ATTACHMENT J
Question BY Question JUSTIFICATION
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This document provides the source and justification for each question on the Baseline Data Collection (Attachment B).
Question # |
Question text |
Source |
Justification |
SECTION I. INTRODUCTION |
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I1 |
Do you agree to participate in the Evaluation of Employment Coaching for TANF and Related Populations? |
New Developed by Mathematica |
Obtaining consent |
SECTION A. CONTACT INFORMATION 1 |
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A1-b |
What is your full name? |
PACT (OMB No. 0970-0403) |
These items will be used to collect contact information necessary to verify the identity of the respondent, to aid in follow-up, and/or to collect administrative data. |
A2 |
What is your date of birth? |
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A3 |
What is your Social Security number? |
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A4 |
What is your home telephone number? |
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A5a |
Do you have a cell phone? |
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A5b |
What is your cell phone number? |
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A6 |
Is it okay for us to text you at this number? Message and data rates may apply. |
Youthbuild 30 Month (OMB No. 1205-0503) |
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A7 |
What is another phone number where you can be reached? |
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SECTION B. DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS |
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B1 |
Next, I would like to ask you some questions about your background. Are you Hispanic, Latino, or of Spanish origin? |
OMB1 |
These items measure demographic and socioeconomic characteristics. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. B4 will enable respondent identity verification in the follow-up survey, along with SSN and DOB. |
B2 |
What is your race? Select all that apply. |
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B3 |
How do you describe yourself? |
Federal Interagency Working Group on Measuring Sexual Orientation and Gender Identity (SOGI) Report |
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B4 |
What is the highest level of education you have completed? |
Adapted from cobra (OMB No. 1291-0001) |
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B5 |
What is your current marital status – are you now married, separated, divorced, widowed, or have you never been married? |
Adapted from omb |
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B6 |
Now I would like to ask you some questions about the people who live with you. How many adults age 18 or older currently live in your household at least half the time? Please include yourself. |
JSA (OMB No. 0970-0400) |
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B7 |
How many children under age 18 live with you at least half the time? This includes biological, adopted, foster, step, and any other children. |
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B8 |
Do you currently own your home or apartment or have a mortgage, rent it, pay some amount toward rent, live rent free with a friend or relative, or do you have some other arrangement? |
WFNJ |
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B9a-f |
In the past month, have you or anyone in your household received any income from…
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ACS (OMB No. 0607-0810) |
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SECTION C. EMPLOYMENT STATUS AND BARRIERS |
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C1 |
The next questions are about work you have done for pay. Are you currently working for pay? Working for pay can include regular paid jobs, odd jobs, temporary jobs, work done in your own business, “under the table” work, or any other types of work you have done for pay. |
csped (OMB No. 0970-0439) |
These items measure baseline employment status. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. |
C2 |
In the past 30 days have you worked for pay? Please include any regular paid jobs, odd jobs, temporary jobs, work in your own business, “under the table” work, or any other types of work you have done. |
Adapted from wfnj2 |
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C3 |
In what month and year did you last work for pay? Please include any regular paid jobs, odd jobs, temporary jobs, work in your own business, “under the table” work, or any other types of work you have done. |
PACT (OMB No. 0970-0403) |
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C4 |
How much do/did you get paid before taxes and deductions, at this job? If your pay varies/varied, please provide an average amount. If you are paid per job or for completing a particular task, please tell us the total amount you usually made per week or per month while doing this type of work. |
Adapted from wia (OMB No. 1205-0504) |
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C5 |
In the past 30 days, how much money did you make from work? Please include tips, bonuses, commissions, and regular overtime pay and count all money you received before taxes and deductions. If you held more than one job, include your total earnings from all of your work during the past 30 days. |
Adapted from wfnj |
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C6 |
I just need to know a range. Can you tell me if it was . . . |
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C7 |
How many hours (do/did) you usually work per week at your current or most recent job? |
Adapted from PACT (OMB No. 0970-0403) |
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C8a-g |
Now I am going to read you a list of things that some people find challenging in finding and keeping a good job. Please tell me if the following has made it not at all hard, a little hard, somewhat hard, very hard, or extremely hard for you to find or keep a good job in the past year.
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Adapted from CSPED (OMB No. 0970-0439) |
These items measure baseline barriers to employment. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. |
C9 |
Do you currently have a valid driver’s license? |
Adapted from acs (OMB No. 0607-0810) |
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C9a |
In the past six months, have you ever not been able to apply to a job because you didn’t have a valid driver’s license? |
New Developed by Mathematica |
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SECTION D. GOAL SETTING, GOAL PURSUIT, AND SELF-REGULATION SKILLS |
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D1a |
Now I am going to ask you about employment-related behaviors. Please tell me if you strongly disagree, disagree, agree, or strongly agree with the following statements. I set long-term employment goals that I hope to achieve within a year, such as finding a job, finding a better job, getting promoted, or enrolling in further education. |
Adapted from Goal Setting Questionnaire |
These are measures of goal setting. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. |
D1b |
I set specific short-term goals that will allow me to achieve my long-term employment goals. |
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D1c |
I know I need to get a job or a better job and really think I should work on finding one. |
LASER Questionnaire |
These are measures of goal pursuit. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. |
D1d |
I guess being out of work is not good, but there is nothing I can do about it right now. |
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D2 |
In the past 6 months, how often have you been late for a job or a job-related appointment like an interview or meeting with a program worker? |
New Developed by Mathematica |
This is a measure of self-regulation. We will use it to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. |
D3.1a-l |
Now we are going to discuss behaviors more generally. During the past month, how often has each of the following behaviors been a problem? Would you say that the following behaviors have been a problem never, sometimes, or often?
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BRIEF-A Questionnaire (These Items Are Copyright Protected so they cannot be included in the OMB submission. Further reproduction is prohibited without permission by Psychological Assessment Resources, Inc) |
These are measures of self-regulation. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. |
D3.2a-h |
During the past month, how often has each of the following behaviors been a problem? Would you say that the following behaviors have been a problem never, sometimes, or often? a. Item 28 b. Item 69 c. Item 1 d. Item 72 e. Item 23 f. Item 50 g. Item 64 h. Item 70- edited |
BRIEF-A Questionnaire (These Items Are Copyright Protected so they cannot be included in the OMB submission. Further reproduction is prohibited without permission by Psychological Assessment Resources, Inc) |
These are measures of self-regulation. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. |
D4a-c |
Next, I’m going to read a list of opinions people have about themselves. After I read each one, I want you to tell me whether you strongly disagree, disagree, agree, or strongly agree? a. I am able to do things as well as most people. b. I certainly feel useless at times. c. All in all, I tend to feel that I am a failure. |
Rosenberg Self-Esteem Scale |
These items measure self-esteem, which might be related to the effectiveness of employment coaching. We will use them to (1) describe the characteristics of study participants and check that random assignment has created treatment and control groups with similar characteristics, (2) define subgroups, (3) provide control variables for regression models that will increase statistical precision, (4) construct weights to adjust for survey nonresponse, and (5) support analysis of the mediating factors driving program impacts. |
Section E. CONTACT INFORMATION 2 |
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E1-E2 |
Contact information for the respondent and three contacts of the respondent. Verifying respondent’s contact information |
PACT |
Contact information for the respondent and for additional contacts who might be able to reach the respondent is necessary to locate the respondent for the first follow-up survey. |
E3a-E5i |
Collecting information for up to three additional contacts |
PACT |
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END |
Thanking participant |
PACT |
Sources: acs (american community survey), BRIEF-A QUESTIONNAIRE (Behavior rating inventory of executive function – adult version), csped (child support noncustodial parent employment demonstration), COBRA (Impact of the ARRa subsidy on cobra take-up), jsa (job search assistance), LASER Questionnaire (LAM Assessment on Stages of Employment Readiness), PACT (parents and children together), ROSENBERG SELF-ESTEEM SCALE, wia (workforce investment act), wfnj (work first new jersey), and YoutHbuild 30 month
1 http://www.ofm.wa.gov/pop/asr/ofm_standards_race_ethnicity_data.pdf
2 Note that Work First New Jersey (WFNJ) was not federally-funded and therefore does not have an OMB control number.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | TANF BASELINE QXQ |
Subject | QxQ |
Author | MATHEMATICA |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |