Form FEMA Form 519-0-54 FEMA Form 519-0-54 Post Disaster Survivor Preparedness Research

Post Disaster Survivor Preparedness Research Survey

FEMA Form 519-0-54 -jts 5-1-18

Adult Public - Cognitive Interview Screener

OMB: 1660-0146

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Department of Homeland Security

Federal Emergency Management Agency

POST DISASTER SURVIVOR Preparedness Research

OMB Control Number: 1660-NEW

Expiration Date: XX/XX/XXXX


PAPERWORK BURDEN DISCLOSURE NOTICE

FEMA Form 519-0-54

Public reporting burden for this data collection is estimated to average 15 minutes per response for surveys, (90 minutes for focus groups, and 45 minutes for interviews). The burden estimate includes the time for reviewing instructions, and completing the questions by the interviewer or group facilitator. This collection of information is voluntary. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW., Washington, DC 20472-3100, Paperwork Reduction Project (1660-NEW).

Introduction

The Instruments for this collection include surveys, cognitive interviews, and focus groups. The primary purpose of the collection is post-disaster survivor research to inform and improve preparedness strategies for more effective response and recovery for the public, particularly for historically underserved socio-demographic populations that are impacted by disasters.


The collection is designed to provide the capacity to field research rapidly post disaster to collect survivor attitudes, actions, experiences during the early recovery timeframe for future disasters. In order to provide the flexibility to apply the instruments to multiple disasters and hazard types, the instruments are constructed with a set of optional questions for potential selection within the approved burden for each instrument. The optional questions are included in the survey instrument below and intended as optional questions for all three instruments.


  1. SURVEY


Burden: Public reporting burden for this survey is estimated to average 15 minutes per response. A bank of questions is provided as the base for selecting options that address a particular disaster and population focus and meet the burden requirements not to exceed 15 minutes.



SECTION I. INTRODUCTION

Hello, this is ______ calling for the Research Company on behalf of FEMA, the Federal Emergency Management Agency.. We are doing a special poll about preparation for {disaster name} disasters and would like to include your opinions. This survey will take about 15 minutes and is completely voluntary.


These questions comply with the Privacy Act of 1974 and have been approved by the Office of Management and Budget under number OMB 1660-NW116. If you have any questions about the survey, you can reach a FEMA contact by calling 202 646-2500) and indicating you want to talk with a contact for the FEMA Survey.


(Interviewer: All interviews are recorded. The recording begins when the respondent answers the phone. This statement is read after the "Continue" response is entered after the Introduction and before the first question.)


  1. LANGUAGE

What is the primary language spoken in your home?

1 English

2 Spanish

3 Other (Please specify) _______________________


(IF 1, CONTINUE. IF 2 OR 3, RESCHEDULE/TRANSER TO APPROPRIATE LANGUAGE INTERVIEWER)


  1. AGE

Please tell me your age.

(Interviewer: Open ended and code actual age using coding table)

(Programmer: Note #1)

Skip: (If “AGE” code 01-17 in above response, ask if someone 18 or over is available. If yes, continue. If no, Thank and Terminate;
Otherwise, Continue.



  1. RECORDING NOTICE

This interview will be recorded for internal quality assurance.


1

(Continue)

2

(Refused) - (Thank and Terminate)




II. Interview Start



  1. LANDLINE/CELL

Have I reached you on a landline phone or on a cell phone?

(Interviewer: If respondent says ‘home phone,’ ‘VOIP/Internet phone,’ or any type of phone other than a cell phone, code as ‘1.’)


1

Landline

2

Cell Phone

3

(DK)

4

(Refused)

5

(Business Line-Landline or Cell) [VOLUNTEERED]



Skip: (If code 5 in is the response code above, Thank and Terminate; Otherwise, Continue)



S1C

  1. For your safety, are you currently driving?


1 Yes

2 No

3 (DK)

4 (Refused)

If code 2 in, Continue;

Otherwise, Termination)



(Interviewer: READ:)

QID:XXXX This is an important study of people's experiences in [Disaster NAME]. Your assistance in this study is voluntary, but your opinions are needed to help other people be better prepared. If there is any question you do not wish to answer, just tell me. Your answers are confidential and will be combined with those of others. You, as an individual, will never be identified.



QID:XXXX What is your zip code?

(Interviewer: Open ended and code all five digits of zip code)


99998 (DK)

99999 (Refused)


QID:XXXX Interviewer: Verify ZIPCODE COUNTY to match SB. If match CONTINUE, Otherwise THANK AND TERMINATE


QID: XXXX Were you in the area last [DATE] when [Disaster NAME] occurred?


1 Yes

2 No

98 (DK)

99 (Refused)


PROGRAMMER NOTE: If CODE 1 in Q## CONTINUE, if CODE 2 THANK AND TERMINATE



PRA OPTONS for targeting underserved communities (IF SURVEY SEEKS TO TARGET/OVERSAMPLE GROUPS, USE THE APPROPRIATE SCREENER(S))

(INTERVIEWER: READ)

For this research, we are looking for the opinions of specific groups who are often not represented in disaster research. To this end, I am going to ask you a few questions to determine if you meet the criteria.

US-S1 SOCIO-ECONOMICALLY DISADVANTAGED

US-S1-1 What is your total MONTHLY household income, before taxes? Please include income from wages and salaries, remittances from family members living elsewhere, farming, and all other sources.

(Interviewer: Open ended and code)


(Interviewer: [(If response is greater than $10,000, read:) Is that a monthly or an annual amount? (If monthly, code as appropriate using coding table; if annual, probe for monthly amount)])


01

Under $60

02

$60 to $499

03

$500 to $999

04

$1,000 to $1,999

05

$2,000 to $2,999

06

$3,000 to $3,999

07

$4,000 to $4,999

08

$5,000 to $7,499

09

$7,500 to $9,999

10

$10,000 to $14,999

11

$15,000 to $19,999

12

$20,000 and over

98

(DK)

99

(Refused)

US-S1-2 EDUCATION

What is your highest completed level of education?

(Interviewer: Read 01-06)


01

Less than high school diploma

02

High school degree or diploma

03

Technical/Vocational school

04

Some college

05

College graduate

06

Post graduate work or degree

07

(DK)

08

(Refused)


US-S1-3 RENT/OWN

Do you rent or own your home?

1 Rent

2 Own

3 Other

4 (DK)

5 (Refused)


US-S2 ACCESS AND FUNCTIONAL NEEDS

US-S2-1 Do you have a disability or a health condition that might affect your capacity to prepare for or respond to an emergency situation?

(Interviewer: If necessary, read:) A mobility, hearing, vision, cognitive, or intellectual disability or physical, mental, or health condition)


1

Yes

2

No

3

(DK)

4

(Refused)

US-S2-2 Do you currently live with or have primary responsibility for assisting someone with a disability who requires assistance?

(Interviewer: If necessary, read:) A mobility, hearing, vision, cognitive, or intellectual disability or physical, mental, or health condition.)


1

Yes

2

No

3

(DK)

4

(Refused)



US-S3 ELEMENTARY SCHOOL-AGED CHILDREN

US-S3-1 Including yourself, how many adults, 18 years of age or older, live in this household?

(Interviewer: Open ended and code actual number)


01

01-

96

96

97

97 or more

98

(DK)

99

(Refused)


US-S3-2 ELEMENTARY CHILDREN

How many children, under the age of 11, are living in your household?

(Interviewer: Open ended and code actual number using coding table)


00

None

01

01-

96

96

97

97 or more

98

(DK)

99

(Refused)


US-S3-3 ELEMENTARY CHILDREN

How many children, under the age of 18 and over the age of 11, are living in your household?

(Interviewer: Open ended and code actual number using coding table)


00

None

01

01-

96

96

97

97 or more

98

(DK)

99

(Refused)


US-S4      SENIORS 75 YEARS AND OLDER

[Qualifying question – age, earlier in the survey script]



US-S5 SEX AND GENDER

What is your identified gender?


1

Male

2

Female

3

Other/prefer to self-identify:________

4

(Refused)



What is your identified sexuality?


1

Straight/Heterosexual

2

Gay/Lesbian

3

Bisexual

4

Queer

5

Prefer to self-describe:________

6

(Refused)





Do you identify as transgender?


1

Yes

2

No

3

(Refused)



US-S6      RACIAL AND ETHNIC MINORITIES

US-S6-1 ETHNICITY

Are you of Hispanic, Latino, or Spanish origin - such as Mexican, Puerto Rican, Central or South American, or other Spanish origin?


1

Yes

2

No

3

Other

4

(DK)

5

(Refused)

US-S6-2 RACE


Which of the following describes your race? You may select one or more. (Read 1-5)


1

White

2

Black or African-American

3

Asian

4

American Indian or Alaska Native, or

5

Native Hawaiian or Pacific Islander

8

(DK)

9

(Refused)

0

(No more responses)



US-S7 TRIBAL POPULATIONS

(FIRST SCREENED FROM US-S6-2)

US-S7-1 What tribe do you self-identify with? (CODE SPECIFIC OPEN RESPONSE, AND AS FEDERALLY RECOGNIZED TRIBE OR NOT FEDERALLY RECOGNIZED TRIBE)

US-S7-1 Do you live on tribal lands?

1

Yes

2

Sometimes

3

No

4

Other:________



SECTION 2: CURRENT DISASTER

Thank you for your responses. We will now ask you questions about your experience with [DISASTER NAME].

WARNINGS

CDW_1. Was a watch or warning alert issued for your area?

    1. Yes

    2. No

    3. (DK)

(IF YES, CONTINUE. IF NO, SKIP TO SECTION ‘EVACUATION’

CDW_2. What was the alert you received?

  1. Severe storm

  2. Flood watch or warning

  3. Hurricane watch or warning

  4. Other specify __________________________________

  5. (DK)

CDW_3. How did you receive the watch or warning alert? You may select one or more (Read 1-6)

  1. Television

  2. Radio

  3. Social media – Facebook, Twitter, other

  4. Smart Phone App

  5. Friend, neighbor or other individual

  6. Local community notification by siren, phone call, email and/or text

  7. A warning from a federal agency such as NOAA or FEMA or DHS

  8. Faith-based institution

  9. Other

  10. (DK)

CDW_4. How far in advance did you learn that you and your household might be impacted by the disaster (read for selection.)

  1. Less than 15 minutes

  2. From 15 minutes to less than 3 hours

  3. From 3 hours to less than 6 hours

  4. From 6 hours to less than 24 hours

  5. More than 24 hours

  6. (DK)

CDW_5. In certain types of disasters, local authorities may make recommendations for actions the public should take. Those may be provided through local news or warning and alert systems. Did you receive advice from local authorities on any of the following: (Select all that apply)

  1. Evacuate based on advice from authorities

  2. Best routes to use when evacuating

  3. Roads to avoid due to flooding or dangerous conditions

  4. Move to a protected location (higher ground, storm shelter, other protected shelter)

  5. Shelter locations

  6. Other

  7. No advice from local authorities

  8. (DK)

CDW_6. On a scale of 0 to 10, where 0 is completely disagree and 10 is completely agree, please rate the warning/watch message on the following statements. The warning/watch message ….

    1. was easy to understand

    2. got my attention

    3. was repeated enough times

    4. was sent out early enough for me to take action

    5. was sent from an agency or group I trust

  1. had the information I needed to feel safe

  2. (DK)

EMERGENCY OFFICIALS

CDEO_1. At any point during the [DISASTER NAME], did you attempt to communicate with emergency officials?

  1. Yes

  2. No

  3. (DK)

IF YES, Were you able to get in contact with emergency officials?

  1. Yes

  2. No

  3. (Refused)

IF YES, what type of communication device were you able to use? (OPEN ENDED, CODE)

  1. Cell phone

  2. Landline

  3. Computer

  4. Radio

  5. Other: (RECORD)

IF NO, how many hours did it take before you were able to communicate with officials?

  1. Less than 1

  2. 1-2 hours

  3. 2-4 hours

  4. 4-8 hours

  5. 8-16 hours

  6. 16-24 hours

  7. 24-48 hours

  8. Over 48 hours

  9. (DK)

CDEO_2. Did you want to be rescued after the hurricane made landfall?

  1. Yes

  2. No

  3. (Refused)

IF YES, Did you successfully contact emergency officials to request a rescue?

  1. Yes

  2. No

  3. (Refused)

IF YES. How many hours after the hurricane made landfall did it take before you made a request?

  1. Less than 1

  2. 1-2 hours

  3. 2-4 hours

  4. 4-8 hours

  5. 8-16 hours

  6. 16-24 hours

  7. 24-48 hours

  8. Over 48 hours

  9. (DK)

IF YES, were you rescued?

  1. Yes

  2. No

  3. (Refused)

IF YES, how many hours did you have to wait before you were rescued or had the opportunity to be rescued?

  1. Less than 1

  2. 1-2 hours

  3. 2-4 hours

  4. 4-8 hours

  5. 8-16 hours

  6. 16-24 hours

  7. 24-48 hours

  8. Over 48 hours

  9. (DK)

IF YES, Was the rescue operation performed by:

  1. Friends and family members

  2. Neighbors

  3. Community Emergency Response Team

  4. Police / Sherriff’s Office

  5. Firefighters

  6. National Guard

  7. Other: _______________

  8. (DK)

EVACUATION

CDE_1. Was a mandatory evacuation issued for your area?

  1. YES

  2. NO

  3. (DK)

(IF YES CONTINUE. IF NO OR DON’T KNOW, SKIP TO SECTION Decision to Leave)

CDE_2. How did you receive the mandatory evacuation order? You may select one or more (Read 1-6)

  1. Television

  2. Radio

  3. Social media – Facebook, Twitter, other social media

  4. Smart Phone App

  5. Friend, neighbor or other individual

  6. Local community notification by siren, phone call, email and/or text

  7. Other

  8. (DK)

CDE_3. On a scale of 0 to 10, where 0 is completely disagree and 10 is completely agree, please rate the evacuation message on the following statements. The evacuation message ….

    1. was easy to understand

    2. got my attention

    3. was repeated enough times

    4. was sent out early enough for me to take action

    5. was sent from an agency or group I trust

  1. had the information I needed to feel safe

DECISION TO STAY

CDS_1. Did you leave or evacuate your home BEFORE the [HAZARD e.g. hurricane] made landfall?

  1. YES

  2. NO

  3. (DK)

(If yes, continue, if no skip to next section)

CDS_2. (Decision to go). How much did the following influence your decision to leave before the hurricane or flooding? on a scale of 0 to 10, where 0 is not at all and 10 is a lot.

    1. I had a household plan to evacuate for this situation and was confident that I could follow it.

    2. Easy transportation options were available to me

    3. It was safer to leave than stay

    4. I had a place to stay out of the impact area

    5. Predictions/warnings were severe

    6. I expected significant power outages

    7. Issued advisory evacuation order

    8. Issued mandatory evacuation order

    9. Concern for my safety

    10. Concern for my family’s safety

    11. Concern for my pet’s safety

    12. Others around me were leaving

    13. Trusted person told me to go

    14. I had a place to go where I could bring my pet

    15. I thought my home would be okay without me there

    16. Other

CDS_3. How much did the following influence your decision to stay on a scale of 0 to 10, where 0 is not at all and 10 is a lot.

  1. I didn’t think the storm would be bad

  2. I was waiting to see if the storm would weaken or miss me

  3. I wanted to protect my house

  4. I didn’t have a place to go

  5. I didn’t have transportation to leave

  6. I was not under mandatory evacuation

  7. People around me weren’t leaving

  8. Concern about taking my pet or service animal

  9. Other

CDS_4. Did you leave your home and go to another location during the storm?

  1. YES

  2. NO

  3. (DK)

(IF YES, CONTINUE. IF NO OR DK, SKIP TO NEXT SECTION)

CDS_5. How much did the following influence your decision to leave during the storm, on a scale of 0 to 10, where 0 is not at all and 10 is a lot.

  1. Flooding in my home

  2. Non-flooding damage to my home

  3. Storm rapidly increased in strength

  4. I did not have sufficient supplies

  5. Easy transportation options were available to me

  6. It was safer to leave than stay

  7. I had a place to stay out of the impact area

  8. Flood water rising rapidly

  9. Predictions/warnings becoming more severe

  10. Issued advisory evacuation order

  11. Issued mandatory evacuation order

  12. Power went out

  13. Concern for my/my family’s safety

  14. Others around me were leaving

  15. Trusted person told me to go

  16. I thought my home would be okay without me there

  17. Other



DECISION TO LEAVE

Section 3: RECOVERY – DECISION TO RETURN OR RELOCATE

R_1. Have you been able to return to your home?

    1. YES

    2. NO

    3. (DK)

R_2. IF YES to “Have you been able to return to your home?” - How long before you were able to return to your home? (open ended, code time frame)

  1. Immediately after the storm ended

  2. Within 1 month

  3. 2 to 6 months

  4. 7 to 12 months

  5. Over 12 months

R_3. IF NO or DK to “Have you been able to return to your home?”: Do you intend to return to your home?

  1. YES

  2. NO

  3. (DK)

R_4. IF YES TO “Do you intend to return to your home?”: When do you expect to return? (open ended, code time frame)

  1. In the next three months

  2. In the next six months

  3. In the next year

  4. More than a year from now

(SKIP TO NEXT SECTION)

R_5. IF NO TO “Do you intend to return to your home?”: How much did the following influence your decision to not return to your home on a scale of 0 to 10, where 0 is not at all and 10 is a lot.

    1. There is too much damage to my home.

    2. The landlord/owner is not rebuilding/reopening

    3. I have already resettled elsewhere

    4. It’s too expensive to repair damages

    5. The area is being bought out

    6. My neighborhood is too damaged to return

    7. My neighborhood is prone to disasters

    8. My neighbors are not returning

    9. My child/children’s school is closed

R_6. IF NO “Do you intend to return to your home?” DO YOU INTEND TO RETURN TO THE COMMUNITY WHERE YOU LIVED?

  1. YES

  2. NO

  3. (DK)

(IF YES, SKIP TO NEXT SECTION. IF NO, CONTINUE)

R_7. How much did the following influence your decision to not return to your community on a scale of 0 to 10, where 0 is not at all and 10 is a lot.

    1. There is too much damage to my home.

    2. The landlord/owner is not rebuilding/reopening

    3. I have already resettled elsewhere

    4. It’s too expensive to repair damages

    5. The area is being bought out

    6. My neighborhood is too damaged to return

    7. My neighborhood is prone to disasters

    8. My neighbors are not returning

    9. My child/children’s school is closed

  1. It’s a challenge to get more funding/financing

  2. I am unable to stay nearby during repairs

SECTION 2. Current Disaster PRA OPTONS for alternate questions

US-S1  IF SOCIO-ECONOMICALLY DISADVANTAGED

R_8. How significant a factor was money in your decision to stay or evacuate prior to the event, on a scale of 0 to 10, where 0 is not at all and 10 is a lot?

    1. IF 5-10, can you elaborate on what costs were too high? (OPEN ENDED, CODE)

      1. Needed to keep working

      2. No car

      3. Buying supplies needed for time at shelter

      4. Gas

      5. Flight

      6. Hotel

      7. Other transit

      8. Other supplies

      9. Medical

      10. Other

R_9. IF RENTERs: As a renter, did your landlord provide you with assistance or directions to secure and protect your home?

  1. YES

  2. NO

  3. (DK)

  4. (REFUSAL)

US-S2 IF ACCESS OR FUNCTIONAL NEEDS

R_10. How significant a factor were your function or access needs to your decision to stay or leave prior to the event, on a scale of 0 to 10, where 0 is not at all and 10 is a lot?

    1. IF 5-10, can you elaborate on what affected your decision? (OPEN ENDED, CODE)

      1. Unable to transport myself

      2. No accommodation for service animals

      3. Unable to transport myself quickly

      4. Nowhere to go

      5. Access to medical supplies

      6. Access to information I can understand

      7. Access to transit that meets my needs

      8. Assisted living did not provide assistance

      9. Unsure if evacuation center could meet my needs

      10. Unsure if evacuation center could take my pet(s)

      11. Other



US-S3 IF ELEMENTARY SCHOOL-AGED CHILDREN



1

Yes

2

No

3

(DK)

4

(Refused)
R_11. Does at least one of the children currently attend a school outside of your home, including day-care or part-time kindergarten?













IF YES TO R-11. Are you aware of the details of the emergency or evacuation plan of the school or schools, including where the school plans to evacuate and how to get information about the child in the event of a disaster?


1

Yes

2

No

3

(DK)

4

(Refused)


IF YES TO R-11. Has your child/ren participated in emergency drills at school?


1

Yes

2

No

3

(DK)

4

(Refused)


R_12. Does your family have an emergency plan that includes your child(ren)?


1

Yes

2

No

3

(DK)

4

(Refused)


IF YES TO R-12. Has your family practiced the emergency plan?


1

Yes

2

No

3

(DK)

4

(Refused)



R_13. Did having young children influence your decision to stay or go?


US-S4      IF SENIOR 75-YEARS OR OLDER

R_14. How significant a factor was your age in your decision to stay or leave prior to the storm, on a scale of 0 to 10, where 0 is not at all and 10 is a lot?

    1. IF 5-10, can you elaborate on what affected your decision? (OPEN ENDED, CODE)

      1. Unable to transport myself

      2. Unable to transport myself quickly

      3. Nowhere to go

      4. Concern about access to medical supplies

      5. Concern about access to power

      6. Assisted living did not provide assistance

      7. Access to transit that meets my needs

      8. Unsure if evacuation center could meet my needs

      9. Unsure if evacuation center could take my pet(s)

      10. Other

R_15. Did the disaster impact your ability to maintain basic needs?

  1. IF 5-10, can you elaborate on what affected your decision? (OPEN ENDED, CODE)

  1. Unable to get adequate food

  2. Was not able to maintain prescribed medicine?

  3. Was not able to get access to power for power-dependent medical needs?

  4. Did not receive regular in-home services for 3 or more days.

  5. Did not have running water to take medicine or for other medical needs.

  6. Other


US-S6      IF RACIAL OR ETHNIC MINORITY

R_16. Do you or your family members speak languages other than English in your home?

          1. IF YES: Do you have access to disaster preparation resources that accommodate those languages?

            1. YES

            2. NO

            3. (DK)

            4. REFUSED

    1. Did you get warning alerts about the storm in your preferred language or in a language you could understand??

            1. YES

            2. NO

            3. (DK)

            4. REFUSED

US-S7 IF TRIBAL POPULATION

R_17. IF ON RESERVATION. Does your reservation have a community plan to respond to disasters?

    1. YES

    2. NO

    3. (DK)

    4. REFUSED

R_18. Did reservation authorities provide warning or guidance on what actions to take to respond to the storm?

R_19. Is there a storm shelter available on the reservation?

Section 3: Preparedness

P_1. Before [Disaster NAME], had you ever experienced a disaster where you considered leaving or left your home because of safety concerns?

1

Yes

2

No

3

(DK)

4

(Refused)



P_2. Before [Disaster NAME], how would you have ranked your household on your storm preparedness, on a scale of 0 (not at all prepared) to 10 (extremely prepared)?



P_3. After your experience in [DISASTER NAME], how prepared would you say your household was for the event, on a scale of 0 (not at all prepared) to 10 (extremely prepared)?



P_4. Prior to the disaster, was your household signed up for alerts and warning systems?

    1. Yes

    2. No

    3. (DK)

    4. REFUSE



    1. IF NO Is your household now signed up for alerts and warning systems?

      1. Yes

      2. No

      3. (DK)

      4. REFUSE

P_5. Prior to the disaster, had your household participated in a sheltering drill?

  1. Yes

  2. No

  3. (DK)

  4. REFUSE



  1. IF NO, Does your household plan to participate in a sheltering drill?

  1. Yes

  2. No

  3. (DK)

  4. REFUSE


Plan

P_6. Did you have a household emergency plan that included instructions for household members about where to go and what to do in the event of a local disaster?

1

Yes

2

No

3

(DK)

4

(Refused)


Skip: (If code 1, Continue; Otherwise, Skip to next section)

P_7. Plans – communications. Did your plan include a process for your household members to get in touch with each other if you were not together when the disaster happens?


1

Yes

2

No

3

(DK)

4

(Refused)

P_8. Plans – evacuation. Did your plan include information about how to leave your community for an evacuation?

1

Yes

2

No

3

(DK)

4

(Refused)

P_9. Plans – shelter. Did your plan include information about where to shelter or a safe place you could stay in the event of [hazard type] disaster?


1

Yes

2

No

3

(DK)

4

(Refused)

P_10. Plans – Checking neighbors. Did your plan include checking on your neighbors (those in your neighborhood or apartment building) to make sure they are okay in the event of a disaster?

1

Yes

2

No

3

(DK)

4

(Refused)



P_11. Did your plan include safeguarding critical documents such as identification, insurance, medical, and banking information, stored in a fireproof/waterproof location or stored electronically?

P_12. Did you have enough supplies set aside in your home to get you through three days without power, running water and without transportation?


1

Yes

2

No

3

(DK)

4

(Refused)

Mitigation

P_13. Had you taken steps prior to the disaster to protect your property from this type of disaster?

1

Yes

2

No

3

(DK)

4

(Refused)



IF YES TO P_13. Please identify and steps taken from the following list: (ONLY INCLUDE STEPS RELEVENT TO THE DISASTER)

  1. Retrofitted or elevated your existing or reconstructed property

  2. Elevated important documents, insurance cards, banking information and items of

sentimental value to a safe location.

  1. Elevated your home’s furnace, water heater and electric panel above potential flood levels.

  2. Installed "check valves" to prevent floodwater from backing up into the drains of your home.

  3. Install flood vents in foundation walls, garages, and other enclosed areas

  4. Use flood resistant materials in building your home

  5. Build a safe room

  6. Install storm shutters to protect windows and glass doors

  7. Purchased an insurance policy

  8. Secure outdoor items

  9. Secure furnace, water heater, and electrical panel to the wall

  10. Strengthen roof, wall, and foundation connections.

  11. Install storm shutters to protect windows and doors

  12. Use flood resistant materials when building your home

  13. Check your gutters and drains. (IF NEEDED, INTERVIEWER DEFINE: Secure your gutters and drains to the building. Be sure they are clear of debris. This will help protect the building from water, ice, wind, and wildfire.)

  14. Protect water and gas systems and install shut-offs. (IF NEEDED, INTERVIEWER DEFINE: Such as install flexible pipe fittings to avoid gas or water leaks and install a shut-off valve for your natural gas line or propane gas to prevent fires.)

  15. Maintain your landscape.

  16. Retrofit buildings

P_14. Based on experience with this disaster, do you intend to make revisions to your property to improve protection from this type of disaster?

  1. Yes

  2. No, don’t want/need to

  3. No, don’t have the resources to

  4. DK



Stages

P_15. Thinking about preparing yourself for disasters or emergencies, have you developed and discussed an action plan with your family, that includes information about how to leave your community or where to shelter, and have set aside supplies such as, food, water, and other essentials that allow you to be self-sufficient for at least three days?



Which of the following best represent your preparedness? (Read 1-5)


1

I have NOT prepared, and I do not intend to prepare in the next year

2

I have NOT prepared, but I intend to prepare in the next year

3

I have NOT prepared, but I intend to prepare in the next six months

4

I have been prepared for the last year

5

I have been prepared for MORE than a year

8

(DK)

9

(Refused)



Prepare - Assessment

P_16. If you could point to one or two things you did before the storm that helped you prepare for the storm, what would you point to? (OPEN QUESTION)

P_17. What is the top thing you wish you had known or done that would have helped? (OPEN QUESTION)



PREPAREDNESS - OPTIONS for optional alternate questions (SELECTED AS DESIRED FOR TARGET AUDIENCES)

P_18. Based on what you learned from this experience, which of the following supplies, equipment, and services did you need and not have: (Select all that apply)

    1. Safe drinking water

    2. Food

    3. Critical documents for identity, banking, insurance, and medical information

    4. Plans for how to get in touch with family, friends, etc.

    5. Generator for emergency power

    6. Flashlights or batteries

    7. Medication or medical supplies

    8. Chargers/electronics

    9. Cash

    10. Gasoline for vehicles or generator

    11. Utilities (water/gas/electric/phone/internet)

    12. Disability/Accessibility needs (wheelchair, hearing devices, glasses, medical devices)

    13. Other



  1. IF SELECT C FROM SUPPLY LIST: What documents were you missing that you needed? (OPEN ENDED, CODE)

      1. Health and medical records including prescriptions

      2. Driver's license, passport, or personal identification

      3. Social Security card

      4. Proof of residence (deed or lease)

      5. Insurance policies

      6. Birth and marriage certificates

      7. Copies of stocks, bonds, and other negotiable certificates

      8. Wills, deeds, and copies of recent tax returns

      9. Other financial documents

      10. Other



P_19. Did you have homeowners or renters insurance for your residence?

  1. Yes

  2. No

  3. DK

  4. Refusal



A. Did you have a separate flood insurance policy from the National Flood Insurance program or from a private insurance company?

  1. Yes

  2. No

  3. DK

  4. Refusal

P_20. Do you and your household keep money aside for emergencies?

  1. Yes

  2. No

  3. DK

  4. Refusal

  5. IF YES: Can you give me a ballpark figure for the amount you have set aside? (OPEN ENDED, CODE)

    1. 1-100

    2. 101-500

    3. 501-1000

    4. 1001-1500

    5. 1501-2000

    6. 2000-3000

    7. 3001-5000

    8. 5001-8000

    9. 8000-10000

    10. Over 10,000

US – S2 IF ACCESS AND FUNCTION NEEDS

P_21. Did you need assistance to evacuate or shelter? If yes, were you able to get the assistance?

    1. Yes

    2. No

    3. DK

    4. Refusal

P_22. What was your most critical need? (OPEN ENDED)

  1. Transportation

  2. Housing

  3. Food

  4. Cash

  5. Gasoline

  6. Healthcare

  7. Water

  8. Critical documents

  9. Emergency power

  10. Medicine or medical supplies

  11. Place for pet/service animal.

  12. Food for pet/service animal.

US – S3 IF ELEMENTARY SCHOOL-AGED CHILDREN

P_23. Who was your primary source of information to prepare and keep your child safe?

  1. School

  2. Doctor

  3. Local government

  4. Federal Government

  5. Myself

  6. Family and friends

  7. The media

  8. Other

P_24. What was your child’s most critical need? (OPEN ENDED)

  1. Transportation

  2. Housing

  3. Food

  4. Cash

  5. Gasoline

  6. Healthcare (physical)

  7. Healthcare (mental)

  8. Water

  9. Critical documents

  10. Emergency power

  11. Medicine or medical supplies

  12. Entertainment

  13. Feeling Secure

  14. Other

P_25. Have you, your family, friends, and neighbors assisted each other with [hazard] preparedness?

  1. Yes

  2. No

  3. DK

  4. REFUSAL



  1. IF YES: What activities did you and your family or close friends assist each other with? Select all that apply.

  1. Creating a plan

  3. Gathering Supplies

  4. Securing important documents

  5. Attending a training

  6. Downloading informational resources

  7. Going over what to do in different scenarios

  8. Finding evacuation routes and locations

  9. Creating an emergency savings account

  10. Other:



Training

T_1. Did you receive any disaster preparedness training through your local government?

O Yes

O No

O Don’t Remember

(Programmer Note: if T_1 response = Yes continue, otherwise skip to next section)

T_2. Which of the following best describes the types of training you participated in:

(Select all that apply)


  • Steps you can take to prepare for disasters

  • Skills for how to respond to a disaster

  • Ways to protect your home or business

  • How to evacuate including routes or public transportation methods

  • Natural hazards and risks relevant to your community

  • Local government actions and plans for preparing and responding to disasters


T_3. Using a rating scale of 1 to 10 where 1 is Not at all Useful and 10 is Very useful how would you rate the advice you received on how to prepare:


T_4. What changes are needed to make the advice more useful? (OPEN ENDED, CODE)

  • More “how-to” or steps

  • More locally relevant

  • More frequent trainings

  • Include handouts

  • Other topics (LIST TOPICS)

  • Other: (RECORD)



Recovery

R_1. How affected was your home by the storm, on a scale of 0 to 10, where 0 is not at all and 10 is extremely affected?

    1. For responses that are 5 and above: What was the most significant impact on your home?

R_2. How affected was your family by the storm, on a scale of 0 to 10, where 0 is not at all and 10 is extremely affected?

  1. 5 and above: What are the most to couple most significant impacts on your family? (Open ended, CODE)

    1. Damage to home

    2. Displaced

    3. Financial – loss of job

    4. School interruption

    5. Separation from friends

    6. Separation from extended family not within your household

    7. Separation from your community, neighborhood or church organizations

    8. Health – physical

    9. Health – mental, coping

    10. other

R_3. Were you employed at the time of the disaster?

      1. Yes

      2. No

      3. Refused

IF YES, How affected was your job by the disaster, on a scale of 0 to 10, where 0 is not at all and 10 is extremely affected?

  1. 5 and above: What was the most significant impact on your job (Open ended)

    1. Damage to work place

    2. Closed for significant time

    3. Boss is relocated/unavailable

    4. Workplace closed

    5. Employees relocated/unavailable

    6. Unable to return to regular business practices because of disruption in supply chain or customers

    7. Other

  2. If your job was interrupted:

    1. Have you been able to return to work in this or another job in your community?

      1. Yes

      2. No

      3. Refused

    2. Did the loss of your job or temporary unemployment cause you to permanently relocate to another community?

      1. Yes

      2. No

      3. Refused

    3. How long were you out of work?

      1. less than 2 weeks

      2. 2 weeks to a month

      3. up to 3 months

      4. more than 3 months

      5. Permanently laid off or business closed

    4. If your job was affected, were services provided to help you find new employment in your community after the disaster?

      1. Yes

      2. No

      3. Refused

      4. IF YES, What was the quality of that information or support using a scale of 0 to 10, where 0 is “no help” and 10 is “a lot of help”



R_4. Overall, how satisfied were you with your overall ability to immediately respond to [DISASTER NAME], on a scale of 0 to 10, where 0 is very dissatisfied and 10 is extremely satisfied?

R_5. In the first 72 hours following [DISASTER NAME], please indicate how much help you received from the following sources, using a scale of 0 to 10, where 0 is “no help” and 10 is “a lot of help”

  1. My extended family

  2. Friends

  3. People in my neighborhood

  4. Non-profit organizations, such as the American Red Cross or the Salvation Army

  5. My faith community, such as a congregation

  6. Fire, police, emergency personnel

  7. Local government agency

  8. State government agency

  9. Federal government agency, including FEMA

  10. Not applicable/No outside help needed



RECOVERY - OPTIONS for optional alternate questions (SELECTED AS DESIRED FOR TARGET AUDIENCES)

R_6. Which of the following are primary causes for delays in your recovery: (Select all that apply)

          1. Money for home repairs

          2. Delays in obtaining permits for repairs

          3. Money for personal property

          4. Money to move to a new residence

          5. Delayed or denied insurance settlement

          6. Delayed FEMA appeal

          7. Lack of affordable and/or accessible housing

          8. Lack of time to make repairs

          9. Lack of contractors and or materials

          10. Medical or disability conditions

          11. Unemployed as a result of the disaster



R_7. To improve your ability to recover, did you need and not have information on… (Select all that apply)

  1. Available rental housing

  2. Insurance coverage and claims

  3. Local contractors and repair services

  4. Local zoning, building codes and permits

  5. Disaster unemployment assistance

  6. Disaster loans from the Small Business Administration (SBA)

  7. Operational status of schools, colleges, etc.

  8. Available public transportation

  9. Locator services for finding displaced family and friends

  10. Measures and resources to mitigate or reduce the hazard risk to your home or business for the next disaster

  11. Information on local government priorities, local redevelopment plans or community goals for recovery

  12. General communication from your local government on recovery progress of the neighborhood, town or city as a whole



R_8. Did your community work together to assist each other in recovery?

  1. Yes

  2. No

  3. DK

  4. REFUSAL

R_9. Based on this experience, who are the people who helped you in your recovery??

Friends

Family

Neighbors

Religious/church community

Local non-profit organizations or community group

City/county representatives

Federal government representatives

R_10. Have you, your family, or friends assisted each other with recovery?

    1. Yes

    2. No

    3. DK

    4. REFUSAL



IF YES: What activities did you, your family, or friends assist each other with? Select all that apply.

    1. Information gathering

    2. Raising money

    3. Getting medical assistance

    4. Filing with FEMA

    5. Housing

    6. Transportation

    7. Other:



DEMOGRAPHICS

(Interviewer: READ:)

D_1. Finally, I have a few demographic questions for classification purposes only. (ONLY REPEAT QUESTIONS IF SCREENERS NOT USED)


D_2. What is your highest completed level of education?

(Interviewer: Read 01-06)


01

Less than high school diploma

02

High school degree or diploma

03

Technical/Vocational school

04

Some college

05

College graduate

06

Post graduate work or degree

07

(DK)

08

(Refused)



D_3. Are you of Hispanic, Latino, or Spanish origin - such as Mexican, Puerto Rican, Central or South American, or other Spanish origin?



1

Yes

2

No

3

(DK)

4

(Refused)



D_4 Which of the following describes your race? You may select one or more.

(Interviewer: (Read 1-5))


(Programmer: Allow FIVE responses)


1

White

2

Black or African-American

3

Asian

4

American Indian or Alaska Native, or

5

Native Hawaiian or Pacific Islander

8

(DK)

9

(Refused)

0

(No more responses)


# of Responses: 5



D_6. Do you have a disability or a health condition that might affect your capacity to respond to an emergency situation?

(Interviewer: If necessary, read:) A mobility, hearing, vision, cognitive, or intellectual disability or physical, mental, or health condition.)


1

Yes

2

No

3

(DK)

4

(Refused)



D_7. Do you currently live with or have primary responsibility for assisting someone with a disability who requires assistance?

(Interviewer: If necessary, read:) A mobility, hearing, vision, cognitive, or intellectual disability or physical, mental, or health condition.)


1

Yes

2

No

3

(DK)

4

(Refused)



D_8. Including yourself, how many adults, 18 years of age or older, live in this household?

(Interviewer: Open ended and code actual number)


01

01-

96

96

97

97 or more

98

(DK)

99

(Refused)



D_9. How many children, under the age of 18, are living in your household?

(Interviewer: Open ended and code actual number)


00

None

01

01-

96

96

97

97 or more

98

(DK)

99

(Refused)


D_10. Is English the primary or main language spoken among those living in your household?


1

Yes

2

No

3

(DK)

4

(Refused)


D_11.

What is the name of the state or territory you live in?

(Interviewer: Open ended and code)

01

Alabama

02

Alaska

04

Arizona

05

Arkansas

06

California

08

Colorado

09

Connecticut

10

Delaware

11

Washington D.C.

12

Florida

13

Georgia

15

Hawaii

16

Idaho

17

Illinois

18

Indiana

19

Iowa

20

Kansas

21

Kentucky

22

Louisiana

23

Maine

24

Maryland

25

Massachusetts

26

Michigan

27

Minnesota

28

Mississippi

29

Missouri

30

Montana

31

Nebraska

32

Nevada

33

New Hampshire

34

New Jersey

35

New Mexico

36

New York

37

North Carolina

38

North Dakota

39

Ohio

40

Oklahoma

41

Oregon

42

Pennsylvania

44

Rhode Island

45

South Carolina

46

South Dakota

47

Tennessee

48

Texas

49

Utah

50

Vermont

51

Virginia

53

Washington

54

West Virginia

55

Wisconsin

56

Wyoming

57

American Samoa.

58

Guam.

59

Northern Mariana Islands.

60

Puerto Rico.

61

U.S. Virgin Islands.

98

(DK)

99

(Refused)



D_12. How long have you lived in this area?

(Interviewer: Open ended and code actual number of years)


00

Less than 1 year

01

01-

96

96

97

97 years or longer

98

(DK)

99

(Refused)



FEMA_REG

FEMA REGION:

(Programmer: If code 09, 23, 25, 33, 44, or 50 in QNSD12_1 OR D6_3, Autocode as 01;
If code 34 or 36 in QNSD12_1 OR D6_3, Autocode as 02;
If code 10, 11, 24, 42, 51, or 54 in QNSD12_1 OR D6_3, Autocode as 03;
If code 01, 12, 13, 21, 28, 37, 45, or 47 in QNSD12_1 OR D6_3, Autocode as 04;
If code 17, 18, 26, 27, 39, or 55 in QNSD12_1 OR D6_3, Autocode as 05;
If code 05, 22, 35, 40, or 48 in QNSD12_1 OR D6_3, Autocode as 06;
If code 19, 20, 29, or 31 in QNSD12_1 OR D6_3, Autocode as 07;
If code 08, 30, 38, 46, 49, or 56 in QNSD12_1 OR D6_3, Autocode as 08;
If code 04, 06, 15, or 32 in QNSD12_1 OR D6_3, Autocode as 09;
If code 02, 16, 41, or 53 in QNSD12_1 OR D6_3, Autocode as 10)


01

Region 1

02

Region 2

03

Region 3

04

Region 4

05

Region 5

06

Region 6

07

Region 7

08

Region 8

09

Region 9

10

Region 10


FEMA_REG(3129-3130)


D_13 Do you currently help care for a family member, relative, or friend, or other person who is over 75 and has a disability, function or access need requiring assistance?


1

Yes

2

No

3

(DK)

4

(Refused)


D_14 Do you currently help care for a family member, relative, or friend, or other person under 75 who has a disability, function or access need requiring assistance?


1

Yes

2

No

3

(DK)

4

(Refused)




D_15 What is your total MONTHLY household income, before taxes? Please include income from wages and salaries, remittances from family members living elsewhere, farming, and all other sources.

(Interviewer: Open ended and code)


(Interviewer: [(If response is greater than $10,000, read:) Is that a monthly or an annual amount? (If monthly, code as appropriate; if annual, probe for monthly amount)])


01

Under $60

02

$60 to $499

03

$500 to $999

04

$1,000 to $1,999

05

$2,000 to $2,999

06

$3,000 to $3,999

07

$4,000 to $4,999

08

$5,000 to $7,499

09

$7,500 to $9,999

10

$10,000 to $14,999

11

$15,000 to $19,999

12

$20,000 and over

98

(DK)

99

(Refused)




Conclusion

  1. Thank you for your time. Is there anything that we have missed in this discussion? Is there anything you might like to add that we haven’t already covered?












  1. Focus Groups



Burden: Public reporting burden for the focus groups will be 90 minutes per focus group participant. The bank of questions in the survey instrument, and the sample instruments below in the moderator guides, are provided as the base for selecting options that address a particular disaster and population focus and meet the burden requirements not to exceed 90 minutes.



Screener-Focus group

Example: Hurricane and Flooding Focus Groups

Recruit/Screener



Sample Selection



  • A total of 12 participants should be recruited for each group. 8-10 participants will be required for each group.

  • The objective is to obtain individuals who experienced the effects of hurricanes and/or flooding.

  • As desired, participants could be recruited from the following targeted groups:

    • Socio-economically disadvantaged

    • Racially disadvantaged

    • Sex and gender

    • Tribal populations

  • Participants will be from the closely surrounding counties of [impact area]

  • Only one participant per household.



INTRODUCTION



Hello, my name is ____________ and I am calling from the Research Company on behalf of the Federal Emergency Management Agency (FEMA). We are interested in talking to groups of individuals who were recently impacted by [IMPACT NAME].



The purpose of these groups is to gather insights to help the U.S. Government better understand how best to serve the public before, during and after a natural disaster. This is a unique opportunity to make a valuable contribution to your community and the Nation.

  1. The discussion groups will be held at a professional market research facility in your community.



INTERVIEWER



1. May I ask you a few questions to see if you qualify for our focus groups?

01 YES (Continue)

02 NO (Thank and terminate)



2. Gender: [NOTE: IF TARGETING SPECIFIC GENDER MIX, RECRUIT BY THAT QUOTA]

  1. Female (RECRUIT A MIX FOR ALL GROUPS)

  2. Male (RECRUIT A MIX FOR ALL GROUPS)



3. Were you in the area [DATE] in the days before [DISASTER NAME]?



  1. YES (Continue to Q4)

  2. NO (THANK AND TERMINATE)



4. Were you impacted by [DISASTER NAME]?

  1. YES (Continue to Q4)

  2. NO (THANK AND TERMINATE)



5. Have you ever attended a group discussion for market research purposes?



01 Yes—go to item 5b below

02 No—Continue to #6



6. How many group discussions have you attended in the past 12 months?



                  1. RECORD #_______________

IF MORE THAN 3, THANK AND TERMINATE



6. On a scale of 1 to 6, where “1” is “Very Uncomfortable” and “6” is “Very Comfortable,” how comfortable do you feel expressing your opinion in a group with 8 or 9 other people?


VERY UNCOMFORTABLE VERY COMFORTABLE


1 2 3 4 5 6



MUST ANSWER 4, 5, OR 6



And to ensure we have a range of perspectives, I’d like to ask you some demographic questions.



DEMOGRAPHICS



D1. Age (RECRUIT A MIX): [NOTE: IF TARGETING SPECIFIC AGE GROUP, RECRUIT BY THAT QUOTA]

  1. 18-25

  2. 26-30

  3. 31- 40

  4. 41-55

  5. 56-65

  6. 66-74

  7. 75+



D2. Would you say your race is? (RECRUIT A MIX) [NOTE: IF TARGETING SPECIFIC DEMOGRAPHIC GROUP, RECRUIT BY THAT QUOTA]



  1. White

  2. African American

  3. Hispanic/Latino

  4. Asian American

  5. Native American

06 Mixed Race

  1. Other



D3. Annual household income? (RECRUIT A MIX) [NOTE: IF TARGETING SPECIFIC SOCIO-ECONOMIC GROUP, RECRUIT BY THAT QUOTA]

01 Less than $25,000

02 $25,000 to $34,999

03 $35,000 to $49,999

04 $50,000 to $74,999

05 $75,000 to $99,999

06 $100,000 to $149,999

07 $150,000 or more



D4. What is your highest completed level of education? (RECRUIT A MIX) [NOTE: IF TARGETING SPECIFIC SOCIO-ECONOMIC GROUP, RECRUIT BY THAT QUOTA]

01 Less than high school diploma

02 High school degree or diploma

03 Technical/Vocational school

04 Some college

05 College graduate

06 Post graduate work or degree



D5. Would you say you live in a coastal community? (RECRUIT A MIX)

  1. Yes

  2. No



D6. Are you the primary caretaker for another person in your household? (y/n)



CLOSE



Our group will be held on DATE at TIME at LOCATION. Will you be able to participate?



If YES to participating, READ and collect the following information:



Thanks for agreeing to participate. I just have a few additional questions.

8. What is a telephone number where we can reach you to remind you of the date and time of the group session?



Telephone #: ___________________________



  1. Do you have e-mail address we can also use to contact you? If YES, record address below.



E-MAIL: _______________________________________________





    1. Group 1 - Perceptions, Preparedness and Warnings: Effect on Actions Taken

Moderator Guide

I. Introduction and Ground Rules

  1. Ground Rules

  • Thank you for taking time out of your schedules.

  • Group will last 90 minutes.

  • No right or wrong answers—goal is to hear a variety of viewpoints, not to reach consensus.

  • Comments are private; Audio/Video taping; Listeners.

  • Speak as loudly as moderator; Speak one at a time;

  • Warning to talkative and quiet people—everyone gets a chance to speak.

  • Feel free to talk to each other, disagree/agree, but observe common courtesy.


  1. Introductions/Warm-up

Let’s have each of you introduce yourselves by saying your first name only, where you live, and something you like about where you live.

Next, please tell the group which disaster you survived and the type of damage you sustained.

II. Attitudes and Knowledge

  1. Attitudes/Perceptions

  1. Prior to the disaster (include disaster name and type e.g. hurricane hitting land), what were your perceptions of risk?

    • [PROMPT: low - wouldn't hit my area, no mandatory evacuation; high - prepared to evacuate/protect my home]

  2. How would you say this [disaster name and type e.g. hurricane] has affected your community?



  1. Awareness

  1. Thinking back, what was your experience with warnings prior to the [disaster e.g. hurricane?

    • [PROMPT: from where (TV, Radio, Social Media, Friend, Siren)]

    • [PROMPT: frequency and timing (15 minutes in advance, 24 hours how far in advance)]

    • [PROMPT: actions being recommended (evacuate, best routes, shelter locations)]

    • [PROMPT: how did they alter your actions]

    • [PROMPT: clarity, relevance to your situation, acceptance, accuracy]



  1. Knowledge

[MODERATOR: Provide all participants a piece of paper.]

  1. I’d like everyone to write down as many ideas as possible that come to mind when you hear the phrase ‘actions to take prior to a [hazard type e.g. hurricane] to be prepared’” [pause for a minute for people to write]. Now let’s go around and share what came to mind.



III. Actions, Barriers, and Motivators

  1. Actions taken

  1. If you could point to one or two things you did before the [hazard type e.g. hurricane] that helped you prepare, what would you point to?

  2. What is the top thing you wish you had known or done that would have helped?

  3. What was your experience with evacuation in the [hazard type e.g. hurricane]?

  • [PROMPT: Mandatory or Advisory?, How did you hear?, Did you stay?)]



  1. Barriers to action

  1. What prevented you from taking additional actions to prepare?

    • [PROMPT: time, funding, transportation, lack of information in my language, neighbors were not preparing, disabled, age]

  2. What prevented you from evacuating?

    • [PROMPT: didn't have anywhere to go, didn't have transportation to leave, concerned about my pet, wasn't under mandatory evacuation, authorities advised shelter rather than evacuation]



  1. Motivation

  1. What would motivate you to prepare for a future [disaster type e.g.hurricane]?



IV. Self-efficacy, Messengers, and Conclusion

  1. Self-efficacy

  1. Describe how confident you are that you are prepared for a future [disaster type e.g. hurricane]?

  2. What might make it easier for you to prepare for a future [disaster type e.g. hurricane]? Are there any helpful tools we could provide?

    • [PROMPTS: improved communication, online guides, community peer groups, FAQs, partnerships]

  3. After the hurricane, what type of help did you receive? From whom?

    • [PROMPT: family/friends, NGO/faith community, emergency personnel, local/state/federal government]



  1. Messages/Messengers

  1. What advice would you give others about preparing for a future [disaster type e.g. hurricane]?

  2. Who do you trust for accurate information about preparing for a future [disaster type e.g. hurricane]?



  1. Conclusion

  1. Thank you for your time. Is there anything that we have missed in this discussion? Is there anything you might like to add that we haven’t already covered?





















    1. Group 2 - Comparing Hazard Types – Sample for Hurricane and Flood

Moderator Guide



Introduction and Ground Rules

  1. Ground Rules

  • Thank you for taking time out of your schedules.

  • Group will last 90 minutes.

  • No right or wrong answers—goal is to hear a variety of viewpoints, not to reach consensus.

  • Comments are private; Audio/Video taping; Listeners.

  • Speak as loudly as moderator; Speak one at a time;

  • Warning to talkative and quiet people—everyone gets a chance to speak.

  • Feel free to talk to each other, disagree/agree, but observe common courtesy.


  1. Introductions/Warm-up

Let’s have each of you introduce yourselves by saying your first name only, where you live, and something you like about where you live.

Tell the group about the type of damage you sustained.



II. Attitudes and Knowledge

  1. Attitudes/Perceptions

  1. Prior to [disaster type or impact e.g. flooding], what were your perceptions of risk?

    • [PROMPT: low – not in floodplain, wouldn't hit my area, no mandatory evacuation; high - prepared to evacuate/protect my home due to location or other hazard factors ]

  2. How would you say the [disaster type e.g. flooding] has affected your community?


  1. Awareness

  1. Thinking back, what was your experience with warnings prior to [disaster e.g. flooding]?

  • [PROMPT: from where (TV, Radio, Social Media, Friend, Siren)]

  • [PROMPT: frequency and timing (15 minutes in advance, 24 hours how far in advance)]

  • [PROMPT: actions being recommended (evacuate, best routes, shelter locations)]

  • [PROMPT: how did they alter your actions]

  • [PROMPT: clarity, relevance to your situation, acceptance, accuracy]



  1. Knowledge

  1. Provide all participants a piece of paper. Then say "I’d like everyone to write down as many ideas as possible that come to mind when you hear the phrase ‘actions to take prior to [disaster type e.g. flooding] to be prepared’” [pause for a minute for people to write]. Now let’s go around and share what came to mind.



III. Actions, Barriers, and Motivators

  1. Actions taken

  1. If you could point to one or two things you did before [disaster type e.g. flooding] that helped you prepare, what would you point to?

  • [PROMPT: insurance, save critical documents, store clean water, plan for shelter or evacuation, sand bags, crank radio, tools]

  1. What is the top thing you wish you had known or done that would have helped?

  2. What was your experience with evacuation [during the disaster e.g. while flooded]?

  • [PROMPT: Mandatory, How did you hear?, Did you stay?)]

  1. Barriers to action

  1. What prevented you from taking additional actions to prepare?

    • [PROMPT: time, funding, transportation, lack of information in my language, neighbors were not preparing, disability, age]

  2. What prevented you from evacuating?

  • [PROMPT: didn't have anywhere to go, didn't have transportation to leave, concerned about my pet, wasn't under mandatory evacuation]

  1. Motivation

  1. What would motivate you to prepare for future [disaster type e.g. flooding]?



IV. Self-efficacy, Messengers, and Conclusion

  1. Self-efficacy

  1. Describe how confident you are that you are prepared for future [disaster type e.g. flooding]?

  2. What might make it easier for you to prepare for future [disaster type e.g. flooding]? Are there any helpful tools we could provide?

    • [PROMPTS: improved communication, online guides, checklists, community peer groups, FAQs, partnerships]

  3. After the [disaster type e.g. hurricane], what type of help did you receive? From whom?

    • [PROMPT: family/friends, NGO/faith community, emergency personnel, local/state/federal government]


  1. Messages/Messengers

  1. What advice would you give others about preparing for a future [disaster type e.g. hurricane]?

  2. Who do you trust for accurate information about preparing for a future [disaster type e.g. hurricane]?



  1. Conclusion

  1. Thank you for your time. Is there anything that we have missed in this discussion? Is there anything you might like to add that we haven’t already covered?






  1. Cognitive Interviews

Burden: Public reporting burden for the cognitive interviews will be up to 45 minutes per interview participant. The bank of questions in the survey instrument, and the sample instruments below, are provided as the base for selecting options that address a particular disaster and population focus and meet the burden requirements not to exceed 45 minutes. Participants will be screened for qualification and scheduling prior to the interview.

Screener-Interviews

Example: Hurricane and Flooding Interviews

Recruit/Screener



Sample Selection



  • A total of 20 participants should be recruited for interviews

  • The objective is to obtain individuals who experienced the effects of hurricanes and/or flooding.

  • As desired, participants could be recruited from the following targeted groups:

    • Those with access and functional needs,

    • Parents of elementary school-aged children,

    • Seniors 75 years old and older,

  • Participants will be from the closely surrounding counties of [impact area]

  • Only one participant per household.



INTRODUCTION



Hello, my name is ____________ and I am calling from the Research Company on behalf of the Federal Emergency Management Agency (FEMA). We are interested in talking to individuals who were recently impacted by [IMPACT NAME].



The purpose of these interviews is to gather insights to help the U.S. Government better understand how best to serve the public before, during and after a natural disaster. This is a unique opportunity to make a valuable contribution to your community and the Nation.

  1. The discussion groups will be held on the phone.



INTERVIEWER



1. May I ask you a few questions to see if you qualify for our interviews?

01 YES (Continue)

02 NO (Thank and terminate)



2. Gender: [NOTE: IF TARGETING SPECIFIC GENDER MIX, RECRUIT BY THAT QUOTA]

  1. Female (RECRUIT A MIX FOR ALL GROUPS)

  2. Male (RECRUIT A MIX FOR ALL GROUPS)



3. Were you in the area [DATE] in the days before [IMPACT NAME]?



  1. YES (Continue to Q4)

  2. NO (THANK AND TERMINATE)



4. Were you impacted by [IMPACT NAME]?

  1. YES (Continue to Q4)

  2. NO (THANK AND TERMINATE)



5. Have you ever attended a group discussion for market research purposes?



01 Yes—go to item 5b below

02 No—Continue to #6



6. How many group discussions have you attended in the past 12 months?



                  1. RECORD #_______________

IF MORE THAN 3, THANK AND TERMINATE



6. On a scale of 1 to 6, where “1” is “Very Uncomfortable” and “6” is “Very Comfortable,” how comfortable do you feel expressing your opinion in a group with 8 or 9 other people?


VERY UNCOMFORTABLE VERY COMFORTABLE


1 2 3 4 5 6



MUST ANSWER 4, 5, OR 6



And to ensure we have a range of perspectives, I’d like to ask you some demographic questions.



DEMOGRAPHICS



D1. Age (RECRUIT A MIX): [NOTE: IF TARGETING SPECIFIC AGE GROUP, RECRUIT BY THAT QUOTA]

  1. 18-25

  2. 26-30

  3. 31- 40

  4. 41-55

  5. 56-65

  6. 66-74

  7. 75+



D2. Would you say your race is? (RECRUIT A MIX) [NOTE: IF TARGETING SPECIFIC DEMOGRAPHIC GROUP, RECRUIT BY THAT QUOTA]



  1. White

  2. African American

  3. Hispanic/Latino

  4. Asian American

  5. Native American

06 Mixed Race

  1. Other



D3. Annual household income? (RECRUIT A MIX) [NOTE: IF TARGETING SPECIFIC SOCIO-ECONOMIC GROUP, RECRUIT BY THAT QUOTA]

01 Less than $25,000

02 $25,000 to $34,999

03 $35,000 to $49,999

04 $50,000 to $74,999

05 $75,000 to $99,999

06 $100,000 to $149,999

07 $150,000 or more



D4. What is your highest completed level of education? (RECRUIT A MIX) [NOTE: IF TARGETING SPECIFIC SOCIO-ECONOMIC GROUP, RECRUIT BY THAT QUOTA]

01 Less than high school diploma

02 High school degree or diploma

03 Technical/Vocational school

04 Some college

05 College graduate

06 Post graduate work or degree



08 Would you say you live in a coastal community? (RECRUIT A MIX)

  1. Yes

  2. No



D5. Do you have a disability or a health condition that might affect your capacity to respond to an emergency situation? (Interviewer: If necessary, read:) A mobility, hearing, vision, cognitive, or intellectual disability or physical, mental, or health condition) [NOTE: IF TARGETING SPECIFIC FUNCTION/ACCESS GROUP, RECRUIT BY THAT QUOTA]


  1. Yes

  2. No

D6. Do you currently live with or have primary responsibility for assisting someone with a disability who requires assistance?

(Interviewer: If necessary, read:) A mobility, hearing, vision, cognitive, or intellectual disability or physical, mental, or health condition.) [NOTE: IF TARGETING SPECIFIC FUNCTION/ACCESS GROUP, RECRUIT BY THAT QUOTA]


  1. Yes

  2. No


D7. Including yourself, how many adults, 18 years of age or older, live in this household?


D8. How many children, under the age of 11, are living in your household? [NOTE: IF TARGETING SPECIFIC PARENTS OF CHILDREN, RECRUIT BY THAT QUOTA]

CLOSE



Interviews will be held on DATE to DATE. Will you be able to participate?



If YES to participating, READ and collect the following information:



Thanks for agreeing to participate. I just have a few additional questions.

8. What is a telephone number where we can reach you to remind you of the date and time of the interview, and to reach you for the interview?



Telephone #: ___________________________



  1. Do you have e-mail address we can also use to contact you? If YES, record address below.



E-MAIL: _______________________________________________



    1. Interview 1: Perceptions, Preparedness and Warnings: Effect on Actions Taken

I. Introduction and Ground Rules

  1. Ground Rules

  • Thank you for taking time out of your schedule.

  • Interview will last 30 to 45 minutes.

  • No right or wrong answers.

  • Comments are private; Audio/Video taping; Listeners.


  1. Introductions/Warm-up

Let’s start by you telling me your first name, where you live, and something you like about where you live.

Next, please tell me which [disaster e.g. hurricane] you survived and the type of damage you sustained.

II. Attitudes and Knowledge

  1. Attitudes/Perceptions

  1. Prior to the [disaster e.g. hurricane hitting land], what were your perceptions of risk?

    • [PROMPT: low - wouldn't hit my area, no mandatory evacuation; high - prepared to evacuate/protect my home]

  2. How would you say this [disaster e.g. hurricane] has affected your community?



  1. Awareness

  1. Thinking back, what was your experience with warnings prior to the [disaster e.g. hurricane]?

    • [PROMPT: from where (TV, Radio, Social Media, Friend, Siren)]

    • [PROMPT: frequency and timing (15 minutes in advance, 24 hours how far in advance)]

    • [PROMPT: actions being recommended (evacuate, best routes, shelter locations)]

    • [PROMPT: how did they alter your actions]

    • [PROMPT: clarity, relevance to your situation, acceptance, accuracy]



  1. Knowledge

[MODERATOR: Provide all participants a piece of paper.]

  1. I’d like you to write down as many ideas as possible that come to mind when you hear the phrase ‘actions to take prior to a [disaster e.g. hurricane] to be prepared’” [pause for a minute for person to write]. What came to mind?



III. Actions, Barriers, and Motivators

  1. Actions taken

  1. If you could point to one or two things you did before the [disaster e.g. hurricane] that helped you prepare, what would you point to?

  2. What is the top thing you wish you had known or done that would have helped?

  3. What was your experience with evacuation in the [disaster e.g. hurricane]?

  • [PROMPT: Mandatory or Advisory?, How did you hear?, Did you stay?)]



  1. Barriers to action

  1. What prevented you from taking additional actions to prepare?

    • [PROMPT: time, funding, transportation, lack of information in my language, neighbors were not preparing, disability, age]

  2. What prevented you from evacuating?

    • [PROMPT: didn't have anywhere to go, didn't have transportation to leave, concerned about my pet, wasn't under mandatory evacuation]



  1. Motivation

  1. What would motivate you to prepare for a future [disaster e.g. hurricane]?



IV. Self-efficacy, Messengers, and Conclusion

  1. Self-efficacy

  1. Describe how confident you are that you are prepared for a future [disaster e.g. hurricane]?

  2. What might make it easier for you to prepare for a future [disaster e.g. hurricane]? Are there any helpful tools we could provide?

    • [PROMPTS: improved communication, checklists, online guides, community peer groups, FAQs, partnerships]

  3. After the [disaster e.g hurricane], what type of help did you receive? From whom?

    • [PROMPT: family/friends, neighbors, NGO/faith community, emergency personnel, local/state/federal government]



  1. Messages/Messengers

  1. What advice would you give others about preparing for a future [disaster e.g. hurricane}?

  2. Who do you trust for accurate information about preparing for a future [disaster e.g. hurricane]?



  1. Conclusion

  1. Thank you for your time. Is there anything that I have missed in my questions? Is there anything you might like to add that we haven’t already covered?







    1. Interview 2: Comparing Hazard Types: Examples include for Hurricane and Flood Research - Heavy Rain and Wind Event, Coastal Flooding, Urban Flooding



I. Introduction and Ground Rules

  1. Ground Rules

  • Thank you for taking time out of your schedule.

  • Interview will last 30 to 45 minutes.

  • No right or wrong answers.

  • Comments are private; Audio/Video taping; Listeners.


  1. Introductions/Warm-up

Let’s start by you telling me your first name, where you live, and something you like about where you live.



Tell me about the type of damage you sustained.



II. Attitudes and Knowledge

  1. Attitudes/Perceptions

  1. Prior to [disaster e.g. flooding], what were your perceptions of risk?

    • [PROMPT: low – not in floodplain, wouldn't hit my area, no mandatory evacuation; high - prepared to evacuate/protect my home due to floodplain location or other location factors]

    • When you think about possible flooding, what is the MOST likely type of flooding you thought would happen in your community? [Coastal, riverine, urban, flash flood – definitions as needed]

    • What did you expect would be the most likely action to take? (follow a planned evacuation route, drive, take public transportation, stay and go to the highest floor, other)

    • Did you expect to get directions from local authorities re what you should do?

  2. How would you say the [disaster e.g. flooding] has affected your community?


  1. Awareness

  1. Thinking back, what was your experience with warnings prior to [disaster e.g. flooding?

  • [PROMPT: from where (TV, Radio, Social Media, Friend, Siren)]

  • [PROMPT: frequency and timing (15 minutes in advance, 24 hours how far in advance)]

  • [PROMPT: actions being recommended (evacuate, best routes, shelter locations)]

  • [PROMPT: how did they alter your actions]

  • [PROMPT: clarity, relevance to your situation, acceptance, accuracy]



  1. Knowledge

  1. I’d like you to write down as many ideas as possible that come to mind when you hear the phrase ‘actions to take prior to [disaster e.g. flooding] to be prepared’” [pause for a minute for person to write]. What came to mind?



III. Actions, Barriers, and Motivators

  1. Actions taken

  1. If you could point to one or two things you did before [disaster e.g. flooding] that helped you prepare, what would you point to?

  • [PROMPT: insurance, store clean water, sand bags, tools]

  1. What is the top thing you wish you had known or done that would have helped?

  2. What was your experience with evacuation during [disaster e.g. flooded]?

  • [PROMPT: Mandatory, How did you hear?, Did you stay?)]

  1. Barriers to action

  1. What prevented you from taking additional actions to prepare?

    • [PROMPT: time, funding, transportation, lack of information in my language, neighbors were not preparing, disabled, age]

  2. What prevented you from evacuating?

  • [PROMPT: didn't have anywhere to go, didn't have transportation to leave, concerned about my pet, wasn't under mandatory evacuation]

  1. Motivation

  1. What would motivate you to prepare for future [disaster e.g. flooding]?



IV. Self-efficacy, Messengers, and Conclusion

  1. Self-efficacy

  1. Describe how confident you are that you are prepared for future [disaster e.g. flooding?

  2. What might make it easier for you to prepare for future flooding? Are there any helpful tools we could provide?

    • [PROMPTS: improved communication, online guides, community peer groups, FAQs, partnerships]

  3. After the hurricane, what type of help did you receive? From whom?

    • [PROMPT: family/friends, NGO/faith community, emergency personnel, local/state/federal government]


  1. Messages/Messengers

  1. What advice would you give others about preparing for a future hurricane?

  2. Who do you trust for accurate information about preparing for a future hurricane?



  1. Conclusion

  1. Thank you for your time. Is there anything that I have missed in my questions? Is there anything you might like to add that we haven’t already covered?





49 | Page

FEMA Form 519-0-54 OMB # 1660-NW116 Post Disaster Survivor Preparedness Research: Instruments

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