 2] Did you receive a GED?
1
Yes
2
No
DK/REF
A20
[IF A17 =1 OR A19 =1] What is the highest level of school you have completed?
1
High school or GED
2
Some college but you did not receive a degree
3
Associate Degree
4
Bachelor’s Degree
5
An advanced degree such as a Master’s, MBA, or PhD
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
A21
[IF A17 =2 AND A19 =2] Did you attend high school?
1
Yes
2
No
DK/REF
V1.
Have you ever served in the United States Armed Forces?
1 Yes
2 No
DK/REF
V4
[IF V1 = 1] Are you currently serving in the United States Armed Forces?
1 Yes
2 No
DK/REF
V8
[IF V4 = 2] What type of discharge did you receive from the United States Armed Forces?
1
Honorable
2
General under honorable conditions
3
Other than honorable
4
Bad conduct
5
Dishonorable
6
Some other type of discharge
DK/REF
A22.
Are you a U.S. citizen?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
CRIMINAL HISTORY
B0.
These next questions are about your experience with crime and the criminal justice system.
Touch the NEXT button to go to the next screen.
B2.
Altogether, how many times have you been arrested or taken into custody for any offense?
1
One time
2
2-3 times
3
4-10 times
4
11 times or more
DK/REF
B3.
Before you were admitted to this facility, had you ever spent time as an adult or juvenile in a
prison, jail, or other correctional facility?
1
Yes
2
No
DK/REF
B4.
Are you currently in this facility because you have been sentenced to serve time for an offense?
1
Yes
2
No
DK/REF
B5.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a property offense?
Property offenses include crimes like burglary, larceny, theft, auto theft, bad checks, fraud,
forgery, arson, or possession of stolen goods.
1
Yes
2
No
DK/REF
B6.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a drug offense?
Drug offenses include crimes like possessing, selling, trafficking, importing, smuggling, or
manufacturing illegal drugs or drug paraphernalia.
1
Yes
2
No
DK/REF
B7.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a violent offense?
Violent offenses include crimes like physical or sexual assault, rape, robbery, manslaughter,
murder, attempted murder, or kidnapping.
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
B8.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for other crimes against
people? Other crimes against people include crimes like vehicular homicide, hit and run, reckless
endangerment, child neglect, harassment, or stalking.
1
Yes
2
No
DK/REF
B9.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a sexual offense?
Sexual offenses include crimes like rape, statutory rape, sexual assault, child molestation, child
pornography, incest, or indecent exposure.
1
Yes
2
No
DK/REF
B10.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a probation, parole,
or community supervision violation?
1
Yes
2
No
DK/REF
B28.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a weapons offense?
Weapons offenses include things like possessing an illegal or stolen weapon, illegally discharging
a firearm, using a weapon during the commission of a crime, or violating probation, parole, or
community supervision by possessing a firearm.
1
Yes
2
No
DK/REF
B12.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for driving under the
influence or driving while intoxicated?
1
Yes
2
No
DK/REF
B11.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a procedural
violation? Procedural violations include things like failure to appear in court, violating a
restraining order, failure to obey a lawful order of a police officer, contempt, escape, resisting
arrest without violence, or a regulatory or tax offense.
1
Yes
2
No
DK/REF
B13.
[IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for some other offense?
Other offenses include crimes like loitering, prostitution, gambling, drunkenness, disorderly
conduct, trespassing, minor traffic violations, or immigration violations.
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
B14.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for a property offense?
Property offenses include crimes like burglary, larceny, theft, auto theft, bad checks, fraud,
forgery, arson, or possession of stolen goods.
1
Yes
2
No
DK/REF
B15.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for a drug offense? Drug
offenses include crimes like possessing, selling, trafficking, importing, smuggling, or
manufacturing illegal drugs or drug paraphernalia.
1
Yes
2
No
DK/REF
B16.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for a violent offense?
Violent offenses include crimes like physical or sexual assault, rape, robbery, manslaughter,
murder, attempted murder, or kidnapping.
1
Yes
2
No
DK/REF
B17.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for other crimes against
people? Other crimes against people include crimes like vehicular homicide, hit and run, reckless
endangerment, child neglect, harassment, or stalking.
1
Yes
2
No
DK/REF
B18.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for a sexual offense?
Sexual offenses include crimes like rape, statutory rape, sexual assault, child molestation, child
pornography, incest, or indecent exposure.
1
Yes
2
No
DK/REF
B19.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for a probation, parole,
or community supervision violation?
1
Yes
2
No
DK/REF
B29.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for a weapons offense?
Weapons offenses include things like possessing an illegal or stolen weapon, illegally discharging
a firearm, using a weapon during the commission of a crime, or violating probation, parole, or
community supervision by possessing a firearm.
1 Yes
2 No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
B21.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for driving under the
influence or driving while intoxicated?
1
Yes
2
No
DK/REF
B20.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for a procedural
violation? Procedural violations include things like failure to appear in court, violating a
restraining order, failure to obey a lawful order of a police officer, contempt, escape, resisting
arrest without violence, or a regulatory or tax offense.
1
Yes
2
No
DK/REF
B22.
[IF B4 = 1] Are you currently sentenced and serving time in this facility for some other offense?
Other offenses include crimes like loitering, prostitution, gambling, drunkenness, disorderly
conduct, trespassing, minor traffic violations, or immigration violations.
1
Yes
2
No
DK/REF
B23.
[IF B4 = 1 OR DK OR REF] Are you currently serving a life sentence or a life sentence without
parole?
1
Yes
2
No
DK/REF
B24.
[IF B23 = 2 OR DK OR REF] Are you currently serving a death sentence?
1
Yes
2
No
DK/REF
B25.
[IF B24 = 2 OR DK OR REF] What is your total maximum sentence length for all of the
sentences you are serving?
1
Less than 1 year
2
At least 1 year but less than 5 years
3
At least 5 years but less than 10 years
4
At least10 years but less than 20 years
5
20 years or more
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
SEXUAL IDENTITY AND PRE-INCARCERATION INFORMATION
D1
Are you currently married, widowed, divorced or separated, or have you never married?
1
Married
2
Widowed
3
Divorced
4
Separated (For reasons other than incarceration)
5
Never married
DK/REF
D2a
[IF GENDER = 1] Which of the following best represents how you think of yourself?
1
Straight; that is, not gay
2
Gay
3
Bisexual; that is, you are sexually attracted to both men and women
4
Something else
DK/REF
D2b
[IF GENDER = 2] Which of the following best represents how you think of yourself?
1
Straight; that is, not lesbian or gay
2
Lesbian or gay
3
Bisexual; that is, you are sexually attracted to both men and women
4
Something else
DK/REF
D3a
What sex was recorded on your original birth certificate?
1
Male
2
Female
DK/REF
D3b
Do you currently think of yourself as…?
1
Male
2
Female
3
Transgender
4
None of these
DK/REF
DEFINE CURRSEX FILL
IF D3b = 1 THEN CURRSEX FILL = “describe yourself as male”
IF D3b = 2 THEN CURRSEX FILL = “describe yourself as female”
IF D3b = 3 THEN CURRSEX FILL = “describe yourself as transgender”
IF D3b = 4 THEN CURRSEX FILL = “do not describe yourself as male, female, or transgender”
DEFINE BIRTHSEX
IF D3a = 1 THEN BIRTHSEX = male
IF D3a = 2 THEN BIRTHSEX = female
ELSE BIRTHSEX = BLANK
Attachment C: NIS-4P ACASI Instrument 4-20-2020
D3c
[IF (D3a = 1 AND D3b = 2 OR 3 OR 4) OR (D3a = 2 AND D3b = 1 OR 3 OR 4)] Just to confirm
what you entered, [BIRTHSEX] was recorded on your original birth certificate and now you
[CURRSEX FILL]. Is that correct?
1 Yes
2 No
DK/REF
D3d
[IF D3c = 2] Please answer this question again: What sex was recorded on your original birth
certificate?
1 Male
2 Female
DK/REF
D3e
[IF D3c = 2] Please answer this question again: Do you currently think of yourself as male,
female, or transgender?
1 Male
2 Female
3 Transgender
4 None of these
DK/REF
DEFINE TRANSID
IF D3b = 3 AND D3e = BLANK THEN TRANSID = 1
IF D3b = 3 AND D3e = 3 THEN TRANSID = 1
IF D3b = 1 OR 2 OR 4 AND D3e = 3 THEN TRANSID = 1
ELSE TRANSID = 2
RANDOM = 95, CONTINUE TO D6
RANDOM = 5, SKIP TO FH_1
Attachment C: NIS-4P ACASI Instrument 4-20-2020
D6
[IF GENDER = 2] Before you entered this facility, had anyone ever physically forced you to have
sex or sexual contact – that is unwanted touching of the breasts, genitals, or butt, or vaginal, oral, or
anal sex?
[IF GENDER = 1] Before you entered this facility, had anyone ever physically forced you to have
sex or sexual contact – that is unwanted touching of the genitals or butt, or vaginal, oral, or anal sex?
1
Yes
2
No
DK/REF
D7
[IF GENDER=2] Before you entered this facility, had anyone ever pressured you or made you feel
you had to have sex or sexual contact – that is unwanted touching of the breasts, genitals, or butt, or
vaginal, oral, or anal sex?
[IF GENDER = 1] Before you entered this facility, had anyone ever pressured you or made you feel
you had to have sex or sexual contact – that is unwanted touching of the genitals or butt, or vaginal,
oral, or anal sex?
1
Yes
2
No
DK/REF
DEFINE SEXTYPE1:
IF D6 = 1 AND D7 NE 1, SEXTYPE1 = “physically forced”
IF D6 NE 1 AND D7 =1, SEXTYPE1 = “pressured or made to feel that you had”
IF D6 = 1 AND D7 = 1, SEXTYPE1 = “physically forced, pressured, or made to feel that you had”
ELSE SEXTYPE1 = BLANK
D8
[IF D6 =1 OR D7 = 1] How many times were you [SEXTYPE1 FILL] to have sex or sexual contact
before you entered this facility?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
D9
[IF D8 NE 1 AND SEXTYPE1 NE BLANK AND CALCAGE = 18 OR OLDER] Were you
[SEXTYPE1 FILL] to have sex or sexual contact before you were 18 years old, after you turned 18,
or both?
1
Before you were 18
2
After you turned 18
3.
Both
DK/REF
D10
[IF D8 = 1 AND CALCAGE = 18 OR OLDER] Were you [SEXTYPE1 FILL] to have sex or sexual
contact before you were 18 years old?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
[IF (D6 = 1 OR D7 = 1) AND B3=1] Before you entered this facility, were you [SEXTYPE1 FILL]
to have sex or sexual contact while you were an adult or juvenile in a jail, prison, or other
correctional facility?
D11
1
Yes
2
No
DK/REF
RANDOM = 95, SKIP TO D16
RANDOM = 5, CONTINUE TO FH_1
FH_1
[IF RANDOM = 5] Is this the only facility you’ve been held in during your current incarceration?
1
Yes
2
No
DK/REF
FH_2
[IF FH_1 = 2 OR DK OR REF] Including this one, how many prisons have you been held in during your
current incarceration? Please do not include any jails you may have been held in before you were transferred
to prison.
NUMBER OF PRISONS: _________ [RANGE: 1 – 15]
DK/REF
D12
Now think about the 6 months before you were incarcerated.
During the 6 months before you were incarcerated, did you live for most of the time…
1
In your own house or apartment, meaning your name was on the title, mortgage, or lease
2
In someone else’s house or apartment, including your parents’ place
3
In a residential treatment facility
4
In a transitional housing facility or halfway house
5
In a shelter
6
On the street or you were homeless
7
In no set place or you moved around a lot
8
In some other place or situation
DK/REF
D13
Have you ever had a job working for pay?
1
2
Yes
No
DK/REF
D14
At any point during the 6 months before you were incarcerated, did you have a job where you worked for
pay?
1
2
DK/REF
Yes
No
Attachment C: NIS-4P ACASI Instrument 4-20-2020
D15
How did you support yourself during the 6 months before you were incarcerated?
D15a A job?
D15b Support from your family?
D15c Support from your friends?
D15d A government program or public assistance?
D15e Illegal income?
D15f Some other type of support?
DK/REF
D16
Yes
1
1
1
1
1
1
No
2
2
2
2
2
2
[IF RANDOM = 5] Still thinking about the 6 months before you were incarcerated, had anyone you were
living with at that time ever been in jail, prison, or some other correctional institution?
[IF RANDOM = 95] Now think about the 6 months before you were incarcerated. Had anyone you were
living with at that time ever been in jail, prison, or some other correctional institution?
1
Yes
2
No
DK/REF
D17
At the time you became incarcerated, how many children under the age of 18 did you have? Please count all
children that you consider yourself to be a parent of.
NUMBER OF CHILDREN: __________ [RANGE 0-25]
DK/REF
D18
[IF D17 > 0] During the 6 months before you were incarcerated, how many of those [D17_FILL] children
lived with you?
CHILDREN LIVED WITH R: ____________ [RANGE 0-25]
DK/REF
D19
Have any of your parents or guardians ever been incarcerated in a prison or jail?
1 Yes
2 No
DK/REF
D20
[IF D19 = 1] Are any of your parents or guardians currently incarcerated in a prison or jail?
1
Yes
2
No
DK/REF
D21
Have any of your brothers or sisters ever been incarcerated in a prison or jail?
1
Yes
2
No
3
I do not have any brothers or sisters
DK/REF
D22
[IF D21 = 1] Are any of your brothers or sisters currently incarcerated in a prison or jail?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
D23
Think about the people you considered to be your closest friends before you were incarcerated. Had any of
those close friends ever been incarcerated in a prison or jail?
1
Yes
2
No
DK/REF
D24
[IF D23 = 1] Are any of those close friends currently incarcerated in a prison or jail?
1
Yes
2
No
DK/REF
RANDOM = 5, SKIP TO CHILDHOOD EXPERIENCES
RANDOM = 95, CONTINUE TO SEXUAL ACTIVITES WITH INMATES
Attachment C: NIS-4P ACASI Instrument 4-20-2020
SEXUAL ACTIVITY WITH INMATES
E1
These next questions are about both wanted and unwanted sex or sexual contact you have had with other
inmates in this facility DOAFILL2.
Touch the NEXT button to go to the next screen.
E2
Males
[IF GENDER = 1] DOAFILL1,
have you been touched on your
butt, thighs, or penis in a sexual
way by another inmate?
E2
1
Yes
2
No
DK/REF
E6
Females
[IF GENDER = 2] DOAFILL1,
have you been touched on your
butt, thighs, breasts, or vagina in a
sexual way by another inmate?
1
Yes
2
No
DK/REF
[IF GENDER = 1] DOAFILL1,
have you given or received a
handjob? A ‘handjob’ is when
someone’s penis is rubbed by
somebody else.
1
Yes
2
No
DK/REF
E8
[IF GENDER = 1] DOAFILL1,
have you given or received oral
sex or a blowjob? Oral sex, or a
blowjob, is when one inmate puts
their mouth on the penis or butt of
another inmate.
E8
1
Yes
2
No
DK/REF
1
Yes
2
No
DK/REF
E10
E12
[IF GENDER = 1] DOAFILL1,
have you had anal sex? Anal sex
is when one inmate inserts their
finger, penis, or an object into
another inmate’s butt.
1
Yes
2
No
DK/REF
[IF GENDER = 2] DOAFILL1,
have you given or received oral
sex? Oral sex is when one inmate
puts their mouth on the vagina or
butt of another inmate.
E12
[IF GENDER = 2] DOAFILL1,
have you had vaginal sex?
Vaginal sex is when one inmate
inserts their finger or an object
into another inmate’s vagina.
1
Yes
2
No
DK/REF
[IF GENDER = 2] DOAFILL1,
have you had anal sex? Anal sex
is when one inmate inserts their
finger or an object into another
inmate’s butt.
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E14
[IF GENDER = 1] DOAFILL1,
have you had any type of sex or
sexual contact with another
inmate other than sexual
touching, handjobs, oral sex or
blowjobs, or anal sex?
1
2
E15
E16
E14
Yes
No
DK/REF
[IF E2 = 1 OR E6 = 1 OR E8 = 1 OR
E12 = 1 OR E14 = 1] These next
questions are only about unwanted sex
or sexual contact.
[IF GENDER = 2] DOAFILL1,
have you had any type of sex or
sexual contact with another
inmate other than sexual
touching, oral sex, vaginal sex, or
anal sex?
1
2
E15
Yes
No
DK/REF
[IF E2 = 1 OR E8 = 1 OR E10 = 1 OR E12 =
1 OR E14 = 1] These next questions are
only about unwanted sex or sexual contact.
Touch the NEXT button to go to the next
screen.
Touch the NEXT button to go to the
next screen.
[IF E2=1] DOAFILL1, did
another inmate use physical force
to touch your butt, thighs, or penis
in a sexual way?
1
Yes
2
No
DK/REF
E17
[IF E2 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to let
them touch your butt, thighs, or
penis in a sexual way?
1
Yes
2
No
DK/REF
E18
[IF E2=1] DOAFILL1, did
another inmate use physical force
to touch your butt, thighs, breasts,
or vagina in a sexual way?
1
Yes
2
No
DK/REF
E19
[IF E2 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to let
them touch your butt, thighs,
breasts, or vagina in a sexual
way?
1
Yes
2
No
DK/REF
E22
[IF E6 =1] DOAFILL1, did
Attachment C: NIS-4P ACASI Instrument 4-20-2020
another inmate use physical force
to make you give or receive a
handjob?
1
Yes
2
No
DK/REF
E23
[IF E6 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to give
or receive a handjob?
1
Yes
2
No
DK/REF
E24
[IF E8 = 1] DOAFILL1, did
another inmate use physical force
to make you give or receive oral
sex?
1
Yes
2
No
DK/REF
E25
[IF E8 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to give
or receive oral sex?
1
Yes
2
No
DK/REF
E26
[IF E8 =1] DOAFILL1, did
another inmate use physical force
to make you give or receive oral
sex or a blowjob?
1
Yes
2
No
DK/REF
E27
[IF E8 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to give
or receive oral sex or a blowjob?
1
Yes
2
No
DK/REF
E28
[IF E10 = 1] DOAFILL1, did
another inmate use physical force
to make you have vaginal sex?
1
Yes
Attachment C: NIS-4P ACASI Instrument 4-20-2020
2
No
DK/REF
E29
[IF E10 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have vaginal sex?
1
Yes
2
No
DK/REF
E32
[IF E12 = 1] DOAFILL1, did
another inmate use physical force
to make you have anal sex?
E32
1
Yes
2
No
DK/REF
E33
E34
[IF E12 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have anal sex?
1
Yes
2
No
DK/REF
[IF E14 = 1] DOAFILL1, did
another inmate use physical force
to make you have any type of sex
or sexual contact other than
sexual touching, handjobs, oral
sex or blowjobs, or anal sex?
1
Yes
2
No
DK/REF
E33
E34
1
Yes
2
No
DK/REF
E35
[IF E14 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have any type of sex or sexual
contact other than sexual
touching, handjobs, oral sex or
blowjobs, or anal sex?
1
Yes
2
No
DK/REF
[IF E12 = 1] DOAFILL1, did
another inmate use physical force
to make you have anal sex?
[IF E12 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have anal sex?
1
Yes
2
No
DK/REF
[IF E14 = 1] DOAFILL1, did
another inmate use physical force
to make you have any type of sex
or sexual contact other than
sexual touching, oral sex, vaginal
sex, or anal sex?
1
Yes
2
No
DK/REF
E35
[IF E14 = 1] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have any type of sex or sexual
contact other than sexual
touching, oral sex, vaginal sex, or
anal sex?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DEFINE forced:
If at least one of (E16, E18, E22, E24, E26, E28, E32, E34) is YES,
then forced = YES
else forced = NO
DEFINE pressured:
If at least one of (E17, E19, E23, E25, E27, E29, E33, E35) is YES,
then pressured = YES
else pressured = NO
DEFINE ForcedOrPressuredFill2:
If forced = YES AND pressured = NO
then forcedOrPressuredFill2 = “physically forced to”
Else if forced = NO AND pressured = YES
then forcedOrPressuredFill2 = “pressured or made to feel that you had to”
Else if forced = YES AND pressured = YES
then forcedOrPressuredFill2 = “physically forced, pressured, or made to feel that you had to”
Else
forcedOrPressuredFill2 = “????”
Note that if forced and pressured are both NO, the fill won’t be used so it doesn’t matter what it is.
E36
[IF GENDER = 1 AND (E22 = 1 OR E23 = 1 OR E26 = 1 OR E27 = 1 OR E32 = 1 OR E33 = 1)]
DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E22 OR E23 = 1] Give or receive a handjob,
[IF E26 OR E27 = 1] Give or receive oral sex or a blowjob, or
[IF E32 OR E33 = 1] Have anal sex?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E36a
[IF E36 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2:
•
•
•
[IF E22 OR E23 = 1] Give or receive a handjob,
[IF E26 OR E27 = 1] Give or receive oral sex or a blowjob, or
[IF E32 OR E33 = 1] Have anal sex?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E36b
[IF E36 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E22 OR E23 = 1] Give or receive a handjob,
[IF E26 OR E27 = 1] Give or receive oral sex or a blowjob, or
[IF E32 OR E33 = 1] Have anal sex?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E37
[IF GENDER = 2 AND (E24 = 1 OR E25 = 1 OR E28 = 1 OR E29 = 1 OR E32 = 1 OR E33 = 1)]
DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E24 OR E25 = 1] Give or receive oral sex,
[IF E28 OR E29 = 1] Have vaginal sex, or
[IF E32 OR E33 = 1] Have anal sex?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E37a
[IF E37 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E24 OR E25 = 1] Give or receive oral sex,
[IF E28 OR E29 = 1] Have vaginal sex, or
[IF E32 OR E33 = 1] Have anal sex?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E37b
[IF E37 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E24 OR E25 = 1] Give or receive oral sex,
[IF E28 OR E29 = 1] Have vaginal sex, or
[IF E32 OR E33 = 1] Have anal sex?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E38
[IF E16 = 1 OR E17 = 1] DOAFILL1, how many times altogether were you
[ForcedOrPressuredFill2 let another inmate touch your butt, thighs, or penis in a sexual way?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E38a
[IF E38 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let
another inmate touch your butt, thighs, or penis in a sexual way?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
E38b
[IF E38 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let
another inmate touch your butt, thighs, or penis in a sexual way?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
E39
[IF E18 = 1 OR E19 = 1] DOAFILL1, how many times altogether were you
[ForcedOrPressuredFill2] let another inmate touch your thighs, breasts, or vagina in a sexual way?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
E39a
[IF E39 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let
another inmate touch your thighs, breasts, or vagina in a sexual way?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
E39b
[IF E39 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let
another inmate touch your thighs, breasts, or vagina in a sexual way?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E40
[IF E36 > 1 OR E37 > 1] How soon after you arrived at this facility were you [ForcedOrPressuredFill2] have
sex or sexual contact with another inmate for the first time?
[IF E36 = 1 OR E37 = 1] How soon after you arrived at this facility were you [ForcedOrPressuredFill2] have
sex or sexual contact with another inmate?
1
Within the first 24 hours after you arrived here
2
More than 24 hours but within your first 3 days here
3
More than 3 days but within your first 30 days here
4
More than 30 days but within your first 6 months here
5
More than 6 months but within your first 12 months here
6
More than 12 months after you arrived here
DK/REF
LCM1 DOAFILL1, did another inmate use physical force, pressure you, or make you feel that you had to have any
type of sex or sexual contact?
1
Yes
2
No
DK/REF
LCM2a How long has it been since another inmate in this facility used physical force, pressured you, or made you feel
that you had to have any type of sex or sexual contact?
1
Within the past 7 days
2
More than 7 days ago but within the past 30 days
3
More than 30 days ago but within the past 12 months
4
More than 12 months ago
5
This has not happened to me at this facility
DK/REF
E162
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did another inmate use
physical force to touch your butt,
thighs, or penis in a sexual way?
1
Yes
2
No
DK/REF
E172
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to let
them touch your butt, thighs, or
penis in a sexual way?
1
Yes
2
No
DK/REF
E182
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
Attachment C: NIS-4P ACASI Instrument 4-20-2020
OR 2 OR 3)] DOAFILL1, did
another inmate use physical force
to touch your butt, thighs, breasts,
or vagina in a sexual way?
1
Yes
2
No
DK/REF
E192
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to let
them touch your butt, thighs,
breasts, or vagina in a sexual
way?
1
Yes
2
No
DK/REF
E222
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND AND E12 = 2 AND E14
= 2 AND (LCM1 = 1 OR LCM2a
= 1 OR 2 OR 3)] DOAFILL1,
did another inmate use physical
force to make you give or receive
a handjob?
1
Yes
2
No
DK/REF
E232
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND AND E12 = 2 AND E14
= 2 AND (LCM1 = 1 OR LCM2a
= 1 OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to give
or receive a handjob?
1
Yes
2
No
DK/REF
E242
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate use physical force
to make you give or receive oral
sex?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E252
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to give
or receive oral sex?
1
Yes
2
No
DK/REF
E262
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate use physical force
to make you give or receive oral
sex or a blowjob?
1
Yes
2
No
DK/REF
E272
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to give
or receive oral sex or a blowjob?
1
Yes
2
No
DK/REF
E282
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate use physical force
to make you have vaginal sex?
1
Yes
2
No
DK/REF
E292
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have vaginal sex?
1
Yes
Attachment C: NIS-4P ACASI Instrument 4-20-2020
2
No
DK/REF
E322
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate use physical force
to make you have anal sex?
E322
1
Yes
2
No
DK/REF
E332
E342
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have anal sex?
1
Yes
2
No
DK/REF
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate use physical force
to make you have any type of sex
or sexual contact other than
sexual touching, handjobs, oral
sex or blowjobs, or anal sex?
1
Yes
2
No
DK/REF
E332
E342
1
Yes
2
No
DK/REF
E352
[IF E2 = 2 AND E6 = 2 AND E8
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have any type of sex or sexual
contact other than sexual
touching, handjobs, oral sex or
blowjobs, or anal sex?
1
Yes
2
No
DK/REF
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate use physical force
to make you have anal sex?
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have anal sex?
1
Yes
2
No
DK/REF
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate use physical force
to make you have any type of sex
or sexual contact other than
sexual touching, oral sex, vaginal
sex, or anal sex?
1
Yes
2
No
DK/REF
E352
[IF E2 = 2 AND E8 = 2 AND E10
= 2 AND E12 = 2 AND E14 = 2
AND (LCM1 = 1 OR LCM2a = 1
OR 2 OR 3)] DOAFILL1, did
another inmate, without using
physical force, pressure you or
make you feel that you had to
have any type of sex or sexual
contact other than sexual
touching, oral sex, vaginal sex, or
anal sex?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
UPDATE forced:
If at least one of (E162, E182, E222, E242, E262, E282, E322, E342) is YES,
then forced = YES
else forced = NO
UPDATE pressured:
If at least one of (E172, E192, E232, E252, E272, E292, E332, E352) is YES,
then pressured = YES
else pressured = NO
UPDATE ForcedOrPressuredFill2:
If forced = YES AND pressured = NO
then forcedOrPressuredFill2 = “physically forced to”
Else if forced = NO AND pressured = YES
then forcedOrPressuredFill2 = “pressured or made to feel that you had to”
Else if forced = YES AND pressured = YES
then forcedOrPressuredFill2 = “physically forced, pressured, or made to feel that you had to”
Else
forcedOrPressuredFill2 = “????”
[Note that if forced and pressured are both NO, the fill won’t be used so it doesn’t matter what it is.]
E353
[IF GENDER = 1 AND (E222 = 1 OR E232 = 1 OR E262 = 1 OR E272 = 1 OR E322 = 1 OR E332 = 1)]
DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2:
•
•
•
[IF E222 OR E232 = 1] Give or receive a handjob,
[IF E262 OR E272 = 1] Give or receive oral sex or a blowjob, or
[IF E322 OR E332 = 1] Have anal sex?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E354
[IF E353 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
[IF E222 OR E232 = 1] Give or receive a handjob,
[IF E262 OR E272 = 1] Give or receive oral sex or a blowjob, or
[IF E322 OR E332 = 1] Have anal sex?
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E355
[IF E353 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E222 OR E232 = 1] Give or receive a handjob,
[IF E262 OR E272 = 1] Give or receive oral sex or a blowjob, or
[IF E322 OR E332 = 1] Have anal sex?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E356
[IF GENDER = 2 AND (E242 = 1 OR E252 = 1 OR E282 = 1 OR E292 = 1 OR E322 = 1 OR E332 = 1)]
DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E242 OR E252 = 1] Give or receive oral sex,
[IF E282 OR E292 = 1] Have vaginal sex, or
[IF E322 OR E332 = 1] Have anal sex?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E357
[IF E356 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E242 OR E252 = 1] Give or receive oral sex,
[IF E282 OR E292 = 1] Have vaginal sex, or
[IF E322 OR E332 = 1] Have anal sex?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E358
[IF E356 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2]:
•
•
•
[IF E242 OR E252 = 1] Give or receive oral sex,
[IF E282 OR E292 = 1] Have vaginal sex, or
[IF E322 OR E332 = 1] Have anal sex?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
PROGRAMMER: DEPENDING ON THE NUMBER OF BEHAVIORS ENDORSED, PLEASE
INCORPORATE THIS PUNCTUATION:
• 1 ITEM – END WITH ?
• 2 ITEMS – 1ST ITEM END WITH or; 2ND ITEM END WITH ?
• 3 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , or; 3RD ITEM END WITH ?
E359
[IF E162 = 1 OR E172 = 1] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let
another inmate touch your butt, thighs, or penis in a sexual way?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E360
[IF E359 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let another inmate
touch your butt, thighs, or penis in a sexual way?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
E361
[IF E359 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let another inmate
touch your butt, thighs, or penis in a sexual way?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
E362
[IF E182 = 1 OR E192 = 1] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let
another inmate touch your butt, thighs, breasts, or vagina in a sexual way?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
E363
[IF E362 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let another inmate
touch your butt, thighs, breasts, or vagina in a sexual way?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
E364
[IF E362 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let another inmate
touch your butt, thighs, breasts, or vagina in a sexual way?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
E365
[IF E353 > 1 OR E356 > 1] How soon after you arrived at this facility were you [ForcedOrPressuredFill2]
have sex or sexual contact with another inmate for the first time?
[IF E353 = 1 OR E356 = 1] How soon after you arrived at this facility were you [ForcedOrPressuredFill2]
have sex or sexual contact with another inmate?
1
Within the first 24 hours after you arrived here
2
More than 24 hours but within your first 3 days here
3
More than 3 days but within your first 30 days here
4
More than 30 days but within your first 6 months here
5
More than 6 months but within your first 12 months here
6
More than 12 months after you arrived here
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DESCRIPTION OF NON-CONSENUAL SEXUAL ACTS (NCSAs)
DEFINE NCSA:
IF E16 = 1 OR E17 = 1 OR E18 = 1 OR E19 = 1 OR E22 = 1 OR E23 = 1 OR E24 = 1 OR E25 = 1
OR E26 = 1 OR E27 = 1 OR E28 = 1 OR E29 = 1 OR E32 = 1 OR E33 = 1 OR E34 = 1 OR E35 = 1
OR E162 = 1 OR E172 = 1 OR E182 = 1 OR E192 = 1 OR E222 = 1 OR E232 = 1 OR E242 = 1 OR
E252 = 1 OR E262 = 1 OR E272 = 1 OR E282 = 1 OR E292 = 1 OR E322 = 1 OR E332 = 1 OR
E342 = 1 OR E352 = 1 THEN NCSA = 1
ELSE NCSA = 2
UPDATE forced:
If at least one of (E16, E18, E22, E24, E26, E28, E32, E34, E162, E182, E222, E242, E262, E282, E322, E342)
is YES,
then forced = YES
else forced = NO
UPDATE pressured:
If at least one of (E17, E19, E23, E25, E27, E29, E33, E35, E172, E192, E232, E252, E272, E292, E332, E352)
is YES,
then pressured = YES
else pressured = NO
UPDATE ForcedOrPressuredFill2:
If forced = YES AND pressured = NO
then forcedOrPressuredFill2 = “physically forced”
Else if forced = NO AND pressured = YES
then forcedOrPressuredFill2 = “pressured or made to feel that you had”
Else if forced = YES AND pressured = YES
then forcedOrPressuredFill2 = “physically forced, pressured, or made to feel that you had”
Else
forcedOrPressuredFill2 = “????”
[Note that if forced and pressured are both NO, the fill won’t be used so it doesn’t matter what it is.]
DEFINE #NCSA1
IF E36 + E37 + E38 + E39 + E353 + E356 + E359 + E362 = 1 THEN #NCSA1 = did it
IF E36 + E37 + E38 + E39 + E353 + E356 + E359 + E362 > 1 THEN #NCSA1 = did it ever
IF ALL (E36, E37, E38, E39, E353, E356, E359, E362) = DK OR REF THEN #NCSA1 = did it ever
DEFINE #NCSA2
IF E36 + E37 + E38 +E39 + E353 + E356 + E359 + E362 = 1 THEN #NCSA2 = were you
IF E36 + E37 + E38 +E39 + E353 + E356 + E359 + E362 > 1 THEN #NCSA2= were you ever
IF ALL (E36, E37, E38, E39, E353, E356, E359, E362) = DK OR REF THEN #NCSA2 = were you ever
DEFINE #NCSA3
IF E36 + E37 + E38 + E39 + E353 + E356 + E359 + E362 = 1 THEN #NCSA3 = was it
IF E36 + E37 + E38 + E39 + E353 + E356 + E359 + E362 > 1 THEN #NCSA3 = was it ever
IF ALL (E36, E37, E38, E39, E353, E356, E359, E362) = DK OR REF THEN #NCSA3 = was it ever
DEFINE #NCSA4
IF E36 + E37 + E38 + E39 + E353 + E356 + E359 + E362 = 1 THEN #NCSA4 = did you
IF E36 + E37 + E38 + E39 + E353 + E356 + E359 + E362 > 1 THEN #NCSA4 = did you ever
IF ALL (E36, E37, E38, E39, E353, E356, E359, E362) = DK OR REF THEN #NCSA4 = did you ever
DEFINE #NCSA5
IF E36 + E37 + E38 + E39 + E353 + E356 + E359 + E362 = 1 THEN #NCSA5 = why didn’t you
IF E36 + E37 + E38 + E39 + E353 + E356 + E359 + E362 > 1 THEN #NCSA5 = why didn’t you ever
IF ALL (E36, E37, E38, E39, E353, E356, E359, E362) = DK OR REF THEN #NCSA5 = why didn’t you ever
Attachment C: NIS-4P ACASI Instrument 4-20-2020
F1
[IF NCSA = 1] DOAFILL1,when you were [ForcedOrPressuredFill2] have sex or sexual contact with another
inmate, [#NCSA1 FILL] involve more than one inmate?
1
Yes
2
No
DK/REF
F6
[IF NCSA = 1] DOAFILL1,when you were [ForcedOrPressuredFill2] have sex or sexual contact
with another inmate, [#NSCA2 FILL] …
F6a. Persuaded or talked into it?
F6b. Given a bribe?
F6c. Blackmailed?
F6d. Given drugs or alcohol to get you drunk or high?
F6e. Offered protection from other inmates?
F6f. Trying to pay off or settle a debt that you owed?
F6g. Threatened with harm?
F6h. Physically held down or restrained?
F6i. Physically harmed or injured?
F6j. Threatened with a weapon?
DK/REF
F8
Yes
1
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
2
[IF NCSA = 1] DOAFILL1,when you were [ForcedOrPressuredFill2] have sex or sexual contact
with another inmate, [#NCSA3] initiated by a gang?
1
Yes
2
No
DK/REF
F9
[IF NCSA = 1] DOAFILL1, when you were [ForcedOrPressuredFill2] have sex or sexual contact
with another inmate, [#NCSA2] injured?
1
Yes
2
No
DK/REF
F10
[IF F9 = 1] DOAFILL1,when you were [ForcedOrPressuredFill2] have sex or sexual contact with
another inmate, [#NCSA4] …
F10a. Receive knife or stab wounds?
F10b. Receive broken bones?
F10c. [IF GENDER = 1] Have anal tearing?
[IF GENDER = 2] Have anal or vaginal tearing?
F10d. Have your teeth chipped or knocked out?
F10e Receive internal injuries?
F10f. Get knocked unconscious?
F10g. Receive bruises, a black eye, sprains, cuts, scratches, swelling,
welts, or burns?
DK/REF
Yes
1
1
1
No
2
2
2
1
1
1
1
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
STAFF SEXUAL MISCONDUCT
G1
These next questions are about the behavior of staff at this facility DOAFILL2. By staff we mean the
employees of this facility and anybody who works as a volunteer in this facility.
Touch the NEXT button to go to the next screen.
G4
DOAFILL1, have any facility staff pressured you or made you feel that you had to let them have sex or
sexual contact with you?
1
Yes
2
No
DK/REF
G5
DOAFILL1, have you been physically forced by any facility staff to have sex or sexual contact?
1
Yes
2
No
DK/REF
DEFINE SEXTYPE2
IF G4 =1 AND G5 = 1 THEN SEXTYPE2 = physically forced, pressured, or made to feel that you had to
IF G4 = 1 AND G5 NE 1 THEN SEXTYPE2 = pressured or made to feel that you had to
IF G4 NE 1 AND G5 = 1 THEN SEXTYPE2 = physically forced to
G6
[IF G4 =1 OR G5 = 1] DOAFILL1, how many times were you [SEXTYPE2 FILL] have sex or sexual
contact with any facility staff?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
G6a.
[IF G6 = 3] DOAFILL1, how many times were you [SEXTYPE2 FILL] have sex or sexual contact with any
facility staff?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
G6b.
[IF G6 = 4] DOAFILL1, how many times were you [SEXTYPE2 FILL] have sex or sexual contact with any
facility staff?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
G8
[IF (G4 = 1 OR G5 = 1) AND G6 > 1] How soon after you arrived at this facility were you [SEXTYPE2]
have sex or sexual contact with facility staff for the first time?
[IF (G4 = 1 OR G5 = 1) AND G6 = 1)] How soon after you arrived at this facility were you [SEXTYPE2]
have sex or sexual contact with facility staff?
1
Within the first 24 hours after you arrived here
2
More than 24 hours but within your first 3 days here
3
More than 3 days but within your first 30 days here
4
More than 30 days but within your first 6 months here
5
More than 6 months but within your first 12 months here
6
More than 12 months after you arrived here
DK/REF
G7
DOAFILL1, have any facility staff offered you favors or special privileges in exchange for sex or sexual
contact?
1
Yes
2
No
DK/REF
G2
DOAFILL1, have you willingly had sex or sexual contact with any facility staff?
1
Yes
2
No
DK/REF
G3
[IF G2 = 1] DOAFILL1, how many times have you willingly had sex or sexual contact with facility staff?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
G3a
[IF G3 = 3] DOAFILL1, how many times have you willingly had sex or sexual contact with any facility
staff?
1
3 times
2
4 times
3
5 times
4
6 times
5
7 times
6
8 times
7
9 times
8
10 times
DK/REF
G3b
[IF G3 = 4] DOAFILL1, how many times have you willingly had sex or sexual contact with any facility
staff?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
G9
[IF G4 = 1 OR G5 = 1] DOAFILL1, on any occasion when you were [SEXTYPE2 FILL] have sex or sexual
contact with facility staff, did you report it to other facility staff?
1
Yes
2
No
DK/REF
G10
[IF G2 = 1 OR G4 = 1 OR G5 = 1] These next questions are about any sex or sexual contact you have had
with facility staff DOAFILL2, whether you wanted to have it or not.
Touch the NEXT button to go to the next screen.
G11
[IF G2 = 1 OR G4 = 1 OR G5 = 1] DOAFILL1, which of the following types of sex or sexual contact did
you have with a facility staff person?
G11a. You touched a facility staff person’s body
or had your body touched in a sexual way?
G11b. You gave or received a handjob?
G11c. You gave or received oral sex or a
blowjob?
G11d. You had vaginal sex? Vaginal sex is when
one person inserts their penis, finger, or an object
into another person’s vagina.
G11e. You had anal sex? Anal sex is when one
person inserts their penis, finger, or an object into
another person’s butt.
DK/REF
G12
Yes
1
No
2
1
1
2
2
1
2
1
2
[IF G2 =1 OR G4 = 1 OR G5 = 1] DOAFILL1, when you had sex or sexual contact with facility staff, did it
ever involve more than one facility staff person?
1
Yes
2
No
DK/REF
G17
[IF G2 =1 OR G4 = 1 OR G5 = 1] DOAFILL1, when you had sex or sexual contact with facility staff were
any of the following methods used to get you to participate?
G17a. You were persuaded or talked into it?
G17b. You were given a bribe?
G17c. You were offered favors or special privileges?
G17d. You were blackmailed?
G17e. You were given drugs or alcohol to get you drunk or high?
G17f. You were offered protection from other inmates?
G17g. You were offered protection from another correctional officer?
G17h. You were trying to pay off or settle a debt that you owed?
G17i. You were threatened with harm?
G17j. You were physically held down or restrained?
G17k. You were physically harmed or injured?
G17l. You were threatened with a weapon?
DK/REF
Yes
1
1
1
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
G28.
[IF G2 = 1 OR G4 = 1 OR G5 = 1] DOAFILL1, did you have sex or sexual contact with male facility staff,
female facility staff, or both male and female facility staff?
1
Male facility staff
2
Female facility staff
3
Both male and female facility staff
DK/REF
G29.
[IF G28 = 1 OR 2] DOAFILL1, did you have sex or sexual contact with any…
G29a. Correctional officers?
G29b. Other staff working in the facility?
G29c. Volunteers in the facility?
DK/REF
G31.
No
2
2
2
Yes
1
1
1
1
1
1
No
2
2
2
2
2
2
[IF G28 = 3] DOAFILL1, did you have sex or sexual contact with any…
G31a. Male correctional officers?
G31b. Female correctional officers?
G31c. Other male staff working in the facility?
G31d. Other female staff working in the facility?
G31e. Male volunteers in the facility?
G31f. Female volunteers in the facility?
DK/REF
G19
Yes
1
1
1
[IF G2 =1 OR G4 = 1 OR G5 = 1] DOAFILL1, when you had sex or sexual contact with facility staff, were
you ever injured?
1
Yes
2
No
DK/REF
G20
[IF G19 = 1] DOAFILL1, when you had sex or sexual contact with facility staff, did you ever …
G20a. Receive knife or stab wounds?
G20b. Receive broken bones?
G20c. [IF GENDER = 1] Have anal tearing?
[IF GENDER = 2] Have anal or vaginal tearing?
G20d. Have your teeth chipped or knocked out?
G20e. Receive internal injuries?
G20f. Get knocked unconscious?
G20g. Receive bruises, a black eye, sprains, cuts, scratches, swelling,
welts, or burns?
DK/REF
Yes
1
1
1
No
2
2
2
1
1
1
1
2
2
2
2
DEFINE RANDOMIZATION_INCIDENT
IF NCSA = 1 AND [G2 OR G5 =1]: RANDOMIZATION_INCIDENT = 1
ELSE, RANDOMIZATION_INCIDENT = 2
IF RANDOMIZATION_INCIDENT = 1, INITIATE RANDOMIZATION TO DETERMINE WHETHER TO
ADMINISTER MODULES DIR AND IIC OR MODULES DIRS AND SI
Note to Programmer: Randomization is 50/50 – half of RANDOMIZATION_INCIDENT = 1 cases should get
the DIR and IIC modules and half should get DIRS and SI modules.
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DETERMINATION OF SPECIFIC INCIDENT FOR INMATE INCIDENT REPORT
DEFINE NUMBER_OF_TIMES:
IF E36=1 OR E353=1 OR E37=1 OR E356=1, NUMBER_OF_TIMES = “1 time”
IF E36=2 OR E353=2 OR E37=2 OR E356=2, NUMBER_OF_TIMES= “2 times”
IF E36=3 OR E353=3 OR E37=3 OR E356 = 3, NUMBER_OF_TIMES= “3 to 10 times”
IF E36=4 OR E353=4 OR E37=4 OR E356=4, NUMBER_OF_TIMES= “11 times or more”
IF E36 = (DK OR REF) OR E353 = (DK OR REF) OR E37 = (DK OR REF) OR E356 = (DK OR REF),
NUMBER_OF_TIMES = NO FILL
ELSE NUMBER_OF_TIMES = MISSING
DEFINE NUMBER_OF_TIMES_TOUCH:
IF E38=1 OR E359=1 OR E39=1 OR E362=1, NUMBER_OF_TIMES_TOUCH = “1 time”
IF E38=2 OR E359=2 OR E39=2 OR E362=2, NUMBER_OF_TIMES_TOUCH=”2 times”
IF E38=3 OR E359=3 OR E39=3 OR E362=3, NUMBER_OF_TIMES_TOUCH = “3 to 10 times”
IF E38=4 OR E359=4 OR E39=4 OR E362=4, NUMBER_OF_TIMES_TOUCH = “11 times or more”
IF E38 = (DK OR REF) OR E359 = (DK OR REF) OR E39 = (DK OR REF) OR E362 = (DK OR REF),
NUMBER_OF_TIMES_TOUCH = NO FILL
ELSE NUMBER_OF_TIMES_TOUCH = MISSING
DIR1
[IF NUMBER_OF_TIMES=1 time AND NUMBER_OF_TIMES_TOUCH IS MISSING] Earlier you
reported that DOAFILL2 you were [ForcedOrPressuredFill2] have sex or sexual contact with another inmate
[NUMBER_OF_TIMES]. Please think about that experience as you answer the next questions.
Touch the NEXT button to go to the next screen.
DIR2
[ IF NUMBER_OF_TIMES_TOUCH=1 time AND NUMBER_OF_TIMES IS MISSING]
[IF GENDER=1]: Earlier you reported that DOAFILL2 you were [ForcedOrPressuredFill2] let another
inmate touch your butt, thighs, or penis in a sexual way [NUMBER_OF_TIMES_TOUCH]. Please think
about that experience as you answer the next questions.
Touch the NEXT button to go to the next screen.
[IF GENDER=2]: Earlier you reported that DOAFILL2 you were [ForcedOrPressuredFill2] let another
inmate touch your butt, thighs, breasts, or vagina in a sexual way [NUMBER_OF_TIMES_TOUCH]. Please
think about that experience as you answer the next questions.
Touch the NEXT button to go to the next screen.
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DIR3
[IF NUMBER_OF_TIMES >= 2 times AND NUMBER_OF_TIMES_TOUCH IS MISSING] Earlier you
reported that DOAFILL2 you were [ForcedOrPressuredFill2] have sex or sexual contact with another inmate
[NUMBER_OF_TIMES].
[IF only one of ((E22=1 OR E23=1), (E24=1 OR E25=1), (E26=1 OR E27=1), (E28=1 OR E29=1), (E32=1
OR E33=1), (E222=1 OR E232=1), (E242=1 OR E252=1), (E262=1 OR E272=1), (E282=1 OR E292=1),
(E322=1 OR E332=1)) is true]: As you answer the next questions, please think about the most recent time
you were [ForcedOrPressuredFill2] have sex or sexual contact with another inmate.
Touch the NEXT button to go to the next screen.
[IF at least two of ((E22=1 OR E23=1), (E24=1 OR E25=1), (E26=1 OR E27=1), (E28=1 OR E29=1), (E32=1
PR E33=1), (E222=1 OR E232=1), (E242=1 OR E252=1), (E262=1 OR E272=1), (E282=1 OR E292=1),
(E322=1 OR E332=1_) are true]: Think about the most recent time this happened to you. What were you
[ForcedOrPressuredFill2] do?
DIR3a. [IF E22=1 OR E23=1 OR E222=1 OR E232=1] Give or
receive a hand job?
DIR3b. [IF E26=1 OR E27=1 OR E262=1 OR E272=1] Give or
receive oral sex or a blowjob?
DIR3c. [IF E24=1 OR E25=1 OR E242=1 OR E252=1] Give or
receive oral sex?
DIR3d. [IF E28=1 OR E29=1 OR E282=1 OR E292=1] Have
vaginal sex?
DIR3e. [IF E32=1 OR E33=1 OR E322=1 OR E332=1] Have anal
sex?
DK/REF
Yes
1
No
2
1
2
1
2
1
2
1
2
As you answer the next questions please think about the most recent time you were [ForcedOrPressuredFill2]
have sex or sexual contact with another inmate.
Touch the NEXT button to go to the next screen.
DIR4
[IF NUMBER_OF_TIMES_TOUCH >=2 times AND NUMBER_OF_TIMES IS MISSING
[IF GENDER = 1]: Earlier you reported that DOAFILL2 you were [ForcedOrPressuredFill2] let another
inmate touch your butt, thighs, or penis in a sexual way [NUMBER_OF_TIMES_TOUCH].
Think about the most recent time this happened to you as you answer the next questions.
Touch the NEXT button to go to the next screen.
[IF GENDER = 2]: Earlier you reported that DOAFILL2 you were [ForcedOrPressuredFill2] let another
inmate touch your butt, thighs, breasts, or vagina in a sexual way [NUMBER_OF_TIMES_TOUCH].
Think about the most recent time this happened to you as you answer the next questions.
Touch the NEXT button to go to the next screen.
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DIR5
[IF (NUMBER_OF_TIMES >=1 time OR DK OR REF) AND (NUMBER_OF_TIMES_TOUCH >=1 time
OR DK OR REF)]
[IF GENDER = 1]: Earlier you reported that DOAFILL2 you were [ForcedOrPressuredFill2] have sex or
sexual contact with another inmate and that you were [ForcedOrPressuredFill2] let another inmate touch your
butt, thighs, or penis in a sexual way.
[IF GENDER = 2]: Earlier you reported that DOAFILL2 you were [ForcedOrPressuredFill2] have sex or
sexual contact with another inmate and that you were [ForcedOrPressuredFill2] let another inmate touch your
butt, thighs, breasts, or vagina in a sexual way.
Think about the most recent time this happened to you. What were you [ForcedOrPressuredFill2] do?
DIR5a. [IF E22=1 OR E23=1 OR E222=1 OR E232=1] Give or
receive a hand job?
DIR5b. [IF E26=1 OR E27=1 OR E262=1 OR E272=1] Give or
receive oral sex or a blowjob?
DIR5c. [IF E24=1 OR E25=1 OR E242=1 OR E252=1] Give or
receive oral sex?
DIR5d. [IFE28=1 OR E29=1 OR E282=1 OR E292=1] Have vaginal
sex?
DIR5e. [IF E32=1 OR E33=1 OR E322=1 OR E332=1] Have anal
sex?
DIR5f. [IF E16=1 OR E17=1 OR E162=1 OR E172=1] Be touched
on your butt, thighs, or penis in a sexual way?
DIR5g. [IF E18=1 OR E19=1 OR E182=1 OR E192=1] Be touched
on your thighs, breasts, or vagina in a sexual way?
DK/REF
Yes
1
No
2
1
2
1
2
1
2
1
2
1
2
1
2
[IF GENDER = 1]: As you answer the next questions please think about the most recent time you were
[ForcedOrPressuredFill2] have sex or sexual contact with another inmate or let another inmate touch your
butt, thighs, or penis in a sexual way.
Touch the NEXT button to go to the next screen.
[IF GENDER = 2]: As you answer the next questions please think about the most recent time you were
[ForcedOrPressuredFill2] have sex or sexual contact with another inmate or let another inmate touch your
butt, thighs, breasts, or vagina in a sexual way.
Touch the NEXT button to go to the next screen.
Attachment C: NIS-4P ACASI Instrument 4-20-2020
[IF DIR1 OR DIR2 OR DIR3 OR DIR4 OR DIR5 is displayed, continue with this module. Else, skip to
Determination of Specific Incident of Staff Incident Report]
INCIDENT CHARACTERISTICS FOR INMATE-ON-INMATE VICTIMIZATION
DEFINE RECENT_FILL:
IF DIR1 OR DIR2 is displayed, then RECENT_FILL = “incident”
IF DIR3 OR DIR4 OR DIR5 is displayed, then RECENT_FILL = “most recent incident”
DEFINE I-ON-I_FILL:
IF DIR1 OR DIR3 is displayed, then I-ON-I_FILL = “sex or sexual contact with another inmate”
IF DIR2 OR DIR4 is displayed AND GENDER=1, then I-ON-I_FILL = “another inmate touching your butt, thighs or
penis in a sexual way”
IF DIR2 OR DIR4 is displayed AND GENDER=2, then I-ON-I_FILL = “another inmate touching your butt, thighs,
breasts, or vagina in a sexual way”
IF DIR5 is displayed AND GENDER=1, then I-ON-I_FILL = “sex or sexual contact with another inmate or another
inmate touching your butt, thighs, or penis in a sexual way”
IF DIR5 is displayed AND GENDER=2, then I-ON-I_FILL = “sex or sexual contact with another inmate or another
inmate touching your butt, thighs, breasts, or vagina in a sexual way”
IIC1
Did this [RECENT_FILL] of [I-ON-I_FILL] happen in [CURRENT YEAR] or [CURRENT YEAR -1]?
1
CURRENT YEAR
2
CURRENT YEAR – 1
DK/REF
DEFINE IIC1_FILL:
IF IIC1=1, then IIC1_FILL=CURRENT YEAR
IF IIC1=2, then, IIC1_FILL=CURRENT YEAR – 1
IIC2
[IF IIC1 NE DK OR REF] In what month in [IIC1_FILL] did this [RECENT_FILL] happen?
[IF IIC1 = DK OR REF] In what month did this [RECENT_FILL] happen?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
IIC3
Did the [RECENT_FILL] happen…
IIC3a. Between 6:00 in the morning and noon?
IIC3b. After noon but before 6:00 in the evening?
IIC3c. After 6:00 in the evening but before midnight?
IIC3d. After midnight but before 6:00 in the morning?
DK/REF
Yes
1
1
1
1
No
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
IIC4
Where did the [RECENT_FILL] happen?
IIC4a. In your own cell, room, or sleeping area?
IIC4b. In the cell, room, or housing area of another inmate?
IIC4c. Somewhere else in the facility?
IIC4d. Off facility grounds?
DK/REF
IIC5
Yes
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
Yes
1
1
1
1
No
2
2
2
2
[IF IIC4d =1] Where were you when the incident happened?
IIC6a. A bus, van, or car?
IIC6b. A courthouse?
IIC6c. Some type of temporary holding facility?
IIC6d. A hospital or other type of medical facility?
DK/REF
IIC7
No
2
2
2
2
[IF IIC4c =1] Where were you when the incident happened?
IIC5a. In a shower?
IIC5b. In a bathroom?
IIC5c. In the yard or recreation area?
IIC5d. In a classroom or library?
IIC5e. In a workshop, kitchen, or other workplace?
IIC5f. In a closet?
IIC5g. In an office or other locked room?
IIC5h. On the stairs?
DK/REF
IIC6
Yes
1
1
1
1
Just before or during this [RECENT_FILL], which, if any of these things, happened? Were you…
IIC7a. Persuaded or talked into the sex or sexual contact?
IIC7b. Given a bribe?
IIC7c. Blackmailed?
IIC7d. Given drugs or alcohol to get you drunk or high?
IIC7e. Offered protection from other inmates?
IIC7f. Trying to pay off or settle a debt that you owed?
IIC7g. Threatened with harm?
IIC7h. Physically held down or restrained?
IIC7i. Physically harmed or injured?
IIC7j. Threatened with a weapon?
DK/REF
Yes
1
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
IIC8
Do you think this [RECENT_FILL] happened because of your…
IIC8a. Race or ethnicity?
IIC8b. Age?
IIC8c. Religion?
IIC8f. Gang affiliation?
IIC8g. [IF TRANSID = 1OR D3c = 1 OR (D3d = 1 AND D3e = 2
OR 3 OR 4) OR (D3d = 2 AND D3e = 1 OR 3 OR 4)]] Gender
identity?
DK/REF
Yes
1
1
1
1
No
2
2
2
2
1
2
DEFINE SexualOrientationFill:
IF D2a=1, then SexualOrientationFill = “gay”
IF D2b=1, then SexualOrientationFill = “lesbian or gay”
IF D2a=3 OR D2b=3, then SexualOrientationFill = “bisexual”
IIC33
[D2a=1 OR D2b=1 OR D2a=3 OR D2b=3] Do you think this [RECENT_FILL] happened because you are
[SexualOrientationFill]?
1
Yes
2
No
DK/REF
IIC9
During this [RECENT_FILL], did one inmate or more than one inmate have sexual contact with you?
1
One inmate
2
More than one inmate
DK/REF
IIC10a [IF IIC9 = 1] Was the other inmate male, female, or transgender?
1
Male
2
Female
3
Transgender
DK/REF
IIC10b [IF IIC9 = 2] Were any of the inmates involved in this incident…
IIC10b1. Male?
IIC10b2. Female?
IIC10b3. Transgender?
DK/REF
DEFINE PerpGenderFill1:
If IIC9=1 AND IIC10a=1
then PerpGenderFill1= “he”
If IIC9=1 AND IIC10a=2
then PerpGenderFill1= “she”
If IIC9=1 AND IIC10a=3
then PerpGenderFill1 = “they”
If IIC9=2
then PerpGenderFill1 = “they”
Yes
1
1
1
No
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DEFINE PerpGenderFill2:
If IIC9=1 AND IIC10a=1
then PerpGenderFill2= “his”
If IIC9=1 AND IIC10a=2
then PerpGenderFill2= “her”
If IIC9=1 AND IIC10a=3
then PerpGenderFill2 = “their”
If IIC9=2
then PerpGenderFill2 = “their”
IIC11
[IF IIC9 = 1] Was the other inmate of Hispanic, Latino, or Spanish origin?
[IF IIC9 = 2] Were any of the other inmates of Hispanic, Latino, or Spanish origin?
1
Yes
2
No
DK/REF
IIC12
[IF IIC9 = 1] Was the other inmate…
[IF IIC9 = 2] Were any of the other inmates…
IIC12a. White?
IIC12b. Black or African American?
IIC12c. American Indian or Alaska Native?
IIC12d. Asian?
IIC12e. Native Hawaiian or other Pacific Islander?
DK/REF
Yes
1
1
1
1
1
No
2
2
2
2
2
IIC13a [IF IIC9 = 1] How old was this other inmate?
1
Under 25
2
25 – 34
3
35 – 44
4
45 – 54
5
55 or older
DK/REF
IIC13b [IF IIC9 = 2] Were any of the inmates…
IIC13b1. Older than you?
IIC13b2. Younger than you?
IIC13b3. About the same age as you?
DK/REF
IIC13DK
Yes
1
1
1
No
2
2
2
[IF IIC13a = DK] Was this other inmate older than you, younger than you or about the same age as you?
1 Older than you
2 Younger than you
3 About the same age as you
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
IIC14a [IF IIC9 = 1] At the time this [RECENT_FILL] occurred was this other inmate assigned to the same housing
unit, pod or dormitory as you?
1
Yes
2
No
DK/REF
IIC14b [IF IIC9 = 2] At the time this [RECENT_FILL] occurred were any of these inmates assigned to the same
housing unit, pod or dormitory as you?
1
Yes
2
No
DK/REF
IIC15a [IF IIC9 = 1] How well did you know this other inmate at the time the [RECENT_FILL] occurred?
1
Did not know the inmate at all
2
Knew the inmate only a little
3
Knew the inmate but not well
4
Knew the inmate very well
DK/REF
IIC15b [IF IIC9 = 2] Did you know these inmates at the time the [RECENT_FILL] occurred?
1
You knew all the inmates who were involved
2
You knew some of the inmates who were involved
3
You did not know any of the inmates who were involved
DK/REF
IIC16a [IF IIC9 = 1] Was this other inmate a member of a gang?
1
Yes
2
No
DK/REF
IIC16b [IF IIC9 = 2] Were any of these inmates members of a gang?
1
Yes
2
No
DK/REF
IIC17
[IF IIC9 = 1] Before this incident happened, were you worried that this inmate might be planning to have
sex or sexual contact with you?
[IF IIC9 = 2] Before this incident happened, were you worried that any of these inmates might be planning
to have sex or sexual contact with you?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
IIC18
[IF IIC9 = 1] Before this incident happened had you had any arguments or fights with this inmate?
[IF IIC9 = 2] ] Before this incident happened had you had any arguments or fights with any of these
inmates?
1
Yes
2
No
DK/REF
IIC19
Were you injured during this [RECENT_FILL]?
1
Yes
2
No
DK/REF
IIC20 [IF IIC19 = 1] How were you injured during the incident? Did you…
IIC20a. Receive knife or stab wounds?
IIC20b. Receive broken bones?
IIC20c. [IF GENDER = 1] Have anal tearing?
[IF GENDER = 2] Have anal or vaginal tearing?
IIC20d. Have your teeth chipped or knocked out?
IIC20e Receive internal injuries?
IIC20f. Get knocked unconscious?
IIC20g. Receive bruises, a black eye, sprains, cuts, scratches, swelling, welts,
or burns?
DK/REF
IIC21
Yes
1
1
1
No
2
2
2
1
1
1
1
2
2
2
2
[IF IIC19 = 1] As a result of any of the injuries you received during this incident, did you see a doctor, nurse,
or other health care provider for any of the injuries you received?
1
Yes
2
No
DK/REF
IIC22
[IF IIC9 = 1] Did this inmate do any of the following things after the incident happened?
[IF IIC9 = 2] Did these inmates do any of the following things after the incident happened?
IIC22a. Gave you gifts or money so that you would keep it a secret?
IIC22b. Threatened to hurt you so that you would keep it a secret?
IIC22c. Said [PerpGenderFill1] would blame it on you if you told anyone?
IIC22d. Said [PerpGenderFill1] would stop spending time with you if you told
anyone?
IIC22e. Had some type of sexual contact with you again?
IIC22f. Ignored you or stayed away from you?
IIC22g. Threatened to harm your family?
IIC22h. Hurt you or beat you up?
DK/REF
IIC23
Did you report this [RECENT_FILL] to anyone?
1
Yes
2
No
DK/REF
Yes
1
1
1
1
No
2
2
2
2
1
1
1
1
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
IIC24
[IF IIC23 = 1] Did you report the incident to…
IIC24a. A correctional officer?
IIC24b. An administrative staff person?
IIC24c. A medical or healthcare staff person?
IIC24d. An instructor or teacher?
IIC24e. A counselor or other mental health care provider?
IIC24f. A chaplain or other religious official?
IIC24g. A volunteer?
IIC24h. Some other type of facility staff person?
IIC24i. A telephone hotline?
IIC24j. Another inmate?
IIC24k. A family member or friend?
DK/REF
IIC25
Yes
1
1
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
2
2
At the time the [RECENT_FILL] happened were any other inmates aware that it was happening?
1
Yes
2
No
DK/REF
IIC26
At the time the [RECENT_FILL] happened were any staff at the facility aware that it was happening?
1
Yes
2
No
DK/REF
IIC27
[IF IIC23 = 1] Did any of the following things happen to you as a result of the report you made?
IIC27a. You were moved to administrative segregation or some other
protective housing?
IIC27b. You were placed in a medical unit, ward, or hospital?
IIC27c. You were confined to your own cell, room, or housing area?
IIC27d. You were given a higher level of custody within the facility?
IIC27e. You were offered a transfer to another facility?
IIC27f. You were written up?
DK/REF
Yes
1
No
2
1
1
1
1
1
2
2
2
2
2
IIC28a [IF IIC9 = 1 AND IIC23 = 1] Did any of the following things happen to the inmate who had sex or sexual
contact with you?
IIC28a1. The inmate was moved to administrative segregation or some other
protective housing?
IIC28a2. The inmate was placed in a medical unit, ward, or hospital?
IIC28a3. The inmate was confined to [PerpGenderFill2] own cell, room, or
housing area?
IIC28a4. The inmate was given a higher level of custody at this facility?
IIC28a5. The inmate was transferred to another facility?
IIC28a6. The inmate was written up?
IIC28a7. The inmate lost privileges?
IIC28a8. The inmate was charged with a crime?
DK/REF
Yes
1
No
2
1
1
2
2
1
1
1
1
1
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
IIC28b [IF IIC9 = 2 AND IIC23 = 1] Did any of the following things happen to the inmates who had sex or sexual
contact with you?
IIC28b1. One or more of the inmates were moved to administrative
segregation or some other protective housing?
IIC28b2. One or more of the inmates were placed in a medical unit, ward, or
hospital?
IIC28b3. One or more of the inmates were confined to their own cell, room,
or housing area?
IIC28b4. One or more of the inmates were given a higher level of custody at
this facility?
IIC28b5. One or more of the inmates were transferred to another facility?
IIC28b6. One or more of the inmates were written up?
IIC28b7. One or more of the inmates lost privileges?
IIC28b8. One ore more of the inmates were charged with a crime?
DK/REF
IIC29
Yes
1
No
2
1
2
1
2
1
2
1
1
1
1
2
2
2
2
[IF IIC9 = 1] Since this [RECENT_FILL] happened has this inmate attempted any type of sexual contact
with you?
[IF IIC9 = 2] ] Since this [RECENT_FILL] happened have any of these inmates attempted any type of
sexual contact with you?
1
Yes
2
No
DK/REF
IIC30
[IF IIC9 = 1 AND IIC29 NE 1] Since this [RECENT_FILL] happened have you been worried that this
inmate will try to initiate sexual contact with you again?
[IF IIC9 = 2 AND IIC29 NE 1] Since this [RECENT_FILL] happened have you been worried that any of
these inmates would try to initiate sexual contact with you again?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
IIC31
Since this [RECENT_FILL] happened have you done any of the following things to reduce the chance that
you would have to have sexual contact again?
IIC31a. Joined a gang?
IIC31b. Carried a weapon?
IIC31c. Fought more?
IIC31d. Worked out in order to bulk up?
IIC31e. Avoided certain areas?
IIC31f. Kept to yourself more?
IIC31g. Stayed in your own cell or housing area more?
IIC31h. Joined a religious group?
IIC31i. Avoided certain inmates?
IIC31j. Requested protective custody?
IIC31k. Requested transfer to another facility?
IIC31l. Requested a different housing unit, pod, or dormitory?
IIC31m. Contacted someone on the outside for help?
IIC31n. Tried to stay near facility staff?
IIC31o. Paid another inmate for protection?
DK/REF
Yes
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DETERMINATION OF SPECIFIC INCIDENT FOR STAFF INCIDENT REPORT
DIRS1 [ IF G3 + G6 = GT 1 TIME] Earlier you reported that, DOAFILL2, you had sex or sexual contact with a
facility staff person more than 1 time.
[IF only one of (G11a, G11b, G11c, G11d, G11e) is YES]: As you answer the next questions please think
about the most recent time when you had sex or sexual contact with a facility staff person.
[IF at least two of (G11a, G11b, G11c, G11d, G11e) are YES] Please think about the most recent time this
happened. Which of the following types of sex or sexual contact did you have with a facility staff person?
DIRS1a. [IF G11a=1] You touched a facility staff
person’s body or had your body touched in a
sexual way?
DIRS1b. [IF G11b=1] You gave or received a
handjob?
DIRS1c. [IF G11c=1] You gave or received oral
sex or a blowjob?
DIRS1d. [IF G11d=1] You had vaginal sex?
DIRS1e. [IF G11e=1] You had anal sex?
DK/REF
Yes
1
No
2
1
2
1
2
1
1
2
2
As you answer the next questions please think about this most recent time when you had sex or sexual contact
with a facility staff person.
Touch the NEXT button to go to the next screen.
DIRS2 [IF G3 + G6 = 1 TIME] Earlier you reported that DOAFILL2 you had sex or sexual contact with a facility
staff person 1 time. Please think about that experience as you answer the next questions.
Touch the NEXT button to go to the next screen.
DIRS3 [IF G6 = DK OR REF] AND [IF G3 = DK OR REF) Earlier you reported that, DOAFILL2, you had sex or
sexual contact with a facility staff person. Please think about that experience as you answer the next
questions.
Touch the NEXT button to go to the next screen.
Attachment C: NIS-4P ACASI Instrument 4-20-2020
[IF DIRS1 OR DIRS2 OR DIRS3 is displayed, continue with this module. Else, skip to Other Victimization
While Incarcerated]
INCIDENT CHARACTERISTICS FOR STAFF-ON-INMATE VICTIMIZATION
DEFINE RECENT_FILL2:
IF DIRS1 is displayed, then RECENT_FILL2 = “most recent incident”
IF DIRS2 OR DIRS3 is displayed, then RECENT_FILL2 = “incident”
SI1 Did this [RECENT_FILL2] of sex or sexual contact with a facility staff person happen in [CURRENT YEAR] or
[CURRENT YEAR -1]?
1
CURRENT YEAR
2
CURRENT YEAR – 1
DK/REF
DEFINE SI1_FILL:
IF SI1=1, then SI_FILL=CURRENT YEAR
IF SI1=2, then SI_FILL=CURRENT YEAR – 1
SI2
[IF SI1 NE DK OR REF] In what month in [SI1_FILL] did this [RECENT_FILL2] happen?
[IF SI1 = DK OR REF] In what month did this [RECENT_FILL2] happen?
1 January
2 February
3 March
4 April
5 May
6 June
7 July
8 August
9 September
10 October
11 November
12 December
DK/REF
SI3
Did the [RECENT_FILL2] happen…
SI3a. Between 6:00 in the morning and noon?
SI3b. After noon but before 6:00 in the evening?
SI3c. After 6:00 in the evening but before midnight?
SI3d. After midnight but before 6:00 in the morning?
DK/REF
SI4
Yes
1
1
1
1
No
2
2
2
2
Yes
1
1
1
1
No
2
2
2
2
Where did the [RECENT_FILL2] happen?
SI4a. In your own cell, room, or sleeping area?
SI4b. In the cell, room, or housing area of another inmate?
SI4c. Somewhere else in the facility?
SI4d. Off facility grounds?
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
[IF SI4c =1] Where were you when the incident happened?
SI5
SI5a. In a shower?
SI5b. In a bathroom?
SI5c. In the yard or recreation area?
SI5d. In a classroom or library?
SI5e. In a workshop, kitchen, or other workplace?
SI5f. In a closet?
SI5g. In an office or other locked room?
SI5h. On the stairs?
DK/REF
SI6
No
2
2
2
2
2
2
2
2
Yes
1
1
1
1
No
2
2
2
2
[IF SI4d =1] Where were you when the incident happened?
SI6a. A bus, van, or car?
SI6b. A courthouse?
SI6c. Some type of temporary holding facility?
SI6d. A hospital or other type of medical facility?
DK/REF
SI9
Yes
1
1
1
1
1
1
1
1
Just before or during this [RECENT_FILL2], which, if any of these things happened? Were you…
SI9a. Persuaded or talked into the sex or sexual contact?
SI9b. Given a bribe?
SI9c. Blackmailed?
SI9d. Given drugs or alcohol to get you drunk or high?
SI9e. Offered protection from other inmates?
SI9f. Trying to pay off or settle a debt that you owed?
SI9g. Threatened with harm?
SI9h. Physically held down or restrained?
SI9i. Physically harmed or injured?
SI9j. Threatened with a weapon?
SI9k. [IF A22 = 2] Told that you would be deported?
SI9l. Told that your family would be deported?
SI9m. Told that you would lose visitation privileges?
DK/REF
SI_NEW
Yes
1
1
1
1
1
1
1
1
1
1
1
1
1
[IF G2 NE 2 AND (S19g – m ALL NE 1)] Who initiated the sexual contact?
1
The staff person initiated it
2
I initiated it
DK/REF
DEFINE TOUCHING ONLY:
IF G11a=1 AND G11b=2 AND G11c=2 AND G11d=2 AND G11e=2
Then TOUCHING ONLY=1
Else TOUCHING ONLY=0
No
2
2
2
2
2
2
2
2
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
SI7
[IF TOUCHING ONLY=1] Did this incident happen as part of a strip search?
1
Yes
2
No
DK/REF
SI8
[IF TOUCHING ONLY=1 AND SI7 NE 1] Did this incident happen as part of a pat down?
1
Yes
2
No
DK/REF
SI10
During this [RECENT_FILL2] did one staff person or more than one staff person have sex or sexual contact
with you?
1 One staff person
2 More than one staff person
DK/REF
SI11
Do you think this [RECENT_FILL2] happened because of your…
SI11a. Race or ethnicity?
SI11b. Age?
SI11c. Religion?
SI11f. Gang affiliation?
SI11g. [IF TRANSID = 1OR D3c = 1 OR (D3d = 1 AND
D3e = 2 OR 3 OR 4) OR (D3d = 2 AND D3e = 1 OR 3 OR
4)]] Gender identity?
DK/REF
Yes
No
1
1
1
1
2
2
2
2
1
2
DEFINE SexualOrientationFill:
IF D2a=1, then SexualOrientationFill = “gay”
IF D2b=1, then SexualOrientationFill = “lesbian or gay”
IF D2a=3 OR D2b=3, then SexualOrientationFill = “bisexual”
SI32 [IF D2a=1 OR D2b=1 OR D2a=3 OR D2b=3] Do you think this [RECENT_FILL2] happened because you are
[SexualOrientationFill]?
1 Yes
2 No
DK/REF
SI12a
[IF SI10 = 1] Was the staff person male or female?
1 Male
2 Female
DK/REF
SI12b
[IF SI10 = 2 OR DK OR REF] Were any of the staff involved in this incident…
Attachment C: NIS-4P ACASI Instrument 4-20-2020
Yes
1
1
SI12b1. Male?
SI12b2. Female?
DK/REF
No
2
2
DEFINE StaffGenderFill1:
IF SI10=1 AND SI12a=1, then StaffGenderFill1 = “he”
IF SI10=1 AND SI12a=2, then StaffGenderFill1= “she”
IF SI10=2 OR DK OR REF, then StaffGenderFill1= “they”
DEFINE StaffGenderFill2:
IF SI10=1 AND SI12a=1, then StaffGenderFill2 = “his”
IF SI10=1 AND SI12a=2, then StaffGenderFill2= “her”
IF SI10=2 OR DK OR REF, then StaffGenderFill2= “their”
DEFINE StaffGenderFill3:
IF SI10=1 AND SI12a=1, then StaffGenderFill3 = “himself”
IF SI10=1 AND SI12a=2, then StaffGenderFill3= “herself”
IF SI10=2 OR DK OR REF, then StaffGenderFill3= “themselves”
SI13
[IF SI10 = 1] Was the staff person of Hispanic, Latino, or Spanish origin?
[IF SI10 = 2 OR DK OR REF] Were any of the staff of Hispanic, Latino, or Spanish origin?
1 Yes
2 No
DK/REF
SI14
[IF SI10 = 1] Was the staff person…
[IF SI10 = 2 OR DK OR REF] Were any of the staff…
SI14a. White?
SI14b. Black or African American?
SI14c. American Indian or Alaska Native?
SI14d. Asian?
SI14e. Native Hawaiian or other Pacific Islander?
DK/REF
SI15a
[IF SI10 = 1] How old was this staff person?
1 Under 25
2 25 – 34
3 35 – 44
4 45 – 54
5 55 or older
DK/REF
Yes
1
1
1
1
1
No
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
SI15b
[IF SI10 = 2 OR DK OR REF] Were any of the staff…
SI15b1. Older than you?
SI15b2. Younger than you?
SI15b3. About the same age as you?
DK/REF
SI15DK
Yes
1
1
1
No
2
2
2
[IF SI15a = DK] Was this staff person older than you, younger than you or about the same age as
you?
1 Older than you
2 Younger than you
3 About the same age as you
DK/REF
SI16a
[IF SI10 = 1] Was the staff person who had sexual contact with you…
SI16a1. A correctional officer?
SI16a2. Another staff person working in the facility?
SI16a3. A volunteer in the facility?
DK/REF
SI16b
No
2
2
2
[IF SI10 = 2 OR DK OR REF] Were any of the staff who had sexual contact with you…
SI16b1. Correctional officers?
SI16b2. Other staff working in the facility?
SI16b3. Volunteers in the facility?
DK/REF
SI17a
Yes
1
1
1
Yes
1
1
1
No
2
2
2
[IF SI10 = 1] Before the [RECENT_FILL2] happened, did any of these things ever happen?
SI17a1. The staff person talked to you about [StaffGenderFill2] personal
life outside of work?
SI17a2. The staff person gave you pictures of [StaffGenderFill3]?
SI17a3. The staff person wrote letters to you?
SI17a4. The staff person offered you things like drugs, cigarettes, alcohol,
or other things you are not allowed to have in this facility?
SI17a5. The staff person offered you money?
SI17a6. The staff person did things for you to help you get out of trouble?
SI17a7. The staff person spent time alone with you and asked that you not
tell anyone else about that time?
SI17a8. The staff person told you that [StaffGenderFill1] had special
feelings for you or was in love with you?
SI17a9. The staff person talked or joked with you about sex or shared
sexual stories with you?
DK/REF
Yes
1
No
2
1
1
1
2
2
2
1
1
1
2
2
2
1
2
1
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
SI17b
[IF SI10 = 2 OR DK OR REF] Before the [RECENT_FILL2] happened, did any of these things ever
happen?
SI17b1. One or more of the staff talked to you about his or her personal
life outside of work?
SI17b2. One or more of the staff gave you pictures of themselves?
SI17b3. One or more of the staff wrote letters to you?
SI17b4. One or more of the staff offered you things like drugs, cigarettes,
alcohol, or other things you are not allowed to have in this facility?
SI17b5. One or more of the staff offered you money?
SI17b6. One or more of the staff did things for you to help you get out of
trouble?
SI17b7. One or more of the staff spent time alone with you and asked that
you not tell anyone else about that time?
SI17b8. One or more of the staff told you that they had special feelings for
you or were in love with you?
SI17b9. One or more of the staff talked or joked with you about sex or
shared sexual stories with you?
DK/REF
SI18
Yes
1
No
2
1
1
1
2
2
2
1
1
2
2
1
2
1
2
1
2
During the [RECENT_FILL2] were you injured?
1
Yes
2
No
DK/REF
SI19
[IF SI18 = 1] How were you injured during the incident? Did you…
SI19a. Receive knife or stab wounds?
SI19b. Receive broken bones?
SI19c. [IF GENDER=1] Have anal tearing?
[IF GENDER=2] Have anal or vaginal tearing?
SI19d. Have your teeth chipped or knocked out?
SI19e Receive internal injuries?
SI19f. Get knocked unconscious?
SI19g. Receive bruises, a black eye, sprains, cuts, scratches, swelling,
welts, or burns?
DK/REF
SI20
Yes
1
1
1
No
2
2
2
1
1
1
1
2
2
2
2
[IF SI18 = 1] As a result of any of the injuries you received during this incident, did you see a doctor,
nurse, or other health care provider for any of the injuries you received?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
SI21
[IF SI10 = 1] Did this staff person do any of the following things after the incident happened?
[IF SI10 = 2 OR DK OR REF] Did any of the staff involved do any of the following things after the
[RECENT_FILL2] happened?
SI21a. Gave you gifts or money so that you would keep it secret?
SI21b. Threatened to hurt you so that you would keep it secret?
SI21c. Said [StaffGenderFill1] would blame it on you if you told
anyone?
SI21d. Said [StaffGenderFill1] would stop spending time with you if
you told anyone?
SI21e. Had sexual contact with you again?
SI21f. Ignored you or stayed away from you?
DK/REF
SI22
Yes
1
1
No
2
2
1
2
1
1
2
2
Did you report this [RECENT_FILL2] to anyone?
1
Yes
2
No
DK/REF
SI23
[IF SI22 = 1] Did you report the incident to…
SI23a. A correctional officer?
SI23b. An administrative staff person?
SI23c. A medical or healthcare staff person?
SI23d. An instructor or teacher?
SI23e. A counselor or other mental health care provider?
SI23f. A chaplain or other religious official?
SI23g. A volunteer?
SI23h. Some other type of facility staff person?
SI23i. A telephone hotline?
SI23j. Another inmate?
SI23k. A family member or friend?
DK/REF
SI24
Yes
1
1
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
2
2
At the time the [RECENT_FILL2] happened were any inmates aware that it was happening?
1 Yes
2 No
DK/REF
SI125
At the time the [RECENT_FILL2] happened were any other staff at the facility aware that it was
happening?
1 Yes
2 No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
SI26
[IF SI22 = 1] Did any of the following things happen to you as a result of the report you made?
SI26a. You were moved to administrative segregation or some other
protective housing?
SI26b. You were placed in a medical unit, ward, or hospital?
SI26c. You were confined to your own cell, room, or housing area?
SI26d. You were given a higher level of custody within the facility?
SI26e. You were offered a transfer to another facility?
SI26f. You were written up?
DK/REF
SI27a
1
1
1
1
1
2
2
2
2
2
Yes
1
1
1
No
2
2
2
1
1
1
2
2
2
[IF (SI10 = 2 OR DK OR REF) AND SI22 = 1] Did any of the following things happen to any of the
staff who had sex or sexual contact with you?
SI27b1. One or more of the staff were fired?
SI27b2. One or more of the staff were transferred to another
facility?
SI27b3. One or more of the staff were transferred to a different job
at this facility?
SI27b4. One or more of the staff were charged with a crime?
SI27b5. One or more of the staff were suspended for a period of
time?
SI27b6. One or more of the staff were punished or disciplined in
some way other than those listed above?
DK/REF
SI28
No
2
[IF SI10 = 1 AND SI22 = 1] Did any of the following things happen to the staff person who had sex
or sexual contact with you?
SI27a1. The staff person was fired?
SI27a2. The staff person was transferred to another facility?
SI27a3. The staff person was transferred to a different job at this
facility?
SI27a4. The staff person was charged with a crime?
SI27a5. The staff person was suspended for a period of time?
SI27a6. The staff person was punished or disciplined in some way
other than those listed above?
DK/REF
SI27b
Yes
1
Yes
1
1
No
2
2
1
2
1
1
2
2
1
2
[IF SI10 = 1] Since this [RECENT_FILL2] happened has this staff person attempted any type of
sexual contact with you?
[IF SI10 = 2 OR DK OR REF] Since this [RECENT_FILL2] happened have any of the staff
involved attempted any type of sexual contact with you?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
SI29
[IF SI10 = 1 AND SI28 NE 1] Since this [RECENT_FILL2] happened have you been worried that
this staff person will try to initiate sexual contact with you again?
[IF (SI10 = 2 OR DK OR REF) AND SI28 NE 1] Since this [RECENT_FILL2] happened have you
been worried that any of the staff involved would try to initiate sexual contact with you again?
1
Yes
2
No
DK/REF
SI30
Since this [RECENT_FILL2] happened, have you done any of the following things to reduce the
chance that you would have to have sexual contact again?
SI30a. Joined a gang?
SI30b. Carried a weapon?
SI30c. Fought more?
SI30d. Worked out in order to bulk up?
SI30e. Tried to make yourself look less attractive?
SI30f. Avoided certain areas?
SI30g. Kept to yourself more?
SI30h. Stayed in your own cell or housing area more?
SI30i. Joined a religious group?
SI30j. Avoided certain staff?
SI30k. Requested protective custody?
SI30l. Requested transfer to another facility?
DK/REF
Yes
1
1
1
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
OTHER VICTIMIZATON WHILE INCARCERATED
XINTRO
These next questions are about other things that may have happened to you in this facility.
Touch the NEXT button to go to the next screen.
X6a DOAFILL1, have you been written up or charged with assaulting another inmate?
1
Yes
2
No
DK/REF
X7a DOAFILL1, have you been written up or charged with physically assaulting a correctional officer or other
facility staff person?
1
Yes
2
No
DK/REF
X8a DOAFILL1, have you been written up or charged with verbally assaulting a correctional officer or other
facility staff person?
1
Yes
2
No
DK/REF
LCM5 DOAFILL1, have you had any sex or sexual contact with staff in this facility whether you wanted to have it
or not?
1
Yes
2
No
DK/REF
LCM6a How long has it been since you had any sex or sexual contact with staff in this facility whether you wanted to
or not?
1
Within the past 7 days
2
More than 7 days ago but within the past 30 days
3
More than 30 days ago but within the past 12 months
4
More than 12 months ago
5
This has not happened to me at this facility
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PAT DOWNS AND STRIP SEARCHES
L0
These next questions are about your experiences with strip searches and pat downs at this facility.
Touch the NEXT button to go to the next screen.
L23
[IF G11a = 1] Earlier you reported that, DOAFILL2, you touched a facility staff person’s body or had your
body touched in a sexual way. Did this happen as part of a strip search?
1
Yes
2
No
DK/REF
L23a
[IF L23 = 1] On any occasion DOAFILL2 when you touched a facility staff person’s body or had your body
touched in a sexual way as part of a strip search, was the strip search conducted by…
L23a1. Male facility staff?
L23a2. Female facility staff?
DK/REF
L24
Yes
1
1
No
2
2
[IF G11a = 1] DOAFILL1, when you touched a facility staff person’s body or had your body touched in a
sexual way, did this happen when it was not part of a strip search?
1
Yes
2
No
DK/REF
L25
[IF G11a = 1] DOAFILL1, when you touched a facility staff person’s body or had your body touched in a
sexual way, did this happen as part of a pat down?
1
Yes
2
No
DK/REF
L25a
[IF L25 = 1] On any occasion DOAFILL2 when you touched a facility staff person’s body or had your body
touched in a sexual way as part of a pat down, was the pat down conducted by…
L25a1. Male facility staff?
L25a2. Female facility staff?
DK/REF
L26
Yes
1
1
No
2
2
[IF G11a = 1] DOAFILL1, when you touched a facility staff person’s body or had your body touched in a
sexual way, did this happen when it was not part of a pat down?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
FACILITY CONDITIONS, SUPPORT AND SAFETY
S0
These next questions are about everyday living in this facility.
Touch the NEXT button to go to the next screen.
S1
Are there inmates in this facility who you think of as your friends?
1
Yes
2
No
DK/REF
S2
Are there inmates in this facility who you can talk to about your personal problems?
1
Yes
2
No
DK/REF
S3
Are there inmates in this facility who would protect you if another inmate was trying to hurt you?
1
Yes
2
No
DK/REF
S4
Are there correctional officers or other staff at this facility who you can talk to about your problems?
1
Yes
2
No
DK/REF
S5
Are there correctional officers or other staff at this facility who would protect you if another inmate was trying
to hurt you?
1
Yes
2
No
DK/REF
S6
How crowded is it in your housing unit?
1
Not at all crowded
2
Slightly crowded
3
Pretty crowded
4
Very crowded
DK/REF
S7
How crowded is it outside of the housing units – for example, in the dining hall, classrooms, gym, or work
areas?
1
Not at all crowded
2
Slightly crowded
3
Pretty crowded
4
Very crowded
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
S8
How much privacy do you have in your housing unit?
1
None
2
A little
3
Some
4
A lot
DK/REF
S9
Please indicate whether you agree or disagree with each of the following statements.
Staff at this facility…
S9a. Are generally fair?
S9b. Do their best to make this facility safe and secure?
S9c. Try to meet the needs of the inmates?
S9d. Break up fights quickly?
S9e. Use physical force only when necessary?
S9f. Let inmates know what is expected of them?
S9g. Generally treat inmates with respect?
S9h. Follow facility rules when handling inmate complaints and
grievances?
S9i. Often write up inmates who don’t deserve it?
DK/REF
S13
Agree
1
1
1
1
1
1
1
1
Disagree
2
2
2
2
2
2
2
2
1
2
DOAFILL1, how often have inmates at this facility been hit, punched, or assaulted by other inmates?
1
Frequently
2
Sometimes
3
Rarely
4
Never
DK/REF
S14
DOAFILL1, how often have you worried about being hit, punched, or assaulted by other inmates in this
facility?
1
2
3
4
Frequently
Sometimes
Rarely
Never
DK/REF
S15
DOAFILL1, how often have you seen other inmates with some type of weapon?
1
Frequently
2
Sometimes
3
Rarely
4
Never
DK/REF
S16
DOAFILL1, how much gang activity has there been at this facility?
1
2
3
4
DK/REF
None
A little
Some
A lot
Attachment C: NIS-4P ACASI Instrument 4-20-2020
S17
DOAFILL1, have you been in a fight, assault, or incident in which another inmate tried to harm you?
1
Yes
2
No
DK/REF
S18
[IF S17 = 1] DOAFILL1, how many times have you been in a fight, assault, or other incident in which
another inmate tried to harm you?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
S36
[IF S17 = 1] DOAFILL1, what injuries have you received in a fight, assault, or incident in which another
inmate hurt you?
S36a. You received knife or stab wounds?
S36b. You received broken bones?
S36c. Your teeth were chipped or knocked out?
S36d You received internal injuries?
S36e. You were knocked unconscious?
S36f. You received bruises, a black eye, sprains, cuts, scratches,
swelling, welts, or burns?
DK/REF
S37
Yes
1
1
1
1
1
No
2
2
2
2
2
1
2
[IF S36a = 1 OR S36b = 1 OR S36c = 1 OR S36d = 1 OR S36e = 1 OR S36f = 1] Did you see a doctor, nurse,
or other health care provider for your injuries?
1
Yes
2
No
DK/REF
S21
DOAFILL1, have you been in a fight, assault, or incident in which a correctional officer or other facility
staff person tried to harm you?
1
Yes
2
No
DK/REF
S22
[IF S21 = 1] DOAFILL1, how many times have you been in a fight, assault, or incident in which a
correctional officer or other facility staff person tried to harm you?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
S34
[IF S21 = 1] DOAFILL1, what injuries have you received in a fight, assault, or incident in which a
correctional officer or other facility staff person tried to harm you?
S34a. You received knife or stab wounds?
S34b. You received broken bones?
S34c. Your teeth were chipped or knocked out?
S34d You received internal injuries?
S34e. You were knocked unconscious?
S34f. You received bruises, a black eye, sprains, cuts, scratches,
swelling, welts, or burns?
DK/REF
S35
Yes
1
1
1
1
1
No
2
2
2
2
2
1
2
[IF S34a = 1 OR S34b = 1 OR S34c = 1 OR S34d = 1 OR S34e = 1 OR S34f = 1] Did you see a doctor, nurse,
or other health care provider for your injuries?
1
Yes
2
No
DK/REF
S25
DOAFILL1, have any of your personal possessions or belongings been taken by another inmate without your
permission?
1
Yes
2
No
DK/REF
S26
[IF S25 = 1] DOAFILL1, how many times have any of your personal possessions or belongings been taken
by another inmate without your permission?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
S29
DOAFILL1, do you think there has been enough staff at this facility to keep inmates safe?
1
Yes
2
No
DK/REF
S30
DOAFILL1, have you filed a grievance for any reason?
1
Yes
2
No
DK/REF
S31
[IF S30 = 1] DOAFILL1, how many times have you filed a grievance for any reason?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
MENTAL HEALTH
R1
The next questions are about how you have been feeling during the past 30 days.
About how often during the past 30 days did you feel nervous?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
R2
During the past 30 days, about how often did you feel hopeless?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
R3
During the past 30 days, about how often did you feel restless or fidgety?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
R4
How often in the past 30 days did you feel so depressed that nothing could cheer you up?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
R5
About how often in the past 30 days did you feel that everything was an effort?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
R6
About how often in the past 30 days did you feel worthless?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
R24
Have you ever been told by a mental health professional, such as a psychiatrist or psychologist, that you
had…
R24a. Manic depression, a bipolar disorder, or mania?
R24b. A depressive disorder?
R24c. Schizophrenia or another psychotic disorder?
R24d. Post-traumatic stress disorder or PTSD?
R24e. Another anxiety disorder, such as panic disorder or OCD?
R24f. A personality disorder, such as antisocial or borderline
personality?
R24g. A mental or emotional condition other than those listed above?
DK/REF
R25
Yes
1
1
1
1
1
1
No
2
2
2
2
2
2
1
2
The next questions are about any times you may have stayed overnight in any type of hospital or other facility
for any problem with your emotions, nerves, or mental health. Please do not include any overnight hospital
stays for alcohol or drug use.
Touch the NEXT button to go to the next screen.
R26
Have you ever stayed overnight or longer in any type of hospital or other facility to receive treatment or
counseling for any problem you were having with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF
R27
[IF R26 = 1] During the 12 months before you were admitted to any facility to serve time on your current
sentence, did you stay overnight or longer in any type of hospital or other facility to receive treatment or
counseling for problems you were having with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF
R28
The next questions are about services you may have received for any problem with your emotions, nerves, or
mental health. As you answer these questions please do not include any services you may have received for
drug or alcohol use. Some questions ask about prescription medicine. Prescription medicines are drugs that
you take if a doctor authorizes them for you.
Touch the NEXT button to go to the next screen.
R29
Have you ever taken any prescription medicine for any problem you were having with your emotions, nerves,
or mental health?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
R30
[IF B4 = 1 AND R29 = 1] At the time of the offense for which you are currently sentenced and serving time,
were you taking prescription medicine for any problem you were having with your emotions, nerves, or
mental health?
[IF B4 = 2 OR DK OR REF AND R29 = 1] At the time of the offense for which you are currently being
held, were you taking prescription medicine for any problem you were having with your emotions, nerves, or
mental health?
1
Yes
2
No
DK/REF
R31
[IF R29 = 1] Since you were admitted to any facility to serve time on your current sentence, have you taken
prescription medicine for any problem you were having with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF
R33
Have you ever received counseling or therapy from a trained professional such as a psychiatrist, psychologist,
social worker, or nurse for any problem you were having with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF
R34
[IF R33 = 1] Since you were admitted to any facility to serve time on your current sentence, have you
received counseling or therapy from a trained professional such as a psychiatrist, psychologist, social worker,
or nurse for any problem you were having with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF
R21
Did you ever in your life have any of the following experiences happen to you:
R21a. A serious fight or physical assault?
R21b. A sexual assault?
R21c. A life-threatening accident or injury?
R21d. The murder or suicide of a loved one?
R21e. The accidental death of a loved one?
R21f. Witnessed someone being seriously
injured or killed?
R21g. Any experience that put you at risk of
death?
DK/REF
Yes
1
1
1
1
1
1
No
2
2
2
2
2
2
1
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DISABILITY STATUS
Q0 The next questions are about difficulties that you might have due to a physical, mental, or emotional problem.
Touch the NEXT button to go to the next screen.
Q1
Are you deaf, or do you have serious difficulty hearing?
1 Yes
2 No
DK/REF
Q2
Are you blind, or do you have serious difficulty seeing even when wearing glasses?
1 Yes
2 No
DK/REF
Q3
Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating,
remembering, or making decisions?
1 Yes
2 No
DK/REF
Q4
Do you have serious difficulty walking or climbing stairs?
1 Yes
2 No
DK/REF
Q5
Do you have difficulty dressing or bathing?
1 Yes
2 No
DK/REF
Q6
Because of a physical, mental, or emotional problem, do you have difficulty doing activities on your own,
such as going to meal time, going outside, working in or outside of this facility, going to classes, or attending
programs?
1 Yes
2 No
DK/REF
Q7
[IF Q1 OR Q2 OR Q3 OR Q4 OR Q5 OR Q6 = 1] Is the difficulty you experience doing activities on your
own caused by…
Q7a. A physical problem?
Q7b. A mental or emotional problem?
DK/REF
Yes
1
1
No
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
Q8. Did a doctor, school counselor, or other professional ever tell you that you have…
Q8a. ADD or ADHD?
Q8b. Dyslexia?
Q8c. A learning disability?
Q8d. Autism or Asperger’s?
DK/REF
Yes
1
1
1
1
No
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PARENTAL INVOLVEMENT
PIV1
Is your biological mother - that is, the woman who gave birth to you - still alive?
1
Yes
2
No
DK/REF
PIV2
[IF PIV1 = 2] How old were you when your biological mother died?
If you were less than a year old when she died, please enter 0.
AGE: __________[RANGE: 0 – CALCAGE]
DK/REF
PIV3 [IF CALCAGE GT 17 AND (PIV1 = 1 OR PIV2 GT 17)] Thinking about your biological mother and her
involvement in your life before you turned 18, would you say she was very involved, somewhat involved,
or not at all involved?
[IF CALCAGE GT 17 AND PIV2 = 6 - 17] Thinking about your biological mother and her involvement in
your life before she died, would you say she was very involved, somewhat involved, or not at all involved?
[IF CALCAGE = 16 OR 17 AND PIV1 = 1] Thinking about your biological mother and her involvement in
your life, would you say she has been very involved, somewhat involved, or not at all involved?
[IF CALCAGE = 16 OR 17 AND PIV2 GT 5] Thinking about your biological mother and her involvement
in your life before she died, would you say she was very involved, somewhat involved, or not at all
involved?
1
Very involved
2
Somewhat involved
3
Not at all involved
DK/REF
PIV4
Do you know the identity of your biological father?
1
Yes
2
No
DK/REF
PIV5
[IF PIV4 = 1] Is your biological father still alive?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PIV6
[IF PIV5 = 2] How old were you when your biological father died?
If you had not been born or were less than a year old when he died, please enter 0.
AGE:
[RANGE: 0 – CALCAGE]
DK/REF
PIV7 [IF CALCAGE GT 17 AND (PIV5 = 1 OR PIV6 GT 17)] Thinking about your biological
father and his involvement in your life before you turned 18, would you say he was very
involved, somewhat involved, or not at all involved?
[IF CALCAGE GT 17 AND PIV6 = 6 - 17] Thinking about your biological father and his
involvement in your life before he died, would you say he was very involved, somewhat
involved, or not at all involved?
[IF CALCAGE = 16 OR 17 AND PIV5 = 1] Thinking about your biological father and his
involvement in your life, would you say he has been very involved, somewhat involved, or not
at all involved?
[IF CALCAGE = 16 OR 17 AND PIV6 GT 5] Thinking about your biological father and his
involvement in your life before he died, would you say he was very involved, somewhat
involved, or not at all involved?
1
Very involved
2
Somewhat involved
3
Not at all involved
DK/REF
PIV8
[IF PIV4 = 1] Were your biological parents married to each other at the time you were born?
1
Yes
2
No
DK/REF
PIV9 [IF CALCAGE GT 17 AND PIV8 = 2 OR DK/REF] At any time between when you were born
and when you turned 18, were your biological parents married to each other?
[IF CALCAGE = 16 OR 17 AND PIV8 = 2 OR DK/REF] At any time between when you were
born and now, have your biological parents been married to each other?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PIV10 [IF CALCAGE GT 17 AND (PIV8 = 1 OR PIV9 = 1)] At any time between when you were
born and when you turned 18, did your biological parents get divorced?
[IF CALCAGE = 16 OR 17 AND (PIV8 = 1 OR PIV9 = 1)] At any time between when you
were born and now, did your biological parents get divorced?
1
Yes
2
No
DK/REF
PIV11 [IF (PIV8 = 1 OR PIV9 = 1)] Between the time you were born and when you turned
[min(18,CALCAGE)], about how long were your biological parents married to each other?
1
2
3
Less than 3 years
At least 3 years but less than 10 years
At least 10 years but less than CALCAGE years
4
CALCAGE years
DK/REF
PIV12 [IF CALCAGE GT 17 AND (PIV4=2 OR PIV6 < 6 OR PIV7 = 2 OR 3 OR DK/REF)] Before you
turned 18 was there another man who was like a father to you?
[IF CALCAGE = 16 OR 17 AND (PIV4=2 OR PIV6 < 6 OR PIV7 = 2 OR 3 OR DK/REF)] Is
there another man who has been like a father to you while you’ve been growing up?
1
Yes
2
No
DK/REF
PIV13 [IF PIV12 = 1 AND CALCAGE GT 17] Who was the other man who was most like a father to
you before you turned 18?
[IF PIV12 = 1 AND CALCAGE = 16 OR 17] Who is the other man who has been most like a
father to you while you’ve been growing up?
1 An adoptive father
2 A stepfather
3 A foster father
4 Your mother’s boyfriend
5 A grandfather
6 An uncle
7 A brother, including a stepbrother or half-brother
8 A cousin
9 A minister or member of the clergy
10 A teacher
11 A neighbor
12 Some other man
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PIV14 Were you living with a male parent or a male parent-figure at the time you were 14 years old?
1
2
Yes
No
DK/REF
PIV15 [IF PIV14 = 1] Who was the male parent or male parent-figure you were living with when you
were 14 years old?
1
Your biological father
2
Your adoptive father
3
Your stepfather
4
A foster father
5
Your mother’s boyfriend
6
Your grandfather
7
Your uncle
8
Some other male parent-figure
DK/REF
PIV16 Were you living with a female parent or a female parent-figure at the time you were 14 years old?
1
Yes
2
No
DK/REF
PIV17 [IF PIV16 = 1] Who was the female parent or female parent-figure you were living with when
you were 14 years old?
1
Your biological mother
2
Your adoptive mother
3
Your stepmother
4
A foster mother
5
Your father’s girlfriend
6
Your grandmother
7
Your aunt
8
Some other female parent-figure
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
RESTRICTIVE HOUSING
RH0
Next, we would like to know about your experiences with solitary confinement at this facility.
Solitary confinement can include administrative or disciplinary segregation and may also be called
secure housing, the hole, lockdown, the SHU, or protective custody.
Touch the NEXT button to go to the next screen.
RH1
[IF A9a = 2 OR DK OR REF] DOAFILL1, have you spent any time in disciplinary or
administrative segregation, or solitary confinement?
1
Yes
2
No
DK/REF
RH2
[GO TO NEXT MODULE]
[GO TO NEXT MODULE]
[IF A9a = 1 OR RH1 = 1] DOAFILL1, how many different times have you been placed in
disciplinary or administrative segregation, or solitary confinement?
1
1 time
2
2 times
3
3 - 5 times
4
6 – 10 times
5
11 times or more
DK/REF
RH3
[IF RH2 = 1 OR DK OR REF] DOAFILL1, how many days did you spend in disciplinary or
administrative segregation, or solitary confinement?
[IF RH2 > 1] DOAFILL1, how many days altogether have you spent in disciplinary or
administrative segregation, or solitary confinement?
1
1 day or less
2
More than 1 day but less than 7 days
3
At least 7 days but less than 14 days
4
At least 14 days but less than 30 days
5
30 days or more
DK/REF
RH4
[IF RH1 = 1] Please think about the [IF RH2 > 1, INCLUDE “most recent”] time DOAFILL2
that you were placed in disciplinary or administrative segregation, or solitary confinement. Why
do you think you were placed in disciplinary or administrative segregation, or solitary
confinement? Was it…
[IF A9a = 1] Why do you think you have been assigned to disciplinary or administrative
segregation, or solitary confinement? Is it…
RH4a. Because you were a danger to yourself?
RH4b. For mental health reasons?
RH4c. For medical reasons?
RH4d. Because you asked to be placed there for your own protection?
RH4e. As a punishment for breaking rules?
RH4f. For a cool down period?
RH4g. For some other reason?
DK/REF
Yes
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
RH7
[IF RH1 = 1 AND RH2 > 1] How long did you remain in disciplinary or administrative
segregation, or solitary confinement the most recent time you were placed there?
1
1 day or less
2
More than 1 day but less than 7 days
3
At least 7 days but less than 14 days
4
At least 14 days but less than 30 days
5
30 days or more
DK/REF
RH10
[IF RH1 = 1] Were you able to leave your cell at least once every day the [IF RH2>1, INCLUDE
“most recent” ] time you were in disciplinary or administrative segregation, or solitary
confinement?
[IF A9a = 1] Are you able to leave your cell at least once every day?
1
Yes
2
No
DK/REF
RH13
[IF RH1 = 1] Were you able to talk to staff every day while you were in disciplinary or
administrative segregation, or solitary confinement [IF RH2>1, INCLUDE “this most recent
time”]?
[IF A9a = 1] Are you able to talk to staff every day in disciplinary or administrative segregation or
solitary confinement?
1
Yes
2
No
DK/REF
RH14
[IF RH1 = 1] Did a trained counselor or mental health professional check on you while you were
in disciplinary or administrative segregation, or solitary confinement [IF RH2>1, INCLUDE “this
most recent time”]?
[IF A9a = 1] Has a trained counselor or mental health professional checked on you while you have
been in disciplinary or administrative segregation, or solitary confinement?
1
Yes
2
No
DK/REF
RANDOM = 95, SKIP TO M0
Attachment C: NIS-4P ACASI Instrument 4-20-2020
CHILDHOOD EXPERIENCES
CE1
Next, we’ll ask about some experiences you may have had growing up.
Which of the following experiences did you have before age 18?
CE1a Did your mother or father die before you were 18?
CE1b Did your parents separate or divorce before you were 18?
CE1c Did either parent attempt or commit suicide?
CE1d Was either parent in prison or jail for 6 months or longer?
CE1e Did either parent, or person who raised you, have a mental illness?
CE1f Did either parent, or person who raised you, have an alcohol or drug problem?
CE1g Were you sent to a juvenile detention center?
DK/REF
CE2
Yes
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
[IF CALCAGE GT 17] At any time before you turned 18 did you live…
[IF CALCAGE = 16 OR 17] At any time since you were born have you lived…
Yes
1
1
1
CE2a With your biological mother?
CE2b With your biological father?
CE2c In a foster home?
DK/REF
CE3
No
2
2
2
[IF CALCAGE GT 17] How often did you do each of the following things before age 18?
[IF CALCAGE = 16 OR 17] How often have you done each of the following things?
_CE3a.Bully or threaten other kids?
CE3b. Start fights?
CE3c. Run away from home and stay away
overnight?
CE3d. Lie, or “con” other people?
CE3e. Set fires?
CE3f. Stay out very late, long after you were
supposed to be home?
CE3g. Skip school?
DK/REF
Very
Often
1
1
Often
Sometimes
Rarely
Never
2
2
3
3
4
4
5
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
Attachment C: NIS-4P ACASI Instrument 4-20-2020
CE4
[IF CALCAGE GT 17] How often did you do each of the following things before age 18?
[IF CALCAGE = 16 OR 17] How often have you done each of the following things?
CE4a Argue, or “talk back,” to adults?
CE4b Disobey rules at home, school, or work?
CE4c Refuse to follow directions from adults
like your parents, teacher, or boss?
CE4d Blame others for your mistakes or bad
behavior?
CE4e Do mean things to “pay people back”
for things they did that you didn’t like?
DK/REF
CE5
Very
Often
1
1
Often
Sometimes
Rarely
Never
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
[IF CALCAGE GT 17] How often did you have each of the following experiences before age
18?
[IF CALCAGE = 16 OR 17] How often have you had each of the following experiences?
CE5a Your family was on welfare?
CE5b You were homeless?
CE5c You had to do chores too hard or
dangerous for someone your age?
CE5d You didn’t have anyone who would take
care of you or protect you?
CE5e Nobody ensured you had adequate food
or clothing or medical care?
CE5f Someone touched you or made you
touch them in a sexual way against your
will?
CE5g You were sexually abused at home?
CE5h You were beaten up or terrorized by
bullies at school or in the
neighborhood?
DK/REF
Very
Often
1
1
Often
Sometimes
Rarely
Never
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Attachment C: NIS-4P ACASI Instrument 4-20-2020
CE6
[IF CALCAGE GT 17] How often did you have each of the following experiences before age 18?
[IF CALCAGE = 16 OR 17] How often have you had each of the following experiences?
CE6a Someone in your family hit you so hard
that it left bruises or marks?
CE6b You were physically abused at home?
CE6c You felt that someone in your family
hated you?
CE6d You were emotionally abused at home?
CE6e People in your family said hurtful or
insulting things to you?
CE6f Someone in your family made you feel
important?
CE6g You felt loved and cared for?
CE6h Your family was a source of strength
and support?
DK/REF
Very
Often
Often
Sometimes
Rarely
Never
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Attachment C: NIS-4P ACASI Instrument 4-20-2020
LIVING AREA AND ACTIVITIES
DEFINE A9c_FILL:
IF A9c=1, A9c_FILL= “an open dorm”
IF A9c=2, A9c_FILL= “a dorm with cubicles”
IF A9c=3, A9c_FILL= “a unit with cells”
IF A9c=4, A9c_FILL= “a unit with rooms”
IF A9c=5, A9c_FILL= “an area not originally intended as housing, such as a gym, classroom, or
day room”
LA_2
These questions are about this prison and how inmates are housed here.
[IF A9c = 1 OR 2 OR 3 OR 4 OR 5]: Earlier you said you spent last night in [A9c_FILL].
Including you, about how many inmates are currently housed in this housing unit?
[IF A9c=6 OR DK OR REF]: Including you, about how many inmates are currently housed in the
housing unit where you spent last night?
1
1
2
2-5
3
6 - 10
4
11 - 15
5
16 - 30
6
31 or more
DK/REF
LA_3
Does your housing unit have any windows that allow the sun to shine in during the day?
1
Yes
2
No
DK/REF
LA_4
How noisy is it in your housing unit during sleeping hours?
1
Not at all noisy
2
Slightly noisy
3
Pretty noisy
4
Very noisy
DK/REF
LA_17 How crowded is it in your housing unit?
1
Not at all crowded
2
Slightly crowded
3
Pretty crowded
4
Very crowded
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
LA_18 How much privacy do you have in your housing unit?
1
None
2
A little
3
Some
4
A lot
DK/REF
LA_5
How often is it too hot in your housing unit?
1
All of the time
2
Most of the time
3
Some of the time
4
Never
DK/REF
LA_6
How often is it too cold in your housing unit?
1
All of the time
2
Most of the time
3
Some of the time
4
Never
DK/REF
LA_7
How often do you see mice, rats, bugs, or insects in your housing unit?
1
All of the time
2
Most of the time
3
Some of the time
4
Never
DK/REF
LA_19 How crowded is it in other parts of the facility, outside of your housing unit – for example, in the
dining hall, classrooms, gym, or work areas?
1
Not at all crowded
2
Slightly crowded
3
Pretty crowded
4
Very crowded
DK/REF
LA_8
During the last 24 hours, about how many hours did you spend in your housing unit? Please
include time when you were sleeping.
NUMBER OF HOURS: __________ [RANGE: 1 – 24]
DK/REF
LA_9
During the last 24 hours, did you spend any time outdoors?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
LA_10 [IF LA_9 = 1] During the last 24 hours, about how much time did you spend outdoors?
1
Less than 30 minutes
2
At least 30 minutes but less than 1 hour
3
At least 1 hour but less than 2 hours
4
At least 2 hours but less than 5 hours
5
5 hours or more
DK/REF
LA_11 During the past 24 hours, about how many hours did you spend sleeping?
1
Less than 30 minutes
2
At least 30 minutes but less than 1 hour
3
At least 1 hour but less than 2 hours
4
At least 2 hours but less than 5 hours
5
At least 5 hours but less than 7 hours
6
At least 7 hours but less than 9 hours
7
9 hours or more
DK/REF
LA_12 The next questions are about how you spend your time at this prison. Please think about how you
spent the last 24 hours.
During the last 24 hours, did you…
LA_12a. Attend a class or training?
LA_12b. Exercise or work out?
LA_12c. Watch television?
LA_12d. Read books, newspapers or magazines?
LA_12e. Work at a job?
LA_12f. Participate in religious meetings or activities?
LA_12g. Have in-person visits with family or friends?
LA_12h. Talk on the telephone with family or friends?
LA_12i. Play games like cards, chess, checkers, or sports with other
inmates?
LA_12j. Talk with your lawyer – either in person or on the telephone?
LA_12k. Visit the library?
LA_12l. Visit the infirmary or medical ward?
DK/REF
Yes
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
1
1
1
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
LA_14 Now think about how you spent your time during the past 7 days. Did you do any of the
following things during the past 7 days?
LA_14a. [IF LA_12a = 2 OR DK OR REF] Attend a class or training?
LA_14b. [IF LA_12b = 2 OR DK OR REF] Exercise or work out?
LA_14c. [IF LA_12c = 2 OR DK OR REF] Watch television?
LA_14d. [IF LA_12d = 2 OR DK OR REF] Read books, newspapers or
magazines?
LA_14e. [IF LA_12e = 2 OR DK OR REF] Work at a job?
LA_14f. [IF LA_12f = 2 OR DK OR REF] Participate in religious
meetings or activities
LA_14g. [IF LA_12g = 2 OR DK OR REF] Have in-person visits with
family or friends?
LA_14h. [IF LA_12h = 2 OR DK OR REF] Talk on the telephone with
family or friends?
LA_14i. [IF LA_12i = 2 OR DK OR REF] Play games with other
inmates such as cards, chess, checkers, or sports?
LA_14j. [IF LA_12j = 2 OR DK OR REF] Talk with your lawyer – either
in person or on the telephone?
LA_14k. [IF LA_12k = 2 OR DK OR REF] Visit the library?
LA_14l. [IF LA_12l = 2 OR DK OR REF] Visit the infirmary or medical
ward?
DK/REF
Yes
1
1
1
1
No
2
2
2
2
1
1
2
2
1
2
1
2
1
2
1
2
1
1
2
2
LA_15 How would you describe the amount of food you currently receive at this facility?
1
There is too much food
2
There is just the right amount of food
3
There is not enough food
DK/REF
LA_16 How would you describe the quality of the food you currently receive at this facility?
1
Excellent
2
Very good
3
Good
4
Fair
5
Poor
DK/REF
LA_20 Are there inmates in this facility who you think of as your friends?
1
Yes
2
No
DK/REF
LA_21 Are there inmates in this facility who you can talk to about your problems?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
LA_22 Are there inmates in this facility who would protect you if another inmate was trying to hurt you?
1
Yes
2
No
DK/REF
LA_23 Are there correctional officers or other staff at this facility who you can talk to about your personal
problems?
1
Yes
2
No
DK/REF
LA_24 Are there correctional officers or other staff at this facility who would protect you if another
inmate was trying to hurt you?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
ALTERCATIONS, FIGHTS AND GRIEVANCES
AFG2 These next questions are about violence in this facility.
DOAFILL1, how often have inmates at this facility been hit, punched, or assaulted by other
inmates?
1
Frequently
2
Sometimes
3
Rarely
4
Never
DK/REF
AFG3 DOAFILL1, how often have you worried about being hit, punched, or assaulted by other inmates
in this facility?
1
Frequently
2
Sometimes
3
Rarely
4
Never
DK/REF
AFG4 DOAFILL1, how often have you seen other inmates with some type of weapon?
1
Frequently
2
Sometimes
3
Rarely
4
Never
DK/REF
AFG5 DOAFILL1, how often has there been gang activity at this facility?
1
Frequently
2
Sometimes
3
Rarely
4
Never
DK/REF
AFG6
DOAFILL1, have you been in a fight, assault, or incident in which another inmate tried to
harm you?
1
Yes
2
No
DK/REF
AFG7
[IF AFG6 = 1] DOAFILL1, how many times have you been in a fight, assault, or other
incident in which another inmate tried to harm you?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
AFG8
[IF AFG6 = 1 AND AFG7 = 1] DOAFILL1, what injuries did you receive in the fight,
assault, or incident in which another inmate tried to harm you?
[IF AFG6 = 1 AND AFG7 = 2 OR 3 OR 4 OR DK OR REF] DOAFILL1, what injuries
did you receive during any of the fights, assaults, or incidents in which another inmate
tried to harm you?
AFG8a. You received knife or stab wounds?
AFG8b. You received broken bones?
AFG8c. Your teeth were chipped or knocked out?
AFG8d. You received internal injuries?
AFG8e. You were knocked unconscious?
AFG8f. You received bruises, a black eye, sprains, cuts, scratches,
swelling, welts, or burns?
DK/REF
AFG9
Yes
1
1
1
1
1
1
No
2
2
2
2
2
2
[IF AFG8a = 1 OR AFG8b = 1 OR AFG8c = 1 OR AFG8d = 1 OR AFG8e = 1 OR AFG8f
= 1] Did you see a doctor, nurse, or other health care provider for your injuries?
1
Yes
2
No
DK/REF
AFG10
DOAFILL1, have you been in a fight, assault, or incident in which a correctional officer
or other facility staff person tried to harm you?
1
Yes
2
No
DK/REF
AFG11
[IF AFG10 = 1] DOAFILL1, how many times have you been in a fight, assault, or
incident in which a correctional officer or other facility staff person tried to harm you?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
AFG12
[IF AFG10 = 1 AND AFG11 = 1] DOAFILL1, what injuries did you receive in the
fight, assault, or incident in which a correctional officer or other facility staff person
tried to harm you?
[IF AFG10 = 1 AND AFG11 = 2 OR 3 OR 4 OR DK OR REF] DOAFILL1, what
injuries did you receive in any of the fights, assaults, or incidents in which a correctional
officer or other facility staff person tried to harm you?
AFG12a. You received knife or stab wounds?
AFG12b. You received broken bones?
AFG12c. Your teeth were chipped or knocked out?
AFG12d. You received internal injuries?
AFG12e. You were knocked unconscious?
AFG12f. You received bruises, a black eye, sprains, cuts, scratches,
swelling, welts, or burns?
DK/REF
AFG13
Yes
1
1
1
1
1
1
No
2
2
2
2
2
2
[IF AFG12a = 1 OR AFG12b = 1 OR AFG12c = 1 OR AFG12d = 1 OR AFG12e = 1 OR
AFG12f = 1] Did you see a doctor, nurse, or other health care provider for your injuries?
1 Yes
2 No
DK/REF
AFG14
DOAFILL1, have any of your personal possessions or belongings been taken by another
inmate without your permission?
1
Yes
2
No
DK/REF
AFG15
[IF AFG14 = 1] DOAFILL1, how many times have any of your personal possessions or
belongings been taken by another inmate without your permission?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
AFG16
DOAFILL1, do you think there has been enough staff at this facility to keep inmates
safe?
1
Yes
2
No
DK/REF
AFG17 DOAFILL1, have you filed a grievance for any reason?
1
Yes
2
No
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
AFG18
[IF AFG17 = 1] DOAFILL1, how many times have you filed a grievance for any
reason?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF
AFG1 DOAFILL1, have you been written up or charged with…
AFG1a. A drug violation, such as possession, use, or dealing in drugs?
AFG1b. Possession of a weapon?
AFG1c. Possession of stolen property?
AFG1d. Possession of any other unauthorized substance or item?
AFG1e. Verbal assault on a correctional officer or other staff
member?
AFG1f. Physical assault on a correctional officer or other staff
member?
AFG1g. Verbal assault on another inmate?
AFG1h. Physical assault on another inmate?
AFG1i. Escape or attempted escape?
AFG1j. Any other major violation, including work slowdowns, food
strikes, setting fires, rioting, etc.?
AFG1k. Any minor violations relating to facility orderliness and
operation, such as use of abusive language, horseplay, failing to follow
sanitary regulations, etc.?
DK/REF
Yes
1
1
1
1
1
No
2
2
2
2
2
1
2
1
1
1
1
2
2
2
2
1
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
WORK ASSIGNMENTS
WA1
Now think about work assignments at this facility.
Do you currently have a work assignment outside this prison facility for which you leave the
prison grounds?
1
2
Yes
No
DK/REF
WA2
[IF WA1 = 1] For how many weeks have you been working at this work assignment that requires
you to leave the prison grounds?
1
2
3
4
Less than 1 week
1 – 5 weeks
6 – 12 weeks
13 weeks or longer
DK/REF
WA3
[IF WA1 = 1] In the past 7 days, about how many hours did you work outside the prison facility?
1
2
3
4
5
1 – 8 hours
9 – 16 hours
17 – 24 hours
25 – 32 hours
33 hours or more
DK/REF
WA4
Do you currently have a work assignment inside this prison or on the grounds of the prison?
1
2
Yes
No
DK/REF
WA5
[IF WA4 = 1] For how many weeks have you been working at this work assignment inside the
prison or on the grounds of the prison?
1
2
3
4
Less than 1 week
1 – 5 weeks
6 – 12 weeks
13 weeks or longer
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
WA6
[IF WA4 = 1] In the past 7 days, about how many hours did you work inside this prison or on the
grounds of the prison?
1
2
3
4
5
1 – 8 hours
9 – 16 hours
17 – 24 hours
25 32 hours
33 hours or more
DK/REF
WA7
[IF WA1 = 1 OR WA4 = 1] Are you required to have a work assignment while in this prison?
1
2
Yes
No
DK/REF
WA8
[IF WA1 = 1 OR WA4 = 1] Are you paid money for the work assignment you have?
1
2
Yes
No
DK/REF
WA9
[IF WA8 = 1] Other than money, do you receive anything else for the work assignment you do,
such as time credits or other privileges?
[IF WA8 = 2 OR DK OR REF] Do you receive anything else for the work assignment you do,
such as time credits or other privileges?
1
2
Yes
No
DK/REF
WA10 [IF WA7 = 2] Inmates choose to have a work assignment for different reasons. Do you have a
work assignment…
WA10a. To break up boredom or see what the work
assignment is like?
WA10b. To spend time with friends or make friends?
WA10c. To try to get out of prison early?
WA10d. To learn some new job skills?
WA10e. To earn spending money?
DK/REF
Yes
No
1
1
1
1
1
2
2
2
2
2
WA11 [IF WA1 = 2 AND WA4 = 2] DOAFILL1, have you ever had a work assignment?
1
2
DK/REF
Yes
No
Attachment C: NIS-4P ACASI Instrument 4-20-2020
WA12
[IF WA11 = 1] When was the last time you had a work assignment at this prison?
1
2
3
4
Within the past month
1 – 3 months ago
4 – 6 months ago
7 – 12 months ago
DK/REF
WA13 [IF WA11 = 1 OR 2] Inmates do not have work assignments for a variety of reasons. For each
reason listed below, please indicate whether or not it is a reason why you don’t currently have a
work assignment.
WA13a. You are not healthy enough to work?
WA13b. You don’t want to do the jobs that
are available?
WA13c. Facility staff will not allow you to
work?
WA13d. You don’t have the skills needed?
WA13e. You would rather do other things
with your time?
DK/REF
Yes
1
No
2
1
2
1
1
2
2
1
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PROGRAM PARTICIPATION
PP_1
These next questions are about programs you have participated in at this facility.
DOAFILL1, have you participated in any job training programs, such as employment readiness or
vocational training?
1
2
Yes
No
DK/REF
PP_2
[IF PP_1 = 1] DOAFILL1, were you required to participate in any job training programs?
1
2
Yes
No
DK/REF
PP_3
[IF PP_1 = 1] Are you currently participating in any job training programs?
1
2
Yes
No
DK/REF
PP_4
[IF PP_3 = 2] Why aren’t you participating in any job training programs?
PP_4a. You completed the program?
PP_4b. You quit or dropped out of the program?
PP_4c. You are no longer allowed to participate in the program?
PP_4d. The program is no longer available at this facility?
PP_4e. Some other reason?
DK/REF
PP_5
Yes
1
1
1
1
1
No
2
2
2
2
2
[IF PP_1 = 2] Why haven’t you participated in any job training programs DOAFILL2?
PP_5a. You are not interested in the program?
PP_5b. You are not eligible to participate in the program?
PP_5c. You are too busy to attend the program?
PP_5d. You don’t need job training?
PP_5e. You don’t think the program would be useful?
PP_5f. Job training programs are no longer offered at this facility?
PP_5g. Some other reason?
DK/REF
Yes
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PP_6
[IF PP_1 = 1] Why did you participate in job training programs DOAFILL2?
PP_6a. To break up boredom or see what the program was like?
PP_6b. To spend time with friends or make friends?
PP_6c. To try to get out of prison early?
PP_6d. To learn some new skills?
PP_6e. Some other reason?
DK/REF
PP_7
Yes
1
1
1
1
1
No
2
2
2
2
2
DOAFILL1, have you participated in any education programs, such as high school, GED, adult
basic education, college courses, or English as a Second Language?
1
2
Yes
No
DK/REF
PP_8
[IF PP_7 = 1] DOAFILL1, were you required to participate in any education programs?
1
2
Yes
No
DK/REF
PP_9
[IF PP_7 = 1] Are you currently participating in any education programs?
1
2
Yes
No
DK/REF
PP_10 [IF PP_9 = 2] Why aren’t you participating in any education programs?
PP_10a. You completed the program?
PP_10b. You quit or dropped out of the program?
PP_10c. You are no longer allowed to participate in the program?
PP_10d. The program is no longer available at this facility?
PP_10e. Some other reason?
DK/REF
Yes
1
1
1
1
1
No
2
2
2
2
2
PP_11 [IF PP_7 = 2] Why haven’t you participated in any education programs DOAFILL2?
PP_11a. You are not interested in the program?
PP_11b. You are not eligible to participate in the program?
PP_11c. You are too busy to attend the program?
PP_11d. You don’t need education training?
PP_11e. You don’t think the program would be useful?
PP_11f. Education programs are no longer offered at this facility?
PP_11g. Some other reason?
DK/REF
Yes
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PP_12 [IF PP_7 = 1] Why did you participate in education programs DOAFILL2?
PP_12a. To break up boredom or see what the program was like?
PP_12b. To spend time with friends or make friends?
PP_12c. To try to get out of prison early?
PP_12d. To learn some new skills?
PP_12e. Some other reason?
DK/REF
Yes
1
1
1
1
1
No
2
2
2
2
2
PP_13 [IF PP_7 = 1] What types of education programs did you participate in DOAFILL2?
PP_13a. Basic education classes up through 8th grade?
PP_13b. High school or GED classes?
PP_13c. College level classes?
PP_13d. English as a Second Language or ESL classes?
PP_13e. Some other education program?
DK/REF
Yes
1
1
1
1
1
No
2
2
2
2
2
PP_14 DOAFILL1, have you participated in any of the following classes or programs?
PP_14a. A parenting or child rearing class?
PP_14b. An anger management or conflict resolution class?
PP_14c. A money management or financial planning class?
PP_14d. A sex offender treatment program?
PP_14e. A religious study group?
PP_14f. A prisoner assistance group such as a prisoner counseling
group, advisory council, worker’s council, or inmate liaison group?
PP_14g. A drug or alcohol support group such as Alcoholics
Anonymous, Al-Anon, or Narcotics Anonymous?
PP_14h. An arts and crafts program?
PP_14i. A health or nutrition program?
DK/REF
Yes
1
1
1
1
1
1
No
2
2
2
2
2
2
1
2
1
1
2
2
PP_15 [IF ANY ITEMS IN PP_14 = 1] Are you currently participating in any of the following classes
or programs?
PP_15a. [IF PP_14a = 1] A parenting or child rearing class?
PP_15b. [IF PP_14b = 1] An anger management or conflict resolution class?
PP_15c. [IF PP_14c = 1] A money management or financial planning class?
PP_15d. [IF PP_14d = 1] A sex offender treatment program?
PP_15e. [IF PP_14e = 1] A religious study group?
PP_15f. [IF PP_14f = 1] A prisoner assistance group such as a prisoner
counseling group, advisory council, worker’s council, or inmate liaison group?
PP_15g. [IF PP_14g = 1] A drug or alcohol support group such as Alcoholics
Anonymous, Al-Anon, or Narcotics Anonymous?
PP_15h. [IF PP_14h = 1] An arts and crafts program?
PP_15i. [IF PP_14i = 1] A health or nutrition program?
DK/REF
Yes
1
1
1
1
1
1
No
2
2
2
2
2
2
1
2
1
1
2
2
Attachment C: NIS-4P ACASI Instrument 4-20-2020
VISITORS AND OUTSIDE CONTACT
VOC_1 These next questions are about contact you have with people outside this facility. By contact we
mean phone calls, video visits, e-mails, text messages, letters, DVDs, CDs, tape recordings, or inperson visits.
DOAFILL1, have you had any contact with your relatives?
1
Yes
2
No
DK/REF
VOC_2 [IF VOC_1 = 1] DOAFILL1, what kinds of contact have you had with any of your relatives?
Have you…
YES
NO
VOC_2a. Had in-person visits?
1
2
VOC_2b. Talked on the phone?
1
2
VOC_2c. Received letters?
VOC_2d. Had some other type of contact such as emails, text messaging,
video visiting, DVDs, CDs, or tape recordings?
1
2
1
2
DK/REF
VOC_3
[IF VOC_2a = 1 OR VOC_2b = 1 OR VOC_2c = 1 OR VOC_2d = 1] When was the last
time you had any kind of contact with your relatives?
1
2
3
4
5
6
Within the past day
More than a day ago but within the past week
More than a week ago but within the past month
More than a month ago but within the past 3 months
More than 3 months ago but within the past 6 months
More than 6 months ago
DK/REF
VOC_4
[IF VOC_1 = 2] Why do you think you have not had any kind of contact with your relatives
DOAFILL2? Do you think it is because…
YES
NO
VOC_4a. They live too far away?
1
2
VOC_4b. They cannot afford to travel to this prison?
1
2
VOC_4c. They don’t want to see you while you are incarcerated?
1
2
1
2
1
2
1
2
VOC_4d. You are not allowed to have visitors?
VOC_4e. You do not want to have visitors?
VOC_4f. They are not healthy enough to travel?
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
DOAFILL1, have you had any contact with your friends or acquaintances?
VOC_5
1
Yes
2
No
DK/REF
VOC_6
[IF VOC_5 = 1] DOAFILL1, what kinds of contact have you had with your friends or
acquaintances? Have you…
YES
NO
VOC_6a. Had in-person visits?
1
2
VOC_6b. Talked on the phone?
1
2
VOC_6c. Received letters?
VOC_6d. Had some other type of contact such as emails, text messaging,
video visiting, DVDs, CDs, or tape recordings?
1
2
1
2
DK/REF
VOC_7
[IF VOC_6a = 1 OR VOC_6b = 1 OR VOC_6c = 1 OR VOC_6d = 1] When was the last time
you had any kind of contact with your friends or acquaintances?
1
2
3
4
5
6
Within the past day
More than a day ago but within the past week
More than a week ago but within the past month
More than a month ago but within the past 3 months
More than 3 months ago but within the past 6 months
More than 6 months ago
DK/REF
VOC_8
[IF VOC_5 = 2] Why do you think you have not had any kind of contact with your friends
or acquaintances DOAFILL2? Do you think it is because…
YES
NO
VOC_8a. They live too far away?
1
2
VOC_8b. They cannot afford to travel to this prison?
1
2
VOC_8c. They don’t want to see you while you are incarcerated?
VOC_8d. You are not allowed to have visitors?
1
2
1
2
1
2
1
2
VOC_8e. You do not want to have visitors?
VOC_8f. They are not healthy enough to travel?
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
POST-RELEASE PLANS
PRP1 [IF B24 NE 1] These last questions are about plans you may have for after you are released from
this facility.
Do you have a definite date on which you expect to be released from prison?
1
2
Yes
No
DK/REF
PRP2
[IF PRP1 = 1] In what year do you think you will be released from prison?
1
2
3
4
5
6
7
[CURRENT YEAR]
[CURRENT YEAR + 1]
[CURRENT YEAR +2]
[CURRENT YEAR + 3]
[CURRENT YEAR + 4]
[CURRENT YEAR + 5]
[CURRENT YEAR + 6] or later
DK/REF
PRP3
[IF PRP1 = 2 OR DK OR REF] Do you expect to ever be released from prison?
1
2
Yes
No
DK/REF
PRP4
[IF PRP3 = 1] In what year is your earliest possible release date?
1
2
3
4
5
6
7
[CURRENT YEAR]
[CURRENT YEAR + 1]
[CURRENT YEAR +2]
[CURRENT YEAR + 3]
[CURRENT YEAR + 4]
[CURRENT YEAR + 5]
[CURRENT YEAR + 6] or later
DK/REF
PRP14
[IF B24 NE 1] How far is this prison from where you were living before you entered prison on
your current incarceration?
1
Less than 5 miles
2
5 – 10 miles
3
11 – 20 miles
4
21 – 50 miles
5
51 – 100 miles
6
101 – 500 miles
7
501 miles or more
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
PRP5
[IF PRP3 NE 2 OR PRP1=1] Do you have a plan for where you will live after you are released
from prison?
1
Yes
2
No
DK/REF
PRP6
[IF PRP5 = 1] Did any staff at this prison help you make plans for where you will live after you
are released from prison?
1
Yes
2
No
DK/REF
PRP7
[IF PRP5 = 1] Do you think you will live alone after you are released from prison or do you
think you will live with other people?
1
Will live alone
2
Will live with other people
DK/REF
PRP8
[IF PRP7 = 2] Who do you plan to live with after you are released from prison?
PRP8a. [IF D1 = 1] Your husband or wife?
PRP8b. Your boyfriend or girlfriend?
PRP8c. Your parents or step-parents?
PRP8d. Your brother or sister?
PRP8e. Your children who are younger than 18?
PRP8f. Your children who are at least 18 years old?
PRP8g. Your grandparents?
PRP8h. Your grandchildren?
PRP8i. Some other relative, such as an aunt, uncle, or cousin?
PRP8j. Someone you are not related to?
DK/REF
PRP9
Yes
1
1
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
2
2
Yes
1
1
1
1
1
1
1
1
No
2
2
2
2
2
2
2
2
[IF PRP5 = 1] Where do you plan to live after you are released from prison?
PRP9a. In your own house, apartment, condo or mobile home?
PRP9b. In someone else’s house, apartment, condo or mobile home?
PRP9c. In transitional housing for former inmates such as a halfway house?
PRP9d. In a residential treatment facility?
PRP9e. In a rooming house, hotel, or motel?
PRP9f. In a car, truck, or other motor vehicle?
PRP9g. In a homeless shelter, on the street, or in some outdoor location?
PRP9h. In some other place?
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
INTERVIEW DEBRIEFING
M0
Thank you for completing the survey. Now we have a few questions about your experience with
this interview.
Touch the NEXT button to go to the next screen.
M1
How difficult was it for you to use the computer to do this survey?
1
Not difficult at all
2
Sort of difficult
3
Very difficult
DK/REF
DEFINE InterviewTypeFill:
IF RANDOM = 95, then InterviewTypeFill = “your own experiences with sex and sexual assault
in this facility”
IF RANDOM = 5, then InterviewTypeFill = “your childhood and your experiences at this facility”
M2
How comfortable did you feel using the computer to answer questions about
[InterviewTypeFIll])?
1
Very comfortable
2
Somewhat comfortable
3
Somewhat uncomfortable
4
Very uncomfortable
DK/REF
M3.
How upsetting did you find it to answer questions about [InterviewTypeFIll]?
1
Not upsetting at all
2
Somewhat upsetting
3
Very upsetting
DK/REF
M4.
How accurate are the answers you entered into the computer?
1
Not very accurate
2
Fairly accurate
3
Very accurate
DK/REF
M5
Did anyone tell you directly that you were required to participate in this study?
1
Yes
2
No
DK/REF
M6
[IF M5 = 1] Who told you that you were required to participate in this study?
1
A facility staff person
2
An interviewer from RTI
3
Another inmate
4
Someone else
DK/REF
Attachment C: NIS-4P ACASI Instrument 4-20-2020
M7
[IF M6 = 2] Were you ever made to feel that you were required to participate in this study?
1
Yes
2
No
DK/REF
M8.
Did anyone put pressure on you to answer the survey questions in a certain way?
1
Yes
2
No
DK/REF
M9.
[IF M8 = 1] Who pressured you to answer the survey questions in a certain way?
1
A facility staff person
2
An interviewer from RTI
3
Another inmate
4
Someone else
DK/REF
M10.
[IF M8 = 1 AND RANDOM = 95] Are there any types of sex or sexual contact that you didn’t
report in this survey because someone pressured you not to?
1
Yes
2
No
DK/REF
M11.
That is all the questions we have. If you found the survey questions upsetting for any reason, your
interviewer can tell you how to contact a mental health counselor employed by this facility.
Thank you very much for participating in this study.
M11a. Please tell your interviewer that you have completed the survey.
M12.
THANK INMATE FOR PARTICIPATING.
NOTIFY OFFICER THAT THE INMATE IS FINISHED AND CAN LEAVE THE INTERVIEW
ROOM. AFTER THE INMATE LEAVES THE ROOM, ENTER THE PASSWORD TO
CONTINUE ON TO YOUR DEBRIEFING QUESTIONS.
ENTER PASSWORD TO CONTINUE.
NOTE TO PROGRAMMER: WE’LL NEED A SHORT PASSWORD SO THAT
RESPONDENTS CAN’T GO ANY FURTHER IN THE INTERVIEW. THE LAST SET OF
DEBRIEFING QUESTIONS WILL BE FOR THE INTERVIEWER.
M13.
Estimate the respondent’s understanding of the interview
1
2
3
M14
No difficulty – no language or reading problem
Some difficulty
A great deal of difficulty
Please record any comments the respondent made about the nature of the questions or the task of
answering the questions during either the CAPI or ACASI portions of the interview.
__________________________________________________________________
Attachment C: NIS-4P ACASI Instrument 4-20-2020
ALLOW 150 CHARACTERS
M15
How upset did the respondent appear to be during the ACASI portion of the interview?
1
2
3
M16
Not upset at all
Somewhat upset
Very upset
[IF M15 = 2 OR 3] Please provide any details you can about why this inmate appeared to be
somewhat or very upset during the ACASI portion of the interview.
__________________________________________________________________
ALLOW 150 CHARACTERS
M17
Did this inmate complete the interview while wearing shackles?
1
2
Yes
No
M18. Did this inmate complete the interview while wearing handcuffs?
1
2
Yes
No
M19. Did the inmate complain to you about how long they had to wait to be seen by an interviewer?
1 Yes
2 No
M20
How much difficulty did you have persuading this inmate to participate in the NIS?
1
2
3
4
5
No difficulty – the inmate was eager to participate
Just a little difficulty – the inmate was willing, but not eager, to participate
Some difficulty – the inmate wasn’t willing but you were able to persuade him/her
Quite a lot of difficulty – you had to really work to counter the inmate’s objections
This inmate had previously refused to participate and you were working the case as a
refusal converter
M21
Indicate the degree of distractions or interruptions during the interview.
1
None
2
A few
3
A lot
M22
Was the privacy of the interview setting compromised at any point during the interview?
1
2
M23
Yes
No
[IF M22 = 1] In what way was the privacy of the interview setting compromised during this
interview?
________________________________________________________________
ALLOW 150 CHARACTERS
M24
[IF I3 = 1] Did the inmate take the incentive that was offered?
Attachment C: NIS-4P ACASI Instrument 4-20-2020
1
2
M26
YES
NO
PLEASE PROVIDE ANY OTHER COMMENTS ABOUT THE INTERVIEW THAT WOULD
BE USEFUL FOR THE PROJECT TEAM TO KNOW:
________________________________________________________________
ALLOW 150 CHARACTERS
REVIEW
INTERVIEWER: YOU HAVE REACHED THE END OF THE INTERVIEW. ENTER 1
AND TOUCH THE FINISH BUTTON BELOW TO FINALIZE THIS CASE AND
RETURN TO THE CASE MANAGEMENT SYSTEM.
| File Type | application/pdf |
| File Title | Section 4: Sexual Activity Within the Facility |
| Author | Emily McFarlane |
| File Modified | 2020-05-04 |
| File Created | 2020-04-22 |